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The ACIP 2016 Update is out for Adult Immunizations. Note the expanded recommendations for asplenia/functional asplenia and immunosuppression, especially the convoluted (not ACIP’s fault) recommendations for dosing the two available pneumococcal vaccines, and the addition of the serogroup B meningococcal vaccine. Download the charts here:
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The news about Zika virus and a marked association with microcephaly is all pretty disturbing, and I have gotten questions about whether we could have a problem in Florida. I think we have an idea from what’s happened with dengue & Chikungunya, which are spread by the same Aedes mosquitos. Chikungunya (another virus from Africa) also spread very quickly through South & Central America & the Caribbean over the last few years.
In U.S. territories, Dengue is endemic in Puerto Rico, Hawaii now, and has established limited local transmission in the Keys, based on antibody screening of that population. About 10% of FL Keys residents surveyed in 2009 had dengue antibodies. Chikungunya has also occurred in very very limited fashion in FL compared to the Caribbean & Puerto Rico.
In 2015, there was 1 locally acquired dengue & 0 Chikungunya in Florida; Puerto Rico had 198 cases of Chikungunya. Contrast this with 2014: 12 locally acquired cases in Florida, 4242 in Puerto Rico, and 38 in the U.S. Virgin Islands. I expect these numbers should be just as low for Zika virus with enhanced surveillance and mosquito control efforts.
Reasons none of these is widespread in the U.S.:
- Mosquito control programs.
- Modern housing with screens & AC.
- Aggressive public health tracking of cases & mosquito spraying around the areas where those individuals live (“ring” control measures).
- Aedes aegypti is the more effective transmitter of these viruses, but is less common here than Aedes ablopictus.
CDC has issued Interim Guidelines for Pregnant Women and an Enhanced Precautions Travel Alert. I suggest to avoid the lower Keys (my own opinion), Caribbean, Central & South America if you are trying to become pregnant and through delivery.
Follow what’s happening weekly with all Arboviruses in FL here.
Share this brochure with friends and neighbors about reducing mosquito breeding around your residence & preventing bites. DEET, picaridin, and IR3535 are safe for use in pregnancy—follow label directions. These are day and night biting mosquitos. Enhanced mosquito avoidance measures are always a good idea in Florida anyway, because we have encephalitis viruses seasonally.
As a healthcare professional and Florida constituent, I ask you to please voice support to your legislators for our (or wherever you live, your) mosquito control programs. In 2011, Florida mosquito control programs lost almost half their state funding, & state funding for mosquito control research was eliminated. The public is just not aware of how very deep a debt of gratitude we owe these programs for making Florida such a lovely state to live in.
All the best,
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Industrial farming practices in the U.S. are one of my pet peeves, from an environmental and health standpoint, as well as my “foodie” sensibilities.
Freshly laid, unfertilized farm eggs actually keep best unwashed until they are cracked, & will keep at room temperature for weeks. An egg, even unfertilized, is alive, exchanging air through the shell & living off yolk nutrients. Think about it, they are designed to be living incubators for a chick. They will slowly dehydrate & lose quality, but they will live and remain edible for a long time. (How do they tell if an egg is unfertilized?)
Americans – Why do you keep refrigerating your eggs? nicely summarizes the interesting & little-advertised facts about how American industrial farming practice requires us to scrub, chlorine wash, & refrigerate eggs at 40F, so as to reduce the risk of Salmonellosis and other infections. In Europe, less industrialized farming practices & vaccination of poultry against Salmonella has dramatically reduced this problem. Washing eggs is illegal, & they are kept at 70F to reduce condensation that might promote bacteria. Kept dry at this temperature, the coating on the egg from laying protects them from dehydration & bacterial entry for a long time on store shelves.
Unfortunately, in the U.S. even backyard flocks have been contaminated with Salmonella & are usually unvaccinated, so the risk is not so low. I keep my farm eggs unwashed but refrigerated to retard bacteria (wash before use, of course). I love eggs from pasture-raised chickens & ducks; they’re richly flavored & higher in omega-3 fatty acids & antioxidants from their naturally “buggy” diets. Discard any egg if it’s slimy, discolored, has an odor (it shouldn’t at all), or has new powdery spots on it.