Saving Lives By Making Pneumonia Vaccine Affordable

Ability to test effectiveness of pneumonia vaccine is a key step to prevent deaths from S. pneumoniae.

Newswise, October 17, 2016 – As a child in war-ravaged Korea, Moon Nahm, M.D., decided his life’s goal would be to create a company and use its profits to fund research. Instead, the Korean-born researcher grew up to build what a recent National Institutes of Health review calls “a national treasure” — the World Health Organization Pneumococcal Serology Reference Laboratory at the University of Alabama at Birmingham.

Nahm uses the lab to help achieve a new goal — affordable pneumonia vaccines for the world. His groundbreaking research is on the threshold of aiding researchers in producing vaccines at prices that will propel their widespread use and help protect the estimated 1.6 million children, most of them under the age of 5, who die yearly from S. pneumoniae infections. S. pneumoniae is the leading cause of pneumonia.

“We need to reduce the cost for use in developing countries — from more than $100 a dose in the United States to less than $10 per dose,” Nahm said. “That is a key goal for the World Health Organization and the Bill & Melinda Gates Foundation.”

One of Nahm’s crucial discoveries was a method to rapidly and inexpensively test whether a vaccine candidate effectively elicits antibodies that can kill the S. pneumoniae bacteria.

The test — developed, improved and validated through years of painstaking work by Nahm’s research team — is vital in Korean, Chinese, Indian and other efforts to develop new generic vaccines.

Nahm’s patents and more than 70 license agreements have made him one of the most prolific inventors at UAB, as measured by licensing income. He is a professor in the UAB Department of Medicine, division of Pulmonary, Allergy and Critical Care Medicine, and director of the WHO Reference Laboratory.

“Very few careers have been as impactful as Dr. Nahm’s,” writes Bernard Beall, Ph.D., chief of the Streptococcus lab at the National Center for Infectious Diseases, Centers for Disease Control and Prevention. “Dr. Nahm’s impressive work in immunology, polysaccharide chemistry, cell biology, vaccinology and many different areas can be described as nothing short of pioneering.”

Why the need for vaccines?

S. pneumoniae bacterial strains are cloaked by a polysaccharide capsule that protects them from phagocytic cells in the lungs and blood during lung infections. Effective vaccines produce antibodies that can bind to the capsule and help phagocytes engulf and destroy the bacteria, thus preventing disease and saving lives.

Pneumonia vaccine creation is challenging because pneumococci have a welter of different capsule types. Instead of just one, pneumococci have 97 different capsule serotypes, seven of them discovered by Nahm.

Current vaccines target the 23 most dangerous serotypes for adult vaccines and the 13 most threatening for young childhood vaccines.

Evaluating the effectiveness of a potential generic vaccine against all these different serotypes is difficult, especially since researchers can get only small amounts of serum from vaccinated young children for use in testing.

Nahm was able to develop an assay to look at antibody response to vaccination that requires only one-fourth of the serum used in previous tests.

He and his team rigorously validated the assay, found a way to make the pneumococcal colonies in the assay turn red for automated counting, and developed a software package to quickly analyze assay data.

More than 100 lab workers across the globe have come to Nahm’s UAB World Health Organization lab to learn this critical, fourfold multiplexed opsonophagocytic-killing assay, and six more will arrive this month for training. The UAB lab also produces standardized reagents for the assay.

As Nahm was developing an NIH pneumococcal reference lab in the 1990s, he turned it into something greater than a routine testing lab.

Under Nahm’s leadership, the lab became a launch pad to study and improve existing assays, and create new assays. One breakthrough was his finding that the then-accepted second-generation ELISA assay lacked specificity to quantitate human antibodies against pneumococcal polysaccharides.

Nahm developed and validated the third-generation assay that was adopted by World Health Organization experts in 2000. “That’s how our lab became the WHO lab,” Nahm said.

Beall, of the CDC, writes, “In my opinion, Dr. Nahm is the world’s foremost authority in pneumococcal capsular structure and immunology. We in the public health arena absolutely depend upon this scientist’s unique insights into the ever-changing serologic landscape of this devastating pathogen.”

Journey to the United States

Nahm was born in Seoul, Korea, just before the Korean War erupted in 1950. His family evacuated to the city of Busan, on the southern coast of Korea, during the war.

“I had to fetch water from a well before sunrise, walking over icy hills in the dark by touch,” Nahm said. “If I waited until after sunrise, the well would be empty.”

