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Influenza & Pneumococcal Vaccines

Your best shot for a healthier life!

The Influenza Vaccine

Why should I get the influenza vaccine?
Influenza is a serious disease that is caused by a virus. The influenza virus is spread from infected persons to the nose or throat of others, and in the U.S., the "flu season" is from November to April each year. Influenza can cause fever, cough, sore throat, headache, chills, and muscle aches. Usually these symptoms last for only a few days, but some people may get much sicker and may even require hospitalization. Complications of influenza include pneumonia, myocarditis, or death. To help decrease the risk of catching the influenza virus, patients at risk should receive the influenza vaccine.

Who should be immunized?
Before receiving an immunization, you should check with your physician. Generally, people at risk for getting a serious case of influenza or complications (or people in close contact with them) should get the vaccine. These include:

Seniors 65 or older

  • Residents of long-term care facilities housing persons with chronic medical conditions
  • Anyone who has a serious long-term health problem with anemia (or any other blood disorders), asthma, heart disease, kidney disease, lung disease, or metabolic disease (such as diabetes)
  • Anyone whose immune system is weakened because of cancer treatment with x-rays or drugs, HIV/AIDS or other diseases that affect the immune system, or long-term treatment with drugs (such as steroids)
  • Anyone 6 months to 18 years of age on long-term aspirin treatment
  • Women who will be past the 3rd month of pregnancy during the influenza season
  • Physicians, pharmacists, nurses, family members, or anyone else coming in close contact with people at risk of serious influenza

Others who should consider getting influenza vaccine include:

  • People who provide essential community services
  • Students and staff at schools and colleges
  • Travelers to the Southern hemisphere between April and September, or those traveling to the tropics any time
  • Anyone who wants to reduce their chance of catching influenza

Who should not receive the influenza vaccine?

There are some people who should not receive the influenza vaccine. They are:

  • Anyone with an anaphylactic (life-threatening) allergy to eggs
  • Anyone experiencing moderate to severe illness at time of immunization (including moderate to severe diarrhea, vomiting, or ear infection)
  • Anyone who has had an anaphylactic reaction to a previous dose of the influenza vaccine

When should I get the influenza vaccine?

The best time to get the influenza vaccine is between September and December; however, the Centers for Disease Control and Prevention has announced a delay in the availability of the vaccine until late October 2000. A new shot is needed each year. People 9 years of age and older need one shot. Children less than 9 years of age may need two shots, given one month apart.



What is the cause of the delay and potential shortage of influenza vaccine?

One of the influenza virus components used to make the vaccine has not grown as well as expected and may cause a shortage of the vaccine. Additionally, two of the manufacturers of the vaccine are experiencing manufacturing problems.


What does the CDC recommend in response to the expected delay and possible shortage of influenza vaccine?

The CDC recommends that the influenza vaccination of individuals at high risk for complications from influenza and their close contacts should proceed routinely during regular health care visits after the vaccine becomes available.


The Pneumococcal Vaccine (PPV)


Why should I get the pneumococcal vaccine?

Pneumococcal disease is a serious disease that causes much sickness and death. In fact, pneumococcal disease kills more people in the U.S. each year than all other vaccine-preventable diseases combined. Pneumococcal disease can lead to serious infections of the lungs (pneumonia), the blood (bacteremia), and the covering of the brain (meningitis). About 1 out of every 20 people who get pneumococcal pneumonia dies from it, as do about 2 people out of 10 who get bacteremia, and 3 people out of 10 who get meningitis. Drugs such as penicillin were once effective in treating these infections, but the disease has become more resistant, making treatment of pneumococcal infections more difficult. This makes prevention of the disease through vaccination even more important.


Who should be immunized?

Before receiving an immunization, please contact your physician. Generally, the following people are candidates for the vaccine:

  • Adults 65 years of age and older
  • Anyone over 2 years of age who has a long-term health problem, such as alcoholism, cardiomyopathy, cardiovascular or pulmonary disorders (including congestive heart failure), cerebral spinal fluid leaks, chronic liver disease (including cirrhosis), COPD or emphysema, diabetes mellitus, or sickle cell disease
  • Anyone over 2 years of age who has a disease or condition that lowers the body’s resistance to infection, such as damaged spleen or no spleen, Hodgkin’s disease, immunosuppressive conditions (including HIV infection or AIDS), kidney failure, lymphoma, leukemia, multiple myeloma, nephritic syndrome, or organ transplantation
  • Alaskan Natives
  • American Indians

How many doses of the pneumococcal vaccine are needed?

Usually only one dose is needed; however, under certain circumstances a second dose may be needed. A second dose is recommended for those people 65 and older who got their first dose when they were under 65 (if 5 or more years have passed
since that dose).

