Disaster Preparedness: Were You Ready?

Last week was pretty trying for those of us living here in the nation’s capitol.  We were literally shaken with fear shaken with fear Tuesday when we experienced the first major earthquake on the east coast in more than 100 years. It measured a noticeable 5.8 on the Richter scale.  As a novice to earthquakes, having lived on the east coast all of my life.  I must say those were the longest 15 seconds I’ve experienced.  We were still assessing structural damage of the National Cathedral and other buildings and infrastructure when the hurricane, Irene in the Caribbean was establishing a clear path up the Atlantic coast. Threatening to make landfall by Friday.

Although Irene was a category 1 hurricane, the expanse of the storm was extremely wide.  While here in DC, we were spared a lot of the flooding suffered by those in NC, New York, and New England, there are still thousands here waiting to have their power restored.  This all begs the very obvious question: WERE YOU READY?  enBloom has compiled a list of resources and steps you want to take to ensure you and your family are prepared in the face of any disaster.

We were blessed in DC that neither natural disaster was as severe as it could have been.  In the case of the hurricane several preventive measures taken by the local and federal governments also served to minimize a disastrous outcome.  Hurricane season is well underway, go ahead and prepare now so your answer is YES! I’M READY when the next natural disaster poses a threat.


Why does the herd have immunity?

Tech Term Tuesday.  When a significant proportion of a community (or herd) is immune to a contagious disease through prior illness or immunization, the remaining members of that community (such as newborns, the chronically ill, the elderly and those otherwise not immunized) also receive some level of protection. This is because the likelihood of coming in contact with an infected individual has been substantially decreased.

History and Epidemiology of Global Smallpox Eradication. From the training course titled "Smallpox: Disease, Prevention, and Intervention". The CDC and the World Health Organization. Slide 16.

Herd immunity begins to fail when immunization rates in the community fall below critical thresholds and the community is exposed to new members who are infected (such is the case with individuals travelling from international regions with a high incidence of vaccine-preventable illnesses). As a result, the choices of individuals can harm the broader community.

Sources: CDC Online Glossary and Merriam-Webster Medical Dictionary

Learn More: Herd Immunity Animation at The History of Vaccines website

MDs Retool for Vaccine Safety Debate

H. Fred Clark and Paul Offit, the inventors of...

H. Fred Clark (l) and Paul Offit (r). Image via Wikipedia

Last month, the National Medical Association convened their Annual Convention and Scientific Assembly in Washington, DC.  In a special Pediatrics Immunization Update, Daniel Salmon, PhD, MPH and Paul Offit, MD presented to physicians and health care providers about current issues in pediatric immunization and managing parental concerns regarding their safety.  This was a timely presentation.  During August, pediatricians see many patients who are preparing to go to school for the first time and their parents who have many questions and concerns.

Sources of Misinformation

Dr. Offit who serves as the Director of the Vaccine Education Center and Chief of the division of infectious diseases at the Children’s Hospital of Philadelphia explained that an increase in parents  refusing to immunize their children correlates strongly with the publication in the medical journal, Lancet of a paper by Andrew Wakefield posing a hypothesis for a link between autism and the MMR (measles-mumps-rubella) combined vaccine.  Though the study has been disproven many times over and a recent British Medical Journal (Jan 5, 2011) editorial characterized Dr. Wakefield’s work as “an elaborate fraud,” parental fear and distrust surrounding the medical need for the standard schedule of childhood immunizations continues to persist.

The Current Challenge

Dr. Salmon who is the Director of Vaccine Safety at the National Vaccine Program Office of the Department of Health and Human Services presented statistics that underscored the immunization refusal trends.  In some counties throughout the country, as many as 25% of appropriately aged children have not been immunized.  On average, however, only about 10% of parents have delayed or refused one or more of the recommended immunizations for their child(ren).  Every state allows exemptions to its laws for medical, religious, or philosophic reasons.  But when you combine these facts with the pervasiveness of unproven or unsubstantiated health information available on the internet, the low health and science literacy of many parents, and poor communication between parents/patients and physicians, it becomes easier to understand how myths and misinformation around childhood immunizations persists.  A dangerous result can be an increase in immunization exemptions to the point where communities can become particularly vulnerable.  When immunization in a community falls below critical thresholds, herd immunity ceases to exist.  There is direct overlap between low prevalence of immunization communities and outbreaks of certain vaccine-preventable disease, such as pertussis (whooping cough).  This was featured in detail in the PBS Frontline broadcast The Vaccine War that we discussed in a previous blog post.