By the early 1960s, Korea was still relatively poor.

“Electricity supply was so irregular in Korea that I remember wondering why one would bother to make an electrical clock,” Nahm said of his childhood. “Centralized heating of a house was inconceivable.”

In 1964, Nahm’s father, a medical doctor who had trained in the United States, decided to move the family to St. Louis. This was well ahead of the surge in Korean emigration to the United States in the 1970s and 1980s. Nahm suddenly found himself an American high school senior, needing to find a college.

He went to Washington University, where he graduated summa cum laude in physics and earned an M.D. degree. Nahm then decided to study infectious disease, noting its potential threat to human existence, as seen in the Black Death that killed one-fourth of Europe’s medieval population.

Ties to his homeland

Throughout his career, Nahm has kept strong ties with Koreans and Korean-Americans. He has mentored many Korean researchers and has also served on the scientific advisory group for the International Vaccine Institute, Seoul.

Nahm was chosen as one of the 20 outstanding Korean medical scientists by the Korean Medical Association in 2002, and he is one of 50 Korean-Americans profiled in the recent book “Korean Leaders LEADING America.”

As Nahm gained stature as a researcher, Korea also prospered, growing into the nation with the 11th-highest total GDP in the world.

“Now, in the 21st century,” Nahm wrote in a recent 50th reunion letter to his classmates from Kyunggi High School, Seoul, “I can feel the rise of Koreans on the world stage, along with many successful Korean-Americans in the USA.”

“I would never have guessed such changes were possible while I was growing up in Korea,” Nahm said.

“Perhaps the next generation will produce winners of Nobel prizes in science, which Koreans consider as the last proof of Korea’s arrival on the world stage.”

Poor Health Literacy A Public Health Issue

Newswise, October 17, 2016 — America’s poor record on health literacy is a public health issue, but one that can be fixed – not by logging onto the internet but by increased interaction with your fellow human beings, a Michigan State University researcher argues.

In a paper published in the journal BMC Public Health, MSU’s R.V. Rikard and colleagues found that people who are more connected with others on a personal level are more literate when it comes to health matters.

Specifically, the researchers discovered that people who are more engaged civically – those who vote and volunteer – are more health literate than those who don’t.

“Gathering information is more than just getting on the internet,” said Rikard, a post-doctoral research associate in the Department of Media and Information and lead author of the paper. “It’s face-to-face. It’s engaging with community.

“If you volunteer, you are more likely to have a higher level of health literacy.”

Health literacy is defined as a person’s ability to not only process and understand basic health information, but to be able to act on that information and make the appropriate decisions.

Rikard said that while gathering health information from the internet is not an all-bad thing to do, ultimately health literacy “is a social concept and should be treated as such.” He said when people discuss this information with others, they have a better chance of understanding it.

“Generally speaking, the best sources of information are family and friends,” he said.

 “But it depends on the context. A young man diagnosed with HIV probably wouldn’t want to discuss that with his parents. But a woman in menopause would talk about it with other women.”

To do the research, Rikard and colleagues did a deep analysis of the National Assessment of Adult Literacy, a 2003 project that surveyed more than 14,000 Americans on their health literacy levels.

Some of their other findings included:

*People who frequent libraries have higher health literacy than those who don’t.

*Women have higher health literacy than men.

*People who are married, or are living as married, have higher health literacy than those who are single.

*Among ethnic minorities, those born in the United States have better health literacy than those born in their native countries.

“One of the lessons from this is we have to do a better job with health communication,” Rikard said. “We have to put it in a social context, knowing where people live and how they communicate with one another.”

To access the paper, visit https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-3621-9.

Other members of the research team were Maxine Thompson, North Carolina State University; Julie McKinney, Health Literacy Services; and Alison Beauchamp, Deakin University, Australia.

Alzheimer's Disease Could Be Treated With Gene Therapy, Suggests Animal Study

Researchers have prevented the development of Alzheimer's disease in mice by using a virus to deliver a specific gene into the brain

Newswise, October 17, 2016— Researchers have prevented the development of Alzheimer's disease in mice by using a virus to deliver a specific gene into the brain.

The early-stage findings, by scientists from Imperial College London, open avenues for potential new treatments for the disease.

In the study, published in the journal Proceedings of the National Academy of Sciences, the team used a type of modified virus to deliver a gene to brain cells.

The research was funded by Alzheimer's Research UK and the European Research Council.

