Swine Flu A (H1N1) Virus Prevention & Treatment FAQ

Here's the second part of the Swine Flu FAQ obtained from CDC website.

This part will have FAQ on prevention and treatment as well as dealing with contamination of the virus. Here is also the first time I heard about the "Swine Flu Parties" LOL! If you don't know what it is, read on and you'll find the answer. All I have to say is there are all sorts of people in this world LOL! Anyway, here goes:-

Prevention & Treatment

What can I do to protect myself from getting sick?

There is no vaccine available right now to protect against this new H1N1 virus. There are everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza.

Take these everyday steps to protect your health:

• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
• Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
• Avoid touching your eyes, nose or mouth. Germs spread this way.
• Try to avoid close contact with sick people.
• Stay home if you are sick for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer. This is to keep from infecting others and spreading the virus further.

Other important actions that you can take are:

• Follow public health advice regarding school closures, avoiding crowds and other social distancing measures.
• Be prepared in case you get sick and need to stay home for a week or so; a supply of over-the-counter medicines, alcohol-based hand rubs, tissues and other related items might could be useful and help avoid the need to make trips out in public while you are sick and contagious.

What is the best way to keep from spreading the virus through coughing or sneezing?
If you are sick, limit your contact with other people as much as possible. If you are sick, stay home for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer. Cover your mouth and nose with a tissue when coughing or sneezing. Put your used tissue in the waste basket. Then, clean your hands, and do so every time you cough or sneeze.

What is the best technique for washing my hands to avoid getting the flu?
Washing your hands often will help protect you from germs. Wash with soap and water or clean with alcohol-based hand cleaner. CDC recommends that when you wash your hands -- with soap and warm water -- that you wash for 15 to 20 seconds. When soap and water are not available, alcohol-based disposable hand wipes or gel sanitizers may be used. You can find them in most supermarkets and drugstores. If using gel, rub your hands until the gel is dry. The gel doesn't need water to work; the alcohol in it kills the germs on your hands.

What should I do if I get sick?
If you live in areas where people have been identified with new H1N1 flu and become ill with influenza-like symptoms, including fever, body aches, runny or stuffy nose, sore throat, nausea, or vomiting or diarrhea, you should stay home and avoid contact with other people, except to seek medical care.

If you have severe illness or you are at high risk for flu complications, contact your health care provider or seek medical care. Your health care provider will determine whether flu testing or treatment is needed

If you become ill and experience any of the following warning signs, seek emergency medical care.

In children, emergency warning signs that need urgent medical attention include:

• Fast breathing or trouble breathing
• Bluish or gray skin color
• Not drinking enough fluids
• Severe or persistent vomiting
• Not waking up or not interacting
• Being so irritable that the child does not want to be held
• Flu-like symptoms improve but then return with fever and worse cough

In adults, emergency warning signs that need urgent medical attention include:

• Difficulty breathing or shortness of breath
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Severe or persistent vomiting
• Flu-like symptoms improve but then return with fever and worse cough

Are there medicines to treat infection with this new virus?
Yes. CDC recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with the new H1N1 flu virus. Antiviral drugs are prescription medicines (pills, liquid or an inhaler) that fight against the flu by keeping flu viruses from reproducing in your body. If you get sick, antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious flu complications. During the current outbreak, the priority use for influenza antiviral drugs during is to treat severe influenza illness.

What is CDC’s recommendation regarding "swine flu parties"?
"Swine flu parties" are gatherings during which people have close contact with a person who has novel H1N1 flu in order to become infected with the virus. The intent of these parties is to become infected with what for many people has been a mild disease, in the hope of having natural immunity to the novel H1N1 flu virus that might circulate later and cause more severe disease.

CDC does not recommend "swine flu parties" as a way to protect against novel H1N1 flu in the future. While the disease seen in the current novel H1N1 flu outbreak has been mild for many people, it has been severe and even fatal for others. There is no way to predict with certainty what the outcome will be for an individual or, equally important, for others to whom the intentionally infected person may spread the virus.

