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Online Discussion: Tracking new emerging diseases and the next pandemic

NHS antivaxers may be banned from treating patient

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: September 11 2018 at 12:12am
A good dose of paracetamol can hide the fever; remember Pauline Cafferky?

Otherwise, spot on, DT! We tend to see doctors as god-like supermen. Yet they are as fallable as anyone else. Then we overwork them to the point of collapse and prosecute them when they fail.

FluMom, I have to back KiwiMum on this; I am certain the quad is better. As Carbon pointed out a few posts back, the last flu "came out of left field" so the more strains the better. Your immune system benefits more from varied strains. The more variety in the vaccine - the more of a wake-up-call it gives your system. So from the point of view of the first 3 strains, adding a fourth is equivalent to getting a bigger hit.

I only wish they offered the 4 strains over here!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote DeepThinker Quote  Post ReplyReply Direct Link To This Post Posted: September 11 2018 at 10:15am
Yes I know Tylenol will take a fever away.   That combined with the strong incentive to not call off is the problem.   The policy should be written in a way that it is in the workers benefit not to hide the fever.

Also I don't tend to think the problem is from the Doctors... they tend to have minimal patient contact and have good PPE practices.   The problem is the front line workers.... The nurses, the aids, housekeeping, laundry, and kitchen.   Also in the average day you have more visitors and vendors coming through the facility than you have patients.    You have very little control over these people.   Maybe everybody coming in the facility needs to have their temps checked.    Technology could make this very doable.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: September 11 2018 at 11:26am
Also agreed!

If I go to a food factory as a visitor, I must wear foot covers, hair covers, sanitise my hands and sometimes wear an overall or apron. If I visit a friend in hospital, I am provided with hand sanitiser - to use if I choose.

First our immune systems have no priming, whilst we are healthy. But when we are already sick, all bets are off. What a joke! - except it's not funny.

Would'nt it be nice if we got things the right way around for a change?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote DeepThinker Quote  Post ReplyReply Direct Link To This Post Posted: September 11 2018 at 2:05pm
Maybe the answer is just a simple law making hospitals liable for nosocomial infections. Then we might actually see policies that are effective.   There is technology available that would greatly reduce the risks in a health care setting.   We can make improvements in ventilation.... UV robots and UV air filters should be used... all exterior doors can be equipped with temperature scanners. Technology also probably exists or could be created that would sniff the air for viruses and bacteria and set off alarms when the loads are high. There is also promise in material science... we will probably be able to create surfaces that are much less hospitable to contagions.

And with flu in particular it might be as simple as maintaining certain specific air temps and humidity levels to prevent it from becoming air born.   There is a reason flu is seasonal.... yes vitamin d levels have an effect but the virus also needs certain specific environmental conditions for it to flourish.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: September 11 2018 at 3:04pm
i think you overthinking it ,

why not just have a flu shot,

it's much cheaper............
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: September 11 2018 at 4:09pm
Odd though it might sound, I think I agree with both of you.

The flu shot is definitely cheaper and easier. But it is an improvement (true it's a big improvement - very big) not a solution. 90% less deaths still leave 10% dying. As the technology progresses and as the tech drops in price, hopefully some of those processes will be adopted.

When Hubby was undergoing his cancer treatments and his immune system was seriously depressed, I put surgical masks and hand sanitiser in my hall. I told our friends to use it or lose our invitation to visit - permanently. Then whilst he was finishing the last of the treatment in the hospital I cleaned my previously grubby house.

If I can manage to avoid nosocomal infections on a delapidated farmhouse with more pets than any sensible no make that sane person would have, surely hospitals can adapt at least a bit.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: September 12 2018 at 12:09am
dont get me wrong im all for keeping the place as clean as possible,

i dont believe you having the shot will protect those around you ,thats just not right ,

for me having the shot means i dont have 2 weeks off work feeling near death,so weak not able to open a can (food LOL),
and 3 /4 weeks to get over it ,

and if it means the hospitals not having staffoff sick , then im all for the plan to vaccinate the staff.