Previous studies by the same team suggest this gene, called PGC1 - alpha, may prevent the formation of a protein called amyloid-beta peptide in cells in the lab.

Amyloid-beta peptide is the main component of amyloid plaques, the sticky clumps of protein found in the brains of people with Alzheimer's disease. These plaques are thought to trigger the death of brain cells.

Alzheimer's disease affects around 520,000 people in the UK. Symptoms include memory loss, confusion, and change in mood or personality. Worldwide 47.5 million people are affected by dementia - of which Alzheimer's is the most common form.

There is no cure, although current drugs can help treat the symptoms of the disease.

Dr Magdalena Sastre, senior author of the research from the Department of Medicine at Imperial, hopes the new findings may one day provide a method of preventing the disease, or halting it in the early stages.

She explained: "Although these findings are very early they suggest this gene therapy may have potential therapeutic use for patients. There are many hurdles to overcome, and at the moment the only way to deliver the gene is via an injection directly into the brain. However this proof of concept study shows this approach warrants further investigation."

The modified virus used in the experiments was called a lentivirus vector, and is commonly used in gene therapy explained Professor Nicholas Mazarakis, co-author of the study from the Department of Medicine: "Scientists harness the way lentivirus infects cells to produce a modified version of the virus, that delivers genes into specific cells. It is being used in experiments to treat a range of conditions from arthritis to cancer. We have previously successfully used the lentivirus vector in clinical trials to deliver genes into the brains of Parkinson's disease patients."

In the new study, the team injected the virus, containing the gene PGC-1 - alpha, into two areas of the brain in mice susceptible to Alzheimer's disease.

The areas targeted were the hippocampus and the cortex, as these are the first regions to develop amyloid plaques in Alzheimer's disease.

Damage to the hippocampus affects short-term memory, and leads to a person forgetting recent events, such as a conversation or what they ate for breakfast. The hippocampus is also responsible for orientation, and damage results in a person becoming lost on familiar journeys, such as driving home from the shops.

The cortex, meanwhile, is responsible for long-term memory, reasoning, thinking and mood. Damage can trigger symptoms such as depression, struggling to work out how much money to give at a checkout, how to get dressed or how to cook a familiar recipe.

The animals were treated at the early stages of Alzheimer's disease, when they still had not developed amyloid plaques. After four months, the team found that mice who received the gene had very few amyloid plaques, compared with the untreated mice, who had multiple plaques in their brain.

Furthermore, the treated mice performed as well in memory tasks as healthy mice. The tasks included challenges such as replacing a familiar object in the mouse's cage with a new one. If the mice had a healthy memory, they would explore the new object for longer.

The team also discovered there was no loss of brain cells in the hippocampus of the mice who received the gene treatment. In addition to this, the treated mice had a reduction in the number of glial cells, which in Alzheimer's disease can release toxic inflammatory substances that cause further cell damage.

The protein PGC-1 - alpha, which is coded by the gene, is involved in metabolic processes in the body, including regulation of sugar and fat metabolism.

Dr Sastre added that other studies from different institutions suggest physical exercise and the compound resveratrol, found in red wine, may increase levels of PGC-1 - alpha protein. However, resveratrol has only been found to have benefits as a pill, rather than in wine, as the alcohol counteracts any benefit.

The team suggest injections of the gene would be most beneficial in the early stages of the disease, when the first symptoms appear.

They now hope to explore translating their findings into human treatments, said Dr Sastre.

"We are still years from using this in the clinic. However, in a disease that urgently needs new options for patients, this work provides hope for future therapies."

Dr David Reynolds, Chief Scientific Officer at Alzheimer's Research UK, said: "There are currently no treatments able to halt the progression of damage in Alzheimer's, so studies like this are important for highlighting new and innovative approaches to take us towards that goal.

“This research sets a foundation for exploring gene therapy as a treatment strategy for Alzheimer's disease, but further studies are needed to establish whether gene therapy would be safe, effective and practical to use in people with the disease.

“The findings support PGC-1-alpha as a potential target for the development of new medicines, which is a promising step on the road towards developing treatments for this devastating condition."

NEW REPORT AIMS TO MAKE EYE HEALTH A PUBLIC HEALTH PRIORITY

Newswise, October 9, 2016 — Vision impairment doesn’t just affect the eyes. It leads to major challenges, such as social isolation, depression, and injuries in adults and developmental, academic, and social issues in children.