CDC recommends that people with novel H1N1 flu avoid contact with others as much as possible. They should stay home from work or school for 7 days after the onset of illness or until at least 24 hours after symptoms have resolved, whichever is longer.

Contamination & Cleaning

How long can influenza virus remain viable on objects (such as books and doorknobs)?
Studies have shown that influenza virus can survive on environmental surfaces and can infect a person for up to 2-8 hours after being deposited on the surface.

What kills influenza virus?
Influenza virus is destroyed by heat (167-212°F [75-100°C]). In addition, several chemical germicides, including chlorine, hydrogen peroxide, detergents (soap), iodophors (iodine-based antiseptics), and alcohols are effective against human influenza viruses if used in proper concentration for a sufficient length of time. For example, wipes or gels with alcohol in them can be used to clean hands. The gels should be rubbed into hands until they are dry.

What surfaces are most likely to be sources of contamination?
Germs can be spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth. Droplets from a cough or sneeze of an infected person move through the air. Germs can be spread when a person touches respiratory droplets from another person on a surface like a desk, for example, and then touches their own eyes, mouth or nose before washing their hands.

How should waste disposal be handled to prevent the spread of influenza virus?
To prevent the spread of influenza virus, it is recommended that tissues and other disposable items used by an infected person be thrown in the trash. Additionally, persons should wash their hands with soap and water after touching used tissues and similar waste.

What household cleaning should be done to prevent the spread of influenza virus?
To prevent the spread of influenza virus it is important to keep surfaces (especially bedside tables, surfaces in the bathroom, kitchen counters and toys for children) clean by wiping them down with a household disinfectant according to directions on the product label.

How should linens, eating utensils and dishes of persons infected with influenza virus be handled?
Linens, eating utensils, and dishes belonging to those who are sick do not need to be cleaned separately, but importantly these items should not be shared without washing thoroughly first.
Linens (such as bed sheets and towels) should be washed by using household laundry soap and tumbled dry on a hot setting. Individuals should avoid “hugging” laundry prior to washing it to prevent contaminating themselves. Individuals should wash their hands with soap and water or alcohol-based hand rub immediately after handling dirty laundry.

Eating utensils should be washed either in a dishwasher or by hand with water and soap.

Thus ends the two parts of the FAQ obtained from CDC. In the next post I will include a FAQ from a more local source that is more applicable to Malaysian.

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Swine Flu A (H1N1) Virus General FAQ

I know, I know, I'm a little slow. Pretty much everyone who intends to write about the A(H1N1) virus would have written it by now. Unfortunately I had been busy with lots of things lately but hey, this is for my own use as well so it doesn't really matter :P

I'm basically getting these FAQ from the CDC page, but just in case if they ever take down the page for whatever reason, at least I will still have it for my own reference. I will be breaking this FAQ into 2 parts. The first part will be about the characteristics of the virus as well as what is CDC doing about this outbreak, and the second part will more on prevention and treatment as well as contamination and cleaning.

Before I go into the FAQ, here are some useful links:

1. Here is where I get the FAQ from.

2. If you want updates on the virus, you can visit CDC website which will be updated on a regular basis.

3. For local (Malaysia) updates, The Star website does have a Swine Flu Watch, but not sure how often they update it as the last time it was updated was on the 29th April 2009. It does provide some more locally related FAQs.

Anyway, here it is, the FAQ obtained from CDC:

Questions & Answers

H1N1 Flu (Swine Flu) and You*

May 8, 2009 12:00 AM ET

Novel H1N1 Flu

What is H1N1 (swine flu)?
H1N1 (referred to as “swine flu” early on) is a new influenza virus causing illness in people. This new virus was first detected in people in the United States in April 2009. Other countries, including Mexico and Canada, have reported people sick with this new virus. This virus is spreading from person-to-person, probably in much the same way that regular seasonal influenza viruses spread.

