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May 26, 2020

Not all birth defects can be prevented, but a woman can take some actions that increase her chance of having a healthy baby. Many birth defects happen very early in pregnancy, sometimes before a woman even knows she is pregnant. Remember that about half of all pregnancies are unplanned.

ABC’s…Pregnancy Tips (A-Z)

A – Avoid exposure to toxic substances and chemicals — such as cleaning solvents, lead and mercury, some insecticides, and paint. Pregnant women should avoid exposure to paint fumes.

B – Be sure to see your doctor at Belize Medical Associates and get prenatal care as soon as you think you’re pregnant. It’s important to see your doctor regularly throughout pregnancy, so be sure to keep all your prenatal care appointments.
and…
Breastfeeding is the healthiest choice for both you and your baby. Talk to your doctor, your family and friends, about how you choose to feed your baby and how they can support you in your decision.

C – Cigarette smoking during pregnancy can result in low birth weight babies. It has been associated with infertility, miscarriages, tubal pregnancies, infant mortality and childhood morbidity. Additionally, cigarette smoking may cause long-term learning disabilities. If you smoke, you should try to quit. Secondary smoke may also harm a mother and her developing baby.

D – Drink extra fluids (water is best) throughout pregnancy to help your body keep up with the increases in your blood volume. Drink at least 6 to 8 glasses of water, fruit juice, or milk each day. A good way to know you’re drinking enough fluid is when your urine looks like almost-clear water or is very light yellow.

E – Eat healthy to get the nutrients you and your unborn baby need. Your meals should include the five basic food groups. Each day you should get the following: 6-11 servings of grain products, 3-5 servings of vegetables, 2-4 servings of fruits, 4-6 servings of milk and milk products, 3-4 servings of meat and protein foods. Foods low in fat and high in fiber are important to a healthy diet.

F – Folic acid. Your doctor will prescribe folic acid daily both before pregnancy and during the first few months of pregnancy to reduce the risk of birth defects of the brain and spine. All women who could possibly become pregnant should take a vitamin with folic acid, every day. It is also important to eat a healthy diet with fortified foods (enriched grain products, including cereals, rice, breads, and pastas) and foods with natural sources of folate (orange juice, green leafy vegetables, beans, peanuts, broccoli, asparagus, peas, and lentils).

G – Genetics. It’s important to know your family history. If there have been problems with pregnancies or birth defects in your family, report these to your doctor.

H – Hand-washing is important throughout the day, especially after handling raw meat or using the bathroom. This can help prevent the spread of many bacteria and viruses that cause infection.

I – Iron. Your doctor will prescribe iron during your pregnancy to reduce the risk of anemia later in pregnancy. All women of childbearing age should eat a diet rich in iron.

J – Join a class on parenting or childbirth.

K – Know your limits. Let your physician at Belize Medical Associates know if you experience any of the following: pain of any kind, strong cramps, uterine contractions at 20-minute intervals, vaginal bleeding, leaking of amniotic fluid, dizziness, fainting, shortness of breath, palpitations, tachycardia (rapid beating of the heart), constant nausea and vomiting, trouble walking, edema (swelling of joints), or if your baby has decreased activity.

L – Legal drugs such as alcohol and caffeine are important issues for pregnant women. There is no safe amount of alcohol a woman can drink while pregnant. Fetal alcohol syndrome, a disorder characterized by growth retardation, facial abnormalities, and central nervous system dysfunction, is caused by a woman’s use of alcohol during pregnancy. Caffeine, found in tea, coffee, soft drinks and chocolate, should also be limited. Be sure to read labels when trying to cut down on caffeine during pregnancy. More than 200 foods, beverages, and over-the-counter medications contain caffeine!

M – Medical conditions/complications such as diabetes, epilepsy, and high blood pressure should be treated and kept under control. Ask your doctor at Belize Medical Associates about any medications that may need to be changed or adjusted during pregnancy. If you are currently taking any medications ask your doctor if it is safe to take them while you’re pregnant. Also, be sure to discuss any herbs or vitamins you are taking. They are medicines, too! Discuss with your doctor at Belize Medical Associates all medications, prescribed and over-the-counter, that you are taking.

N – Never be afraid to ask your doctor at Belize Medical Associates questions about your health. It is better to take all precautions and discuss any questions or concerns you may have.

O – Over-the-counter cough and cold remedies may contain alcohol or other ingredients that should be avoided during pregnancy. Ask your doctor at Belize Medical Associates about prescription or over-the-counter drugs that you are taking or may consider taking while pregnant.

