YOUR HEALTH
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Edition 61, Summer 2011/12 Rabies. How to reduce your risk Rabies. How to reduce your riskAsk your GP about the risk of rabies if you are going overseas. Rabies is found in over 150 countries, including destinations in Asia, Africa, the Americas and Europe. Rabies has reappeared in Bali over the last 3 years and over 100 deaths have been reported as of June 2011. A risk for travellers is at the monkey temples where at least 6% of visitors are bitten by macaque monkeys. Rabies is a viral infection usually caught from the bite or scratch of an infected domestic or wild animal (e.g. dog or monkey). Symptoms typically occur 1-3 months after exposure but can appear within a week. Initially, a flu-like illness develops with pain, tingling or burning at the wound site. The virus then spreads to the brain and spinal cord causing anxiety, paralysis, confusion and convulsions. Once symptoms develop, rabies is nearly always fatal. Death usually follows within 1-2 weeks. How to prevent rabiesPreventative strategies are vital as there is no effective treatment once symptoms appear. The first rule is to avoid close contact with wild and domestic animals overseas. This is especially important for children. Forty per cent of people bitten by animals suspected of having rabies are under 15 years old. Travellers to areas in rabies-affected countries should consider vaccination before they leave, especially when longer trips are planned. Vaccination is also recommended for vets, animal handlers, cavers and certain laboratory workers who are at a higher risk of being exposed to the rabies virus. A course of 3 injections of rabies vaccine before departure is effective and well tolerated. Possible side effects include a sore arm and headache. Make sure you are also up-to-date for tetanus and other routine vaccinations as well. Treatment after a bite or scratchIf you are bitten or scratched in a region known to have rabies, you must seek medical attention urgently. Flush and wash the wound thoroughly with warm, soapy water for at least 15 minutes and then apply iodine antiseptic. Vaccination is required as soon as possible: If you have not been vaccinated, 5 doses of rabies vaccine plus a dose of rabies immunoglobulin (RIG) are given. If you have been vaccinated you need 2 additional doses of rabies vaccine. Pre-travel rabies vaccination makes the management of a bite or scratch from an animal infected with rabies easier because fewer doses of vaccine are needed and RIG is not required. RIG is difficult or even impossible to obtain in many countries and often people return home early to get treatment. For more information about rabies, speak to your GP before you travel. Increased measles in AustraliaRecent outbreaks of measles in Australia and overseas are a reminder that this serious disease is still common in many other countries. Most cases in Australia are either acquired abroad or have been spread to non-immune local residents by foreign visitors or returning travellers. In 2010 there were 70 cases of measles reported in Australia. In 2011, that number was almost doubled by September. Measles is a highly infectious viral infection spread by coughing and sneezing. It begins with a feeling unwell (malaise), dry cough, runny nose and red eyes (conjunctivitis). A red, blotchy rash then typically develops on the face and neck and spreads to the body. Measles is a serious and sometimes fatal infection. Complications are more common and more severe in adults, people with a chronic illness and children under 5 and include:
Who is most at risk of measles? Those most at risk are infants <12 months of age, any child not vaccinated against the disease and adults born in the late 1960s to mid-1980s who may lack immunity. Most people born before 1966 are likely to be immune from natural infection which was common before that time. Low immunity is of particular concern for healthcare workers, those who work with children or women planning pregnancy. International travellers are also vulnerable. Reported cases of measles have increased considerably in many European countries in 2011. Closer to home, New Zealand, Singapore and China have also had outbreaks. Ask your GP about your risk of measles. For more information go to www.immunise.health.gov.au. This article is sponsored by GSK Australia Osteoporosis. Are you at risk?Almost one in every three Australians has fragile bones and most are unaware of it. Osteoporosis occurs when bones lose their density and become weak. Weak bones are at risk of being easily fractured (broken). Once a fracture occurs your risk of having another increases dramatically. Are you at risk? The risk of osteoporosis increases with age in men and women but is highest in women after menopause. You may be at risk if you:
