Tag Archives: CDC

AKC or Mutt – Does Your Prized Pooch Need a Flu Shot?

Credit: Neil Manning

With all the media last year about H1N1 we are by now all aware of the risks of the flu for ourselves and children, but what about our pets? In 2004 an outbreak of a new flu strain broke out in racing Greyhounds in Florida dubbed H3N8.

The flu mimics the symptoms of kennel cough and like the human version of the flu is transmitted by contact. Since it is a new flu strain most dogs do not have any immunity and H3N8 can spread rapidly in kennels, animal shelters, pet stores, veterinary clinics, groomers, day cares and other dog friendly places.

Testing is available through veterinary testing labs so outbreaks can be monitored. According to the CDC as of 2009 only 30 states and the District of Columbia had verified outbreaks. 

Some dogs show no signs of infection, some get sick – coughing, sneezing, and runny nose. A few dogs may end up with secondary infection, pneumonia, which can be life-threatening.

Credit: Neil Manning

So, how do you decide?

As with any flu vaccine the health of your dog and your lifestyle play into it. So ask yourselves these questions?

  • How healthy is my dog?
  • Is it a breed that is susceptible to pneumonia?
  • Does my dog spend a lot of time with other dogs?
  • Do I spend a lot with other dogs?
  • Do you travel with your dog?

If the answer is yes, talk to your veterinarian. They will be able to let you know what the current risks are and if any outbreaks have occurred in your area or the states you are traveling through. The cost is relatively minimal around $50 for the shot and booster.    

~ Tess

Credit:Neil Manning

(This was originally written for an online outlet but I missed the deadline – I know pathetic – but I thought I’d put it up just for the fun of it. FYI canine flu has not reached the west coast – so all of you PNW dog lovers can breathe easy.)

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HPV Vaccinations – By the Numbers

I was out a few nights ago and a friend asked me my thoughts on vaccinating her daughters for HPV – Human Papillomavirus. We’ve all seen the ads but what is it? Why is it taking center stage now? And in the grand scheme of sexually transmitted infections (STI) how dangerous is it?  

I didn’t have an opinion – although my gut was telling something so I thought I’d take a look. I’m writing this as I’m doing my research… so I’m taking you on my “thought” journey to look at the data and see what I think. This is how I’m thinking about the numbers – but if you find a different way let me know.

HPV is actually better known as the virus that causes warts – yep those icky things on your hand and feet. There are around 100 HPV strains that have been categorized.

There are about 40 known strains of HPV that infect the genital region. Of these 9 of these are considered high-risk – causing anything from low-grade cervical changes to cancers in women. Low-risk strains (the American Cancer Society lists 2) may cause genital warts, respiratory pappillomas (very rare – and involves the transmission from a mother to a new born) or low-grade changes in the cervix.

So… what about the other 29 strains?

The Centers for Disease Control state that 50% of sexually active adults (men and women) will get HPV at some point in their life.

According to the American Cancer Society “70% of HPV infections appear to go away within a year and 90% within 2 years.” The CDC adds that “in 90% of the cases, the body’s immune system clears the HPV infection naturally.” Most people don’t even know that they’ve had it.

So for a huge number of the infected there is no cause for alarm – our body takes care of itself and off we go.

Forgive me while I do a little math… let’s start with 200 people, 100 men and 100 women. Okay out of each group 50 will get some strain of HPV – whether it is a high-risk or a low-risk strain 90% of them will clear it up in two years. That leaves 1 woman and 1 man left to worry about right (I know – it could be 2 women or 2 men – but this is a thought experiment)?

So what about that 10% – which is a huge number if you’re looking at the total population of the US – what happens to them? Remember they can have either high-risk or low-risk HPV infections.

Now I’m going to limit this to cancer – the other types of problems HPV creates can be dealt with fairly easily – but cancer kills.

To figure out the risk to our 10% I plugged in the American Cancer Society’s estimates of the number of HPV related cancers in 2008 and the US population curtsey of the US Census Bureau and got the table below.

So… this gets a little funky – I made the US Population numbers to equal 10% of the population. So the risk to the 10% is the percent below. Not the risk to the general population.

HPV Related Cancer  Est. Number of cases US Population Est. (2008) the 10% problematic HPV Percent of the problemenat HPV population at risk for Cancer
Cevical                11,070                30,382,464.00 0.03643549%
Vulvar                  3,460                30,382,464.00 0.01138815%
Vaginal etc                  2,210                30,382,464.00 0.00727393%
Penile etc                  1,250                30,382,464.00 0.00411422%
Anal Men                  3,050                30,382,464.00 0.01003869%
Anal Women                  2,020                30,382,464.00 0.00664857%
       
RRP                  2,000                      450,514.29* 0.44393709%
       
Total                25,060                30,382,464.00 0.08248179%

  *estimation of US births in 2008

Our two people – have less than a .08% chance of getting a HPV related cancer to their problematic HPV strain – less if you are male and a little more if you are female. And there isn’t a vaccine for men – so if you are looking at the 30 million remember that the vaccine could only help 15 million of them.

