Tag Archives: Epidemic

The Flu in Focus: Epidemiology, History and Research of Global Influenza

I live in Baltimore, USA and it has been getting cold here. The nippy winds have been turning my nose red and when I come inside, I always need to have a tissue handy. With the cold weather, there is a looming fear of the flu.

Even if it is not winter where you live, the flu is a serious concern especially for older adults. The flu season in North America generally peaks in the winter months, somewhere between December – February. In tropical climates, however, the flu can strike at any time of the year. As you can see from the map, huge swaths of the world including Russia, Australia, and parts of Europe and the Middle East are experiencing higher levels of the flu, and areas in South America, and South Asia and North Africa are experiencing moderate flu levels. Most of the recent flu outbreaks, including the much-feared Middle East Respiratory Syndrome (MERS), were particularly deadly for older adults.

 Photo Credit: Sanofi Pasteur

                                                                                        Photo Credit: Sanofi Pasteur

For a healthy young or middle-aged adult, the flu will generally lead to physical discomfort and some sick days from work, but it is typically not a deadly disease. The flu can be very deadly for older adults. Older adults often have weakened immune systems that make it harder for them to fight off the flu virus. In addition, hospitals and nursing homes can provide an ideal environment for the transmission of the flu virus, even when nurses and doctors take proper safety precautions.

The flu is more than just a problem for older adults. For instance, the so-called “Spanish Flu” of 1918 was a worldwide killer that was particularly deadly for healthy young adults. The Spanish Flu resulted in the deaths of between 40- 50 million people worldwide, or approximately the modern population of South Korea. Take a moment to consider the implications of a virus so deadly that it could wipe out the population of a country in less than a year. With modern air travel, the danger of a new strain of the flu is even more acute. Approximately 250,000 to 500,000 people die in an average year with a normal flu season, according to World Health Organization (WHO).

The flu is a particularly challenging virus because it frequently mutates. Scientists originally believed that the 1918 flu mutated from a form of flu commonly found in pigs, and the “swine flu” has since been observed in different parts of the world. However, evidence has shown that the 1918 flu was likely an avian bird flu that transferred into humans. If you are interested in learning more about the scientific search for the flu virus, the book Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus That Caused It by Gina Kolata is an excellent read.

WHO tracks the flu to try to predict the strain of flu that will be most common in a given year. In addition, WHO has a global action plan to increase the availability of the influenza vaccine. It is important that all countries, not just rich nations, have access to a flu vaccine. In India, Indonesia, Romania, Republic of Korea, and Thailand, new manufacturers are now producing the flu vaccine, thanks to WHO grants. Other developing countries such as Brazil, Mexico, and South Africa have also been given grants to improve flu vaccine manufacturing capabilities.

A flu pandemic should not keep you awake at night, but it is important that countries and international bodies are prepared for the possibility of a more deadly strain of the flu. Modern medical advances will likely increase the probability of surviving such a flu outbreak, but older adults and the immuno-compromised are always at higher risk of death or complications due to respiratory infections. The goal is to promote healthy-living strategies, such as good diet and exercise, to improve the immune system and protect at-risk populations from the flu virus and other infections.

Grace Mandel is pursuing a Master of Public Health in Health Systems and Policy at the Johns Hopkins University Bloomberg School of Public Health.

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Aquatics for Life

Inactivity in the elderly has become an ever increasing epidemic in the United States. Politicians as well as insurance and health care providers need to band together to reverse this trend to insure the longevity and quality of life. The elderly are not only at risk for lifetime diseases such as diabetes and heart disease; they are at risk for greater loss in bone density which translates into greater probability of falling and breaking bones.

gray-green-topper
Land-based physical activity is important for the elderly as it increases muscle and strength development, bone density and endurance which are both respiratory and cardiovascular. On the other hand, aquatic exercise benefits EXCEED land-based activities since it trains muscle parity and balance. Land-based exercise in the elderly is fraught with potential for injury. Likewise, unsupervised weight training can lead to torn muscle fibers, strained or torn ligaments, and unbalanced overtraining of some muscles while not sufficiently training the complementary muscles equally. Water exercise in a class format allows for participants to work at their own comfort level of perceived exertion. Good water instructors will always cue participants to work below the threshold of pain. In other words, participants can work to tension and ask for modifications of moves when in pain.