You can find out your risk of having a fracture atwww.garvan.org.au/bone-fracture-risk In most cases, osteoporosis causes no symptoms until a fracture occurs. Sometimes a fracture is silent. Your doctor may order an X-ray of the spine to detect a past silent fracture. To find out if you have low bone density, a bone mineral density (BMD) test is performed to measure your 'T score'. A T score of greater than -1.0 is normal. In osteoporosis, the bone density is much lower with a T score of less than -2.5. Effective treatment is available Adequate calcium is important for strong bones either from the diet (mainly dairy foods) or supplements. You can calculate your calcium intake at www.iofbonehealth.org Getting adequate vitamin D intake from sunshine or supplements, reducing alcohol and stopping smoking also help. Regular weight-bearing exercise such as walking, Tai chi and gentle weights can also improve bone health. A number of effective osteoporosis treatments are available. Ongoing changes to the PBS mean that more people may now be eligible for PBS funded treatment. Speak to your doctor for more information or go to www.osteoporosis.org.au This article is sponsored by MSD (Australia) The Pill now 50 years old!The oral contraceptive pill has now been available for over 50 years. Here are the answers to common questions women ask. How effective is 'the Pill'? The Pill is 99% effective if taken correctly at the same time every day. To remember, link it to another daily activity like brushing your teeth or set reminders on your mobile phone. The effectiveness of the Pill may be reduced by:
In these circumstances, you may need an additional form of contraception e.g. condoms. Always ask your doctor for further information. Does the Pill protect women from STIs? No. The only form of contraception that protects you from STIs (sexually transmitted infections) is a condom. What are some other benefits of the Pill? For many women, the Pill may be used to help manage period problems — periods may become more regular, shorter, lighter and less painful. Women may also experience improvements in acne and pre-menstrual symptoms. The Pill may also reduce the risk of cancer of the womb and ovary. When can I start trying to get pregnant? You can start straight after stopping the Pill. Most women will be ovulating (producing an egg) within 3 months but you can get pregnant in the first menstrual cycle. What is the minipill? The minipill contains progestogen only and is an alternative for women who can't take oestrogen or combined pills (oestrogen + progestogen). It may be suitable while breastfeeding as it does not affect breast milk supply. Is the Pill suitable for everyone? No, some women shouldn't be taking the Pill. Ask your GP if the Pill is right for you. Coeliac disease. Many cases undiagnosedAbout 160,000 Australians have coeliac disease and don't know it. Untreated it can lead to malnutrition, chronic poor health, osteoporosis, infertility, miscarriage, depression, liver disease and some forms of cancer. In people with coeliac disease, the immune system reacts abnormally to gluten (a protein found in wheat, rye, barley and oats) causing damage to the small bowel. The damaged bowel is unable to absorb certain nutrients. People are born with a genetic predisposition to develop coeliac disease and the condition affects about 1 in 100 Australians. Could you have coeliac disease? Some people have no symptoms at all while others have severe complaints including:
Treatment of coeliac disease There is no cure for coeliac disease, but a life-long gluten free diet lets the gut heal and the symptoms improve. Suitable foods are:
