'Walking pneumonia' are you a victim?

By Carol Aloysius

That wracking cough, sore throat, body aches and pains accompanied by breathing difficulties may not be just a passing flu - or dengue fever which could be over in a few days with bed rest. If neglected, it could result in something more deadly like pneumonia which could be fatal to young and old alike with compromised or weakened immune systems.

The symptoms are so similar to dengue fever that many patients aren’t aware they are walking around with a viral flu that could lead to pneumonia.

“We call it walking pneumonia”, said a leading chest physician. “People have to closely observe their own symptoms and take precautions by visiting a qualified western doctor to get themselves examined if the fever and breathing difficulties as well as the cough, cold and general feeling of fatigue persists”. Viral flu, he said, is highly contagious and extreme personal hygiene must be observed at all times to prevent its spread.

Consultant, Respiratory Chest Physician of the National Hospital for Respiratory Diseases at Welisara, Dr Saman Kularatne explains what this flu is, and warns of the possible complications if undetected or neglected. He reiterates the need to maintain good personal hygiene and stay at home when experiencing symptoms so as to prevent infecting others.

Question: Almost everyone these days seem to be suffering from colds, coughs, fever, heavy chests. Your comments?

Answer: Several Influenza viral strains have been identified as the cause of the present flu like illness prevailing in the country these days. Those who are suffering from the influenza infection however, present with cough , cold, fever, sore throat, aches and body pains, as well as and some with breathing difficulties.

Q. Is it normal at this time of the year with the onset of monsoon rains?

A. Yes.

Q. How do you describe this illness? Is it an upper respiratory disease or just dengue fever ?

A. Influenza is a viral infection mainly affecting the upper respiratory tract. But it can cause serious pneumonia in vulnerable groups.

It is a self-limiting illness in most people and different to dengue fever. Both Influenza and Dengue are at epidemic levels in the country now.

Q. How do you differentiate Influenza from the normal dengue fever? What are the symptoms?

A. Since both these conditions are present with fever, one should not try to differentiate these on symptoms and should see a doctor early and should undergo investigations.

Otherwise you may have a risk of delayed recognition of dengue.

Q. Who are the high risk groups? Why are they more vulnerable than other?

A. Pregnant women, those over 65 years of age and children less than two years and those with non-communicable diseases such as diabetes, kidney failure, chronic lung disease, neurological illness and coronary heart diseases have been recognised as high risk groups. Severe pneumonia and death due to influenza is high in these patients.

Q. Is having a non communicable disease delay or make treatment more complicated?

A. Having a non-communicable disease such as diabetes, chronic lung disease, kidney failure and coronary heart disease increases the risk of getting more severe influenza disease and they are more prone to develop secondary Bacterial pneumonia after viral influenza infection.

Q. Is it contagious? Can it be treated at home? What is the procedure?

A. It is contagious. Typically, influenza is transmitted through the air by coughs or sneezes, creating aerosols containing the virus. Influenza can also be transmitted by direct contact with nasal secretions, or through contact with contaminated surfaces.

Any person who has the symptoms should see a doctor early and those who have evidence of severe disease with evidence of pneumonia need hospital admission. Most of the patients have a minor illness and can be treated at home.

Rest and adequate fluid intake is important. Those who develop breathing difficulties should meet the doctor again without any delay.

Q. Will a good nutritious diet help ward off the disease or reduce its complications?

A. Good nutritious diet and adequate fluid intake is anyway important.

Q. Can drugs help? If so what kind of medication should you take or not take?

A. Patients who are ill need admission and specific anti-viral treatment and others can be treated at home with symptomatic treatment and antibiotics if indicated.

Q. When should a patient see the doctor?

A. Patients should see a doctor very early, within one or two days.

Q. What is the adverse health impacts of the disease?

A. Patients especially of the high risk group can develop pneumonia due influenza virus and some can develop secondary bacterial pneumonia.

Q. Will having an attack of this flu prevent future attacks?

A. No. The Influenza virus can change and the next epidemic would be due to a different strain.

Q. What about anti-flu shots? Will getting a flu shot prevent one getting the flu again? For how long will it give one immunity?