A second dose is also recommended for people who have the following:

  • A damaged spleen or no spleen
  • Sickle-cell disease
  • HIV infection or AIDS
  • Cancer, leukemia, lymphoma, multiple myeloma
  • Kidney failure
  • Nephritic syndrome
  • Organ or bone marrow transplant
  • Taking medication that lowers immunity (such as chemotherapy or long-term steroids)

Children age 10 and younger may get this second dose 3 years after the first dose. Those older than 10 should get the second dose 5 years after the first dose.

Who should not receive the pneumococcal vaccine?

The following people should not receive the pneumococcal vaccine:

  • Anyone experiencing moderate to severe illness at time of immunization (including moderate to severe diarrhea, vomiting, or ear infection)
  • The safety of the pneumococcal vaccine in pregnant women has not yet been studied. There is no evidence that the vaccine is harmful to either the mother or the fetus, but pregnant women should consult with their doctor before being vaccinated. Women who are at high risk of pneumococcal disease should be vaccinated before becoming pregnant, if possible.





Glaucoma

Glaucoma is the second most common cause of blindness in the United States. Glaucoma affects approximately 2 million Americans, but only half of these people realize they have glaucoma. Many times there are no symptoms until after eye damage has occurred and the vision is diminished.

Glaucoma is a condition characterized by progressive damage to the optic nerve in the eye. The optic nerve carries the images seen in the eye to the brain. Damage to the nerve causes a reduction in peripheral vision. As the disease worsens, blindness may occur.

Glaucoma is often caused by an increase of the pressure within the eye. This is called increased intraocular pressure. The pressure builds up in the eye when the clear fluid called the aqueous humor in the eye, is prevented from draining from the eye properly.

Greatest Risk Factors

  • Anyone over the age of 60
  • African-Americans over the age of 40
  • Family history of glaucoma

Other Risk Factors

  • Increased intraocular pressure (IOP)
  • Previous eye injury, long-term steroid use, or nearsightedness
  • Diabetes

Diagnosis of Glaucoma
Because most people with glaucoma experience no symptoms, it is very important to have frequent eye examinations for early detection.

The American Academy of Ophthalmology recommends everyone to have regular eye exams, but those with a higher risk for glaucoma should have more frequent exams.

The American Academy of Ophthalmology recommends an eye examination... ...If you
Every 3 to 5 years
  • Are age 39 or older
Every 1 to 2 years
  • Are age 50 or older
  • Have a family member with glaucoma
  • Are of African-American heritage
  • Have had a serious eye injury
  • Are taking steroid medications

Each doctor may perform different tests to detect glaucoma. Some of these tests could include:

  • Tonometry - the tonometer measures the pressure in the eye. There are two ways this can be done.
    1. Applanation tonometry - After the eye is numbed with drops, a plastic prism is lightly pushed against the eye in order to measure the intraocular pressure.
    2. Air tonometry - A puff of air is sent into the cornea to measure the pressure.
  • Gonioscopy - A special lens in placed on the eye to see if there is something blocking the drainage of the aqueous humor.
  • Visual Field Test - A visual field test allows the doctor to know how a person's vision has been affected by glaucoma.
  • Ophthalmoscopy - This allows the doctor to look directly through the pupil at the optic nerve. The color and appearance of the optic nerve can indicate if there is damage.

If glaucoma is suspected in a patient, the patient is usually referred to a practitioner who is either a member of the American Academy of Ophthalmology (AAO) or the American Optometric Association (AOA). These organizations have guidelines established for the management of glaucoma and the patient will be treated using these guidelines.

Types of Glaucoma
There are four major types of glaucoma:

  • Open-angle glaucoma
    Open-angle glaucoma is the most common form of glaucoma. It accounts for about 60-70% of all glaucomas. Usually both eyes are effected, but not necessarily equally. This type of glaucoma is a progressive deterioration of the optic nerve due to the slowly increasing pressure in the eye. There are generally no early symptoms present with this type of glaucoma. By the time the patient is aware of the failing vision, the degree of damage to the nerve is significant.
  • Angle-closure
    Angle-closure accounts for about 10% of all glaucomas. As a person gets older, the lens of the eye grows larger, resulting in the decreased ability of the aqueous humor to pass through the angle between the iris and the cornea. In some acute cases, the space can become completely blocked causing the intraocular pressure to rapidly increase. If this happens, optic nerve can damage within hours of onset.
  • Secondary glaucoma
    A previous injury or other diseases of the eye causes secondary glaucoma.
  • Congenital glaucoma
    Congenital glaucoma is present at birth and is a result of abnormal development of the structures of the eye. This type of glaucoma is hereditary and is corrected by surgery

Treatment of Glaucoma
There is no cure for glaucoma; however, it can be controlled. In most cases, medication is used to control glaucoma, but in some cases glaucoma surgery may be used to help treat the glaucoma. To prevent loss of eyesight, those with glaucoma will probably need to continue treatment for the rest of their lives. It is very important to let the doctor know if any change in vision occurs.