P – Physical activity during pregnancy can benefit both you and your baby by lessening discomfort and fatigue, providing a sense of well-being, and increasing the likelihood of early recovery after delivery. Light to moderate exercise during pregnancy strengthens the abdominal and back muscles, which help to improve posture. But always check with your doctor at Belize Medical Associates before beginning any kind of exercise, especially during pregnancy.

Q – Queasiness, stomach upset and morning sickness are common during pregnancy. Foods that you normally love may make you feel sick to your stomach. You may need to substitute other nutritious foods. Eating five or six small meals a day instead of three large ones may make you feel better.

R – Read about and make plans to baby-proof your home. These are important tips for making your home a safer environment for your baby.

S – Shopping. Be sure to purchase all the things you will need for your pregnancy.

T – Toxoplasmosis is an infection caused by a parasite that can seriously harm an unborn baby. Avoid eating undercooked meat and handling cat litter, and be sure to wear gloves when gardening.

U – Uterus size increases during the first trimester, which, along with more efficient functioning of your kidneys, may cause you to feel the need to urinate more often. You may also leak urine when sneezing, coughing or laughing. This is due to the growing uterus pressing against your bladder, which lies directly in front of and slightly under the uterus during the first few months of pregnancy. If you experience burning along with frequency of urination, be sure to tell your doctor.

V – Vaccinations are an important concern for pregnant women. Get needed vaccines before pregnancy. Belize Medical Associates has clear guidelines for the use of vaccines during pregnancy. Be sure to discuss this with your doctor.

W – Being overweight or underweight during pregnancy may cause problems. Try to get within 15 pounds of your ideal weight before pregnancy. Remember, pregnancy is not a time to be dieting! Don’t stop eating or start skipping meals as your weight increases. Both you and your baby need the calories and nutrition you receive from a healthy diet. Be sure to consult with your doctor at Belize Medical Associates about your diet.

X – Avoid X-rays. If you must have dental work or diagnostic tests, tell your dentist or physician that you are pregnant so that extra care can be taken.

Y – Your baby loves you, and you should show your baby that you love her, too. Give your baby a healthy environment to live in while you are pregnant. Infants and children require constant care and guidance. Their health and safety should be carefully watched at all times.

Zoo – Get your ZZZZZZZZZ’s…Be sure to get plenty of rest… Resting on your side as often as possible, especially on your left side is advised, as it provides the best circulation to your baby and helps reduce swelling.

Please consult your doctor at Belize Medical Associates on any and all issues regarding your pregnancy. Although these may be good general pregnancy tips, every pregnancy is different, and each deserves the attention of a doctor.

Submitted by:  Dr. Marcelo Coyi
Gynecologist/Obstetrician
Belize Medical Associates

May 26, 2020

What is swine flu?

Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza viruses that causes regular outbreaks in pigs. People do not normally get swine flu, but human infections can and do happen. Swine flu viruses have been reported to spread from person-to-person, but in the past, this transmission was limited and not sustained beyond three people.

Is this swine flu virus contagious?

CDC has determined that this swine influenza A (H1N1) virus is contagious and is spreading from human to human. However, at this time, it not known how easily the virus spreads between people.

What are the signs and symptoms of swine flu in people?

The symptoms of swine flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and vomiting associated with swine flu. In the past, severe illness (pneumonia and respiratory failure) and deaths have been reported with swine flu infection in people. Like seasonal flu, swine flu may cause a worsening of underlying chronic medical conditions.

How does swine flu spread?

Spread of this swine influenza A (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 of people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.

How can someone with the flu infect someone else?

Infected people may be able to infect others beginning 1 day before symptoms develop and up to 7 or more days after becoming sick. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick.

What should I do to keep from getting the flu?

First and most important: wash your hands. Try to stay in good general health. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food. Try not to touch surfaces that may be contaminated with the flu virus. Avoid close contact with people who are sick.

Are there medicines to treat swine flu?

Yes. CDC recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with these swine influenza viruses. 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. For treatment, antiviral drugs work best if started soon after getting sick (within 2 days of symptoms).

How long can an infected person spread swine flu to others?
People with swine influenza virus infection should be considered potentially contagious as long as they are symptomatic and possible for up to 7 days following illness onset. Children, especially younger children, might potentially be contagious for longer periods.

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 and then touches their own eyes, mouth or nose before washing their hands.

How long can viruses live outside the body?

We know that some viruses and bacteria can live 2 hours or longer on surfaces like cafeteria tables, doorknobs, and desks. Frequent handwashing will help you reduce the chance of getting contamination from these common surfaces.

What can I do to protect myself from getting sick?

