Corporate Health Management - vaccinations and medical consulting in Dallas, Texas

UNDERSTANDING VACCINES

[Influenza] [Hepatitis A] [Hepatitis B] [Pneumococcal Disease] [Tetanus] [Meningococcal Disease]

DON'T CATCH THE FLU!

[Why offer a flu vaccine?] [What's included] [Influenza fact sheet]

UNDERSTANDING THE TESTS

[History and physical examination] [Follow-up for review and recommendations] [Blood Chemistry Profile] [Complete Blood Count] [Electrocardiogram] [HDL] [Urinalysis] [Chest X-Ray] [Spirometry] [Hemoccult Test] [Sigmoidoscopy] [Screening Audiometry] [Cardiac Stress Test] [Pap Smear] [Mammograms] [Prostate Specific Antigen]

UNDERSTANDING VACCINES

INFLUENZA
Influenza is an acute respiratory illness that produces cough, congestion, muscle pain, headache, feverishness and sore throat. It may be complicated by pneumonia and sometimes requires hospitalization. It is produced by a virus and, therefore, does not respond to antibiotics. Episodes usually occur in the winter and may last 1-3 weeks or longer if complications occur.

Who is at risk? The greatest risks occur in persons over the age of 50, persons with heart or lung disease, chronic illnesses, diabetes, renal disease, asthma or a weakened immune system. Medical professionals and anyone in contact with large numbers of people in office, retail, school, etc. and individuals wanting to reduce their risk of developing the flu should get a flu shot.

How can I protect myself? The influenza vaccine should be given annually and is most effective when administered in early to mid autumn.

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HEPATITIS A
What is Hepatitis A? Hepatitis A is an acute viral infection which produces loss of appetite, nausea, vomiting, fatigue, weakness, muscle pain, sore throat, jaundice and cough often lasting one to two weeks or more. It is spread by contaminated food, water, milk, shellfish and contact with person who have the infection. No specific treatment is available.

Who is at risk? Persons working in health care, childcare, restaurants, food processing, large institutions (universities, government agencies, corporations), and foreign travelers.

How can I protect myself? Protection from Hepatitis A infection requires a series of two
injections six months apart.

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HEPATITIS B
What is Hepatitis B? Hepatitis B is an acute viral infection that often lasts several months and may become permanent in some individuals. Long term disability and death are not uncommon with this infection. It is transmitted through contaminated needles, blood products, sexual contact and all body fluids.

Who is at risk? International travelers, health care, day care, and nursing home workers. Also, persons who abuse drugs.

How can I protect myself? Protection requires three injections over a six-month period.

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PNEUMOCOCCAL DISEASE
What is pneumococcal disease? Pneumococcal infection is caused by a bacterium that may infect the lungs, throat, ears, and other parts of the body producing fever, pain, and in some case death.

Who is at risk? The entire population is at risk but most problems occur in children and persons over 50 years of age, especially with chronic illnesses, such as heart disease, lung disease and diabetes.

How can I protect myself? A single dose of pneumococcal vaccine taken every six years prevents infection with the strains that cause disease in humans.

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TETANUS
What is Tetanus? Tetanus is a neurological disease cause by a toxin elaborated by the bacterium Clostridium Tetani. Tetanus is often fatal and is completely preventable with immunization.

Who is at risk? Tetanus may affect anyone and the greatest risks occur in newborns, infants and persons with injuries, or major illnesses.

How can I protect myself? Protection requires a series of three immunizations (required before one can enter school in the United States) and booster injections every ten years.

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DON'T CATCH THE FLU! Absentee Reduction with Influenza Immunization

Why offer a Flu Vaccine?
The flu virus is dependable --it arrives every winter. You can always be sure it will make its presence known in your office.

A case of the flu usually results in two to five days absence from work.

The effects of the flu may be felt for weeks after the major symptoms subside. Persistent cough, weakness and inefficiency due to reduced stamina are part of the aftermath.