Medical Treatment
In most cases of glaucoma, medication will be tried first to lower the intraocular pressure or to improve the fluid drainage. The medication may be a topical product such as eye drops, inserts, or ointments or oral medications such as pills. Many times a combination of products is used for the treatment.

Topical Medications

Brand Name

 Generic Name
Miotics
Carboptic®
 Carbachol
Pilocar®, Pilostat®, Pilopine®, Ocusert®
 Pilocarpine
Humorsol®
 Demecarium

Phospholine Iodide®

Echothiophate
Carbonic Anhydrase Inhibitors

Trusopt®

Dorzolamide
Azopt® Brinzolamide

Sympathomimetics
Iopidine®

Apraclonidine
Epifrin®

Epinephrine
Propine® Dipivefrin
Alphagan® Brimonidine
Beta-Blockers
Betoptic® Betaxolol
Ocupress® Carteolol
Betagan® Levobunolol
OptiPranolol® Metipranolol
Timoptic®, Betimol®

Timolol

Prostaglandin analogues
Xalatan®

Latanoprost
Rescula® Unoprostone


Oral Medications
Brand Name Generic Name
Carbonic Anhydrous Inhibitors
Daranide® Dichlorphenamide
Diamox® Acetazolamide
GlaucTabs®, Neptazane® Methazolamide

When administering an eye drop, the patient should be taught to press his/her finger in the inside corner of the eye near the bridge of the nose to prevent systemic absorption
of the drug.

If more than one medication is being put in the eye, they need to be separated by at least
5 minutes.

Possible side effects from the medication could include:

  • Stinging or redness of the eyes
  • Blurred Vision
  • Headache
  • Changes in pulse, heartbeat, or breathing
  • Change color of iris (if using a prostaglandin analog)

Most of these side effects are not serious, and may disappear after a while. It is important for the patient to discuss any side effects with the physician.

Surgical Treatment
If the physician decides that surgery is necessary, the surgery may be either laser surgery or conventional surgery.
Laser - Most laser surgeries can be performed in the ophthalmologist office. Eye drops will be placed in the eye to numb the eye before the procedure. The recovery period from laser surgery is only a short time.
Conventional - Conventional therapy is used when laser surgery is not feasible. The recuperation time is longer than with laser surgery and there may be some restrictions after the surgery.

Some patients may still need to use glaucoma medications even after surgery because the surgery may not entirely correct the problem.

Protecting Your Vision
Glaucoma is a common disease that can effect many people. Frequent routine eye examinations are essential for early detection of the disease. If glaucoma is detected and treated early, it can usually be controlled before major vision loss occurs.

For More Information About Glaucoma...
The American Academy of Ophthalmology - www.aao.org/public/glaucoma
The American Optometric Association - www.aoanet.org
The Glaucoma Foundation - www.glaucoma-foundation.org
The Glaucoma Research Foundation - www.glaucoma.org

Challenges of Weight Management

Ninety-seven million adults in the US are considered to be overweight or obese. Since 1960, there has been an increase in the
percentage of people that are considered overweight or obese. Currently, 54.9% of people age 20 or older are considered to be
either overweight or obese. Ethnic groups, lower socioeconomic groups, and those with less education have been found to be more
likely to be overweight.

Why does obesity occur? The main reason obesity occurs is that more food is eaten than is burned off. To lose off one-pound/week
500 calories per day need to be decreased from the total caloric intake. Factors that help to promote obesity include a genetic
predisposition for obesity, an inactive lifestyle, and a high fat diet.

Why does it matter if we're overweight or obese? Obesity raises the risk for high cholesterol, high blood pressure, and diabetes.
Other risks associated with obesity include strokes, heart disease, arthritis, respiratory problems, and certain types of cancer.
Weight loss helps to decrease the risk for these conditions. Weight loss also improves self-image, confidence, mood, energy,
and endurance.

BMI, Body Mass Index, is used as an indicator of obesity. This measurement takes into account body weight and height.
To calculate your BMI:


Weight (kg)/Height (meters2)=BMI

OR

(Weight (lbs.)/Height (inches2))*705


Many web sites have a calculator that will determine your BMI for you. One such web site is Shape Up America!
(http://shapeup.org/bmi/start.htm).
Your BMI can also be determined from a chart like the one shown below.

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5'1"

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5'3"

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5'4"

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5'5"

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5'6"

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5'7"

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5'8"

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5'9"

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5'10"

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5'11"

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6'0"

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6'1"

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6'2"

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6'3"

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6'4"

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