just makes sense well to me
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Post Options Post Options   Thanks (0) Thanks(0)   Quote KiwiMum Quote  Post ReplyReply Direct Link To This Post Posted: September 12 2018 at 12:15am
We have visited Christchurch hospital 4 times in the last month, and the entrance way was so full of people all coming and going. I can't see how it is possible to stop a flu virus spreading when hospitals no longer have visiting hours and the world and his wife can come and go.
If it is to be, it is up to me.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote DeepThinker Quote  Post ReplyReply Direct Link To This Post Posted: September 12 2018 at 12:27am
Technophobe a big part of it in your situation was probably just about all bugs you had at home was stuff he had already been exposed to and developed immunity to.   We have a saying in healthcare: "you can't get sick from your own stuff". On balance the hospital was probably more clean than your home however... the bugs it did have would have probably been very dangerous to him.   If you are able to recover at home it is almost always a preferred option to doing so in the hospital.

That being said good job on taking care of your Hubby!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: September 12 2018 at 5:12am
Thank you Deep Thinker.

On balance the hospital was/is massively cleaner. For starters they have no pets and for seconds their cleaners are both able bodied and professional. It goes on from there. Currently they have hot and cold running water - I don't.

But you are absolutely on the nail! Familiar bugs are reasonably safe whereas bugs which are familiar with antibiotics are the most dangerous.

As for care of hubby - that was pure selfishness on my part.   
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: September 12 2018 at 10:01am
[FluMom, this is the official line on the vaccine choice. It does not lead me to chamge my approach or conclusions, but you know your own immune system best and how sensible those around you are when it comes to vaccinations. So here goes:]

What You Need To Know About This Year's Flu Vaccines
Will they protect against Aussie and Japanese flu?

After an awful winter last year – there were 15,000 deaths caused by flu in England (almost double the national average) – health officials are increasing efforts to protect the population’s health.

This winter there will be two flu vaccines on offer. The quadrivalent vaccine, which protects against four strains of flu, will be available to those under 65, for the first time ever in the UK – in previous years, the flu vaccine only protected against three.

Meanwhile the over-65s will be offered an immune-boosting vaccine which only protects against three strains, but is still hugely recommended for this age group.

Public Health England’s medical director Professor Paul Cosford said that strains of flu circulating in the southern hemisphere’s winter are similar to last year. Although it has been a mild season in terms of flu in the southern hemisphere, it doesn’t necessarily mean it will be a mild flu season in the UK, he added.

Cosford warned the public that the number one way to protect against flu is to have a vaccination. So which should you have?

The standard jab

This year’s quadrivalent vaccine - generally available to most people aged 65 and under - protects against the following flu strains:

:: Influenza A/H1N1 – the strain of flu that caused the swine flu pandemic in 2009.

:: Influenza A/H3N2 – a strain of flu (otherwise known as Australian flu) that mainly affects the elderly and people with long-term health conditions. Professor Cosford said the vaccine wasn’t as effective as they’d hoped in protecting against this strain last year.

:: Influenza B/Brisbane – a strain of flu that particularly affects children.

:: Influenza B/Yamagata (otherwise known as Japanese flu) - a strain of flu that impacts children more, however last winter it also impacted the elderly.

A nasal spray version of the vaccine will also be on offer to children and young people aged two to 17 years in an eligible group.

The immune-boosting jab

The ‘adjuvanted trivalent’ vaccine works by improving the body’s immune response to the vaccine. This is important because typically older adults’ bodies do not respond as well to the flu vaccine due to their naturally weaker immune systems. They are also more likely to suffer complications from flu.

PHE estimates this vaccine, which is available to the over-65s only, will reduce GP consultations by 30,000. It’s also thought there will be 2,000 fewer hospitalisations and 700 hospital deaths prevented as a result of the jab being on offer.

The jab wasn’t available last year as it was only licensed for use in the UK in 2017. It protects against three strands of flu, as there currently isn’t an immune-boosting vaccine that protects against the four strains.

The downside is that it doesn’t protect against Japanese flu, however health officials believe there might be some “cross protection” offered from the other strains the jab protects against.

Who gets the vaccine for free?

