Viability of Influenza Vaccine Among Physicians

Objective: Influenza is a common but miserable illness with rare but serious cases of encephalitis, associated community acquired pneumonia and high risk of absenteeism from work.  Could this malady be avoided by getting the influenza vaccine?

Methods:  Survey of 12 physicians (10 of them them radiologists at UHN in Toronto) from all parts of the world on whether it was worth it to get a "flu" vaccine.  Countries represented included: South Korea, Germany, Australia, former USSR, Saudi Arabia, India, Ireland, Greece, Canada and USA.

Results: A total of six physicians received the vaccine and two reported having side effects of fever and chills.  Six physicians declined the vaccine citing concerns of side effects including symptoms of infection, terrifying ascending paralysis (Guillain-Barre syndrome) and one physician reporting, "I never get sick".

Discussion: We can state that the influenza vaccine may be effective against contracting the influenza virus.  None of the vaccinated physicians have become infected (so far) and five of the six non vaccinated physicians have not become infected.  However, at least two of the six vaccinated physicians were symptomatic and regretted getting vaccinated.  The one physician who was infected would only consider receiving the vaccine for next year.

Conclusion:  Never say, "I never get sick." and you can meet people from all over the world in Toronto.

Case of the Day - December 8, 2008

History: A family of 4 children, all under 10 years old, present on different days with high grade fever (lasting 5 days), vomiting and extreme malaise and myalgia (muscle pain).  Seven days after the first child's symptoms the father presented with the same high fever, severe vomiting (including small amount of hematemesis) and unable to go to work for three days.

                                             Figure 1.

Finding: Both patients in figure 1. could not retain food for 5 days.  Ultimately the orange jello was vomited.

Diagnosis: Influenza A or B

Discussion: Although vomiting is more common in children while infected with the influenza virus, this shows the youthfulness of the dad.  None of the family received the influenza vaccine (which was widely advertised in community health system).  Miraculously the mother dodged this bullet but had the unfortunate responsibility to care for all invalids. According to the patients, especially the dad, this illness should be avoided as it was the most miserable encountered in some 15 years.

Sunday Dinner

Even though we miss our Sunday family dinners in Utah, we have found good friends here in Toronto to continue the tradition. If fact they cooked a delicious  Swiss meal for us. Ute and Dirk are from Germany and are training in Toronto like Colin.

Toronto Life at 52 Douglas Avenue

We've only been (pronounced 'bean') here for just over 4 months and already I'm starting to view life a little differently.  It no longer seems like I'm allowed to stay in my own little bubble doing the same things I want to do every day.  It no longer feels like I can just coast along.

Instead, I've been integrated into a multiethnic society that thrives on community living and conforming standards.  What I mean is that people around here seem to expect you to be part of the 'whole'.  You really should follow all the parking rules if you want to be a good citizen.  You really should contribute to the 'Multiple Sclerosis' fund at school- it's the right thing to do.  You really should know the Jewish holidays (at least in my neighborhood) and be considerate of their celebration time.

In the public sector are many reminder of how to behave publicly.  The subway door windows have signs that urge you to be considerate and not block the doors, another train will come soon.  On the highways signs are posted to remind you not to tailgate or drive over the speed limit. One day I had an etiquette lesson from the garbage collector on the proper way to dispose of your waste.  For the compost-able material (the green bin) I should store it in the freezer until garbage day. That way it won't stink in the bin outside.

 

The children don't seem to be affected by much of this with the exception of always asking what bin to throw their trash in: green, grey or blue.  They are taught polite manners at school (but not much differently than when we were in Texas).  And they are learning to play/exercise in public areas as our yard is not much bigger than a postage stamp.

With the birth of Kelsey (our fourth) each day is carefully orchestrated to get everyone on time to school.  The fact that the kids come home at lunch time only compounds the chaos.  Poor Alek and Kelsey have to be dragged back and forth to Brooklyn and Reina's school four times every day.

But overall I'm really enjoying my time here.  Colin seems to be learning quite a bit of new things.  He's happy to be working with very intelligent mentors.  I've made some very nice friends at church and in the neighborhood. I feel like I'm fitting in with the other immigrants: another American, a German, an English mum and even a Czechoslovakian. 

I can't imagine ever living in another place quite like this.