Fear of overloading the immune system, a belief that vaccine-preventable diseases are not dangerous or their children simply are not at risk for contracting the illness are all among reasons why parents refuse to immunize their children.  “We may practice evidence-based medicine, but most parents are motivated by anecdotes,”  Dr. Salmon continues, “It’s important to try to understand the parents’ concerns and what influences them.”

What can be done?

It is imperative that physicians take the time to have productive conversations with their patients (and their patients’ parents).  Providing accounts of patients who were saved because of vaccinations or describing the suffering and complications caused by vaccine-preventable illnesses may prove to be more persuasive and meaningful to concerned parents.  If you are a concerned parent and want to have a meaningful conversation with your child’s pediatrician, consult the Screening Guide for Child and Teen Immunizations on the health guides page before your next appointment.

Read more:

Paulsen, Emily.  Parental Fears Over Childhood Vaccination Must Be Addressed. Medscape Medical News at Medscape.com.

9 Reasons To Eat Blueberries

The Department of Agriculture encourages each of us to fill half of our plates with fruits and vegetables  at every meal.  Despite their tiny size, research findings are showing how blueberries are powerhouses of nutrition and disease fighting substances.

Blueberries are rich in antioxidants.

  1. Low calorie snack.  In a single serving (1 cup or 148 grams) of raw blueberries is a low, low 84 calories.
  2. Low fat desert.  Unlike so many things that taste great, raw blueberries are very low in salt (sodium), cholesterol and saturated fat.
  3. Delicious source of fiber.  In a single serving of raw blueberries, you can get 14% of the recommended daily value of fiber.  Fiber is so important for keeping our digestive systems regular.  It also lowers cholesterol and helps to keep our hearts healthy.
  4. Great source of Manganese.  Blueberries are high in the trace element manganese that is crucial in bone development as well as converting the proteins, carbohydrates and fats in food into energy that our bodies can use.
  5. Rich in Vitamin C.  In that same cup of raw blueberries you can meet almost a quarter of the recommended daily value of Vitamin C.  In addition to fortifying our immune systems, Vitamin C is essential to collagen formation, capillary development and iron absorption.
  6. Rich in Vitamin K.  Get a little over a third (36%) of the recommended daily value of Vitamin K that is important to bone density and bone growth.  The antioxidant properties of Vitamin K have been found to reduce damage to nerve cells.
  7. High in Antioxidants.  Blueberries have been shown to rank high among fruits in their antioxidant properties.  Antioxidants are molecules that fight unstable molecules known as free radicals that cause injury and damage to our cells.  The activity of free radicals has been linked to the development of cancer, cardiovascular disease, and other age-related illnesses like Alzheimer’s Disease.
  8. Keeps the Urinary Tract Healthy.  Blueberries also contain the healthy substance known as proanthocanidins.  Research shows they prohibit the attachment of harmful bacteria to the lining of the urinary tract.
  9. You can get them fresh now.  Blueberries are available fresh locally from July into September so you can stock up on them now.

I’ve come up with 9 great reasons for you to add or increase blueberries in your diet.  Now, you all can provide a 10th so tell me your favorite reason for eating blueberries. Just leave me a comment below.

Sources: NutritionData.com and US Highbush Bluberry Council

Supporting Research Studies:

Joseph, J.A. et al. J Neurosci. 1999, 19:8114-21.

Lau, F.C. et al. Neurobiol. Aging 2005, 26S:128-132.

Schmidt, B. M. et al. J Agric Food Chem. 2004, 52:6433-42.

Wu, X et al. J Agric Food Chem. 2004, 5:4026-37.