There is no vaccine available right now to protect against swine flu. 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.
  • If you get sick with influenza, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

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. Do not go to work or school if ill. Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick. Put your used tissue in the waste basket. Cover your cough or sneeze if you do not have a tissue. 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. we recommend 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 swine influenza cases have been identified and become ill with influenza-like symptoms, including fever, body aches, runny nose, sore throat, nausea, or vomiting or diarrhea, you may want to contact their health care provider, particularly if you are worried about your symptoms. Your health care provider will determine whether influenza testing or treatment is needed.

If you are sick, you should stay home and avoid contact with other people as much as possible to keep from spreading your illness to others. 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 skin color
  • Not drinking enough fluids
  • 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
  • Fever with a rash

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

How serious is swine flu infection?

Like seasonal flu, swine flu in humans can vary in severity from mild to severe. Between 2005 until January 2009, 12 human cases of swine flu were detected in the U.S. with no deaths occurring. However, swine flu infection can be serious. In September 1988, a previously healthy 32-year-old pregnant woman in Wisconsin was hospitalized for pneumonia after being infected with swine flu and died 8 days later. A swine flu outbreak in Fort Dix, New Jersey occurred in 1976 that caused more than 200 cases with serious illness in several people and one death.

Can I get swine influenza from eating or preparing pork?

No. Swine influenza viruses are not spread by food. You cannot get swine influenza from eating pork or pork products. Eating properly handled and cooked pork products is safe.

Content Source: Centers for Disease Control and Prevention

Belize Medical Associates advises the general public that if you have flu-like symptoms, kindly advise the clinic nurse immediately as you may be at risk for Swine flu. You will be required to wear a mask and seen promptly by a doctor.

May 26, 2020

Sunscreen: How to Select, Apply, and Use It Correctly

Sunscreens help shield you from the sun’s dangerous ultraviolet (UV) rays in two ways. Some work by scattering the light, reflecting it away from your body. Others absorb the UV rays before they reach your skin.

When To Apply Sunscreen
  • Apply sunscreen at least two times a day. First application should be approximately 30 minutes before being in the sun so that it can be absorbed by the skin and less likely to wash off when you perspire. Second application should be around midday (12-1pm).
  • Application of sunscreen is advisable even on cloudy days because although UVB radiation is minimal, UVA radiation (known to brake down collagen and cause skin cancer) is always present during daytime. Also most lamps irradiate small but continuos ammounts of UVA when lit.
  • Remember to reapply sunscreen after swimming or strenuous exercise.
  • Apply sunscreen often throughout the day if you work outdoors (every two hours), and wear hats (caps do not protect the ears and nape of neck area) and protective clothing (long sleeves shirts and long pants).

How To Apply Sunscreen
  • Shake well before use to mix particles that might be clumped up in the container. Consider using the new spray-on or stick types of sunscreen.
  • Be sure to apply enough sunscreen. As a rule of thumb, use an ounce (a handful) to cover your entire body.
  • Use on all parts of your skin exposed to the sun, including the ears, back, shoulders, and the back of the knees and legs.
  • Apply thickly and thoroughly.
  • Be careful when applying sunscreen around the eyes.

What To Look for When You Buy Sunscreen
  • Pick a broad-spectrum sunscreen that protects against UV-A and UV-B rays.
  • Read product labels. Look for a waterproof brand if you will be sweating or swimming. Buy a nonstinging product or one specifically formulated for your face.
  • The SPF factor rates how effective the sunscreen is in preventing sunburn caused by UVB rays. If you would normally burn in 10 minutes, SPF 15 multiplies that by a factor of 15, meaning you could go 150 minutes before burning.· People who have very fair skin, who suffer conditions like lupus or are taking medication that makes your skin more sensitive to sunlight should consider SPF 30 or higher. Keep in mind that the higher the SPF, the smaller the increased benefit: contrary to what you might think, SPF 30 isn’t twice as strong as SPF 15. While SPF 15 filters out 93% of UVB, SPF 30 filters out 97%. UVA protection. amazon site down Look for a sunscreen that contains at least one of the following: ecamsule, avobenzone + octocrilene, oxybenzone, titanium dioxide, zinc oxide.
  • Buy a brand that does not contain para-aminobenzoic acid (PABA) if you are sensitive to that ingredient.
  • Try a sunscreen with different chemicals if your skin reacts badly to the one that you are using. Not all sunscreens have the same ingredients.
  • Use a water-based sunscreen if you have oily skin or are prone to acne.
  • Be aware that more expensive does not mean better. Although a costly brand might feel or smell better, it is not necessarily more effective than a cheaper product.
  • Be aware of the expiration date because some sunscreen ingredients might degrade over time.