A. Vaccination is currently the leading effective means of reducing the burden of morbidity and mortality of influenza in the community. Since the virus is changing constantly, vaccination should be done annually depending on the new strain.

Q. Will repeated attacks especially in the case of respiratory flu affect the lungs and kidneys?

A. Repeated attacks of flu and secondary bacterial pneumonia can cause permanent damage to the lungs.

Q. How does one prevent its spread?

A. With good personal hygiene and a good nutritious diet, and avoiding getting wet, going out amidst large crowds, and washing one’s hands well after returning home.

Q. Your message to the public?

A. People who are at risk of developing severe disease such as pregnant mothers, elderly, patients with diabetes, chronic lung disease, heart and kidney disease should avoid exposure as much as possible (public transport, hanging around in public places, unnecessary hospital/ clinic visits). Should seek medical advice early and reassessment if symptoms are not getting better or worsened especially if develop breathing difficulty. Rest and adequate fluid intake is important.

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What Health officials have to say…

Chief Epidemiolgist Dr Paba Palihawadene, in a directive to hospital directors and nursing staff emphasises the use of respiratory hygiene followed by hand hygiene. On the latter, she tells nursing staff attending on patients, “Wash hands with soap and water before and after attending to patients. Cover nose and mouth during coughing and sneezing with a medical mask, tissue, sleeve or flexed elbow.”

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What a health official at the National General Hospital had to say…

“Students must be warned against taking part in a sports event, especially one needing strenuous activity such as a marathon, while running a temperature or immediately after having had a viral flu. There’s a viral flu running around now. After an attack of viral flu, it is possible for a person to get myocarditis which affects the heart muscles. While only a very small fraction (one percent) may develop this condition, we strongly advise any student taking part in such events to refrain from doing so.

Instead they should stay at home and rest in bed till they have fully recovered to avoid complications.”

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What ScienceDaily says…

Upper respiratory infections, commonly referred to the acronym URI, is the illness caused by an acute infection which involves the upper respiratory tract: nose, sinuses, pharynx, larynx, or bronchi. It is the most common cause of days missed from work or school and one of the most common reasons for a medical visit.

It is estimated that the average adult has from two to three URI-type illnesses per year and the average child six to 10. In the United States. This represents approximately one billion acute upper respiratory illnesses annually.

Recent studies show that up to 98 percent of all cases are viral in nature.

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What Health Education Bureau officials had to say…

Since this flu is transmitted mostly through nasal droplets, avoid sending your child to school, if he shows symptoms of having caught the disease. As young and old are vulnerable, keep your child at home even if he or she is attending a day care or a crèche if he has fever , a cold or body aches and pains.

Isolate the child from his siblings as far as possible, as close contact can spread the disease. If the patient develops chest problems such as breathing difficulties, DON’T give him antibiotics. Take him to the nearest hospital or medical clinic and get him properly examined. Give all the details of his case history to the examining physician and the medication (if any) you have given.. Don’t allow the patient to be in an air conditioned room or under fans. Give him plenty of hot drinks and make sure he gets a good nutritious meal to build up his strength.

Above all, maintain good personal hygiene. When you have a cough, or a cold don’t wipe your nose on the sleeve of your shirt. Cough into your arm if you don’t have anything to cover your mouth. Ideally you should use a disposable tissue as re-cycling used hankies can also spread the disease.

Non-verbal clues about words boost a child's vocabulary

The clues that parents give toddlers about words can make a big difference in how deep their vocabularies are when they enter school, new research shows.

By using words to reference objects in the visual environment, parents can help young children learn new words, according to the research. It also explores the difficult-to-measure quality of non-verbal clues to word meaning during interactions between parents and children learning to speak.

For example, saying, “There goes the zebra” while visiting the zoo helps a child learn the word “zebra” faster than saying, “Let's go to see the zebra.”

Differences in the quality of parents’ non-verbal clues to toddlers (what children can see when their parents are talking) explain about a quarter (22 percent) of the differences in those same children's vocabularies when they enter kindergarten, researchers found. The results are reported in the paper, “Quality of early parent input predicts child vocabulary three years later,” published in Proceedings of the National Academy of Sciences.

“Children's vocabularies vary greatly in size by the time they enter school,” said lead author Erica Cartmill, a postdoctoral scholar. “Because preschool vocabulary is a major predictor of subsequent school success, this variability must be taken seriously and its sources understood.”