Why is this new H1N1 virus sometimes called “swine flu”?
This virus was originally referred to as “swine flu” because laboratory testing showed that many of the genes in this new virus were very similar to influenza viruses that normally occur in pigs in North America. But further study has shown that this new virus is very different from what normally circulates in North American pigs. It has two genes from flu viruses that normally circulate in pigs in Europe and Asia and avian genes and human genes. Scientists call this a “quadruple reassortant” virus.

Novel H1N1 Flu in Humans

Are there human infections with this H1N1 virus in the U.S.?
Yes. Cases of human infection with this H1N1 influenza virus were first confirmed in the U.S. in Southern California and near Guadalupe County, Texas. The outbreak intensified rapidly from that time and more and more states have been reporting cases of illness from this virus. An updated case count of confirmed novel H1N1 flu infections in the United States is kept at http://www.cdc.gov/h1n1flu/investigation.htm. CDC and local and state health agencies are working together to investigate this situation.

Is this new H1N1 virus contagious?
CDC has determined that this new H1N1 virus is contagious and is spreading from human to human. However, at this time, it is not known how easily the virus spreads between people.

What are the signs and symptoms of this virus in people?
The symptoms of this new H1N1 flu virus in people are similar to the symptoms of seasonal flu and include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. A significant number of people who have been infected with this virus also have reported diarrhea and vomiting. Also, like seasonal flu, severe illnesses and death has occurred as a result of illness associated with this virus.

How severe is illness associated with this new H1N1 virus?
It’s not known at this time how severe this virus will be in the general population. CDC is studying the medical histories of people who have been infected with this virus to determine whether some people may be at greater risk from infection, serious illness or hospitalization from the virus. In seasonal flu, there are certain people that are at higher risk of serious flu-related complications. This includes people 65 years and older, children younger than five years old, pregnant women, and people of any age with chronic medical conditions. It’s unknown at this time whether certain groups of people are at greater risk of serious flu-related complications from infection with this new virus. CDC also is conducting laboratory studies to see if certain people might have natural immunity to this virus, depending on their age.

How does this new H1N1 virus spread?
Spread of this H1N1 virus is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing by people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.

How long can an infected person spread this virus to others?
At the current time, CDC believes that this virus has the same properties in terms of spread as seasonal flu viruses. With seasonal flu, studies have shown that people may be contagious from one day before they develop symptoms to up to 7 days after they get sick. Children, especially younger children, might potentially be contagious for longer periods. CDC is studying the virus and its capabilities to try to learn more and will provide more information as it becomes available.

Exposures Not Thought to Spread New H1N1 Flu

Can I get infected with this new H1N1 virus from eating or preparing pork?
No. H1N1 viruses are not spread by food. You cannot get this new HIN1 virus from eating pork or pork products. Eating properly handled and cooked pork products is safe.

Is there a risk from drinking water?
Tap water that has been treated by conventional disinfection processes does not likely pose a risk for transmission of influenza viruses. Current drinking water treatment regulations provide a high degree of protection from viruses. No research has been completed on the susceptibility of the novel H1N1 flu virus to conventional drinking water treatment processes. However, recent studies have demonstrated that free chlorine levels typically used in drinking water treatment are adequate to inactivate highly pathogenic H5N1 avian influenza. It is likely that other influenza viruses such as novel H1N1 would also be similarly inactivated by chlorination. To date, there have been no documented human cases of influenza caused by exposure to influenza-contaminated drinking water.

Can the new H1N1 flu virus be spread through water in swimming pools, spas, water parks, interactive fountains, and other treated recreational water venues?
Influenza viruses infect the human upper respiratory tract. There has never been a documented case of influenza virus infection associated with water exposure. Recreational water that has been treated at CDC recommended disinfectant levels does not likely pose a risk for transmission of influenza viruses. No research has been completed on the susceptibility of the H1N1 influenza virus to chlorine and other disinfectants used in swimming pools, spas, water parks, interactive fountains, and other treated recreational venues. However, recent studies have demonstrated that free chlorine levels recommended by CDC (1–3 parts per million [ppm or mg/L] for pools and 2–5 ppm for spas) are adequate to disinfect avian influenza A (H5N1) virus. It is likely that other influenza viruses such as novel H1N1 virus would also be similarly disinfected by chlorine.