Modified from:

http://www.webmd.com/parenting/sunscreen-use-correctly and http://www.webmd.com/content/article/133/118761.htm

Submitted by: Dr. Jorge Lopez-Granja

May 26, 2020

What is high cholesterol?
Cholesterol is a type of fat. Your body needs it for many things, such as making new cells. But too much cholesterol in your blood increases your chances of having a heart attack and stroke.

What are the different kinds of cholesterol?

Cholesterol travels through your blood attached to a protein. This cholesterol-protein package is called a lipoprotein. Lipoproteins are either high-density or low-density, based on how much protein and fat they have.

Low-density lipoproteins (LDL) are mostly fat with only a small amount of protein. LDL is the bad kind of cholesterol because it can clog your arteries. If you have high cholesterol, your doctor will want you to lower your LDL.

High-density lipoproteins (HDL) help clear the bad cholesterol from your blood and keep it from clogging your arteries. HDL is the good kind of cholesterol. High levels of HDL (60 or above) can protect you from a heart attack.

Triglycerides are another type of fat in your blood. If you have high triglycerides and high LDL, your chances of having a heart attack are higher.

What causes high cholesterol?

High cholesterol may run in your family. The foods you eat also may cause high cholesterol.

Causes include:

  • Your diet. Eating too much saturated fat and cholesterol can cause high cholesterol. Saturated fat and cholesterol come from animal foods such as beef, pork,  milk, eggs, butter, cheese
  • Your weight. Being overweight may raise triglycerides and lower HDL.
  • Your activity level. Not exercising may raise LDL and lower HDL.
  • Your overall health. Having diseases such as low thyroid can raise cholesterol. Cigarette smoking may lower HDL.
  • Your age. After you reach age 20, your cholesterol starts to rise. In men, cholesterol levels usually level off after age 50. In women, cholesterol levels stay fairly low until menopause. After that, they rise to about the same level as in men.
  • Your family. A disease called a lipid disorder can also cause high cholesterol. This rare problem is inherited from family members, and it changes how your body handles cholesterol.

What are the symptoms?

There are usually no signs or symptoms of high blood cholesterol. Many people don’t know that their cholesterol level is too high. If cholesterol builds up in your arteries, it can block blood flow to your heart or brain and cause a heart attack or stroke.

Everyone age 20 and older should have their cholesterol levels checked at least once every 5 years. You and your doctor can discuss how often you should be tested.

May 26, 2020

Babies under 6 months:
  • Avoiding sun exposure and dressing infants in lightweight long pants, long-sleeved shirts, and brimmed hats are still the top recommendations to prevent sunburn. However when adequate clothing and shade are not available, parents can apply a minimal amount of sunscreen to small areas, such as the infant’s face and the back of the hands.

For Young Children:
  • Apply sunscreen at least 30 minutes before going outside, and use sunscreen even on cloudy days. The SPF (sun protection factor) should be at least 15.

For Older Children:
  • The first, and best, line of defense against the sun is covering up. Wear a hat with a three-inch brim or a bill facing forward, sunglasses (look for sunglasses that block 99-100% of ultraviolet rays), and cotton clothing with a tight weave.
  • Stay in the shade whenever possible, and avoid sun exposure during the peak intensity hours – between 10 a.m. and 4 p.m.
  • Use a sunscreen with an SPF (sun protection factor) of 15 or greater. Be sure to apply enough sunscreen – about one ounce per sitting for a young adult.
  • Reapply sunscreen every two hours, or after swimming or sweating.

Heat Stress In Exercising Children:
  • The intensity of activities that last 15 minutes or more should be reduced whenever high heat and humidity reach critical levels.
  • At the beginning of a strenuous exercise program or after traveling to a warmer climate, the intensity and duration of exercise should be limited initially and then gradually increased during a period of 10 to 14 days to accomplish acclimatization to the heat.
  • Before prolonged physical activity, the child should be well-hydrated. During the activity, periodic drinking should be enforced, for example, each 20 minutes, 5 oz of cold tap water or a flavored sports drink for a child weighing 88 lbs, and 9 oz for an adolescent weighing 132 lbs, even if the child does not feel thirsty.
  • Clothing should be light-colored and lightweight and limited to one layer of absorbent material to facilitate evaporation of sweat. Sweat-saturated garments should be replaced by dry garments.

