“Narcolepsy is a neurological disorder that causes persistent sleepiness and additional symptoms such as brief episodes of muscle weakness known as cataplexy, vivid, dreamlike hallucinations, brief episodes of paralysis when falling asleep or upon awakening (sleep paralysis), and fragmented nighttime sleep. Symptoms typically develop over several months and last a lifetime.

Narcolepsy is a manageable condition, and people with narcolepsy can lead full and rewarding lives.  One cause is genetic factors clearly play a role. Most people with narcolepsy have inherited a gene that codes for the human leukocyte antigen (HLA) DQB1*06:02, which is important for immune function. This gene is found in 12–25% of the general population, and it increases the risk of developing narcolepsy 7- to 25-fold.³ Additional genes can increase or decrease the risk of developing narcolepsy, and, like HLA-DQB1*06:02, most of these affect the functions of the immune system. Normally, the immune system kills off bacteria and viruses. These discoveries suggest that narcolepsy is an autoimmune disease in which the immune system accidentally kills off the hypocretin-producing neurons. “.

Harvard University (https://healthysleep.med.harvard.edu/narcolepsy)

Those bugs that are common in fall, winter that are also seen in the spring time are       2 Viruses =The COLD and The FLU.

You may ask yourself why the flu when its also in the fall and winter but in the beginning of the spring we have up and down temperatures; days when freezing and days when warm.  Less than 2 weeks ago in certain areas of the NE it was 50 degrees or higher and after a few days back to freezing temperatures.  People dress in warm clothes and forget when freezing comes in to still dress for winter weather.  Than the flu starts hitting again with colds over those areas of the NE.

HOW ARE THESE BUGS DIFFERENT:

Both influenza and the common cold are viral respiratory infections (they affect the nose, throat, and lungs). Viruses are spread from person to person through airborne droplets (aerosols) that are sneezed out or coughed up by an infected person, direct contact is another form of spread with infected nasal secretions, or fomites (contaminated objects). Which of these routes is of primary importance has not been determined, however hand to hand and hand to surface to hand to contact seems of more importance than transmission. The viruses may survive for prolonged periods in the environment (over 18 hours for rhinoviruses in particular=a common virus for colds) and can be picked up by people’s hands and subsequently carried to their eyes or nose where infection occurs. In some cases, the viruses can be spread when a person touches an infected surface (e.g., doorknobs, countertops, telephones) and then touches his or her nose, mouth, or eyes. As such, these illnesses are most easily spread in crowded conditions such as schools.

The traditional folk theory that you can catch a cold in prolonged exposure to cold weather such as rain or winter settings is how the illness got its name. Some of the viruses that cause common colds are seasonal, occurring more frequently during cold or wet weather. The reason for the seasonality has not yet been fully determined. This may occur due to cold induced changes in the respiratory system, decreased immune response, and low humidity increasing viral transmission rates, perhaps due to dry air allowing small viral droplets to disperse farther, and stay in the air longer. It may be due to social factors, such as people spending more time indoors, as opposed to outdoors, exposing him or her “self” to an infected person, and specifically children at school. There is some controversy over the role of body cooling as a risk factor for the common cold; the majority of the evidence does suggest a result in greater susceptibility to infection.

The SIMPLE COMMON COLD:

The common cold (also known as nasopharyngitis, rhinopharyngitis, acute coryza, head cold) or simply a cold is a viral infection of the upper respiratory tract which primarily effects the nose. There are over 200 different known cold viruses, but most colds (30% up to 80%) are caused by rhinovirusesThis means you can pass the cold to others, so stay home and get some much-needed rest for yourself and not passing it on to others for the contagious period at least.

If cold symptoms do not seem to be improving after a week, you may have a bacterial infection, which means you may need antibiotics, which only kill bacterial infections not viral.

Sometimes you may mistake cold symptoms for allergic rhinitis (hay fever) or a sinus infection (bacterial). If cold symptoms begin quickly and are improving after a week, then it is usually a cold, not allergy. If your cold symptoms do not seem to be getting better after a week, check with your doctor to see if you have developed an allergy or inflammation or the sinuses (sinusitis).

