The past three years the holidays have been clouded with pandemic concerns. Now, with COVID, the flu and RSV circulating—what should folks look out for at gatherings?
The Sacramento Bee service journalism team posed the same questions to three California hospitals. The following doctors provided emailed responses:
- Dr. Matthew Eldridge, chief of infectious diseases for Kaiser Permanente South Sacramento
- Dr. Dean Blumberg, chief of pediatric infectious disease at UC Davis
- Dr. Namrita Gogia, vice chair of internal medicine and COVID-19 czar at Dignity Health
Here is what they had to say,
The following has been edited for clarity and brevity.
Is it safe to gather indoors—or should we head outside?
Eldridge: Gathering outdoors is safer than indoors; if there is an indoor gathering you want the space to be well ventilated—open doors and windows, run HVAC systems, and install high-quality air filters. Properly worn masks remain an effective option to reduce the risk of respiratory viral infections.
Blumberg: Events outdoors will be safer, but this may be uncomfortable or not feasible due to the weather.
Gogia: I think it really depends on the amount of risk that each individual and family is willing to tolerate. Overall, I think it’s reasonable to gather indoors.
Is a potluck-style gathering safe?
Eldridge: Potluck style can be done safely, but you may want to limit everybody touching the same foods and of course people should wash their hands before eating.
Blumberg: No problem at all. COVID and influenza are primarily transmitted via the respiratory route, and RSV is transmitted via large droplets, which means touching contaminated serving utensils may result in transmission. But food is not a risk for transmission of these viruses. To reduce risk of RSV transmission, you can carry a small container of hand sanitizer and use it after serving yourself with shared utensils prior to eating.
Gogia: Many of the illnesses we are seeing this season are respiratory illnesses, so whether the food is served potluck style or plated, it should be fine.
If someone is sick with the flu—not COVID—should they gather?
Eldridge: If someone is sick with the flu then they can readily infect others. People with the flu should isolate at home until they have no fever for at least 24 hours.
Blumberg: No way. Influenza is no treat and may result in serious illness or death. Those ill with the flu should stay home until they are clinically improved and without a fever for at least 24 hours, generally 4-5 days after symptom onset.
Gogia: It is recommended that those who aren’t feeling well or have any upper respiratory symptoms such as a runny nose, cough, fevers, chills, nausea, body aches, or sore throat stay home.
What tips do you have those hosting a holiday gathering?
Eldridge: In terms of how to gather safely, the same approaches that were relevant to COVID these past few years still apply. As noted by public health agencies, there are clear ways to reduce the spread of disease or decrease the severity of illness.
- Getting the yearly flu vaccine and COVID boosters. These are ok to receive at the same time.
- Stay home if you’re sick, or if you feel under the weather, and be sure test for COVID
- Wash your hands often
- Consider testing for COVID before gathering
- If gathering indoors, try to open windows and doors to ensure good air flow through the room. Consider running the HVAC system with high quality air filters.
- Flu testing is not recommended for everyone but is important for certain high-risk groups. Talk to your provider if you’re unsure if you should test for flu. RSV testing is not required for most people.
Blumberg: Make sure that everyone at home is fully vaccinated with indicated boosters for COVID and influenza, and request that your guests also be fully vaccinated. Anyone who has a fever or respiratory symptoms should opt out of the gathering so that others are not at risk of infection. For those who want to reduce the risk further, request that all attendees test for COVID the day of the event to make sure that those with asymptomatic infection stay away to further reduce transmission.
Gogia: This holiday season, I encourage my patients to gather with their family, friends, and loved ones. That being said, nobody wants to be the host of a super spreader event! Hosts can consider asking those attending to refrain from coming if they have any upper respiratory symptoms. If possible, have the event in an outdoor area or an open area with good ventilation. In some situations, for example, if an elderly or immunocompromised person will be in attendance, it may be ideal to ask those attending the event to test beforehand.
What are your tips to those participating in holiday parties and how should they prepare?
Eldridge: Same as above.