Scholars have found that the number of words youngsters hear greatly influences their vocabularies. Parents with higher socioeconomic status - those with higher income and more education - typically talk more to their children and accordingly boost their vocabularies, research has shown.

That advantage for higher-income families doesn't show up in the quality research, however.

“What was surprising in this study was that social economic status did not have an impact on quality. Parents of lower social economic status were just as likely to provide high-quality experiences for their children as were parents of higher status,” said co-author Susan Goldin-Meadow. Although scholars have amassed impressive evidence that the number of words children hear - the quantity of their linguistic input - has an impact on vocabulary development, measuring the quality of the verbal environment - including non-verbal clues to word meaning - has proved much more difficult.

To measure quality, the research team reviewed videotapes of everyday interactions between 50 primary caregivers, almost all mothers, and their children (14 to 18 months old). The mothers and children, from a range of social and economic backgrounds, were taped for 90-minute periods as they went about their days, playing and engaging in other activities. The team then showed 40-second vignettes from these videotapes to 218 adults with the sound track muted. Based on the interaction between the child and parent, the adults were asked to guess what word the parent in each vignette used when a beep was sounded on the tape.

A beep might occur, for instance, in a parent's silenced speech for the word “book” as a child approaches a bookshelf or brings a book to the mother to start story-time. In this scenario, the word was easy to guess because the mother labelled objects as the child saw and experienced them.

In other tapes, viewers were unable to guess the word that was beeped during the conversation, as there were few immediate clues to the meaning of the parent's words. Vignettes containing words that were easy to guess provided high-quality clues to word meaning.

Although there were no differences in the quality of the interactions based on parents’ backgrounds, the team did find significant individual differences among the parents studied. Some parents provided non-verbal clues about words only five percent of the time, while others provided clues 38 percent of the time, the study found.

The study also found that the number of words parents used was not related to the quality of the verbal exchanges.

“Early quantity and quality accounted for different aspects of the variance found in the later vocabulary outcome measure,” the authors wrote. In other words, how much parents talk to their children (quantity), and how parents use words in relation to the non-verbal environment (quality) provided different kinds of input into early language development.

“However, parents who talk more are, by definition, offering their children more words, and the more words a child hears, the more likely it will be for that child to hear a particular word in a high-quality learning situation,” they said. This suggests that higher-income families’ vocabulary advantage comes from a greater quantity of input, which leads to a greater number of high-quality word-learning opportunities. Making effective use of non-verbal cues may be a good way for parents to get their children started on the road to language.

ScienceDaily

Environment may affect dishonest behaviour

A new study from researchers at leading business schools reveals that expansive physical settings (e.g. having a big desk to stretch out while doing work or a large driver's seat in an automobile) can cause individuals to feel more powerful, and in turn these feelings of power can elicit more dishonest behaviour such as stealing, cheating, and even traffic violations.

“In everyday working and living environments, our body postures are incidentally expanded and contracted by our surroundings - by the seats in our cars, the furniture in and around work-spaces, even the hallways in our offices - and these environments directly influence the propensity of dishonest behaviour in our everyday lives,” said Andy Yap, a key author of the research in Columbia Business School.

The study states that while individuals may pay very little attention to ordinary and seemingly innocuous shifts in bodily posture, these subtle postural shifts can have tremendous impact on our thoughts, feelings and behaviour.

Building on previous research that expansive postures can lead to a state of power, and power can lead to dishonest behaviour, the study found that expanded, nonverbal postures forced upon individuals by their environments could influence decisions and behaviour in ways that render people less honest.

“This is a real concern. Our research shows that office managers should pay attention to the ergonomics of their work-spaces. The results suggest that these physical spaces have tangible and real-world impact on our behaviors” said Yap.

The research includes findings from four studies conducted in the field and the laboratory.

One study manipulated the expansiveness of work-spaces in the lab and tested whether “incidentally” expanded bodies (shaped organically by one's environment) led to more dishonesty on a test.

Another experiment examined if participants in a more expansive driver's seat would be more likely to “hit and run” when incentivised to go fast in a video-game driving simulation.

- Medical Xpress