Pool Safety:
  • Never leave children alone in or near the pool, even for a moment.
  • Ensure that the pool has a fence at least four-feet high around all four sides of the pool. The fence should not have openings or protrusions that a young child could use to get over, under, or through the fence.
  • Make sure pool gates open out from the pool, and self-close and self-latch at a height children can’t reach.
  • Keep rescue equipment (a shepherd’s hook – a long pole with a hook on the end – and life preserver) and a portable telephone near the pool.
  • Avoid inflatable swimming aids such as “floaties.” They are not a substitute for approved life vests and can give children a false sense of security.
  • Children may not be developmentally ready for swim lessons until after their fourth birthday. Swim programs for children under 4 should not be seen as a way to decrease the risk of drowning.
  • Whenever infants or toddlers are in or around water, an adult should be within arm’s length, providing “touch supervision.”

Bug Safety:
  • Don’t use scented soaps, perfumes or hair sprays on your child.
  • Avoid areas where insects nest or congregate, such as stagnant pools of water, uncovered foods and gardens where flowers are in bloom.
  • Avoid dressing your child in clothing with bright colors or flowery prints.
  • To remove a visible stinger from skin, gently scrape it off horizontally with a credit card or your fingernail.
  • Insect repellents containing DEET are the most effective.
  • The concentration of DEET in products may range from less than 10 percent to over 30 percent. The benefits of DEET reach a peak at a concentration of 30 percent, the maximum concentration currently recommended for infants and children. DEET should not be used on children under 2 months of age.
  • The concentration of DEET varies significantly from product to product, so read the label of any product you purchase.

Playground Safety:
  • Install and maintain a shock-absorbing surface under and around the play equipment. Use at least 9 inches of wood chips, mulch, or shredded rubber for play equipment up to 7 feet high. If sand or pea gravel is used, install at least a 9-inch layer for play equipment up to 5 feet high.
  • Carefully maintain all equipment. Open “s” hooks or protruding bolt ends can be hazardous.
  • Swing seats should be made of soft materials such as rubber, plastic or canvas.
  • Make sure children cannot reach any moving parts that might pinch or trap any body part.
  • Never attach-or allow children to attach-ropes, jump ropes, leashes, or similar items to play equipment; children can strangle on these.
  • Make sure metal slides are cool to prevent children’s legs from getting burned.
  • Parents should never purchase a home trampoline or allow children to use home trampolines. * Parents should supervise children on play equipment to make sure they are safe.

Bicycle Safety:
  • Do not push your child to ride a 2-wheeled bike until he or she is ready, at about age 5 or 6. Consider the child’s coordination and desire to learn to ride. Stick with coaster (foot) brakes until your child is older and more experienced for hand brakes.
  • Take your child with you when you shop for the bike, so that he or she can try it out. The value of a properly fitting bike far outweighs the value of surprising your child with a new bike.
  • Buy a bike that is the right size, not one your child has to “grow into.” Oversized bikes are especially dangerous.
  • Your child needs to wear a helmet on every bike ride, no matter how short or how close to home. Many accidents happen in driveways, on sidewalks, and on bike paths, not just on streets. Children learn best by observing you. Whenever you ride your bike, put on your helmet.
  • A helmet protects your child from serious injury, and should always be worn. And remember, wearing a helmet at all times helps children develop the helmet habit.
  • A helmet should be worn so that it is level on the head, not tipped forwards or backwards. The strap should be securely fastened, and you should not be able to move the helmet in any direction. If needed, the helmet’s sizing pads can help improve the fit.

Submitted by Dr. Victor Rosado
Source: http://www.aap.org/advocacy/releases/summertips.htm

May 26, 2020
¿Qué es la influenza porcina?

La influenza porcina (gripe porcina) es una enfermedad respiratoria de los cerdos causada por el virus de la influenza tipo A, el cual provoca brotes comunes de influenza entre estos animales. Los virus de la influenza porcina enferman gravemente a los cerdos pero las tasas de mortalidad son bajas. Estos virus pueden propagarse entre los cerdos durante todo el año, pero la mayoría de los brotes infecciosos ocurren en los meses finales del otoño e invierno, al igual que los brotes en las personas. El virus de la influenza porcina clásico (virus de la influenza H1N1 tipo A) fue aislado por primera vez de un cerdo en 1930.