Influenza is commonly referred to as “the flu”, this is an infectious disease of birds and mammals caused by RNA viruses of the family Orthomyxoviridae, the influenza viruses. The most common sign or symptom are chills, fever, runny nose, coughing, aches and weakness to headache and sore throat. Although it is often confused with other influenza-like illnesses, especially the COMMON COLD, influenza is a more severe illness or disease caused by a different virus. Influenza nausea and vomiting, particularly in children but these symptoms are more common in the unrelated gastroenteritis, which is sometimes inaccurately referred to as “stomach flu” or “25 hour flu”. The flu can occasionally lead to pneumonia, either direct viral pneumonia or secondary bacterial pneumonia, even for persons who are usually very healthy. In particular it is a warning sign if a child or presumably an adult seems to be getting better and then relapses with a high fever as this relapse may be bacterial pneumonia. Another warning sign is if the person starts to have trouble breathing.

Each year, 10% to 20% of Canadians are stricken with influenza. Although most people recover fully, depending on the severity of the flu season, it can result in an average of 20,000 hospitalizations and approximately 4000 to 8000 deaths annually in Canada. Deaths due to the flu are found mostly among high-risk populations, such as those with other medical conditions (such as diabetes or cancer) or weakened immune systems, seniors, or very young children. There are 3 types of influenza viruses: A, B, and C. Type A influenza causes the most serious problems in humans and can be carried by humans or animals (wild birds are commonly the host carriers). It is more common for humans seem to carry the most with ailments with type A influenza. Type B Influenza is found in humans also. Type B flu may cause less severe reaction than A type flu virus but for the few for the many can still be at times extremely harmed. Influenza B viruses are not classified by subtype and do not cause pandemics at this time. Influenza type C also found in people but milder than type A or B. People don’t become very ill from this Type C Influenza and do not cause pandemics.

The common cold eventually fizzles, but the flu may be deadly. Some 200,000 people in the U.S. are hospitalized and 36,000 die each year from flu complications — and that pales in comparison to the flu pandemic of 1918 that claimed between 20 and 100 million lives.

The best defense against it:   a vaccine once a year.  It works for me; and being a RN 28 years almost with getting it yearly with being average healthy I personally have not had the flu since childhood.  I am no spring chicken either.

References for Part 1, 2, and 3 on the two bugs The FLU and The COLD (Spring bugs):

1-Wikipedia “the free encyclopedia” 2013 website under the topic Influenza.

2-Kimberly Clark Professional website under the influenza.

3-Web MD under “COLD, FLU, COUGH CENTER” “Flu or cold symptoms?” Reviewed by Laura J. Martin MD November 01, 2011

4-2013 Novartis Consumer Health Inc. Triaminic “Fend off the Flu”

5-Scientific American “Why do we get the flu most often in the winter? Are viruses virulent in cold weather? December 15, 1997

LET’S PREPARE FOR THE FALL, WINTER and SPRING BUGS. WHO ARE THEY & WHAT ARE THEIR STATISTICS?   Part 1

Those bugs that are common in fall, winter and spring are 2 Viruses =The COLD and THE FLU.

HOW THEY ARE DIFFERENT:

Both influenza and the common cold are viral respiratory infections (they affect the nose, throat, and lungs). Viruses are spread from person to person through airborne droplets (aerosols) that are sneezed out or coughed up by an infected person, direct contact is another form of spread with infected nasal secretions, or fomites (contaminated objects). Which of these routes is of primary importance has not been determined, however hand to hand and hand to surface to hand to contact seems of more importance than transmission. The viruses may survive for prolonged periods in the environment (over 18 hours for rhinoviruses in particular=a common virus for colds) and can be picked up by people’s hands and subsequently carried to their eyes or nose where infection occurs. In some cases, the viruses can be spread when a person touches an infected surface (e.g., doorknobs, countertops, telephones) and then touches his or her nose, mouth, or eyes. As such, these illnesses are most easily spread in crowded conditions such as schools.

The traditional folk theory that you can catch a cold in prolonged exposure to cold weather such as rain or winter settings is how the illness got its name. Some of the viruses that cause common colds are seasonal, occurring more frequently during cold or wet weather. The reason for the seasonality has not yet been fully determined. This may occur due to cold induced changes in the respiratory system, decreased immune response, and low humidity increasing viral transmission rates, perhaps due to dry air allowing small viral droplets to disperse farther, and stay in the air longer. It may be due to social factors, such as people spending more time indoors, as opposed to outdoors, exposing him or her “self” to an infected person, and specifically children at school. There is some controversy over the role of body cooling as a risk factor for the common cold; the majority of the evidence does suggest a result in greater susceptibility to infection.

The SIMPLE COMMON COLD:

The common cold (also known as nasopharyngitis, rhinopharyngitis, acute coryza, head cold) or simply a cold is a viral infection of the upper respiratory tract which primarily effects the nose. There are over 200 different known cold viruses, but most colds (30% up to 80%) are caused by rhinovirusesThis means you can pass the cold to others, so stay home and get some much-needed rest for yourself and not passing it on to others for the contagious period at least.