Blumberg: Be fully vaccinated and stay home if you are sick. For those who become symptomatic after a large gathering, are quick to test for COVID—and if the COVID test is negative —then consider getting a test for influenza if you are interested in starting antiviral treatment since this is most effective if started within 48 hours of symptom onset. (And for those who may be drinking a lot, stay hydrated!)
Gogia: After the event, if they develop any symptoms of an upper respiratory infection, they should stay home and test for COVID-19. They can do a rapid test at home when symptoms begin and, if negative, test again in 48 hours to reduce the risk of missing an infection and spreading it to others.
Is there anything else you would like to add?
Eldridge: We encourage everyone at the individual level to do what they can to protect themselves and others. We urge people to receive their flu vaccines and their COVID-19 vaccinations/boosters, which continue to protect against severe illness and death. And we continue to recommend wearing masks and social distancing, especially during surges in indoor spaces amongst other people. These measures help protect the most vulnerable in our communities from COVID-19 disease.
Blumberg: I didn’t mention masking for these situations since it is less practicable when people will be eating and drinking. But masking is also proven to reduce risk of COVID, influenza and RSV so can be considered if feasible.
©2022 The Sacramento Bee.
Distributed by Tribune Content Agency, LLC.
Are indoor holiday parties safe as COVID, flu and RSV spread? Three experts provide answers (2022, December 21)
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Good Dental Health Essential in Sickle Cell Anemia, Study Finds |… – Sickle Cell Anemia News
Good oral health is essential in people with sickle cell anemia (SCA), according to a new study from Saudi Arabia that found that several disease-causing bacteria species — including Enterobacteriaceae — were significantly more abundant in a group of patients with poorer dental health than in those with better oral care.
“A healthy mouth has a balance of bacteria, but inadequate oral health narrows the range of bacteria, resulting in oral dysbiosis, a state in which beneficial bacteria decrease and potentially pathogenic [disease-causing] bacteria increase,” the researchers wrote.
The findings also indicated that patients with low levels of hemoglobin F — a type of hemoglobin normally produced during fetal development — had a significantly higher prevalence of harmful bacteria species than those who had higher levels of the protein.
“Our data further emphasise the importance of routine oral hygiene visits for patients with SCA,” the team wrote, adding, “This is especially important for patients with SCA and low [hemoglobin F], who have a higher probability of hospitalisation and clinical complications compared to patients with SCA and high [hemoglobin F].”
The research’s findings were reported in “Oral microbiota analyses of Saudi sickle cell anemics with dental caries,” a study published in the International Dental Journal.
Examining good versus poor dental health in SCA
Sickle cell disease (SCD) is caused by mutations in the HBB gene that lead to the production of a faulty version of hemoglobin, the protein in red blood cells that is responsible for carrying oxygen through the body. This faulty version is called hemoglobin S.
People with sickle cell anemia or SCA, the most common and often the most severe form of SCD, have two faulty gene copies encoding hemoglobin S.
Complications of dental caries or tooth decay, including acute pain, are often observed in patients with SCA — and have been associated with poor quality of life.
In a healthy mouth, different bacteria species co-exist in a balanced ratio. However, in cases of inadequate oral health, the number of beneficial bacteria decreases, while that of potentially harmful ones increases. This can lead to dental caries, which often result in cavities and other oral health problems.
“Although ample evidence indicates a causative correlation between the disruption of the oral [bacteria] and dental caries, the effect in SCA has not been investigated,” the researchers wrote.
Now, a team from the Netherlands and Saudi Arabia conducted a study to examine oral bacteria composition in people with SCA. Their aim was to compare bacteria species in patients with a high decayed, missing, and filled permanent teeth (DMTF) index — a measure of dental health — compared with others who had a low index.
In addition, they evaluated the effect of hemoglobin F levels on bacterial composition by comparing the profiles of patients with low and high levels of the protein. Fetal hemoglobin or hemoglobin F is considered a major modulator of disease severity in SCA.
