5 Important Things to Know About the 2018 Flu Season

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It's normal for people to fantasize about taking a Hawaiian vacation in the dead of winter, but the far-flung tropical state holds extra allure right now: Hawaii is the only area in the U.S. that hasn't yet reported widespread influenza activity, according to the Center for Disease Control's latest flu report.

Thirty-two states so far (plus New York City and Puerto Rico) are currently experiencing "high" flu activity, and nearly 9000 influenza-related hospitalizations (mainly involving seniors, middle aged patients, and children) have been reported since October 1, 2017. Whether you've been personally affected by the virus or managed to avoid it thus far, here's what you need to know about this year's flu season.

1. IT'S BAD BUT NOT UNPRECEDENTED.

Yes, this flu season is bad, but not apocalyptically so. In fact, the 2014–2015 season was "just as bad, if not worse," Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health (NIH), told MD Magazine. "Though the perception has been ‘Wow, this is unprecedented,' in no way is it unprecedented."

Most states have reported high influenza levels and an increase in pediatric influenza hospitalizations. But both the 2014–2015 and 2012–2013 seasons saw even greater child hospitalization rates in early January, according to Fauci. The current flu season has been hyped mostly because it came in earlier than expected, and with a vengeance—not because it's more severe than in the past.

2. MULTIPLE STRAINS OF FLU ARE CIRCULATING—AND ONE IS PARTICULARLY VIRULENT.

Multiple influenza strains are currently circulating throughout the U.S., with the most vicious one being the H3N2 flu. According to CDC experts, flu seasons dominated by H3N2 can lead to an increase in hospitalizations and deaths—and unfortunately, the current flu vaccine may be just 30 percent effective against this particular strain. On average, a flu shot is around 40 to 60 percent effective.

The seasonal flu shot allows individuals to develop infection-fighting antibodies against strains that experts predict will soon be be widespread. This year, experts thought that the H1 strain would reign supreme, and they designed the vaccine accordingly. People are indeed still catching it, and the shot grants them protection against this strain. While it offers less protection against H3N2, it can still lessen the severity of your illness if you do come down with it.

3. THE FLU SEASON HAS LIKELY PEAKED, BUT IT'S NOT OVER QUITE YET.

The CDC announced on Friday, January 12, that the influenza illness had likely reached its zenith for the 2017–2018 flu season. But just because it's peaked doesn't mean it's over; in fact, officials say we may have up to three months to go until we're officially out of the germy woods. Keep your guard up: Wash your hands, tote around hand sanitizer, and avoid sniffly colleagues.

4. IT'S NOT TOO LATE TO GET YOUR FLU SHOT.

Getting an annual flu shot in the fall provides you with maximum protection, but it isn't too late to get vaccinated if you forgot to schedule a seasonal appointment.

Even if you're not worried about getting sick yourself, it's still important to get the shot to protect others; when it comes to infectious disease, we're all in this together. Epidemiologists call that mutual collective protection herd immunity. Hundreds of thousands of people are hospitalized with influenza each year, and thousands or tens of thousands die from it, according to the CDC. The flu can be particularly dangerous for seniors, young children, pregnant women, and those with chronic medical conditions. They run the risk of developing severe complications that can lead to hospitalization and even death. Eighty-five percent of the 30 children who have died from flu this year so far were not vaccinated.

Bottom line: Make a beeline to your doctor or pharmacy post-haste if you haven't gotten your shot. This also goes for those who've already come down with the flu—it's still possible that you could become infected by yet another strain.

5. FLU CAN LIVE FOR A LEAST A DAY IN A HANDKERCHIEF. 

In addition to hand hygiene, practice tissue hygiene—and steer clear of hankies at all cost—to avoid coming down with the flu. Viruses can survive in a handkerchief for about a day and spread, and the same presumably goes for a used tissue, which is why it's important to use it just once before tossing it into the trash.

BONUS: SCIENTISTS ARE WORKING ON A UNIVERSAL FLU VACCINE.

In 2017, the NIH resolved to work towards a universal flu vaccine, designed to safeguard against all (or almost all) flu strains. More than 150 researchers have collaborated to work on the initiative, with researchers searching for rare flu targets and playing close attention to animal flu strains that might jump to humans.

Several vaccine prototypes are now entering the first stages of human safety testing. One vaccine removes the "head" of a protein coating the virus, where mutations often occur. Another alters the protein so that it's alien to the immune system, triggering a response. Yet another combines four different proteins in hopes the immune system will mount defenses against multiple strains. Ideally, a universal vaccine would be given to people when they are young to hopefully create a lifetime of protection, the NIH's Fauci told CBS News: "The vision of the field is that ultimately if you get the really good universal flu vaccine, it's going to work best when you give it to a child."

The Best (and Worst) States to Have a Baby

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While having a baby is usually a joyous occasion, the logistics of the process can differ wildly based on where you’re raising your family. Healthcare costs, hospital rankings, mortality rates, availability of doctors and midwives, and many other factors vary from state to state and region to region.