24 million people will be offered free flu vaccines this season - that’s three million more than last year. It will be offered to the following groups:

:: those aged 65 and over

:: those aged 18-64 with a long-term health condition

:: children aged 2-3 years old via their GP practice

:: children in reception class and school years 1-5

:: pregnant women

:: health and social care workers (including hospice workers)

:: carers

:: morbidly obese people

When should you get it?

The earlier, the better. Due to GPs receiving the vaccines in staged deliveries, people will be contacted when they need to have it. This should be around October time. If you don’t hear from your GP, ask them when you can have it.

Boots pharmacy is already offering the quadrivalent jab for free, if you are deemed as being in an ‘at-risk’ group, or for £12.99 if you aren’t.

PHE emphasised that it’s never too late to get vaccinated, but ultimately before December is best.
Where can you get the vaccine?

:: GP practices.

:: Pharmacies (including Superdrug, Boots, Lloyds Pharmacy, Asda and Tesco).

:: Some people may be offered the flu vaccine through their work’s health scheme.

Are there any side effects?

Side effects of the nasal vaccine can include a runny or blocked nose, headache, tiredness and some loss of appetite. The injection can cause a sore arm, low grade fever and aching muscles for a day or two afterwards.

Is the flu vaccine suitable for vegans?

If you’re vegan, or a vegetarian who strictly doesn’t eat eggs, the flu vaccine won’t be suitable because it will have been incubated in egg. That said, it’s fine for people with egg allergies, according to PHE, as the levels are very low.

A spokesperson previously told HuffPost UK: “The production and availability of egg-free flu vaccines is determined by flu vaccine manufacturers and they have not made any egg-free flu vaccines this season.”

[size4]What are the symptoms of flu?

Flu differs from the common cold in that symptoms are usually far worse. People with colds are more likely to have a runny or stuffy nose, while flu symptoms often come on quickly with sufferers experiencing a fever, a dry chesty cough, tiredness, the chills, joint pain or aching muscles.

Much of the time it will make them too unwell to do anything.

Other symptoms include: diarrhoea, abdominal pain, nausea, vomiting, a sore throat, a blocked or runny nose, sneezing, loss of appetite and difficulty sleeping.
Other ways to prevent it

Practice good hand hygiene – for example, washing your hands with soap and warm water before preparing and eating food, or after using public transport –and avoid having unnecessary contact with other people if you or they are experiencing symptoms of flu.


Source and video:   https://www.huffingtonpost.co.uk/entry/flu-vaccine-2018-what-you-need-to-know_uk_5b966942e4b0cf7b0041e27e

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: September 12 2018 at 10:02am
Of course there is option 3: Get whichever is supplied for free then get the other privately 3-4 weeks later.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: September 12 2018 at 2:02pm
Adjuvant
From Wikipedia, the free encyclopedia
Jump to navigationJump to search
For adjuvant therapy in cancer care, see adjuvant therapy.
An adjuvant is a pharmacological or immunological agent that modifies the effect of other agents. Adjuvants may be added to a vaccine to modify the immune response by boosting it such as to give a higher amount of antibodies and a longer-lasting protection, thus minimizing the amount of injected foreign material. Adjuvants may also be used to enhance the efficacy of a vaccine by helping to modify the immune response to particular types of immune system cells: for example, by activating T cells instead of antibody-secreting B cells depending on the purpose of the vaccine.[1][2] Adjuvants are also used in the production of antibodies from immunized animals. There are different classes of adjuvants that can push immune response in different directions, but the most commonly used adjuvants include aluminum hydroxide and paraffin oil.[1][2]