Can H1N1 influenza virus be spread at recreational water venues outside of the water?
Yes, recreational water venues are no different than any other group setting. The spread of this novel H1N1 flu is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing of people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.

Response & Investigation

What is CDC doing in response to the outbreak?
CDC has implemented its emergency response. The agency’s goals are to reduce transmission and illness severity, and provide information to help health care providers, public health officials and the public address the challenges posed by the new virus. CDC continues to issue new interim guidance for clinicians and public health professionals. In addition, CDC’s Division of the Strategic National Stockpile (SNS) continues to send antiviral drugs, personal protective equipment, and respiratory protection devices to all 50 states and U.S. territories to help them respond to the outbreak.

What epidemiological investigations are taking place in response to the recent outbreak?
CDC works very closely with state and local officials in areas where human cases of new H1N1 flu infections have been identified. In California and Texas, where EpiAid teams have been deployed, many epidemiological activities are taking place or planned including:

• Active surveillance in the counties where infections in humans have been identified;
• Studies of health care workers who were exposed to patients infected with the virus to see if they became infected;
• Studies of households and other contacts of people who were confirmed to have been infected to see if they became infected;
• Study of a public high school where three confirmed human cases of H1N1 flu occurred to see if anyone became infected and how much contact they had with a confirmed case; and
• Study to see how long a person with the virus infection sheds the virus.

Who is in charge of medicine in the Strategic National Stockpile (SNS) once it is deployed?
Local health officials have full control of SNS medicine once supplies are deployed to a city, state, or territory. Federal, state, and local community planners are working together to ensure that SNS medicines will be delivered to the affected area as soon as possible. Many cities, states, and territories have already received SNS supplies. After CDC sends medicine to a state or city, control and distribution of the supply is at the discretion of that state or local health department. Most states and cities also have their own medicines that they can access to treat infected persons.

*Note: Much of the information in this document is based on studies and past experience with seasonal (human) influenza. CDC believes the information applies to the new H1N1 (swine) viruses as well, but studies on this virus are ongoing to learn more about its characteristics. This document will be updated as new information becomes available.

For general information about swine influenza (not new H1N1 flu) see Background Information about Swine Influenza.

There you have it. First part of the FAQ. Will post 2nd part asap.

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Can't Take This Sh*t No More!!? (A Remedy For Diarrhoea)

Recently I just received another forwarded email about some kind of magical remedy for some kind of ailment. This time, it is for diarrhoea.

This caught my attention straight away because for most of my life, I've been having a very sensitive bowel. Having diarrhoea can sometimes be a daily event for me. Not only that, after becoming a parent, it's sometimes quite scary when your little ones have severe diarrhoea, not to mention the horror of cleaning them up after that, especially if you're using cloth nappy LOL! Of course, after we know for sure that something is not right, we will let them wear disposable for the rest of the day, but still, the smell is almost unbearable.

According to the email, the very simple, and more importantly, perfectly safe remedy, is rice water. My wife and I heard of it before but we didn't really take it seriously. Anyway I will copy and paste the whole email below. I will also include an article from Rehydration Project that was mentioned in the email. Hope you find these information useful.


"> > Subject: Fw: Diarrhoea

Drinking sugar dilute in water also makes a simple and quick remedy!

With recent case on the Geylang Serai food poisoning out break.. would like to share the info received from a friend pls read on it may be of help...

When someone gets diarrhoea, sometimes the solution is so easy, we wonder why anyone has to suffer.

The secret is in rice water.

This is already known in this region. Ask your maids -- Sri Lankan, Indonesian, Filipina and they would know about it.

(My mother) knew about it. When Dr Albert Winsemius came to Singapore or a farewell and thank you dinner in his honour, he brought along his wife Aly and his granddaughter, Jolijn. Both women came down with very bad gastroenteritis. They saw the doctor who gave them medication. It was slow to work.

Mother boiled some rice in lots of water and went to their hotel with two 1.5L bottles of rice water.