Influenza vaccine offers:
Effectiveness--Providing up to 80 percent protection
Assurance of safety--Highly purified so there are few reactions

Offering this fringe benefit amplifies the value your company places on personal health and encourages employees to take responsibility for their own well-being.

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What’s included in the Immunization Program?
Influenza vaccine for each employee. Family members may be included.

Trained, experienced medical personnel and all necessary supplies.

Literature for each person receiving the vaccine, describing the purpose of the Influenza Immunization Program and possible side effects of the vaccine.

Informational signage to display prior to the date of service.

Individualized flyer for reproduction and disbursement to employees.

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American Lung Association Fact Sheet - Influenza
Influenza is a potentially life-threatening, contagious disease that is caused by a virus. When influenza attacks the lungs, the lining of the respiratory tract is damaged. The tissues temporarily become swollen and inflamed, but usually heal within two weeks.

In 1993, influenza and pneumonia (the most common complication of influenza) combined was the fifth leading cause of death among all American women and the fifth leading cause of death among all Americans over the age of 65. Influenza and pneumonia together resulted in 82,820 deaths.

In 1994, there were more than 90 million estimated cases of influenza nationwide, resulting in 170.1 million bed days.

Total costs of influenza were estimated at $14.6 billion in the U.S. for 1993. This included $1.4 billion in direct health care costs, which were primarily hospital care, physician, and other health service costs. There were also $13.2 billion in indirect health costs comprised of lost earnings due to illness and lost future earnings due to mortality from influenza.

According to the most recent data, in 1994 there were 69,320,000 work-loss days attributed to influenza (in employed persons age 18 and over).

A person can have influenza more than once because the virus that causes influenza may belong to different strains of one of three different influenza virus families, A, B or C. Type A viruses tend to have a disproportionate effect on adults, Type B viruses have a disproportionate effect on children. Both A and B have strains that cause illness of varying severity. The influenza A family has more strains than the B family.

Influenza can be prevented with influenza vaccine. This vaccine is produced each year so that the vaccine can contain influenza viruses that are expected to cause illness that year. A yearly influenza vaccination has been reported to be between 70 and 92 percent effective in preventing influenza and reducing the severity of the influenza.

Most people experience little or no reaction to the vaccine. One in four people might have a swollen, red, tender area where the vaccination was given.

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UNDERSTANDING THE TESTS
In order to understand the benefits of a comprehensive examination it is important to know what each test or examination involves and what is learned from each one.

History and physical examination
This is the most important and fundamental part of any medical examination. Details from previous illnesses, injuries and surgery are reviewed. The function of each organ system is discussed and any related symptoms reviewed in detail. The past medical history including previous surgery, use of medications, reactions to medications, smoking history, and use of alcohol and caffeine is reviewed. A discussion of the family history often reveals important trends that help predict future medical risks. Information obtained during the history is then used to guide and focus the physical examination. The entire body is examined with special emphasis on the heart and signs of atherosclerosis and cancer. The information obtained from the history and physical examination provides an understanding of the general health picture that is essential for selecting other tests and making recommendations for management of risk factors.

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Follow-up for review and recommendations
A follow-up conference comes at the end of the examination process, but ranks second in importance only to the history and physical examination itself. During the review findings are discussed, questions are answered and recommendations are made for reducing risk and improving general health in the future. The importance of the review and recommendation conference increases significantly if there are positive findings in the examination or any of the tests.

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Blood chemistry profile (SMAC)
The blood chemistry profile provides more than 20 different chemical tests on the blood to evaluate the function of organ systems and levels of critical substances in the blood such as electrolytes, uric acid, cholesterol, triglycerides and proteins.

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Complete blood count (CBC)
This test determines if a person is anemic and also gives important information about infection, the number of red blood cells present and the adequacy of nutrients such as iron, vitamin B12, folic acid and others.

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Electrocardiogram (EKG)
Heart rhythm, old injuries and a general assessment of heart size and function can be determined from the electrocardiogram. While it does not evaluate the heart’s function during exercise, it does provide important fundamental information about the heart.