Are We Safe from Vaccine-Preventable Illnesses?

None - This image is in the public domain and ...

Image via Wikipedia

First Friday in First Person.  Imagine having your newborn baby, just over a month old begin suffering from what appears to be a cold with a persistent cough. The situation persists. Over a period of two weeks and several visits to the pediatrician the best diagnosis you receive is the croup or a virus. No remedies resolve the situation and your young daughter is not getting better. This is what happened to Alvaro and Myriam Fontan’s daughter Vanessa. They shared their ordeal in an April 2010 interview in The Vaccine War (a PBS Frontline production). During one particularly severe crisis, young Vanessa stopped breathing and turned blue.

In the emergency call to the doctor, Alvaro exclaimed, ”Tell me that this is normal. I mean, she’s turning blue.”

At the doctor’s advice, the Fontans rushed to the nearby emergency room but it was not equipped to handle pediatric patients so an ambulance had to transfer Vanessa to a children’s hospital where Dr. Cynthia Cristofani was on duty. Immediately she diagnosed the Fontan baby with Pertussis, commonly known as whooping cough. Finally, the Fontans received a diagnosis which had until now eluded them. This is probably because younger physicians are not coming across many vaccine-preventable illnesses during their training or practice. For Vanessa, there remained a long steady road to recovery, after spending nearly a week in the pediatric intensive care unit and another two months suffering through less severe crises as the antibiotics took effect and managed the bacterial infection.

What is Whooping Cough?


Cynthia Cristofani, MD the pediatric critical care physician in Portland, Oregan that treated Vanessa Fontan describes whooping cough. “Whooping cough is a particularly miserable disease. You cough and you cough and cough, and you cannot stop. Eventually you manage to inhale a little air, and that’s the whoop. And if you don’t inhale any air, you may pass out. If you do, you’re likely to make the noise of the whoop and throw up, and then a few hours later or even an hour later you do it all over again. These spells happen many, many times a day, and they’ll also wake you up in the middle of the night. So these people are sleep-deprived, miserable. They never know when the next attack is going to get them. Just the mechanics of the cough will hurt. Adults get rib fractures. It takes a pretty brutal cough to break your ribs. Little kids will get hernias; they’ll get rectal prolapse; they’ll get bleeding around the eye; occasionally they get bleeding in their skull; they’ll bite their tongues. They do all kinds of damage just from the mechanics of the cough, never mind the fact that these people are suffocating and miserable. In the [developing world], this is a huge killer. Somewhere between 200,000 and 400,000 people die a year. In [developed countries], most people don’t die of it, with the exception of very young infants. People who have had no immunizations at all have very poor immune defenses. This is where most of the reported mortality in the United States happens.”

How did Vanessa Get Whooping Cough?


Vanessa was 40 days old when she was diagnosed with whooping cough. According to the immunization schedule of the time, she was too young to have received the vaccination. This left her dependent on the herd immunity that prevents many infectious diseases from attacking communities. Unfortunately, the original childhood immunization for Pertussis did not provide patients of that time with lifelong immunity. This may have played a significant role in the way in which Vanessa became infected. The Centers for Disease Control and Prevention investigation ultimately traced the whooping cough to a student who attended high school with Vanessa’s brother.

Although, vaccine-preventable illness occurs less often in the United States, it does not make these infectious diseases less dangerous. This is particularly true for the youngest and the oldest members of our community who have less robust immune system. Use our page of health guides to check the immunization schedules for 2011.

Learn more:  The Vaccine War on Frontline website at www.pbs.org and The Vaccine War Transcript

Was the Debt Deal a Pyrrhic Victory?

Image by Gary Varvel

Humpday Humor.  Thanks to legislation passed on Tuesday, the debt crisis has been averted (for now).  Was it a Pyrrhic victory?  If so, for whom: Tea Party? America? Will this pummel the extremely slow and fragile progress of economic recovery?  Will the ‘Super Congress’ effectively work to solve the real issues that remain?  Just how will Medicare be restructured and will the partially implemented new provisions of the Affordable Care Act survive? Tell me what you think.