Meningitis B

It seems like every year there are several outbreaks of meningococcal infections on college campuses across the country. This disease is caused by a bacterium called n. meningitides which can infect both the brain and the blood. Although meningococcal infections are rare even with treatment this infection can be deadly in 10-15% of patients. Those who survive can experience permanent disabilities like amputation, hearing loss, brain damage, kidney damage, and scarring from skin grafts. As a student at The Ohio State University you are required to be vaccinated for meningitis before you can live in university housing. This vaccine covers meningitis type A,C,Y, and W-135. It does not cover meningitis B which causes nearly half of meningitis cases in patients aged 17-22. There are currently two vaccines on the market for meningitis B, Trumenba and Bexsero. Both vaccines are approved in the United States for patients aged 10-25 for the prevention of meningococcal type B infection. Although the medication is approved for 10-25 the Advisory Committee on Immunization Practices and the CDC give these recommendations.

These vaccines are recommended for patients ten years and older who:

  • Are at risk due to a type b outbreak
  • Have a damaged or removed spleen
  • Have an immune system condition known as “persistent complement component deficiency.”
  • Are taking eculziumab (Soliris)
  • Routinely work with N. meningitides.

There is an additional recommendation that the vaccine may be given to anyone aged 16-23 with a preferred age of vaccination being 16-18. This allows patients and their healthcare providers to determine if they want the vaccine.

Both vaccines require multiple doses. Bexsero is a two dose series with the doses being administered at least one month apart. Trumenba can be a two or three dose series depending on your risk level for meningococcal B infection.

 

Michael Kowalczyk

PharmD candidate 2018

It’s OK to use your sleeve

Growing up sleeves were a big no-no.  We weren’t supposed to use our sleeves to wipe our noses or our mouths.  We weren’t supposed to stretch out our sleeves. And we weren’t to use our sleeves as rags to wipe things down.  Sleeves were to be – well – sleeves.

The wiping of the nose thing – that’s still good advice, but our sleeves can serve a purpose other than being sleeves.  Sleeves are great for coughing and sneezing.  If you’re coughing/sneezing into your sleeve, you’re limiting the spread of germs into the air, protecting those around you.

Medical Mythbusters – Can you catch the flu from the flu vaccine?

Q: I’ve heard that you the flu shot can give you the flu.  Is that true?

A: Definitely not! This is one of the most pervasive and frustrating medical myths out there. The flu shot contains only dead virus so there is no way it can infect you.

It is possible that the shot can induce an immune response that gives you flu-like symptoms such as muscle aches or a low grade fever, but nothing compared to getting the actual flu.  If you do get the flu after a flu shot, it is likely that you were exposed to the flu or another illness before getting the shot, since it takes about 2 weeks after your shot for full immunity to develop. The flu vaccine doesn’t guarantee 100% protection; it is always possible to catch a strain of the flu not included in the vaccine.

Certain people who are at especially high risk of complications from the flu definitely need to get vaccinated every year, but the flu shot is available to anyone who wants to avoid getting the flu.

You can find information on getting the flu vaccine at OSU Student Health Services here.  

Angela Walker, Med IV (Ohio State College of Medicine)

John A. Vaughn, MD (Ohio State Student Health Services)

Reviewed by Tina Comston, M.Ed. (Ohio State Student Health Services)

I stepped on a nail. Do I need a tetanus shot?

Ouch!!!

Get your vaccination

Jogging with tunes

Q: I stepped on a nail and am wondering if I need a tetanus shot.  My last shot was 5 years ago.

A: You should probably get a tetanus shot in this case.  Tetanus vaccines are given to children in the USA with a series of 5 childhood shots called the DTaP.  The vaccine covers diphtheria, tetanus, and pertussis.  A booster that contains vaccines to all three diseases is given between the ages of 11 and 18.  After that, it is recommended that adults get the booster vaccine every 10 years, and sooner (every 5 years) if there is an injury. 

What kinds of injuries are concerning?

Puncture wounds from objects like nails and bites are most susceptible to infection with tetanus. However, you can also get tetanus from any exposure to soil, including minor cuts, scrapes, and burns, and sometimes with no injury at all. 

Is tetanus a bad diease?