Contents
1     Immunologic adjuvants
1.1     Mechanism
1.2     Adjuvants as stabilizing agents
1.3     Types of adjuvants
1.4     The mechanism of immune stimulation by adjuvants
1.5     Alum as an adjuvant
2     Concerns
3     References
4     External links
Immunologic adjuvants
Main article: Immunologic adjuvant
Immunologic adjuvants are added to vaccines to stimulate the immune system's response to the target antigen, but do not provide immunity themselves. Adjuvants can act in various ways in presenting an antigen to the immune system. Adjuvants can act as a depot for the antigen, presenting the antigen over a longer period of time, thus maximizing the immune response before the body clears the antigen. Examples of depot type adjuvants are oil emulsions. An adjuvant can also act as an irritant, which engages and amplifies the body's immune response.[3] A tetanus, diphtheria, and pertussis (DPT) vaccine, for example, contains minute quantities of toxins produced by each of the target bacteria, but also contains some aluminium hydroxide.[4] Such aluminium salts are common adjuvants in vaccines sold in the United States and have been used in vaccines for more than 70 years.[5]

Mechanism
Adjuvants are needed to improve routing and adaptive immune responses to antigens. This reaction is mediated by two main types of lymphocytes, B and T lymphocytes. Adjuvants apply their effects through different mechanisms. Some adjuvants, such as alum, function as delivery systems by generating depots that trap antigens at the injection site, providing a slow release that continues to stimulate the immune system.[6] This is now under debate, as studies have shown that surgical removal of these depots had no impact on the magnitude of IgG1 response.[7]

Adjuvants as stabilizing agents
Although immunological adjuvants have traditionally been viewed as substances that aid the immune response to the antigen, adjuvants have also evolved as substances that can aid in stabilizing formulations of antigens, especially for vaccines administered for animal health.[3]

Types of adjuvants
Analgesic adjuvants
Inorganic compounds: alum, aluminum hydroxide, aluminum phosphate, calcium phosphate hydroxide
Mineral oil: paraffin oil
Bacterial products: killed bacteria Bordetella pertussis, Mycobacterium bovis, toxoids
Nonbacterial organics: squalene
Delivery systems: detergents (Quil A)
Plant saponins from Quillaja (See Quillaia), Soybean, Polygala senega
Cytokines: IL-1, IL-2, IL-12
Combination: Freund's complete adjuvant, Freund's incomplete adjuvant
Food-based oil: Adjuvant 65, which is a product based on peanut oil.[8] Adjuvant 65 was tested in influenza vaccines in the 1970s, but was never released commercially.[9]
The mechanism of immune stimulation by adjuvants
Adjuvants can enhance the immune response to the antigen in different ways:

Extend the presence of antigen in the blood
Help the antigen presenting cells absorb antigen
Activate macrophages and lymphocytes
Support the production of cytokines
Alum as an adjuvant
Alum was the first aluminium salt used as an adjuvant, but has been almost completely replaced by aluminium hydroxide and aluminium phosphate for commercial vaccines.[10]

Concerns
Adjuvants may make vaccines too reactogenic, which often leads to fever. This is often an expected outcome upon vaccination and is usually controlled in infants by over-the-counter medication if necessary.

An increased number of narcolepsy (a chronic sleep disorder) cases in children and adolescents was observed in Scandinavian and other European countries after vaccinations to address the H1N1 “swine flu” pandemic in 2009.[11]

Narcolepsy has previously been associated with HLA-subtype DQB1*602, which has led to the prediction that it is an autoimmune process. After a series of epidemiological investigations, researchers found that the higher incidence correlated with the use of AS03-adjuvanted influenza vaccine (Pandemrix). Those vaccinated with Pandemrix have almost a 12 times higher risk of developing the disease. The adjuvant of the vaccine contained vitamin E that was no more than a day’s normal dietary intake. Vitamin E increases hypocretin-specific fragments that bind to DQB1*602, leading to the hypothesis that autoimmunity may arise in genetically susceptible individuals,[11] but there is no clinical data to support this hypothesis yet.

References
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Adjuvants also increase the frequency of guillain barre syndrome, but as that is an over-reaction of the immune system, it becomes vanishingly rare as you age.

This is a tightrope. Too little reaction and the flu can still kill you, too much and the vaccine itself could be fatal. The high wire we walk moves as we age. The older the person being vaccinated the greater the risk from the flu itself, the younger the person, the greater the risk from the vaccine; although even in very small children, the flu kills many thousands of times as many as the vaccine.