WalletHub recently decided to crunch some numbers to figure out which states are the best for soon-to-be and brand-new parents, and which are the worst. The financial advisory site (which loves to rank states on characteristics like how happy, fun, and environmentally friendly they are) examined a number of different factors related to pregnancy, childbirth, and infancy in all 50 states plus the District of Columbia.

The data encompassed 26 different factors related to childbirth and parenting, including how much hospitals typically charge for C-sections and conventional deliveries, the average cost of a babysitter, the state’s parental-leave policy, maternal and infant mortality rates, vaccination rates, and how many pediatricians, OB-GYNs, midwives, and childcare centers there are per capita.

Below are the top 10 best states for having a baby overall, according to WalletHub's analysis.

1. Vermont
2. Massachusetts
3. Minnesota
4. New Hampshire
5. North Dakota
6. Connecticut
7. Colorado
8. Nebraska
9. District of Columbia
10. California

And here are the top 10 worst:

1. Mississippi
2. Alabama
3. South Carolina
4. Louisiana
5. Oklahoma
6. West Virginia
7. Georgia
8. Arkansas
9. New Mexico
10. Nevada

Few states had consistent ratings across all categories, in part because in the U.S., good healthcare is incredibly expensive. Vermont, the overall winner, was number one in the healthcare category and number five in family friendliness, but it ranked all the way down at number 20 for cost. California cracked the overall top 10, but was more costly than any other state save Alaska. Louisiana, meanwhile, was the cheapest state to have a baby, but was 51st in the healthcare rankings.

The best states to give birth in aren’t necessarily the best states to raise a child in, either, according to the site's analysis. New Hampshire was second in health care, but number 40 for baby friendliness, meaning it has few child care centers and poor parental leave policies. Maine, too, was number seven in the healthcare rankings but only number 37 in baby friendliness.

Overall, it seems that when it comes to having kids, no state is perfect. See the full list at WalletHub.

[h/t a plus]

12 Facts About Kidney Stones

Illustration by Mental Floss. Images: iStock
Illustration by Mental Floss. Images: iStock

Kidney stones are more common than ever. According to Harvard Medical School, every year more than 3 million people see a doctor for relief from these hard mineral and salt deposits, which form in your kidney when urine becomes too concentrated. Here's what we know about the condition formally called nephrolithiasis.

1. KIDNEY STONES TYPICALLY CAUSE REALLY PAINFUL SYMPTOMS.

At first you may notice your urine is cloudy, bloody, and foul smelling. Your back may begin to ache, and nausea may come over you. Then, as the stone moves from your kidney into your urinary tract or bladder, sometimes becoming trapped, there’s often an intense, stabbing pain that many people say they wouldn’t wish on their worst enemy.

2. MOST PEOPLE DEVELOP ONE TYPE OF STONE …

What kind of kidney stone you get depends on your diet, fluid intake, genetics, hereditary disorders, and even whether you take certain medications, but the vast majority of people get calcium oxalate stones. They're formed from a mix of calcium in urine and the compound oxalate, which is found naturally in food like nuts, chocolate, and some vegetables, including beets and spinach; oxalate is also produced by your liver. There's some evidence that people who take the seizure medicine topiramate can develop these stones in the form of calcium phosphate.

3. … BUT THERE ARE THREE OTHER KINDS TOO.

Struvite stones are fast-growing mineral deposits that typically develop in response to a urinary tract infection, and can grow large enough to block the kidney, ureter, or bladder before you notice any symptoms; they affect women more than men. Uric acid stones turn up in people who eat a lot of red meat, shellfish, and organ meats, which contain hefty doses of an organic compound called purine that can lead to more uric acid than the kidneys can excrete. Cystine stones are caused by a rare hereditary disorder called cistinuria in which your kidneys excrete excessive amounts of the amino acid cystine.

4. THEY'RE EXTREMELY COMMON—ESPECIALLY IN MEN.

There's a solid chance you could end up with a kidney stone. The National Kidney Foundation notes that one in 10 people will develop one during the course of their life. And if you’re male, take note: Your gender alone is considered a kidney stone risk factor. Men are twice as likely as women to develop them. Another factor is age: Although stones are most common from ages 20 through 50, they tend to peak around age 30.

5. IF YOU’VE HAD A KIDNEY STONE, YOU’LL PROBABLY DEVELOP ANOTHER ONE …

Sorry to say, but simply having a kidney stone puts you at risk for a recurrence. If you’ve had one, the U.S. National Library of Medicine notes that there’s a 30 to 50 percent chance more stones will form within five years.

6. … BUT YOU CAN TAKE STEPS TO PREVENT THEM.

Cutting back on sodium (i.e. deli meats, packaged soups, and processed foods) can help, because a stone can form from excessive salt consumption. You should also avoid too much animal protein—it produces urine containing more acid, which is known to increase your risk for kidney stones—and increase your intake of fruits, vegetables, whole grains, and low-fat dairy. And be sure to drink plenty of fluids, especially water—at least 12 glasses a day. (That's good advice for everyone, not just those prone to kidney stones.)