Thanks to the vaccine, Tetanus (or “lockjaw” as it used to be known) is pretty rare in the United States, which is a good thing because it is seriously bad news.  Once the tetanus bacteria get into your tissues, it starts creating toxins that interfere with nerves.  This leads to muscle spasms, contractions, and ultimately, respiratory failure.  We emphasize the importance of the vaccine because Tetanus is deadly and there is no cure for it. 

How do I care for my wound?

It is important to take care of a skin wound to prevent infection.  The steps are:

  • Clean the wound thoroughly with soap and water. 
  • Use an antibiotic cream and keep the wound covered with a bandage until it scabs over. 
  • Remember to change the dressing daily or it becomes wet or dirty.
  • Seek care if the wound is getting more red or painful, or if you have other concerns. 

Student Health Services offers services for most non-life-threatening injuries and wounds, and the full range of adult immunizations, including the Tetanus/Diphtheria and Tetanus/Diphtheria/Acellular Pertussis boosters used most commonly in this situation.  Check out our price list, in case you are concerned about the cost.

FINAL SUMMARY – if you get hurt, consider getting a tetanus shot if it has been more than 5 years since your last booster, and keep your tetanus protection up-to-date every ten years. 

Student Health Services
The Ohio State University

What is covered as part of a routine physical?

Let's Get (a) Physical!

Last week we talked about what tests and examinations are involved in a “routine physical” for most college, graduate and professional students.  Now we’re going to talk about some special situations in which a physical might entail something different.  

It’s important to note that health insurance companies vary as to what preventive medicine services they will pay for.  Most base their coverage on the recommendations of several expert groups who have studied the relative value of various screening tests, immunizations, and health counseling.  These groups include the CDC (Centers for Disease Control and Prevention), the USPSTF (U.S. Preventive Services Task Force), the American Cancer Society, the ACOG (American College of Obstetrics and Gynecology), the ACIP (Advisory Committee on Immunization Practices – part of the CDC) and others.

Fortunately, students between the ages of 18-45 who are in good health don’t require many preventive measures.  Those that are generally recommended (and covered by insurance) are:

  • Annual flu (influenza) shots
  • A tetanus booster every 10 years (the shot actually prevents diphtheria and pertussis as well)
  • The HPV vaccine (Gardasil)- a series of three shots that prevent Human Papilloma Virus infection
  • Counseling about quitting tobacco use
  • Counseling about healthy alcohol intake
  • Counseling about physical activity
  • Counseling about weight
  • Screening for the STD’s chlamydia, gonorrhea, HIV, and syphilis

Other screening tests may be recommended (and covered) in certain situations.  These include:

1. Cholesterol screening IF:

  • you are over age 35 (men) or over age 45 (women) OR
  • you are obese OR
  • you have a biologic brother, sister, mother, or father who has a history of Sudden Cardiac Death or cardiovascular disease (like a heart attack or heart surgery)

2. Updates on other immunizations if you have not received all the recommended shots as a child

3. For women, an annual pelvic exam, which usually includes a PAP smear and screening for STD’s

What about an actual physical examination?  Believe it or not, doing a head-to-toe complete physical isn’t recommended by most of the groups above because it’s never been shown to be an effective way to screen for hidden health problems.  SOME insurance companies do cover these physical exams, but the specifics of what is included may vary based on your age.  For example, hearing and vision screening is often included for children and older adults, but not for young adults.  When in doubt, check with your insurance company.

If you have any questions about your health or what exams, tests and immunizations you need, you should make an appointment to see us at the Student Health Center – we’re always glad to help. 

And check back next week, when we finish our series on physicals by discussing the different kinds of physical exams you may come to see us for.

Mary Jane Elam, MD
Student Health Services
The Ohio State University

Travel Medicine In Focus

cardiophile.com

Gorakhpur, India

Q:  I am going to (FILL IN YOUR DESTINATION HERE) and I don’t really think I need any shots to go there.  Should I still make a travel appointment at Wilce Student Health?