I cringed in shame at the offer of this folk remedy, which seemed so primitive to me. Never heard of this cure before. To my surprise, it worked, and they were even able to go out for dinner the next day. Both were exclaiming how the rice water did the trick of making them well again. Well, lucky it worked, I thought to myself.

I was discussing this some years back with Kim Ng, the ex-matron of KK Hospital. She said, yes, that is what Professor Wong Hock Boon, the notable paediatrician teaches.. I was shocked and made some comment how could he? It was common knowledge so what had he to do with it?

Many months later, I regretted laughing at it. Dr Christina Shanta Emmanuel, who is the CEO of...uh, which group I have forgotten. Either National Health Group, or Polyclinics, or whatever.. regarded me seriously when I brought up the topic like it was good fun. She said that Prof Wong Hock Boon had presented a paper on it. At some conference. After he had done clinical trials.

Then his results were published in the Lancet, the Medical Journal all doctors read. In fact, said Shanta, he was credited for saving the lives of 2 million African babies by this method.

Ah, so! I am impressed.

It is rice water and not rice, that does the trick. I have found it effective again and again. You take a handful of rice and boil it in a large saucepan with lots of water. Like three or four large glasses. Then you cool that and drink the water. If you are in a hurry to relieve the ailing person, take the saucepan off the fire and dunk it in a frying pan or basin of cool water with ice cubes if necessary.

This gives the patient a chance to drink the rice watersooner and cure himself or herself sooner.

When drinking the rice water, make sure there is lots of it. You have to tell the patient that enough water must go in to line your guts from throat to other end, all 10 to 12 metres of it. If you take rice, it stays in the stomach. If you take broth, some of it may go into the small intestine.

But if you take rice water, it will carry rice grains to every inch of your small and large intestine to the end where the problem is.

How does it work? Even Prof Wong Hock Boon doesn't know. Read the attached file. Or go to
*http://rehydrate.org/dd/dd06.htm#page2*

It is good to pass on the news to everyone you know because the complaint is so common and people suffer unnecessarily. You would be doing your friends a great favour to relieve them of their misery when the occasion arises."

You can visit the link above to read the article, or you can just read it here :P

"Rice water and diarrhoea

The advantage of using rice water is that rice is cooked daily in South East Asia. WHO photograph by Dr Gramiccia In South East Asia, rice is prepared in two ways - to produce either dry, cooked rice or, with extra water, rice porridge. This leaves a fluid (rice water) on top of the cooked rice grains. Professor Wong Hock Boon, a paediatrician working in Singapore, has been using rice water to rehydrate babies for several years. If the babies are bottle-fed rice water is given exclusively for the first 24 hours of treatment - breastfeeding can continue as normal (1). Professor Wong and his colleagues have found that many babies who have not responded to other rehydration solutions respond well to rice water. If diarrhoea starts again with the re-introduction of milk, extra rice water is given with additional rice porridge. Older babies are sometimes given rice porridge alone.

The means by which rice water helps to stop diarrhoea are still being researched. One explanation could be that starch-like sugars tend to draw less fluid out of the body and into the gut compared with a similar amount of simple sugar such as glucose. Some babies with diarrhoea can digest starch more easily than simple sugars. The International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B) is carrying out studies on the inclusion of locally available starches (such as rice starch) as the carbohydrate in oral rehydration solution.

As Professor Wong stresses, the advantage of using rice water is that rice is cooked daily in South East Asia. The rice water is boiled and does not have to be made up and kept in large quantities as is frequently the case with sugar-salt rehydration solutions.

If you would like more information about the use of rice water for rehydration, write to: Professor Wong Hock Boon, National University of Singapore, University Department of Paediatrics, Singapore General Hospital, Outram Road, Singapore.

For information on ICDDR, B's work on locally available starches, write to: Library and Publication Unit, International Centre for Diarrhoeal Disease Research, Bangladesh, G.P.O. Box 128, Dacca-2, Bangladesh.

(1) Wong H B 1981 Rice water in treatment of infantile gastroenteritis. The Lancet vol 2: 102-103."