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High density lipoprotein cholesterol (HDL)
HDL cholesterol is thought to be the most important single laboratory test for predicting risk of heart disease. Often referred to as "good cholesterol," it is usually low when there is an increased risk of heart disease and rises as the risk of heart disease decreases. It is important, however, to interpret the HDL value in light of the total cholesterol, other lipid levels and the general state of health. Taken alone it can be misleading.

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Urinalysis
Chemical and microscopic examination of the urine helps to identify bladder disorders, such as infection and inflammation, diabetes, kidney disease and other medical disorders. Used in conjunction with other tests, the urinalysis is also very helpful in assessing the general state of health.

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Chest x-ray
The chest x-ray is most commonly thought of as a means for identifying lung cancer, however, it is also critical for the evaluation of the heart, blood vessels, lungs and spine. In women, it is particularly useful in helping to identify the early signs of osteoporosis.

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Spirometry
Evaluation of the lungs and lung function is difficult because so many factors affect lung function. Spirometry, especially in conjunction with a chest x-ray, provides the most useful single means of evaluating functional capacity of the lungs. It is especially helpful in identifying damage from cigarette smoking, asthma and the changes caused by other chronic lung diseases.

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Hemoccult test
The hemoccult test is a very useful simple test for identifying hidden blood in stool. Cancer, diverticulosis, ulcer disease, esophagitis and gastritis can all produce hidden blood which this test helps to identify.

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Sigmoidscopy (flexible)
The flexible sigmoidoscopic examination has replaced the old proctoscopic examination as a means for identifying cancer, polyps and other lesions in the distal colon and rectum. This is one of the most important advances in cancer prevention in the last 50 years. With minimal inconvenience and almost no risk, the procedure provides an opportunity to find cancer and polyps at an early state when they are easily treated. The American Cancer Society has strongly recommended a major emphasis on sigmoidoscopy and hemoccult testing to help control the rapidly increasing incidence of colon cancer.

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Screening audiometry (hearing test)
This test is a simple, inexpensive, convenient way to identify hearing loss at an early stage. Since hearing loss usually develops slowly over a period of years, many people suffer from a major hearing loss without knowing it. Their performance and interaction with other people can be significantly impaired before they realize what is happening if the hearing is not tested.

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Cardiac stress test
Cardiac stress testing is the most important single test in determining the heart’s functional capability. This is the only non-invasive means to identify coronary disease at an early stage. It is the best means available to identify a person who is about to have a heart attack, but has no symptoms or early warning signs. Medical judgment is important in determining when stress tests should be done and how the results should be interpreted.

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Pap smear
Cervical cancer and some types of uterine cancer can often be identified with a simple Pap test. When used properly this test can identify cancer at an early state when it is easily treatable and prevent major medical complications.

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Mammograms
Mammograms help identify breast cancer at an early stage when it can be treated effectively. The American Cancer Society and other groups recommend that mammograms be used on a regular basis after age 40. Since breast cancer is prominent in certain families, it may be important to do mammograms at an earlier age in some women. Medical judgment should be used in ordering and interpreting this test.

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Prostate specific antigen (PSA)
Development of the PSA test (Prostate-Specific Antigen test) has revolutionized early detection of prostate cancer. This test along with examination of the prostate can identify cancers at a very early stage when they are treatable. This test is recommended for all men over 40 years of age.

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NOTE: Cancer screening tests such as mammograms, Pap smears, PSA tests, sigmoidoscopy and hemoccult tests should be done on a regular basis according to the patient’s age, family history and personal medical history. It is not appropriate to wait until symptoms develop in these areas since that defeats the purpose of early detection. The time and frequency of use depends on several factors and requires some medical judgment, but in general these tests should be used regularly in all persons over 40 since cancer is more commonly seen in that age group. Pap smears, a major exception to that rule, should be done annually in all women who are sexually active or of childbearing age.