Influenza porcina en seres humanos

¿Los seres humanos pueden contagiarse de influenza porcina?
Los virus de la influenza porcina por lo general no infectan a los seres humanos. Sin embargo, han ocurrido casos esporádicos de infecciones de influenza porcina en seres humanos. Por lo general, estos casos se presentan en personas que tienen exposición directa a los cerdos (es decir, niños que se acercan a los cerdos en ferias o trabajadores de la industria porcina). Además, ha habido algunos casos documentados de personas que han contagiado el virus de la influenza porcina a otras. Por ejemplo, en 1988, un presunto brote infeccioso de influenza porcina en cerdos en Wisconsin causó múltiples infecciones en seres humanos y, aunque no ocurrió un brote en la comunidad, se identificaron anticuerpos que comprobaron la transmisión del virus de un paciente a personal de atención médica que habían tenido contacto cercano con él.
¿Con qué frecuencia se registran infecciones de influenza porcina en seres humanos?
En el pasado, los CDC recibían notificaciones de aproximadamente un caso de infección por el virus de la influenza porcina en seres humanos cada uno o dos años en los Estados Unidos; sin embargo, de diciembre del 2005 a febrero del 2009 se han reportado 12 casos de infecciones por influenza porcina en personas.
¿Cuáles son los síntomas de la influenza porcina en los seres humanos?
Los síntomas de la influenza porcina en las personas son similares a los de la influenza estacional común en seres humanos y entre estos se incluyen fiebre, letargo, falta de apetito y tos. Algunas personas con influenza porcina han reportado también secreciones nasales, dolor de garganta, náuseas, vómitos y diarrea.
¿Las personas pueden contraer influenza porcina por comer carne de cerdo?
No. Los virus de la influenza porcina no se transmiten por los alimentos. Usted no puede contraer influenza porcina por comer carne de cerdo o sus productos derivados. No hay riesgos si se come carne de cerdo y sus derivados que han sido manipulados y cocinados de manera adecuada. Si se cocina la carne de cerdo a una temperatura interna de aproximadamente 71° C (160° F), se eliminan los virus de la influenza porcina, como también otras bacterias y virus.
¿Cómo se propaga la influenza porcina?
Los virus de la influenza se pueden transmitir directamente de los cerdos a las personas y de las personas a los cerdos. Las infecciones en seres humanos por los virus de la influenza provenientes de los cerdos tienen más probabilidad de ocurrir en las personas que están en contacto cercano con cerdos infectados, como las que trabajan en criaderos de cerdos y las que participan en las casetas de cerdos en las ferias de exhibiciones de animales de cría. La transmisión de la influenza porcina de persona a persona también puede ocurrir. Se cree que esta transmisión es igual a la de la influenza estacional en las personas, es decir principalmente de persona a persona cuando las personas infectadas por el virus de la influenza tosen o estornudan. Las personas pueden infectarse al tocar algo que tenga el virus de la influenza y luego llevarse las manos a la boca o la nariz.
¿Qué información tenemos sobre la transmisión de la influenza porcina de persona a persona?
En septiembre de 1988, una mujer embarazada sana de 32 años de edad fue hospitalizada por pulmonía y falleció 8 días después. El virus de la influenza porcina H1N1 fue detectado. Cuatro días antes de enfermarse, la paciente había visitado una exhibición de cerdos en una feria del condado donde se registraba una enfermedad seudogripal generalizada entre los cerdos.

En estudios de seguimiento, el 76% de los expositores de cerdos a los cuales se les realizaron pruebas presentaron anticuerpos que comprobaron infección por influenza porcina, aunque en este grupo no se detectaron enfermedades graves. Estudios adicionales indicaron que de uno a tres empleados del personal de atención médica que habían tenido contacto con la paciente presentaron enfermedad seudogripal leve y anticuerpos contra la infección de la influenza porcina.