For the elderly, a good rule of aquatic exercise is to be mindful of aches and pains in advance of a water workout. If two hours later, the pain is greater than before training, then the participant has done too much. At this point, they can notify the instructor for modifications of moves that may affect their pain experienced. Because aquatic exercise trains complementary muscle pairs like biceps and triceps, the potential for injury in land-based exercise or activities of daily living (ADL) is reduced. Moreover, aquatic activities not only balance muscle pairs, they inherently strengthen the core muscles which provide for better over-all balance and strength. Core strength can show some correlation to immunity and overall health.

All seniors, especially those who are overweight, need to exercise in a muscle-balancing, core strengthening and reduced-risk-of-injury environment. Aquatic exercise is perhaps the ultimate life-time sport!

Felecia Fischell is an aquatic specialist with 25 years experience in aquatics. She leads aquatic classes and consults as an aquatic personal trainer and a swim instructor in and around Smith Mountain Lake, Virginia, USA. The Founder of FunLife Aquatics Consulting and Personal Training, Felecia presents at health fairs and has given aquatic presentations to high schools, Howard County Board of Education, Howard County General Hospital and Howard Community College.

Ebola and the Elderly: Focusing on a Vulnerable Population

Certain diseases like pertussis and dementia are associated with distinct populations. Pertussis is generally linked to children and dementia is generally linked to older adults. While both diseases can affect atypical populations, health professionals cannot have the same mindset when rare diseases like Ebola are concerned.

Miguel-Pajares
The Ebola outbreak continues to make headlines around the world and the focus has been on adults and children. If one studies the media and research papers, older adults are nearly absent. The aging population remains sidelined from the Ebola epidemic although the disease has affected the elderly around the world. Some may argue that Ebola mainly affects adults and children but few reports have shown that the elderly are also casualties. The rate of casualties regarding the elderly may not be accurate since there is little focus on this population. How long will older adults continue to be sidelined from issues that also affect them? Ebola attacks the elderly in unique ways compared to adults and children. For instance, older adults are prone to disease and disability because of their age. Specific risk factors that affect older adults also include:

  • Injury and poverty
  • Development of non-communicable diseases
  • Social isolation and exclusion, mental health disorders
  • Elder maltreatment.

These medical conditions in addition to contracting the Ebola virus disease (EVD) make matters worse for the elderly.

Cases regarding the elderly and EVD are not widespread in the media hence this piece will highlight just a few of these instances. The first case is an elderly woman who tested positive of the Ebola Virus Disease in Port Harcourt, Rivers State, Nigeria. The elderly woman had been quarantined in the Ebola Isolation Centre because she shared the same ward with the late Dr. Ike Enemuo, a Port Harcourt-based medical practitioner who treated an ECOWAS diplomat with the Ebola virus. Dr. Enemuo was ill and receiving treatment at the Good Heart hospital in Port Harcourt. He died of Ebola on August 22, 2014. The second case is an 87-year-old woman from Madrid, Spain, who was isolated in the senior center where she lives. The elderly woman was driven in the same ambulance as Nurse Teresa Romero, the first person to become infected in Europe. A key point about this case is that the elderly woman had suffered a fall which made matters worse. Another case in Spain is 75-year-old Miguel Pajares, an elderly priest who was working in Liberia. He was carrying out missionary work when he tested positive for Ebola.

The goal is not to ignore populations that are affected by certain diseases. Health professionals need to have a holistic view for disease outbreaks, knowing that outbreaks still affect populations that are marginalized. As Ebola remains in the news, let us remember the elderly, people with disabilities, and more because each population faces unique challenges during disease outbreaks. Treatment is not just for certain groups, it’s for all groups affected. Health and media professionals can think outside the box when it comes to reporting events. If not, public health interventions may continue to ignore elderly issues around the world.

Sophie Okolo is the Founder of Global Health Aging.