Which means that the Jill on the street has a .008% chance of getting a HPV related cancer and yes genital warts can be an embarrassment but they aren’t cancer. I think most lottery odds are better. On the site Dr. Math it is reported that a person has a 1:80,089,128 chance in matching all 5 numbers plus the power ball if playing Powerball Lotto. I didn’t look at his formula but thought we’d roll with it – it makes my point.

Now let’s play another game because even 15 million problematic HPV infections in women seems a like a lot. But remember there are 40 strains of HPV that infect the genital region – of which 9 are high-risk.  

Gardasil, one of the two vaccinations for HPV on the market, was designed to prevent the following:

  • 2 types of high-risk HPV known to cause cervical cancer that are responsible for 70% of all HPV related cervical cancers.
  • 2 types of low-risk HPV known to cause genital warts that are responsible for 90% of all genital warts.

Cevarix will protect against the same high-risk HPV but not the low-risk.

So, if our young woman gets cancer from HPV – she has a 41% chance of having a cancer that isn’t cervical. She also has a 30% chance, if she has cervical cancer, that it isn’t one of the two strains included in the vaccinations.

These odds become more astronomical by the minute….     

The American Cancer Society in their guidelines state:  

  • girls ages 11 to 12
    The vaccine should be given to girls ages 11 to 12 and as early as age 9.
  • girls ages 13 to 18
    Girls ages 13 to 18 who have not yet started the vaccine series or who have started but have not completed the series should be vaccinated.
  • young women ages 19 to 26
    Some authorities recommend vaccination of women ages 19 to 26, but the American Cancer Society experts believed that there was not enough evidence of benefit to recommend vaccinating all women in this age group. We do recommend that women ages 19 to 26 talk to their doctors or nurses about whether to get the vaccine based on their risk of previous HPV exposure and potential benefit from the vaccine.

I’m not against vaccinations – I think they are great! In fact just got a booster shot at the doctor the other day for tetanus. No Small Pox almost no Polio – these were great things that saved lives and dealt with viruses that were killing us. But we are being asked to “protect our girls” from an almost nonexistent cancer. A cancer that appears in a sliver of the population and the biggest risk is from cervical cancer which currently has a survival rate of 92% with early detection and 71% for detection at all stages.

Yes – HPV is very infectious but statistically it’s not killer.

So why? Why the huge ad campaign? Why make us feel that something is terribly wrong when the number don’t really support it?

Viruses evolve with their hosts – that said HPV has been around for a very long time – infecting us for millions of years.

The odds are that it will continue to be an occasional problem and general nuisance. A lot of viruses are in a push-me-pull-you state with their hosts. They come. They go. And Leave immunity in their wake.

Which makes me wonder if there is any indication of reinfection with HPV? You know like the common cold – you get it and then get it again and we never seem to get much better at fighting it. But the raw data – just the numbers that we’ve looked at suggest that infection happens – is cleared – and then you have your own immunity. 

Is it the right thing to do? Why are so many women talking about this and wondering what they should do? Well… remember the ads?

Let’s look at the issue another way.  

If we become convinced, as a society, that the guidelines should be adhered to there are an estimated 4.5 million children born every year in the US. Imagine half of them are girls…2.25 million. That means that if we go by the America Cancer Society guidelines and vaccinate every young woman, right now, between the ages of 11 and 18 that is an estimated18 million young women.

Gardasil goes for $120 a dose and three doses are required for immunity so that is $360 per woman.

18 million young women multiplied by $360 per treatment is $6.5 billion…with an additional $900 million possible every year thereafter.

If they succeed in making us believe… what? That we are doing a disservice to our young women not to vaccinate them – this may be a “nice to have” but I just can’t classify it as a “need to have”.  

Oh, and on the American Cancer Society website they have a section that interests me in their FAQs. “Did the American Cancer Society play a role in the development of the HPV vaccines?”

The answer… Yes. One of the four teams received funding from the ACS in the mid 1990s – the grant could be anything from a little to a lot…  

And you wonder why you’ve seen all the ads. I don’t. This is economics driving healthcare – and I have to admit I’m rather sad about it.

But there is a flip side… I was talking to another friend who has decided to immunize her daughter. She did it because she and another mother she knows had been one of the 10% – the ones with some sort of problem with their vaginal wall cells caused by HPV. The treatment was painful and my friend felt that since her insurance was paying for it she would rather not take the risk of there being a genetic predisposition.