People with lower socioeconomic status and poor health are at even greater risk for negative outcomes related to poor vision. And vision impairment is widespread—one model estimates more than 142 million Americans over the age of 40 have it, as well as millions more in younger populations.

“Yet, vision impairment remains notably absent from many population health agendas and community programs,” say the authors of a new report, Making Eye Health a Population Health Imperative: Vision for Tomorrow.

The report, created by The National Academies of Sciences, Engineering, and Medicine, comes out of 2 years of work analyzing a consensus study on public health approaches to reduce vision impairment.

The new report issues nine concrete recommendations for improving eye and vision health and increasing health equity, which the authors hope will serve as a “framework to guide action and coordination among various—and sometimes competing—stakeholders.”

Research to Prevent Blindness and nine other organizations provided sponsorship for the study, which addresses both correctable and uncorrectable vision impairment.

The recommendations fall under five key themes:
• Facilitate Public Awareness through Timely Access to Accurate and Locally Relevant Information;
• Generate Evidence to Guide Policy Decisions and Evidence-based Action;
• Expand Access to Appropriate Clinical Care;
• Enhance Public Health Capacities to Support Vision-Related Activities; and
• Promote Community Actions that Encourage Eye- and Vision-Healthy Environments.

“RPB is so pleased to have supported the work that went into developing this comprehensive and forward-looking report. Bringing eye health into population health efforts, as the data clearly shows, is an important step toward achieving equitable vision care for all.

“We believe that RPB can play a valuable role, working collectively with other vision-focused organizations, to get there,” said Brian F. Hofland, PhD, President, Research to Prevent Blindness.

Specifically, RPB is committed to expanding the pool of evidence-based research through the support of grants that allow researchers to target the causes of and potential treatments or cures for vision disorders that can lead to blindness.

In the report, Recommendation 4 calls for grant programs led by a common research agenda, developed by the U.S. Department of Health and Human Services with public, private, and community involvement.

The report and its calls to action are “very timely because we’re on the verge of getting hit by the baby boomer generation, in their 50s and 60s,” said Rohit Varma, MD, MPH, Interim Dean, Keck School of Medicine; Professor and Chair, Department of Ophthalmology; Director, USC Gayle and Edward Roski Eye Institute; and President, USC Care, during a report-related webinar on September 20.

Dr. Varma’s comments refer to the predicted surge in age-related eye diseases such as glaucoma, age-related macular degeneration, cataracts, and diabetic retinopathy that will result from a growing senior population. Among several key goals coming out of the report, Dr. Varma stressed the pressing need to understand the factors that affect vision, as well as develop effective interventions.

AS THE THERMOSTAT GOES UP, COPD SYMPTOMS MAY WORSEN

Photo by Dennis Murphy, Aston, PA, own work, taken with a Nikon D7100 digital camera, 9/30/2014. Lux Products TX9600TS Universal 7-Day Programmable Touch Screen Thermostat.

Newswise, October 3, 2016─High indoor temperatures appear to worsen symptoms of chronic obstructive pulmonary disease, or COPD, particularly in homes that also have high levels of air pollutants, according to new research published in the Annals of the American Thoracic Society.

In “Respiratory Effects of Indoor Heat and the Interaction with Air Pollution in COPD,” Meredith C. McCormack, MD, MHS, and her Johns Hopkins University colleagues report on a longitudinal study of 69 participants with moderate to severe COPD during the hottest days of the year.

“Previous studies have found that the elderly are particularly vulnerable to the effect of heat and more likely to die or be hospitalized during heat waves,” said Dr. McCormack, an associate professor of medicine at Johns Hopkins and lead study author.

“Our study builds on these findings by investigating exposure at the individual level, including in-home assessment of temperature and specific health effects of COPD. To our knowledge, this is the first study to report an interactive effect between indoor temperature and indoor air pollution in COPD.”

Participants completed a daily questionnaire that included the Breathlessness, Cough, and Sputum Scale (BCSS), which provides a standardized rating of respiratory symptoms.

Participants also performed daily spirometry to assess their lung function and recorded their use of rescue inhalers to manage symptoms.

This information was analyzed along with measurements of two air pollutants in their homes--fine particulate matter (PM2.5) and nitrogen dioxide (NO2)--as well as outdoor temperatures during the study period.