¿Cómo se diagnostican las infecciones por influenza porcina en seres humanos?
Para diagnosticar una infección por influenza porcina tipo A, por lo general se debe recoger una muestra de secreción del aparato respiratorio entre los primeros 4 a 5 días de aparecida la enfermedad (cuando una persona infectada tiene más probabilidad de diseminar el virus). Sin embargo, algunas personas, especialmente los niños, pueden propagar el virus durante 10 días o más. Para la identificación del virus de la influenza porcina tipo A es necesario enviar la muestra a los CDC para que se realicen pruebas de laboratorios.
¿Qué medicamentos existen para tratar a las personas con infecciones por influenza porcina?
Existen cuatro medicamentos antivirales diferentes que están autorizados en los Estados Unidos para el tratamiento de la influenza: amantadina, rimantadina, oseltamivir y zanamivir. Aunque la mayoría de los virus de la influenza porcina han sido sensibles a los cuatro tipos de medicamentos, los siete virus más recientes de la influenza porcina asilados de personas son resistentes a la amantadina y la rimantadina. En la actualidad, los CDC recomiendan el uso de oseltamivir o zanamivir para la prevención y el tratamiento de la infección por los virus de la influenza porcina. Puede encontrar más información sobre las recomendaciones para el tratamiento en el sitiowww.cdc.gov.
¿Qué otros casos de brotes de influenza porcina hay?
Probablemente el caso más conocido sea el brote de influenza porcina entre los soldados de Fort Dix, Nueva Jersey, en 1976 . Este virus causó pulmonía, demostrada mediante radiografías, a por lo menos 4 soldados y 1 muerte; todos estos pacientes anteriormente gozaban de buena salud. El virus se transmitió a contactos cercanos en un ambiente de entrenamiento básico, y no ocurrió transmisión afuera del grupo de entrenamiento básico. Se cree que el virus permaneció en ese lugar un mes y desapareció. Se desconocen la fuente del virus, la fecha exacta de su ingreso a Fort Dix, los factores que limitaron su transmisión y su duración. El brote de Fort Dix pudo haber sido causado por el ingreso de un virus de un animal a una población humana bajo estrés en contacto cercano con instalaciones saturadas de gente y durante el invierno. El virus de la influenza porcina tipo A recogido de un soldado de Fort Dix fue bautizado A/New Jersey/76 (Hsw1N1).
¿El virus de la influenza porcina H1N1 es igual a los virus H1N1 de la influenza en seres humanos?
No. Los virus de la influenza porcina H1N1 son antigénicamente muy diferentes de los virus H1N1 de los seres humanos, por consiguiente las vacunas de la influenza estacional para las personas no proporcionan protección contra los virus de la influenza porcina H1N1.

Influenza porcina en cerdos

¿Cómo se propaga la influenza porcina entre los cerdos?
Se cree que los virus de la influenza porcina se transmiten principalmente mediante el contacto cercano entre cerdos y posiblemente mediante objetos contaminados que se mueven entre los cerdos infectados y sanos. Las manadas de cerdos con continuas infecciones de influenza porcina y las manadas que son vacunadas contra esta enfermedad pueden enfermarse de manera esporádica, pueden ser asintomáticas o solo presentar síntomas leves de la infección.
¿Cuáles son los signos de la influenza porcina en los cerdos?
Los signos de la influenza porcina puede ser la aparición súbita de fiebre, depresión, tos (gruñido), secreciones de la nariz y los ojos, estornudos, dificultad para respirar, enrojecimiento o inflamación de ojos y pérdida del interés en la comida.
¿Qué tan frecuente es la influenza porcina entre los cerdos?
Los virus de la influenza porcina H1N1 y H3N2 son endémicos entre las poblaciones de cerdos en los Estados Unidos y es una situación que la industria aborda de manera habitual. Los brotes entre los cerdos se presentan por lo general en los meses de temperaturas frías (finales del otoño y el invierno) y a veces con el ingreso de nuevos cerdos a manadas vulnerables. Los estudios han demostrado que la influenza porcina H1N1 es común entre las poblaciones de cerdos de todo el mundo y que un 25 por ciento de los animales presentan evidencia de anticuerpos de la infección. Los estudios en los Estados Unidos han demostrado que el 30 por ciento de la población de los cerdos sometidos a pruebas han presentado evidencia de anticuerpos por la infección H1N1. Para ser más precisos, se ha comprobado la presencia de los anticuerpos de la infección H1N1 en el 51 por ciento de los cerdos en el norte de la región central de los Estados Unidos. Las infecciones en las personas por los virus H1N1 de la influenza porcina son poco comunes. En la actualidad, no hay forma de diferenciar en los cerdos los anticuerpos producidos en reacción a la vacunación de los anticuerpos generados ante las infecciones por influenza porcina H1N1.

Aunque los virus de la influenza porcina H1N1 se han encontrado en las poblaciones de cerdos desde por lo menos 1930, los virus de la influenza porcina H3N2 no comenzaron a presentarse entre los cerdos en los Estados Unidos hasta 1998. Los virus H3N2 inicialmente ingresaron a las poblaciones de cerdos por los humanos. Los virus actuales de la influenza porcina H3N2 están estrechamente asociados a los virus H3N2 de los seres humanos.

¿Hay alguna vacuna para la influenza porcina?
Existen vacunas que se administran a los cerdos para la prevención de la influenza porcina. Sin embargo, no hay una vacuna para proteger a las personas contra la influenza porcina. Es posible que la vacuna contra la influenza estacional proporcione protección parcial contra los virus H3N2, pero no contra los virus H1N1 de la influenza porcina.

Content Source: Centers for Disease Control and Prevention

Belize Medical Associates advises the general public that if you have flu-like symptoms, kindly advise the clinic nurse immediately as you may be at risk for Swine flu. You will be required to wear a mask and seen promptly by a doctor.

