Pneumonia Prevention

Stay warm, keep your head and feet covered, to stay healthy. That's the advice from our newest contributing writer. That's the way to stay healthy and avoid getting ill from pneumonia. Not that the research agrees with that assessment. However just as there are studies, three (3) on the issue of cold catching illnesses. Only the oldest Army study says that heat is released mostly through your head hands or feet. The biggest current stories on the disease are concerning Montana sheep, catching a virus from a monkey (in 2009) and Zyvox (Linezolid) from Pfizer to treat pneumonia.

"FWP will let Pneumonia Run its Course in Anaconda Bighorns - Montana Fish, Wildlife and Parks (FWP) reports that the pneumonia outbreak it confirmed in Anaconda area bighorn sheep on August 19th has spread beyond management control, and wildlife officials say they will let the disease run its course. FWP killed sick sheep this fall in an attempt to eradicate the infection before it spread to healthy sheep.  But, officials decided last week to cease further culling efforts after evidence mounted that the pneumonia was already widespread." - Montana's Office State Website (News Article)

That's not the only animal story concerning a virus. Though it isn't in our region and is on the other side the country. It's an old story in that the incident occurred in 2009 and there was only one person affected and only one animal involved and none other. The incident is interesting in that the impossible appears to have become possible. Illness have either passed from animals to humans. Though even those at the University of California at Davis doubt the finding. Who are we to argue.

"New virus caused 2009 outbreak at California National Primate Research Center - This would be the first time an adenovirus had been shown to jump species, (UC San Francisco virologist Charles) Chiu said. His findings have not been published in a peer-reviewed journal. An adenovirus is a type of virus that commonly causes respiratory and gastrointestinal symptoms. The employee had experienced a flulike illness around the same time that the monkeys fell ill. The employee recovered uneventfully without medical treatment. No other employees who worked with the Titi colony were found to have developed antibodies showing that they had been exposed to the virus. Nor did any monkeys outside the colony." - University of California, Davis (News and Information)

What are the federally sanctioned ways to preventing pneumonia? There are medications that can be taken but even that information is disputed by professionals in the field. That the research is disputed without the research to support their conclusions means to us that they have to be ignored. Our concerns to to keep people alive and well and if the suggestions or disputes do not advance that reality its not of much use. According to the Center for Disease Control and Prevention (CDC) how do you prevent pneumonia?

"Pneumonia Can Be Prevented – Vaccines Can Help - Reduce Your Risk - Pneumonia can be prevented with vaccines. Following good hygiene practices can also help prevent respiratory infections. This includes washing your hands regularly, cleaning hard surfaces that are touched often (like doorknobs and countertops), and coughing or sneezing into a tissue or into your elbow or sleeve. You can also reduce your risk of getting pneumonia by limiting exposure to cigarette smoke and treating and preventing conditions like diabetes and HIV/AIDS." - Center for Disease Control and Prevention (Current Features) 

PearlieMae died from a respiratory failure as a result of complications to her cancer. She was in an institution before being revived to succumb within the nearby hospital. When you're in an institution its difficult too not follow good hygiene practices. It's certainly important for the institution's personnel to practice good hygiene. Indeed it is critical and a matter of life and death. For prevention within an institution we found this information from local John Hopkins University Hospital (JHUH) for the prevention of infection. What we didn't expect to find as a preventive measure against pneumonia was the suggestion of the simple act of coughing and breathing deeply. 

"Incentive Spirometry: You will be expected to do some very simple breathing exercises to help prevent respiratory infections by using an incentive spirometry device (these exercises will be explained to you during your hospital stay). Coughing and deep breathing is an important part of your recuperation and helps prevent pneumonia and other pulmonary complications. " - Johns Hopkins University (WHAT TO EXPECT AFTER SURGERY)

We do remember the urban legend email that you'll see every now and then claiming that coughing can prevent a heart attack. Fortunately almost every debunking website has discredited the claim and though we haven't searched for the actual research or study to disprove the claim we do know that the information isn't "endorsed by Rochester General Hospital and Mended Hearts" as the message claims. 