Please Share: For those who have tried this method, or have heard of stories and testimonies, please do not hesitate to share with us.

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Shit Happens, and lots of it! (Oh the smell!)

My youngest son, the 2 1/2 year old, is having the worst diarrhoea (or diarrhea depending on where you're from) that our kids had ever had. Even the worst that my 6 yo experienced was nothing like this. That being said, we thank God that there's still no need for him to be hospitalized. One thing that I could never understand though, is how can such disgusting, terribly foul smelling stuff comes out of such a cute tiny little body?? Even the fart! Oh me oh my, LOL!! Well, I guess shit happens, but that's not the end of it. The next day, it was my turn to have diarrhoea, about as bad as his but I dare say no where near as foul smelling as his. Then the day after, it was my mom's turn (she is staying with us). Like I said, lots of shit happened, and will probably continue on for another day or two.

Let's talk about my son since I'm most worried about him. His stool was very watery and every time after he drank some water, he passed it out almost immediately. I guessed that's the reason why it's recommended for them to take sips of water. The first night that he had diarrhoea, he soiled easily about 8 heavy diapers.

We got pretty worried, so the next day we decided to get some Oral Rehydration Salt (ORS). Can be obtained easily from any pharmacy. Just add one packet to 8 oz (240 ml) of water (or according to what the instruction says) and shake well. We used a water tumbler and let him take small sips through out the day. You can also use a bottle for younger children. He's acting well, still playing, active, but gets tired easily, didn't have much of an appetite and was eating less than usual, but we weren't really worried about that as long as he is well hydrated.

Today is the third day for him (and 2nd for myself). I pray tomorrow we'll all be fine. One thing though, all my life I always thought that diarrhoea is not contagious, until about 4 years ago, when a doctor told me otherwise. Well, I guess diarrhoea itself is not contagious but the microorganism that causes it is. So always practice proper hygiene especially after changing a soiled diaper, or you may find yourself, or another member in your family, follow suit with the slam dunking action.

Since my wife is just over 3 months pregnant, she was quite worried that she may catch it too. So in her visit to her gynaecologist today, she asked about it, and the doctor said that once or twice of soft stool is ok, if it's more severe, she better get it treated. The doctor was afraid that too much stress and strain may cause her to pass out the foetus!! LOL! Lucky she asked as she may very well catch it. Guess her paranoia pays off eh.

To learn more about diarrhoea (especially in young children) and dealing with dehydration, you can visit the sites below:

1. Rehydration Project

2. Babycentre

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Pica?!!

My wife was a quite worried about eating seafood as she is in the first trimester and some seafood is known to contain high levels of mercury, and so I did a google search on it. As I was reading an article about eating during pregnancy from KidsHealth, at the food cravings section, I came across this word - Pica.

What in the world is Pica?? The only Pica I know is the noise that Pikachu made in Pokemon LOL! So I clicked on the link and this is what I learnt:-

Pica is an eating/medical disorder (it's also a unit of measurement, but that's not what I'm talking about) characterized by having an appetite mostly for nonfood or non-nutritive items which can also include food ingredients.

While it's normal for young kids to put various items into their mouth (most kids do that at some point in time) since it's how they explore and learn about their surroundings, kids with Pica goes beyond innocent exploration and it's characterized by persistant and complusive cravings.

Pica can be seen in young children (especially those who are developmentally disabled), pregnant women (as food cravings), people with epilepsy and also in animal (mostly dogs). It can last for one month or longer.

Here are some examples of nonfood items people with Pica normally crave or consume (source: KidsHealth):-
- dirt
- clay
- paint chips
- plaster
- chalk
- cornstarch
- laundry starch
- baking soda
- coffee grounds
- cigarette ashes
- burnt match heads
- cigarette butts
- feces
- ice
- glue
- hair
- buttons
- paper
- sand
- toothpaste
- soap

Below is a picture of items found in a pica patient's stomach (picture obtained from Wikipedia)

1,440 items found in a patient suffering from Pica

Ewww!! We learn new things everyday, and I learned that we're living in a crazy world that's always full of surprises LOL!!