Don't drink much apple or cranberry juice as both contain oxalates and are linked to an increased risk of developing calcium oxalate stones. High doses of Vitamin C may boost the concentration of oxalate in urine; the Cleveland Clinic recommends a daily maximum of 500 milligrams.

7. IT'S A MYTH THAT CALCIUM CREATES SOME KIDNEY STONES.

Despite the fact that the word calcium is part of the most common kind of kidney stone, you don’t need to treat calcium as the enemy. In fact, having too little calcium can actually increase the odds you’ll get these types of stones. According to the Cleveland Clinic, eating about two or three servings of calcium-rich foods daily reduces oxalate absorption, helping to keep calcium oxalate stones away. So get out the cheese.

8. IF YOU PASS A STONE, CONGRATULATIONS! NOW TAKE IT TO A DOCTOR.

Ninety percent of kidney stones are passed through urination. Getting one out this way may hurt a lot, but once the stone has finished causing you agony, it could provide clues that could help you avoid developing another one. If you’re able to retrieve the stone, bring it to your doctor, who can order an analysis. Identifying its components can reveal the kind of stone it is and potentially point to a treatment or prevention plan.

9. IF YOU CAN’T PASS A STONE, TREATMENTS ARE AVAILABLE …

In an attempt to exit the body, a stone travels from the kidney to the bladder through a narrow tube called the ureter. If the stone is larger than a quarter-inch, it's simply too big to pass through the ureter, and will get trapped there. (If it can make it through to your bladder, it's small enough to pass out out of your body through the urethra.) This causes intense pain, blocked urine flow, and possible bleeding from urinary tract walls. That's when it's time for treatment.

There are several methods for getting rid of a kidney stone, all of which aim to break the stone into smaller pieces so they can leave the body. In an extracorporeal shock wave lithotripsy (from the Greek for "crushed stone"), high-frequency sound waves are applied externally to break stones up, allowing them to pass when you pee. Laser lithotripsy takes a similar approach: Stones in the ureter are broken up with a laser and also leave the body naturally. More invasive is percutaneous ultrasonic lithotripsy, which involves passing narrow instruments (including a fiberoptic camera) through your back to your kidney; ultrasound breaks the stones up, and then fragments are removed by an instrument. Finally, a ureteroscopy is a treatment option in which a small scope is inserted in the ureter towards the bladder to determine the stone's location. Then it's broken up for natural passage or removed altogether. Luckily, you're unconscious under general anesthesia during the last procedure.

10. … AND THEY'RE FAR SUPERIOR TO THOSE USED IN THE PAST.

Kidney stones are nothing new—mentions of the painful formations go back more than 5000 years, to Mesopotamian medical texts—and medical interventions have occurred for just as long. Stones made it into the Hippocratic Oath, in which physicians swore they would "not use the knife, not even on sufferers from stone," leaving the procedure to "such men as are engaged in this work" [PDF]. Surgeons in ancient Greece and India were attempting stone removal as far back as the 7th century BCE.

The 16th to 18th centuries were a heyday for stone surgeons, who were largely self-taught. The most notorious of them was Frere Jacques Beaulieu. He pioneered the lateral perineal lithotomy—which involved making an incision in the perineum, inserting a terrifying cutting instrument into the bladder, cutting up the stone, and then extracting the pieces with the instrument or his fingers—in the late 17th century. Unfortunately for his patients, he had no technical training, and his method was often deadly; in 1698, after 25 of his 60 patients died, he was banned from doing the procedure—but he didn't stop. He's thought to have performed more than 5000 lithotomies. (And no, the song doesn't seem to be about him.)

11. IF ALL ELSE FAILS, TRY RIDING A ROLLER COASTER.

If you’re a thrill seeker who happens to have kidney stones (and some vacation time), you may be in luck. After a "notable number" of patients reported that riding the Big Thunder Mountain roller coaster at Walt Disney World in Orlando helped them to pass their kidney stones, Michigan State University urologist David Wartinger decided to investigate. He created a kidney replica—complete with kidney stones—put it in a backpack, and let it ride the roller coaster 60 times. It worked—but passing the stones depended on where the backpack was placed in the coaster. Rides in the last car were the most effective, with the stones passing 64 percent of the time, while the front few cars yielded only a 16 percent success rate.

Big Thunder Mountain was the only ride in the theme park that was effective. Neither Space Mountain nor Aerosmith's Rock 'n' Roller Coaster did the trick, likely because they were too fast, with a G-force that pinned the stones in place. Of course, while this is an interesting finding, if you suspect you have kidney stones, speak to your doctor before you high-tail it to Walt Disney World.

12. A KIDNEY STONE THE SIZE OF A MOUSE WAS REMOVED FROM A MAN IN 2004.

The stone measured 5.11 inches at its widest point—a world record. Five years later, a whopping 2.5-pound stone was surgically removed from a man in Hungary in 2009. Perhaps seeing a bunch of kidney stones in one place other than originating from your own body will put you at ease. If that’s the case, check out the International Museum of Surgical Science in Chicago, where a collection of stones is on display in glass jars.

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