"This coughing technique to maintain blood flow during brief arrhythmias has been useful in the hospital, particularly during cardiac catheterization. In such cases the patient's ECG is monitored continuously, and a physician is present." American Heart Association (Cough CPR)

John Hopkins is also our source for research on the issue of vaccination to prevent pneumonia. Which while presenting the information and research on the effectiveness of vaccination isn't the source that physicians tend to quote. While the myth is that the vaccines are more effective, often doubling the effectiveness percentages even among their own physicians. Even on their very own website. What's true today isn't necessarily true tomorrow. Taking that into consideration we'll allow that what was thought to be true then isn't statistically true today.

"PREVENTABLE PNEUMONIA - One vaccine, developed 20 years ago, is ninety per cent effective against these afflictions. Yet for some reason only about 30 per cent of people who ought to get the pneumococcal vaccine actually do. Johns Hopkins professor of International Health Dr. Mark Steinhoff says it could be because people assume antibiotics will clear up any health problems, especially pneumonia. But that's a mistake." - The Johns Hopkins University InteliHealth (Health Newsfeed # 941)

The most current research from a different wing of the largely same institution has found that the most recent studies are substantially different. Again we think that the sites differ only because the information that might have been considered true at the time the information was release was true at the time of publication. So while the information from the same institution differs in content and contradicts the earlier info we attribute it to time and more research.

"Pneumococcal Vaccine: Vaccinate! Revaccinate?? - It should be noted that vaccination does NOT reduce pneumonia.  A meta-analyses shows no decrease in pneumonia incidence as a result of vaccination, however it has been shown to be about 60-70% effective in preventing invasive disease (meningitis, bacteremia).  Only one study by Riley et al (Lancet. 1977 Jun 25;1(8026):1338-41) has demonstrated decreased mortality (by 44%).  Other studies to date have not been powered to do so or have not shown a statistically significant difference.  There are 40-50,000 cases of bacteremia plus 3-6,000 cases of meningitis.  Maybe half of these would be vaccine preventable." - Johns Hopkins Medicine (Pneumococcal Vaccination)

Internally we found that the John Hopkins staff was given this set of instructions which we also believe is probably outdated mostly replaced by mroe recent memos. If not one of the problems with a research institution is that the facts that always replace the procedures:

"Preventing Infections - To prevent pneumonia, carefully follow instructions about breathing treatments." - John Hopkins Medicine (National Patient Safety Foundation 2003)

While research sponsored by the Pfizer corporation found that the medication Crestor is more effective than previous thought. The Food and Drug Administration (FDA) gave the corporation a "new indication" based on the February research from the Justification for the Use of statins in Prevention: an Intervention Trial Evaluation Rosuvastatin (JUPITER) trial. What the February research and FDA gave to one (1) drug a new study taketh away from another.

"Popular antibiotic may not be best for pneumonia - The study was recently published in the Critical Care Medicine Journal. Dr. Andre Kalil, an infectious disease specialist at UNMC, found that the antibiotic linezolid is not superior to two other common antibiotics used to treat patients with hospital-acquired pneumonia. Pfizer manufactures the drug. Dr. Mark Kunkel, an executive director in a unit for the company, said other recent international research shows that the drug is superior to its counterparts. People get hospital-acquired pneumonia, or nosocomial pneumonia, from prolonged hospitalization and more resistant germs, Kalil said." The North Platte Telegraph (State News)

So if you're in the hospital recovering you might want to keep warm wearing a hat, gloves, warm socks, cough and breath deeply to prevent pneumonia. Remember our newest contributor and suggestions from John Hopkins University. It's good to know what doesn't work and what does work. It helps to know that there are drug that we can take to give us more protection but not unfortunately full protection.