Researchers found:
• Participants spent the overwhelming majority of their time indoors. On the days they did go out, they spent on average about two hours.
• BCSS scores worsened with rising indoor temperatures and the use of rescue inhalers also increased.
• The effect of higher indoor temperatures was magnified by high levels of PM2.5 and NO2. A 10 degree increase in temperature in a home at the 75th percentile of PM2.5 levels resulted in a severe increase in symptoms, compared to only a mild increase in symptoms that occurred when the home was at the 25th percentile of PM2.5.
• The effects of higher indoor temperatures were experienced immediately and continued for one to two days.
• Lung function, as measured by spirometry, was unaffected by increasing temperatures or higher levels of indoor air pollutants.
• Although 86 percent of participants lived in a home with some form of air conditioning, they did not turn it on during 37 percent of study days.

Dr. McCormack added that the study also found that even the short time participants spent outdoors led to respiratory symptoms on hotter days.

In a recent study of air pollution and the health consequences related to outdoor PM2.5 and ozone levels in cities across the U.S., researchers found that reducing these air pollutants to levels below those set by the EPA would likely save thousands of lives each year and result in far fewer serious illnesses as well as dramatically reduce missed days of school and work.

As temperatures rise due to global warming, she believes that study findings present health care professionals with an opportunity for targeted interventions and policy makers with the need to develop mitigation strategies to protect those most vulnerable to heat.

“Given that participants spent an overwhelming majority of their time indoors, which we believe is representative of patients with COPD generally, optimizing indoor climate and reducing indoor pollution represents a potential avenue for improving health outcomes,” Dr. McCormack said.

Potential study limitations include being geographically confined to Baltimore and the decision to not measure indoor ozone levels because previous studies found those levels to be low indoors in the city.

Funding for this study was provided by the National Institute of Environmental Health Sciences and the Environmental Protection Agency.

Treating patients’ misperceptions is key

October 3, 2016--Federal health officials are already urging all Americans to get their flu shots as soon as possible. Yet the number of people who receive flu shots remains low, with less than one-third of adults between the ages of 18 and 49 getting vaccinated.

“Flu is serious. Flu is unpredictable,” Dr. Thomas Frieden, the director of the Centers for Disease Control and Prevention, told reporters ​last week during a joint briefing with the National Foundation for Infectious Diseases. “Flu often does not get enough respect.”

Unfortunately, there’s no clear prescription for how health care providers and public policy officials can effectively encourage patients to hit the flu clinic. Filling the communication gap are patients’ personal beliefs and biases about the vaccine’s effectiveness and impact on their own health.

“Many people refuse to get vaccinations due to misconceptions, such as flu shots are ineffective, cause people to get sick, or are unnecessary for healthy people. These beliefs minimize the benefits of vaccination and tip the scale in favor of not getting a flu shot,” says Wake Forest University’s Frederick Chen, an expert in the economics of public health.

The public health costs are staggering. Each year, between 5 and 20 percent of Americans are infected with influenza. The infectious virus lands more than 200,000 people in the hospital and causes thousands of deaths. The economic impact has been estimated at more than $80 billion a year.

“There seems to be this sentiment in the public health community that to combat these misconceptions we should give people more information, more statistics, and more data about flu vaccines, but recent studies have shown that this approach can have a backfire effect,” said Chen, an associate professor of economics.

“Vaccine skeptics inundated with pages of written information about why the vaccine is effective or safe might become more skeptical, not less.”

Chen’s most recent paper, published by Health Promotion International and co-authored with Ryan Stevens in the department of economics at New York University, combines behavioral economics and psychology to offer suggestions to boost flu shot numbers. Recognizing that people’s situations and understanding of flu shots can differ widely, Chen and Stevens recommend methods that humanize the issue and employ a more personal, concrete approach. Suggestions include:

• Mobilize community volunteers — Connect real people with positive outcomes from flu shots as they talk one-on-one about the benefits of vaccination with neighbors. The idea is based on door-to-door canvassing campaigns which have proven highly effective in increasing voter turnout, especially when canvassers are friends or people from one’s own community.

• Invest in public service ads and videos — People sharing stories about how they stayed healthy after a flu shot should be more memorable and have better impact on decision-making than reading a pamphlet.

• Partner with celebrities — Well-known figures have the potential to raise awareness on health issues. Katie Couric’s live colonoscopy on NBC’s TODAY Show 16 years ago led to a 20 percent increase in the number of colonoscopies performed in the following months.