This type of hemoglobin normally is found in fetuses and newborn babies, but is typically replaced by another hemoglobin variant after birth. However, hemoglobin F is more effective at transporting oxygen than its adult counterpart, and may, therefore, help to counteract the harmful effects of hemoglobin S on blood flow and oxygen transport.
In some individuals, the levels of hemoglobin F remain relatively high during childhood, and only start to decline later on in life, rather than immediately after birth.
High levels of Enterobacteriaceae bacteria found
This new study was conducted in the Eastern Province of Saudi Arabia, where the disease is highly prevalent. It included 100 patients, ages 5–12, from whom saliva was collected.
Among the patients, 27 had high dental caries — reflected by a high DMTF index of five points or more — and 73 had low dental caries, indicated by a low DMTF index of four points or fewer.
The research team identified 416 bacteria species in the patients’ samples. When analyzing their prevalence, seven were found to be significantly more abundant in patients with a high DMTF index than in those with a low index.
In addition, eight bacteria species were found to be significantly more prevalent in patients with low hemoglobin F levels compared with those with high levels of the protein.
In particular, the Enterobacteriaceae bacteria species, which have been associated with severe infections and high rates of antibiotic resistance, were found in great abundance in both patient groups, being the most significantly abundant bacteria species among those with low levels of hemoglobin F.
“It has been suggested that the presence of the Enterobacteriaceae species in the oral cavity is favoured when an individual’s immunity is compromised,” the researchers wrote, adding that “patients with SCA are immunocompromised.”
Overall, these findings indicate that Saudi SCA patients with poorer dental health and low levels of hemoglobin F have a higher predominance of harmful bacteria in their mouth.
Our data further emphasise the importance of routine oral hygiene visits for patients with SCA.
“Our results provide a valuable addition to the global microbiome reference data set in an underexamined community,” the researchers wrote, adding, “These efforts are essential and warranted given the scarcity of [bacteria composition] data in Middle Eastern populations.”
Nevertheless, a study with a large sample size evaluating how oral bacterial species can relate to dental caries in SCA patients is required, the team noted.
The researchers said their findings indicate the important of good dental health in people with sickle cell anemia, given that the bacteria species otherwise found “are thought to drive the development and progression of dental caries.”
Good Oral Health Crucial in People with Sickle Cell Anemia, Study Finds – Oral Health
A new study from Saudi Arabia found that good dental health is vital for people with sickle cell anemia (SCA). The findings observed that multiple disease-causing bacteria were seen much more in the patients with poorer oral health than those with better oral health.
Patricia Valerio, PhD, noted, “The findings also indicated that patients with low levels of hemoglobin F – a type of hemoglobin normally produced during fetal development – had a significantly higher prevalence of harmful bacteria species than those who had higher levels of the protein.”
This research shows how important good oral hygiene is for patients with SCA and low hemoglobin F.
Respiratory viruses on decline: Province – Brandon Sun – The Brandon Sun
Hospitalizations due to influenza, COVID-19 and respiratory syncytial virus (RSV) have all decreased in Manitoba, according to the province’s latest epidemiological respiratory virus surveillance report.
Data for the week of Jan. 15 to Jan. 21 indicates this respiratory virus season may finally be nearing its end, after it began earlier than usual and caused surges of severe illness and hospitalizations, particularly among babies and toddlers.
There were two flu-related hospital admissions that week, none requiring intensive care, while the Influenza A test positivity rate fell to 0.8 per cent, compared with 1.9 per cent the previous week. No cases of Influenza B have been detected provincially yet this season.
There were 105 detected cases of RSV, with a weekly RSV test positivity rate of 8.3 per cent. The previous week, the test positivity rate for RSV was 8.7 per cent.
There were seven patients with COVID-19 in hospital, as well as three in intensive care. No new COVID deaths were reported, but the province retroactively updated its COVID-19 death toll. There were 15 deaths added to the total count last week, for an overall number of 316 Manitobans who lost their lives to COVID since this fall.
» Winnipeg Free Press
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