FluMom has had repeated bouts of pneumonia post-flu. That suggests a tightrope far over to the weaker immune reaction side. This means that FOR HER SPECIFICALLY the microscopic risk of guillain barre and its commoner milder cousins is even more minute. Therefore in her shoes, I would get one flu shot as early in the season as I could and the other weeks later (the time delay also reduces the over-reaction risk). It is a numbers game and there is no 100% safe choice for any of us. Something will kill us all some day. But, to me, that looks like the least risky course.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: September 12 2018 at 3:53pm
Life's a gamble.....

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: September 12 2018 at 4:37pm
Exactly!

But let's count cards and weigh the odds.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: September 12 2018 at 4:45pm
I may have made up my own mind, but everyone else has to do so themselves, so I will keep posting additional data and opinion pieces.

Here is the latest. I should have posted it hours ago, but my internet died. Anyway it's here:

New flu vaccine fails to protect the elderly from strain that killed thousands, health officials admit



The new flu jab will leave pensioners unprotected against the so-called Japanese flu that claimed thousands of lives last winter, health officials have said.

Public Health England (PHE) confirmed on Tuesday night that the latest vaccine will offer no direct protection against the B/Yamagata strain, thought to have been responsible for six in 10 ­influenza-related hospital admissions in January.

A jab that does protect against the strain will be available to those under the age of 65, the agency announced. It is not, however, considered useful for pensioners as it lacks the "adjuvanted" booster needed to prompt an immune response in older people.

Instead, they will be offered an adjuvanted vaccine that works against H2N2 "Aussie" flu, H1N1 "swine" flu and a different "Brisbane" strain of flu B.

"Decisions about who gets what all come down to cost and economics, rather than any great scientific understanding"Professor Jonathan Ball, Nottingham University

PHE acknowledged that offering people over 65 a boosted trivalent jab was not ideal, but better than a non-boosted vaccine protecting against the Yamagata strain.

"We'd much prefer to have a quadrivalent adjuvanted vaccine, but we don't have it this year," said Professor Paul Cosford, the organisation's medical director.

The announcement follows the worst flu season for seven years, which saw 15,000 deaths related to the disease last winter. The average number of related deaths is 8,000.

Health planners were caught off-guard by the presence of two concurrent B strains of flu, coupled with the poor performance of the non-boosted trivalent vaccine in older people.

Health leaders faced criticism on Tuesday night as it emerged that a better jab might have been available sooner, but for licensing issues.

Prof Jonathan Ball, an expert in molecular biology at Nottingham University, said: "The adjuvanted vaccine was licensed in lots of other countries way before last year. Decisions about who gets what all come down to cost and economics, rather than any great scientific understanding."

PHE said it expects the new jab will prevent more than 700 flu-related hospital deaths, 2,000 hospitalisations and 30,000 GP appointments.

Analysts believe that roughly one third of the ­extra pressure piled on A&E systems last winter was due to the high rates of flu.

Protect yourself and your family by learning more about Global Health Security

Source:   https://www.telegraph.co.uk/news/2018/09/12/vaccine-fails-protect-elderly-killer-flu/
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Post Options Post Options   Thanks (0) Thanks(0)   Quote FluMom Quote  Post ReplyReply Direct Link To This Post Posted: September 12 2018 at 4:46pm
Techno, thanks for your comment, I just got the Quad shot today! I am going to get the new Pneumonia shot after the first of October. LOL, I had a time getting the correct shot. The poor lady filling out the paper work had not an idea of what shot was what for the flu. She had me taking the High Dose then something that was not the Quad. At least the Pharmacist heard me and made sure I got the right flu shot. Nice guy.

I just don't want to take a chance on the Tri because the more variants the better in my way of thinking. My Doc does not seem to think the High Dose is any better for us older people so I am glad I took the Quad.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: September 12 2018 at 4:49pm
Always welcome, FluMom!   
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: October 08 2018 at 5:09am
I promised to tell you all what our local GP surgery did this year.

When they are not worried about the circulating strains I can't get a free jab.
In a "normal" year I have to beg for one.
In a year when the stuff going round worries them they offer it to me.

They just phoned me and offered hubby and I a free jab - I did not have to beg.
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