To read more about Pica such as signs and causes of it; treatment etc, please visit the sites below for more information.

References:
1. Wikipedia
2. KidsHealth

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War On Dengue (& Chikungunya)

As far as parenting is concern, some news just doesn't sit right with me. For example:

Taken from http://thestar.com.my/news/story.asp?file=/2009/1/20/nation/3065279&sec=nation
Tuesday January 20, 2009

War on dengue
By LOH FOON FONG and AUDREY EDWARDS

PETALING JAYA: The Health Ministry has declared war on dengue following an alarming rise in cases and related deaths in the first two weeks of the year.

Minister Datuk Liow Tiong Lai also raised an alarm against chikungunya, which has seen a sharp rise in the number of cases from last year.

Liow, who described the spike in cases as “unusual”, warned that the situation could worsen if there was not enough co-operation from all parties involved.

Go here for the full story.

After almost 6 years of being parents, one thing still freaks my wife and I out, sometimes a little, and sometimes a lot, is when our kids fall sick. If you're living in Malaysia, especially in Kuala Lumpur (Wilayah Persekutuan) and Selangor area, dengue fever is something that we're always watching out for.

But wait, I know about dengue fever, but what in the world is this Chikungunya virus they are talking about? Well if you have not read about it, the Aedes mosquito is the carrier of both Dengue and Chikungunya virus.

First, let's take a look at the little buggers,

From Wikipedia:
The yellow fever mosquito, Aedes aegypti (=Stegomyia aegypti, =Aedes (Stegomyia) aegypti), is a mosquito that can spread the dengue fever, Chikungunya and yellow fever viruses, and other diseases as well. The mosquito can be recognized by white markings on legs and a marking of the form of a lyre on the thorax. The mosquito originated from Africa^[1] but is now found in the tropics worldwide^[2].

Aedes Mosquito - See it, Fear it, KILL IT!

Aedes mosquitoes are most active early morning and late evening. Avoid bringing your child/children out at those times and avoid bringing them to crowded places as the mosquitoes spread the diseases through bites. I know it's kinda hard sometimes, but at least try avoiding public places such as shopping complexes that you know have a lot of mosquitoes, especially at places with high dengue cases.

Quick facts on Dengue and Chikungunya:

To make it easier for you to read, I've compiled information about Dengue Fever and Chikungunya I collected from various sources and tabulated it. Hope this is helpful. I will provide the links to the sources at the end of this post so that you can go and read more about it.

	Dengue Fever	Chikungunya
Incubation Period	Approximately 4 days	Ranging from 3 - 12 days, usually 3 - 7 days
Signs & Symptoms	Sudden burst of continuous high fever (3 - 7 days) Red rashes on skin (may appear as fever reduces) Acute pain in bones, muscles, joints, eye-balls and head Loss of appetite Vomiting Stomach Pain Bleeding from body, nose and mouth	Sudden onset of high fever Redness with rashes appearing on the hand, leg and body Headache Severe joint pains Nausea and vomiting Redness of the eyes Fever can occur for a period from 1 - 7 days (usually 5 days) (Commonly mistaken for dengue fever)
Rush to hospital when	High fever with bleeding symptoms Suspect Dengue Haemorrhagic Fever (DHF)(Severe Dengue with complications) Blood spots under the skin (petechiae) Bleeding from gums Nose Bleeding (epistaxis) Vomiting blood (hematemesis) when acompanying normal dengue symptoms	In Malaysia, Chikungunya has never been reported as causing haemorrhage ordeath
Care & Treatment	No specific treatment, must let it run it's course Use supportive care - pain relief, drink fluids, rest - Use Panadol (paracetamol) - Do NOT use aspirin (salicyclic acid) - Do NOT use ibuprofen Watch out for bleeding symptoms (DHF)	No specific treatment treated symptomatically (treating for specific symptoms) Majority need only outpatient treatment
Vaccine	No vaccine	No vaccine
Immunity	There are four types of dengue viruses DEN1, DEN2, DEN3 & DEN4. A person infected with one type of dengue will subsequently only be immune to that type. They will not be immune to other types of dengue and will, in fact, be at risk of developing severe symptoms if they contract another type of dengue.	Most patients who have been infected will be immune for life.
Is it Contagious?	It is not contagious, in other words one human can't directly pass to another human. However an aedes mosquito after biting an infected person can transmit the disease by biting someone else	Same as dengue

One of the best way to battle these diseases is to prevent the Aedes mosquitoes from breeding. Click the below flyers/posters provided by http://www.infosihat.gov.my to learn how to do it.