A: We see OSU students traveling to nearly every destination on the globe, and the risks do vary from country to country, no doubt.  However, there is more to a travel appointment than getting an exotic vaccine.  Our travel medicine providers will: 

·   Provide current health and security information about your destination(s)

·   Update your routine immunizations

·   Recommend tuberculosis (TB) testing when indicated

·   Prescribe travel medicines, including anti-malaria pills

·   Advise you on getting adequate supplies of your prescription medicines

·   Provide information on staying healthy while traveling, such as food and water safety, sun and insect protection, and more

·   Explain and recommend travel vaccines for diseases like typhoid and yellow fever

So, even if you are traveling to a destination with limited risk, you still might want to consider coming in for some advice and recommendations. 

Wilce Student Health is an Ohio Department of Health-approved vaccine site, and routinely stocks the most commonly used travel shots at reasonable prices.  We also issue official World Health Organization vaccine certificates to all travel patients. 

Happy Travels! 

Roger Miller, MD (OSU Student Health)

 

Take a trip with SHS

Gorakhpur, India

Surfer on the Beach

 

Take a trip with SHS!

Student Health Services sees a lot of students with plans to travel internationally, either as part of one of the many OSU Study Abroad opportunities, other travel associated with academic programs, or recreational travel.  Before you grab that passport and head for the airport, here are some healthy pointers:

  • Plan ahead – Most students plan for months or even years to get ready for international travel. Don’t forget to include health matters in those plans. Some vaccines are given in series over months, so start those early.
  • Get your shot records – Updating any incomplete or expired vaccinations from your childhood is an important part of travel preparation.
  • Talk to your health care provider about your trip – This is especially important for those students with chronic illnesses or prescriptions that they plan to continue while traveling.
  • Do your health insurance homework – Are you covered in Caracas? What is your deductible in Denmark? Is there a co-pay for Tetracycline in Timbuktu? Find out how your travel plans will impact your coverage.
  • Visit a travel expert – Our Student Health Services travel providers are ready to address your needs comprehensively, and offer an extensive selection of travel vaccines and medications. If you plan to visit someone else, make sure they are up to date on the changing health situations around the globe. (BTW, SHS is an Ohio Department of Health-certified Yellow Fever Vaccine clinic)
  • Be Patient! – Travel visits usually take a bit longer than a typical visit to the doctor, as each visit includes a thorough review of your health history, a discussion of your destination country’s or countries’ current health and safety conditions, and orders for all necessary medications and shots. Many students also start their vaccines at that same visit, so we would expect that you would be with us 40-60 minutes at a minimum. (All vaccines are recorded on an official International Vaccine Certificate for your convenience.)

Keep in mind, disease exposures can occur on a 3 month excursion across a continent or during a 5 day trip to a beach resort.  So, come see us before you order your Spring Break airline tickets.  Reduce the risk of having your trip to Cabo result in spending the first weeks of Spring Quarter sick from a preventable illness.

Healthy Travels!

Roger Miller, MD and Pat Balassone, CNP (OSU Student Health Services)

 

Are immunizations paid for at the Student Health Center?

Get your vaccination

Q: Are immunizations covered at the Student Health Center?

A: If you have the Comprehensive Student Health Insurance Plan, many immunizations are covered with no cost sharing under the Preventive Services benefit.  That means you have no out of pocket expense for these immunizations.  The following immunizations recommended by the Advisory Committee on Immunization Practices are covered at 100% under the Comprehensive Student Health Insurance Plan:

  • Hepatitis A
  • Hepatitis B
  • Hepatitis A&B
  • Human Papilloma Virus (HPV) for students under 27 years of age only
  • Influenza
  • Measles-Mumps-Rubella (MMR)
  • Meningococcal
  • Tetanus-Diphtheria toxoids (Td)
  • Tetanus-Diphtheria-Acellular Pertussis (TdaP)
  • Varicella (Chickenpox)

The following immunizations are covered at 50% under the Comprehensive Student Health Insurance Plan.  You will be responsible for half of the cost of the immunization and administration fee:

  • Polio
  • Typhoid
  • Japanese Encephalitis
  • Rabies
  • Yellow Fever

The price for all immunizations can be found on the SHS website.

Preventive Medicine services including immunizations are specifically excluded under the WilceCare Supplement.  For more details on the WilceCare Supplement or the Comprehensive Student Health Insurance Plan, see the Student Health Insurance website.