"Excess heat loss in the hatless - As temperatures drop, hats and caps flourish. Even the US Army Field manual for survival recommends covering your head in cold weather because “40 to 45 percent of body heat” is lost through the head. If this were true, humans would be just as cold if they went without trousers as if they went without a hat. But patently this is just not the case." British Medical Journal (December 2008)

Though the information was mostly published in the British Medical Journal the research and information is from American institutions. The facts are from the seasonal myth busters of science. Disproving other seasonal misstatements of science that are more like medical myths than actual facts. Even if there are researchers that challenge the study not on their techniques so much as their conclusions. We suggest a study to study the study. Until there is research to contradict their conclusions we'll take the Indiana University School of Medicine professors words just like we accepted the US Army Field manual information until now.

If you want and need a prescription to address your pneumonia concerns then Pfizer is here for you thanks to researchers at the University of Virginia (UVA). The study was first revealed in September 2008 concerning the effectiveness of the medication. While any medication, indeed any treatment can have side effects, the purpose of the drug is to prevent an infection that could lead to death. If we or our loved ones can survive the side effects, no matter how uncomfortable, it beats the alternative.

"Study Shows Higher Rates of Success for Zyvox Versus Vancomycin in MRSA Nosocomial Pneumonia - Investigators from 156 centers worldwide randomized 1,225 patients, of whom 448 patients had  proven MRSA nosocomial pneumonia (modified intent-to-treat group); 339 patients also met key protocol criteria at the end of study (per-protocol group) and were included in the primary analysis." Infection Control Today (Oct 26, 2010)

So you can take the drug or follow the dictates of our federal government. The Food and Drug Administration (FDA) offers their prevention tips to survive the cold weather season. We support any and all ideas to help us survive until tomorrow. We're also willing to do anything other than exercise more and lose weight. Stop smoking, we don't smoke so sure we're all for it. So what does our FDA suggest we do to get ready:

"Get Set for Winter Illness Season - Certain people are more at risk for developing complications from flu; they should be immunized as soon as vaccine is available. These groups include:

• people 65 and older
• residents of nursing homes or other places that house people with chronic medical conditions such as diabetes, asthma, and heart disease
• adults and children with heart or lung disorders, including asthma
• adults and children who have required regular medical follow-up or hospitalization during the preceding year because of chronic metabolic diseases (including diabetes), kidney dysfunction, a weakened immune system, or disorders caused by abnormalities of hemoglobin (a protein in red blood cells that carries oxygen)" - FDA (Prevention Tips)

We're concerned that there is something about "certain people" who are "more at risk." Why and what is it about these people that makes them "more at risk?" We know that pneumonia is much like cancer not a single one of a kind infection. What causes it isn't. According to the US Department of Health and Human Services, National Institutes of Health (NIH) the solution to prevention for the elderly and those "more at risk" is vaccines. According to the University of Virginia the best vaccine if you're hospitalized or in an institution is Pfizer's Zyvox.

"University of Virginia Study Reveals Promising Method for Reducing MRSA Infections in Hospital Intensive Care Units - In a study published in the September 3, 2008 issue of Surgical Infections, UVA researchers report that switching between two antibiotics, linezolid and vancomycin, every three (3) months in the surgical ICU decreased the MRSA infection rate from 1.9 to 1.4 patients per 100 admissions. In-hospital mortality from surgical ICU-acquired MRSA infections fell from 3.8 patients per year to none." - University of Virginia Health System (Medical News)

That's been true since 2008 and to date is the best hope for surviving pneumonia. It's certainly better than it to have been a sheep with pneumonia under the previous care of the Montana Fish, Wildlife and Parks (FWP) before they decided to "cease further culling efforts." Better to suffer and survive than to be "culled." However the infection is spread complete protection is still years away. This is a constantly changing world and researchers are constantly making and releasing new information each day and when they do we'll bring the information to you. Because staying alive and keeping you alive is our reason for every season.