Speak to your GP or visit www.coeliac.org.au How much fluid should you drink daily?Good advice for the average person is to be guided by thirst – drink when you're thirsty and avoid drinking if you're not. There is no scientific evidence for the recommendation to drink 2 litres per day. While extra fluids in hot weather and when exercising are a good idea, too much fluid can be harmful and can lead to 'water intoxication'. Plain tap water is the preferred drink and is much cheaper and more environmentally friendly than bottled water. Sports drinks are only needed if exercising vigorously for 90 minutes or more. Sugary soft drinks, fruit drinks, fruit juices, cordials and alcoholic drinks should be kept to a minimum. Many children have poor asthma controlA recent review revealed that a lot needs to be done to improve asthma control in Australian children (www.aihw.gov.au). Asthma affects 1 in 5 children. The good news is that there has been a 25% drop in the number of kids with asthma since 2001. Poor asthma control is common The study found that many children have poorly controlled asthma. Poor control leads to more severe symptoms, more flareups, days off school and hospital admissions. Management plans Most asthmatic children have not had an 'Asthma Cycle of Care', a full asthma assessment and treatment plan from their GP. Half of Australian children with asthma do not have a written Asthma Action Plan which helps recognise and treat any deterioration. Action Plans improve asthma control. Incorrect use of medication Many children use their short-acting relievers too often, instead of taking a daily preventer such as an inhaled corticosteroid. Preventers should be taken on a regular once- or twice-daily basis, but are most often used intermittently. Passive smoking Exposure to tobacco smoke makes asthma more severe and harder to control. The study found 1 in 12 children with asthma is exposed to smoke at home every day. What you can do:
For more information about asthma, speak to your GP or visit www.nationalasthma.org.au. The latest advice on infant feedingInfant feeding guidelines were recently updated by the National Health and Medical Research Council. Here are some of the key messages from the draft report. Breastfeeding Breastfeeding is best and helps protect infants against infection, obesity and some chronic diseases. Ideally, aim for 'exclusive' breastfeeding until 6 months of age and continue breastfeeding for 12 months or more. However, any amount of breastmilk is beneficial to the infant and mother. Exclusively breastfed infants do not require additional fluids up to 6 months of age. When fluids are given, tap or bottled water is best and should be boiled for infants. If diarrhoea occurs, continue breastfeeding and add an oral electrolyte solution if needed. Bottle feeding Use commercial formulas until 12 months and then start full cream cow's milk. Do not use reduced-fat milks before 2 years of age. When an infant formula is used, always follow the instructions carefully. Use the correct scoop and never overfill. Avoid feeding an infant using a 'propped' bottle as this increases the risk of choking, ear infection and tooth decay. Solids Introduce solid foods at around 6 months. Include iron-containing foods in the first foods e.g. iron-fortified cereals, pureed meat and poultry dishes, and some pureed vegetables. Do not add salt or sugar to infant foods. Ricotta, tomato & basil torte (gluten free)This healthy recipe is gluten free and is suitable for people with coeliac disease. Serves 8 Ingredients 500g low fat fresh ricotta 100g low fat feta, crumbled 3 eggs 2 cloves garlic, crushed 1 bunch fresh basil, finely shredded 375g grape tomatoes, halved Method Preheat oven to 180° C. Oil side and line with baking paper the base of 20cm springform tin. Beat ricotta, feta, eggs and garlic until smooth. Stir in basil. Put into prepared tin and smooth top. Arrange tomatoes on top cut-side up. Bake in preheated oven for 1 hour or until set and golden. Cool completely before putting in fridge for at least1 hour to firm. Nutrient analysis Per serve: Energy 620kj; Protein 13g; Fat 9g; Saturated Fat 5g; Carbohydrate 2.5g Source Coeliac Australia Gluten Free Recipe Book (3rd edition). http://www.coeliac.org.au/coeliac-disease/recipes.html or phone Coeliac Australia on 1300 990 273. FUNNY BONESAlways follow doctor's advice A 92 year-old man went to the doctor to get a checkup. A few days later the doctor saw the man walking down the street with a gorgeous young lady on his arm. At his follow up visit the doctor said, "I see you're really doing well, aren't you?" The man replied, "Just doing what you said doctor, 'Get a hot mamma and be cheerful'." The doctor said, "I didn't say that. I said you've got a heart murmur. Be careful!" Things You Don't Want to Hear During Surgery "Accept this sacrifice, O Great Lord of Darkness" "Rusty! Rusty! Come back with that! Bad dog!" "Better save that. We'll need it for the autopsy." "Wait a minute, if this is his spleen, then what's that?" "What do you mean he wasn't in for a sex change?" |