Chikungunya

Dengue Fever

Dengue Fever

References:
Do visit these sites for more information on Dengue Fever and Chikungunya:
1. Wikipedia (on Aedes Aegypti)
2. Info Sihat (for both diseases)
3. World Health Organisation (WHO) (for Dengue Fever)
4. Queensland Government website (for Dengue Fever)
5. www.stanford.edu/group/virus/flavi/2000/dengue.htm (for Dengue Fever)
6. diabetescare.yoscare.in/content/chikungunya-what-you-must-know (for Chikungunya)

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Impossible Morning Sickness??!!

I've heard of stories where the pregnant wife asked the husband to go out hunting for THE food of their desire (cravings) very late at night, or very early in the morning depending on how you look at it (I'll share a funny story in my next post); I've also heard of stories where the morning sickness is so bad that the wife just didn't feel like eating anything. How about a wife who's experiencing morning sickness and feels sensitive to most of the food, and still feel very hungry most of the time??

HOW, OH HOW, CAN I SATISFY MY WIFE??? WHAT SHOULD I DO???

Just the smell, and sometimes, just by thinking about some food, is enough to make her nauseous, and she also gets hungry pretty frequently. When I asked her if she's craving for any food or what does she feel like eating, she usually can't think of anything. Occasionally she may thought of something, but most of the time, nothing. And if I don't fill her stomach quick enough, she'll get nauseous again because being too hungry makes her want to vomit. Argh!!! Thank God she is someone who will try her best to make do with what's available to her, such as a cup of Milo with a few pieces of cream crackers or cereal, but it makes me feel helpless not being able to do anything for her.

Cream Crackers - believed to be good for combating morning sickness. Munch 1 or 2 pieces when you feel nauseous, it may help you to feel better.

Please Share: Feel free to share or leave a comment if you have any suggestions or advice for ME!! LOL! Or just share about your experiences. I'll be more than happy to hear them :)

For those who have not experience morning sickness, don't get me wrong, it's NOT a bad thing. Granted it's not a good feeling, and despite it's name (which is rather misleading), unfortunately morning sickness does not occur only in the morning but can affect you at any time of the day, and to some people is an all-day affair. Different people will have a different experience. Some mothers did not feel anything througout the whole duration of pregnancy (the lucky ones), some have mild discomfort and some are affected very badly. It also does not necessary last through out the whole pregnancy. Like for my wife, usually after the 1st trimester she will start feeling better. There are of course some unlucky ones who suffered from severe morning sickness throughout pretty much the whole 9 months.

Scary as it may sound, some people believes that having morning sickness usually means that your baby is healthy and growing well. According to Wikipedia, studies have shown that women who suffers from morning sickness are less likely to have miscarriages or to give birth to a baby with birth defects. There are of course doctors who disagree with it. Go and read more about it here. HOWEVER, not having any morning sickness does NOT mean that there's anything wrong with your pregnancy. I've met people who did not suffer from morning sickness but still gave birth to beautiful babies.

Moral of the story: Do your routine check up and listen to your gynecologist. Don't worry about having or not having any morning sickness. As long as you do your check ups, or if you are in doubt, just go to your doc, I'm sure he/she will tell you if there's anything wrong, and if the sickness is really bad, I'm sure your doc will be able to help you out by giving some anti-nausea medication.

To read more about morning sickness, you can look up Wikipedia. Another site that offers good and simple to understand information is www.morningsicknesshelp.com. Granted they are also trying to sell their products, but no harm in checking out good info.


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