Immunizations are considered preventive medicine services by most insurance plans.  Due to recent changes in health care laws, these services may be covered when given at the Wilce Student Health Center.  To find out how or if your plan will cover immunizations at Wilce (or any other facility) you will need to contact your insurance company.

Michael Bower, CPC-A
Student Health Services
The Ohio State University

Can I get the flu shot if I’m sick? What if I have a fever?

Flu shots available in the pharmacy.

We’re quickly heading into the heart of flu season here, Buckeyes – in fact we’ve already seen a couple of cases – so it’s time to talk flu vaccine. 

There are a few valid reasons to not get a flu vaccine:

  • You’ve had a severe allergic reaction to eggs in the past
  • You’ve had a bad reaction to a flu vaccine in the past
  • You’ve had something called Guillain-Barré Syndrome (GBS) after receiving influenza vaccine in the past. 

These are pretty rare conditions, but being sick this time of year sure isn’t and we get asked all the time whether or not someone can get a flu shot if they’re sick.  Or even worse – people just assume they can’t and we never see them!  So let’s set the record straight.

If you’re sick with a cold or other mild illness (respiratory or otherwise) and you don’t have a fever, you can absolutely get your flu vaccine.  If you have a fever (temp over 99.5ish), the general consensus has always been that you should hold off on getting the flu vaccine until it breaks.  Why?  Two reasons:

  1. If you spike a fever right after getting the vaccine, we won’t know if you’re having a bad reaction to the vaccine (see above) or if it’s just your illness.  We don’t want to confuse the matter and cause you to not get the vaccine in the future.
  2. The vaccine might not be as effective.  If your immune system is all fired up fighting an infection, your white blood cells might get confused and attack the vaccine along with whatever ails you, leading to a weaker response to the vaccine.

As you can see, neither of these issues is a safety concern – getting a flu shot while you have a fever isn’t going to hurt you.  Because of this, and because influenza can be deadly even in healthy teenagers, many health care providers are starting to think it might be better to give the flu vaccine to someone with a fever and risk them having a slightly weaker response than to send them away and risk them not coming back for the vaccine at all. 

When in doubt, just ask us.  You can come into our pharmacy to get your flu shot between 8:30am – 4:00pm, Monday through Friday – no appointment necessary!  Just go to the first floor registration desk at the Wilce Student Health Center.  We’ll collect your payment; you’ll turn around and walk about 12 steps to the pharmacy where one of our highly skilled and dedicated pharmacists will administer the immunization.  We’ll ask you to stick around for 10 minutes to ensure you do not have a bad reaction.

So come in and see us for your flu vaccine!  To save yourself time, you can even download the 3 forms you’ll need to fill out here and bring them in with you.  See how easy it is?

John A. Vaughn, MD
Student Health Services
The Ohio State University

 

Can I get the flu from a flu shot?

fluvaccine.com

Fall Colors

Q: I don’t want the flu shot because it always gives me the flu.  Is it okay not to get vaccinated?

A: Here are a facts to consider:

1. Injected influenza vaccine is an inactivated viral vaccine, meaning that there is no living influenza in the injection.  Therefore, you cannot get influenza from the vaccine.   This is a commonly held misbelief, in part because people commonly get upper respiratory illnesses in the winter months that they attribute to the vaccine.

2. The influenza vaccine is designed to protect against the most likely flu strains to appear in the upcoming season.  Against those strains, the vaccine is 70-90% effective in prevent infection.  If a different strain appears in the community, which is possible, then the vaccine may not protect against that one.

3. Nearly all vaccines can cause a brief period of low grade fever and body aches in the 1-2 days following vaccination, along with some discomfort in the injection site.  The fever and aches are due to your immune system responding to the vaccine (although the absence of these symptoms doesn’t mean the vaccine didn’t work), so in essence, this is a good thing.

All in all, the benefits of this vaccine greatly outweigh the risks.  Come see us if you have more questions, or are interested in getting the flu vaccine.   It is fully covered for those of you on the Comprehensive Student Health Insurance Plan, and several other insurance plans are covering it, too.  

Check out our Events Calendar for upcoming walk-in flu vaccine programs. 

Good Health!

Roger Miller, MD (OSU Student Health Services)