 

May 26, 2020
Description

Travelers’ diarrhea (TD) is a clinical syndrome resulting from microbial contamination of ingested food and water; it occurs during or shortly after travel, most commonly affecting persons traveling from an area of more highly developed hygiene and sanitation infrastructure to a less developed one. Thus, TD is defined more by circumstances of acquisition than by a specific microbial agent. In fact, there is considerable diversity in etiologic agents, which include bacteria, parasites, or viruses. A similar but less common syndrome is toxic gastroenteritis, caused by ingestion of pre-formed toxins. In this syndrome, vomiting may predominate, and symptoms usually resolve within 12-18 hours.

Risk for Travelers

Travelers’ diarrhea occurs equally in males and females and is more common in young adults than in older people. In short-term travelers, bouts of TD do not appear to protect against future attacks, and more than one episode of TD may occur during a single trip.

Prevention

For travelers to high-risk areas, several approaches may be recommended, which can minimize but never completely eliminate the risk of TD. These include

  1. instruction regarding food and beverage selection,
  2. use of agents other than antimicrobial drugs for prophylaxis, and
  3. use of prophylactic antibiotics.
Treatment

Antibiotics are the principal element in the treatment of TD. Adjunctive agents used for symptomatic control may also be recommended.

Antibiotics

As bacterial causes of TD far outnumber other microbial etiologies, empiric treatment with an antibiotic directed at enteric bacterial pathogens remains the best therapy for TD.

Oral Rehydration Therapy

Fluid and electrolytes are lost in cases of TD, and replenishment is important, especially in young children or adults with chronic medical illness. In adult travelers who are otherwise healthy, severe dehydration resulting from TD is unusual unless vomiting is present. Nonetheless, replacement of fluid losses remains an important adjunct to other therapy. Travelers should remember to use only beverages that are sealed or carbonated. For more severe fluid loss, replacement is best accomplished with oral rehydration solutions.

 

 

May 26, 2020

Belize Medical Associates Traveler’s Guide has been established to assist international patients and their accompanying family members while visiting our beautiful country.  We will guide you through many phases of your visit, from the time of your personal inquiry to your departure from the hospital.

Business travelers as well as recreational travelers can benefit from this guide which was developed with an emphasis on preparedness.  We understand that business travelers may be under stress and pressure.  The traveler needs to have a resource available to turn to when faced with medical concerns while traveling abroad.  Therefore, Belize Medical Associates will keep you healthy and productive while away on assignments or pleasure.

Patient Services

Here are some of the services offered through our Traveler’s Guide Program:

  • Providing you with a list of physicians and contact information to schedule an appointment
  • Obtaining cost estimates on hospital fees, physician fees, and procedures you will be receiving
  • Financial arrangements, such as opening an account with a local bank, wire transfers, contacting your insurance company or employer to determine authorization requirements needed prior to your visit, and other transactions
  • Travel arrangements, confirming airline reservations, air and ground ambulance, transportation to and from the airport/airstrip and accommodations
  • Assistance with making accommodations at local hotels for relatives overnight stay
  • Assistance with any emergency situations that may develop while a patient has been admitted to Belize Medical Associates Hospital
  • Advice on leisure activities

Approvals

To eliminate financial hardship, confusion and delays should you or a family member require medical care while on your visit, check with your payer (insurance company, employer, etc.) prior to leaving to ensure that you have written approvals and that you understand exactly how much of he charges they will cover and how much will be your responsibility.  (Some restrictions apply)

Airline Tickets

It is best to have your return trip with an open date to avoid extra charges which may be imposed in the event of changes in your travel schedule, due to unforeseen circumstances such as delays in travel due to extended treatment and/or hospitalization.

Dress Comfortably

At the hospital, wear casual clothing and comfortable shoes.  A light sweater is recommended all year round since hospital room temperatures are generally very cool.

Telephone Calls

Telephone calls can be made with telephone cards (available at the pharmacy), collect calling or charges placed on patient bill.

Payment Options
  • Cash
  • Wire transfers
  • Visa/Mastercard/Travelers Cheques/American Express/Discover Insurance (a letter of authorization outlining benefits from the insurance company will be required before you receive treatment).  Some restrictions apply.

Checklist
Review these items for your convenience and preparation prior to your departure:

  • Passport or other form of photo identification
  • Copies of medical records, diagnostic films (CT scans, x-rays, etc.)
  • Original authorization letter from insurance company
  • Name, address and telephone number of your referring physician(s)
  • A list of your current medications and dosages
  • A book, magazines or any other items to keep you occupied between appointments
  • Money for payment of services, travel and subsistence