The 1918 Influenza Epidemic’s Long Reach in Time

“It would be impossible to relate all the sad and terrible scenes . . . all night long . . . witnessing death scenes, seeing weeping relatives and trying to take care of emergencies . . . “

A mother’s death remembered.

Litter carriers at Red Cross Emergency Ambulance Station in Washington, D.C., during influenza pandemic of 1918.

When my grandfather was six years old, his mother went to sleep one night and never woke up. She was one of the nearly 700,000 Americans who died during the 1918–1919 influenza pandemic, which killed an estimated 50 million people worldwide. The rest of her young family—my grandfather and his twin brother, their seven-year-old sister, and my great-grandfather—survived. The shock of losing his mother so suddenly was still evident when my grandfather talked about her 70 years later. She was 29 years old and healthy, and then she was gone.

High mortality, even among healthy young adults.

My family was not alone as it mourned. The CDC estimates that one-third of the world’s population was infected by what’s become known as the “Spanish flu.” (The origin of this name is unclear: some sources suggest it’s due to a misunderstanding […]

2018-03-07T09:08:45-05:00March 7th, 2018|infectious diseases, Nursing, Public health|1 Comment
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Late in a High Anxiety Season, Some Flu and Vaccine Basics

After what has seemed like constant media scrutiny for months, influenza hasn’t been in the news as often in recent days. Still, CDC data indicate that flu activity remains “widespread” across the country, so it’s still too early to eliminate flu from your list of “differential diagnoses,” at work or at home.

Maybe it’s the general state of our national psyche, but this year the “flu” seems to have caused more than its usual share of anxiety. This is not a pandemic; there are no brand-new strains of flu in circulation to which no one is immune. But the H3N2 strain that has been predominant this year does tend to lead to a harsher-than-usual season. (The 2014-2015 season was also severe, but the public heard relatively little about it because media were focused on the Ebola outbreak.)

Influenza surveillance basics.

How do we know how bad a flu season really is? Since the 1997–1998 flu season, lab data and clinical reporting have facilitated real-time flu surveillance in the U.S. Public health laboratories in every state, in collaboration with National Respiratory and Enteric Virus Surveillance System laboratories, track the types (A or B) and subtypes (H3N2, H1N1, etc.) of flu in circulation.

To complement these data, the U.S. Outpatient Influenza-Like Illness Surveillance Network (ILINet) tracks the percentage of […]

2018-02-28T12:20:28-05:00February 28th, 2018|infectious diseases, Nursing, Public health|0 Comments
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Low Physical Activity Among Chinese American Immigrants with Prediabetes and Type 2 Diabetes

“…compared with the general population, people who have or are at risk for type 2 diabetes are significantly less likely to engage in regular physical activity.”

On this month’s cover, group practices tai chi during snowfall in Shenyang, China. ©Photo Reuters/Stringer.

We all know that physical activity is important for maintaining health—for everyone. It’s especially important to prevent or manage prediabetes and type 2 diabetes.

AJN’s February research feature, “Physical Activity Among Chinese American Immigrants with Prediabetes or Type 2 Diabetes,” takes a special look at the issue among Chinese American immigrants. Diabetes is the fifth leading cause of death among Asian Americans, so researchers wanted to investigate what this population’s knowledge of and barriers to physical activity might be.

Recruiting from a community health center in New York City, researchers conducted interviews with 100 foreign-born Chinese American adults having a diagnosis of prediabetes or type 2 diabete

According to the study authors:

“Chinese American immigrants with prediabetes or type 2 diabetes tend to be sedentary and are less likely to perform moderate or vigorous physical activity than the general population . . . .The findings also highlight some of the barriers to such activity and suggest a need for greater involvement […]

2018-02-07T10:30:12-05:00February 7th, 2018|exercise, Nursing, nursing research, patient engagement, personal health practices|0 Comments
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Who’s to Blame for Poor Health?

We hear it over and over and probably say it to our patients: to be healthy, follow a proper diet, don’t smoke, and be active. And if diagnosed with an illness, adhere to the agreed-upon plan of care. Sounds simple—and when patients return time and again with the same issues, we often blame them (secretly, of course) for not taking care of themselves.

But for how many of our patients is what we’re asking them to do less a matter of personal choice than a function of the neighborhood in which they live and the limitations imposed by their socioeconomic circumstances?

Many people don’t live within walking distance of a grocery store that offers fresh vegetables and fruit. Or if they do, they may not be able to afford the more nutritious choices, which are often more expensive. Many urban areas lack playgrounds. Air pollution and substandard housing materials can cause asthma and heart disease. Being born into poverty can result in poor nutrition, contributing to poor health, as well as limited access to health care, education, and job opportunities.

Social determinants of health, before we called them that.

Nurse and social worker Lillian Wald understood this when she and colleague Mary Brewster established the Henry Street Settlement in New York City’s Lower East Side, where she offered […]

2017-12-20T10:31:27-05:00December 20th, 2017|Nursing, Public health|0 Comments
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What if Our Antibiotic Prescribing Practices are Wrong?

How often have you emphasized to patients, family, and friends that they must finish their prescribed antibiotics, even if they feel better? A provocative new analysis in BMJ takes a close look at why standard antibiotic protocols may promote, rather than prevent, antibiotic resistance.

The authors’ arguments center around two key points:

  • The length of a course of antibiotic therapy is not evidence based, but rather “set by precedent [and] driven by fear of undertreatment.”
  • Typical, prolonged courses of these drugs cause endogenous or colonizing bacteria to become antibiotic resistant. It is these “collateral” organisms, they argue, and not the organism that has actually caused the infection, that drive the spread of antibiotic resistance.

Individualized antibiotic courses.

The BMJ authors present a strong argument for more individualized courses of antibiotic treatment. Unfortunately, when the news media picked up this story, much of what was written and broadcast erroneously suggested that everyone should simply stop their antibiotics when they feel better. […]

2017-12-13T10:41:02-05:00December 13th, 2017|infection control, Nursing, Public health|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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