Another woman said that she would have done it – her daughters are older now – just because it was one less thing to worry about.

Yet another said that since there are very few “wins” when preventing cancers of any kind that it was just nice to know you were doing something.

So where are we?

A drug company is going to make billions off our sense of responsibility? This will be a choice each of us will have to make. The risks are low yet it seems this is a bizarrely difficult decision to make.

What about you?  

 ~ Tess

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Washing hands – the myth of a clean world

So I tend to go against the grain anyway, but our current obsession with hand washing and the wonders of antibacterial soap – sorry… it is now antimicrobial soap is driving me just a little up the wall.

The climb became faster after suffering from an antibiotic resistant sore throat.

See – the problem here is that we are self selecting for better, stronger, and more infectious bugs. The faster something can reproduce the faster it can respond to environmental factors and boy are we giving them a lot to respond to. 

Back when I took Microbiology my lab consisted of taking a petri dish and rubbing my hand on it – taking all of the microorganisms from my hand and giving them a lovely nutritious place to live. After several days I came back to something that looked like this:

Petri Dish

From there we then picked one or two colonies – the round spots on the dish – and grew them. Then we had the enviable task of figuring out what they were. We did this by growing them in different petri dishes with different types of food and with antibiotics.

That was really the thing – and the point. Some of the microbes that grew on my hand were susceptible to antibiotics and some were not. And some were in the process of developing immunity – they often had smaller colonies on the antibiotic dish than on the one with just good food.

If I want to get really technical I could tell you all about how antibiotic immunity can be transmitted between bacteria – kind of like sex but not quite – it’s called conjugation.  That should worry you because only one bacteria has to develop the immunity and then it can not only create copies of itself (bacteria reproduce by binary fission – one cell divides into two cells). But it can pass the immunity to their friends and family.

Oh, and a bacterial colony can double in size every 10 minutes. They also have a genome with a high base line mutation rate – they can afford to and need to. Individuals are expendable and their environment enormously changeable.     

The thing is that all of these things were on my hand so… what happened in the petri dish happens on my hands.

First off – there is a huge difference between washing your hands and washing your hands. We are going to assume, for the sake of this mental experiment, that this hand washing involves one of those antibacterial gels – because they are one of the problems. When you wash your hands with soap and water – you kill everything and then you wash it all off. When you use an antibacterial product it doesn’t get washed off – instead it hangs on providing regions in which resistant colonies can develop.

If I was obsessive about using antibacterial gel hand sanitizer that means that I could be selecting for resistant bacteria and after a single work day (say 10 hours – to make the math easy) I could be washing my hands every 20 minutes – 3x an hour so 30 times in the day.  But the stuff I was trying to get rid of was multiplying by 6x an hour so 60 times a day. Each time I used my antibacterial gel I would kill some but not all of the bacteria on my hands. Each time I would be selecting for those bacteria that could live in the new conditions.

Just like I did with my petri dishes.

Now I’m not saying that we are going to develop a ‘superbug’ this way – but it just seems to me to be a bad trend. We know that decades of giving antibiotics to anyone and everyone created some hellish strains of resistant bacteria. Right now infections in hospitals are up – not ones you come in with but the ones you get once you are there. It seems to me such a simple thing to avoid.    

Oh, and by the way… the Centers for Disease Control has written about this as has Scientific American and WebMd.

No one is saying that you shouldn’t wash your hands – but triclosan hand sanitizers antimicrobial soaps are over kill with some unpleasant side effects. There is indication that triclosan finds its way into human breast milk and has other effects – I haven’t yet tracked down the original articles (the ones published in scientific journals) so if you want to read more see the article below. 

Triclosan Article

So why take the risk… besides you aren’t only using this stuff on your body, it is getting onto other surfaces, into our bodies, and being washed into the water system (that is a post for another time).

But now your thinking H1N1 – well sorry to burst your bubble but H1N1 is a RNA virus that ‘buds’ from the cell taking the components of the cell wall with it. Cell walls are almost entirely made up of a lipid bi-layer – which is not the strongest thing in the world and can destroyed by drying out. H1N1 is being passed by fluid contact – the virus is suspended in droplets – like those you produce when you cough or sneeze and the microscopic ones you create when you talk.

So the odds against being infected by hand to hand contact is astronomical. Besides the best way to destroy a lipid bi-layer is plain old fashioned soap and water.

So the next time you see that hand sanitizer sitting there – give a thought to my petri dishes and all the things we didn’t know about the overuse of antibiotics fifty years ago. Maybe you’ll make a different decision. 

~ Tess

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