• Make it personal — Asking people to recall the last time they were sick or someone close to them was sick with the flu is potentially much more effective than public health messages that simply tell people to “take time to get a flu vaccine.”

Chen says recent research in behavioral economics and psychology shows that misconceptions can arise when people construct ‘stories’ in their mind to help make sense of the world. These stories, which may not be accurate descriptions of the world, can nevertheless influence people’s decision-making.

“We can see when the vaccine fails to protect us because we get sick and feel terrible but we can’t see anything different from our normal healthy state when it works,” said Chen.

“Because negative experiences with flu vaccinations are more noteworthy and newsworthy than the positive experiences, if we are exposed to more negative stories than positive ones through our family members, friends, the media, and online, that may cause us to believe that flu shots aren’t all that effective when in fact a good match between vaccines and the flu virus reduces our risk of catching the flu by 60 percent.”

Behavioral economists and psychologists have made enormous strides recently in studying how errors and biases arise when people process information and how these affect decision-making.

Based on this research, adopting a more personal and humanistic approach that makes it easier for people to relate to the flu and its consequences could increase vaccination rates and reduce the societal cost of influenza.

YOU'LL FEEL THE PINCH THIS YEAR: GET THE FLU SHOT

The children of Loyola Medicine colleagues encourage everyone to get a flu shot before flu season takes hold. The flu shot protects children, their family and friends from this truly “yucky” virus. According to the CDC, everyone 6 months of age and older should get the flu vaccine.

Newswise, October 3, 2016 — This year, everyone will have to roll up their sleeves and receive the flu shot via injection, as the Centers for Disease Control and Prevention (CDC) no longer recommends the nasal flu mist vaccine due to ineffectiveness.

"Feeling the pinch is a small price to pay to protect your health and, importantly, to protect the health of those more vulnerable to illness," said Jorge Parada, MD, MPH, medical director, infection prevention and control program, Loyola Medicine.

"The message is still loud and clear," said Dr. Parada, a professor in the Division of Infectious Disease of Loyola University Chicago Stritch School of Medicine.

"Everyone six months and older should be vaccinated effective immediately. The flu shot is safe and effective and it's a myth that you can get the flu from the flu vaccine."

Flu season traditionally begins in October and ends around April, peaking in January and February.

"It takes almost two weeks after vaccination for the flu shot to become fully effective," said Dr. Parada. "Similarly, it can take four to five days after exposure to the flu virus to develop symptoms."

According to the CDC, the flu kills 3,300 to 49,000 people each year, with children and the elderly particularly vulnerable.

"Unlike many infectious diseases, the flu can be prevented and even eliminated when everyone in a community gets the vaccine," said Dr. Parada.

"Just as a hard hat is necessary safety equipment for construction workers, those of us who work in healthcare know that we need to take special precautions. Getting a flu shot protects ourselves, our patients and our entire community from harm."

Loyola is a leader in infectious disease prevention and is in its seventh season of mandatory flu vaccine as a condition of employment.

Each February, an FDA committee determines which virus strains will go into vaccines sold in America for the coming season. The committee considers which viruses are making people sick in Asia, where the flu season first begins, and the effectiveness of the previous season's vaccine.

According to the CDC, flu vaccines protect against the three or four viruses that research suggests will be most common. For 2016-2017, three-component vaccines (trivalent) are recommended to contain:

• A/California/7/2009 (H1N1)pdm09-like virus
• A/Hong Kong/4801/2014 (H3N2)-like virus
• B/Brisbane/60/2008-like virus (B/Victoria lineage)

Four component vaccines (quadrivalent) are recommended to include the same three viruses above, plus an additional B virus called B/Phuket/3073/2013-like virus (B/Yamagata lineage).

Dr. Parada offers the following tips to protect yourself and your community this flu season:

• Get your flu shot anytime starting now, and certainly before the end of October
• Wash your hands thoroughly and frequently throughout the day
• Cover your mouth and nose with the crook of your arm when you sneeze to limit the spreading of germs
• Stay home if you have the flu

"You'll know you have the flu, and not just a cold, if you also have a fever," said Dr. Parada. "Stay home for two to three days until you are not in danger of infecting others. And remember there are multiple strains of the flu virus so it is possible to get sick with flu more than once during the flu season."

Loyola University Medical Center is one of a few select hospitals who invest in universal screening of all inpatients for MRSA, was the only academic hospital to participate in a national C. difficile study and performs the most accurate testing for bacteria.