If cold symptoms do not seem to be improving after a week, you may have a bacterial infection, which means you may need antibiotics, which only kill bacterial infections not viral.

Sometimes you may mistake cold symptoms for allergic rhinitis (hay fever) or a sinus infection (bacterial). If cold symptoms begin quickly and are improving after a week, then it is usually a cold, not allergy. If your cold symptoms do not seem to be getting better after a week, check with your doctor to see if you have developed an allergy or inflammation or the sinuses (sinusitis).

Influenza is commonly referred to as “the flu”, this is an infectious disease of birds and mammals caused by RNA viruses of the family Orthomyxoviridae, the influenza viruses. The most common sign or symptom are chills, fever, runny nose, coughing, aches and weakness to headache and sore throat. Although it is often confused with other influenza-like illnesses, especially the COMMON COLD, influenza is a more severe illness or disease caused by a different virus. Influenza nausea and vomiting, particularly in children but these symptoms are more common in the unrelated gastroenteritis, which is sometimes inaccurately referred to as “stomach flu” or “25 hour flu”. The flu can occasionally lead to pneumonia, either direct viral pneumonia or secondary bacterial pneumonia, even for persons who are usually very healthy. In particular it is a warning sign if a child or presumably an adult seems to be getting better and then relapses with a high fever as this relapse may be bacterial pneumonia. Another warning sign is if the person starts to have trouble breathing.

Each year, 10% to 20% of Canadians are stricken with influenza. Although most people recover fully, depending on the severity of the flu season, it can result in an average of 20,000 hospitalizations and approximately 4000 to 8000 deaths annually in Canada. Deaths due to the flu are found mostly among high-risk populations, such as those with other medical conditions (such as diabetes or cancer) or weakened immune systems, seniors, or very young children. There are 3 types of influenza viruses: A, B, and C. Type A influenza causes the most serious problems in humans and can be carried by humans or animals (wild birds are commonly the host carriers). It is more common for humans seem to carry the most with ailments with type A influenza. Type B Influenza is found in humans also. Type B flu may cause less severe reaction than A type flu virus but for the few for the many can still be at times extremely harmed. Influenza B viruses are not classified by subtype and do not cause pandemics at this time. Influenza type C also found in people but milder than type A or B. People don’t become very ill from this Type C Influenza and do not cause pandemics.

The common cold eventually fizzles, but the flu may be deadly. Some 200,000 people in the U.S. are hospitalized and 36,000 die each year from flu complications — and that pales in comparison to the flu pandemic of 1918 that claimed between 20 and 100 million lives.

The best defense against it:   a vaccine once a year.

References for Part 1 and 2 on the two bugs The FLU and The COLD:

1-Wikipedia “the free encyclopedia” 2013 website under the topic Influenza.

2-Kimberly Clark Professional website under the influenza.

3-Web MD under “COLD, FLU, COUGH CENTER” “Flu or cold symptoms?” Reviewed by Laura J. Martin MD November 01, 2011

4-2013 Novartis Consumer Health Inc. Triaminic “Fend off the Flu”

5-Scientific American “Why do we get the flu most often in the winter? Are viruses virulent in cold weather? December 15, 1997

“Infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse.  Infertility affects millions of people – and has an impact on their families and communities. Estimates suggest that approximately one in every six people of reproductive age worldwide experience infertility in their lifetime.  In the male reproductive system, infertility is most commonly caused by problems in the ejection of semen (1), absence or low levels of sperm, or abnormal shape (morphology) and movement (motility) of the sperm.  In the female reproductive system, infertility may be caused by a range of abnormalities of the ovaries, uterus, fallopian tubes, and the endocrine system, among others.”

WHO World Health Organization (https://www.who.int/news-room/fact-sheets/detail/infertility)

“MERS-CoV infection refers to a viral respiratory illness called Middle East respiratory syndrome (MERS) that’s caused by a coronavirus (CoV).

Coronaviruses cause some cases of the common cold. But viruses in this group — such as MERS–CoV, SARS-CoV and SARS-CoV-2, which is the virus that causes COVID-19 — also cause serious illness.

MERS–CoV was first reported in Saudi Arabia. Since then, it’s been reported in other countries in the Middle East and in Africa, Europe, Asia and the United States. Most infections outside of the Middle East have been reported by people who recently traveled there.

MERS–CoV infection ranges from mild to severe.”.

MAYO CLINIC (https://www.mayoclinic.org/diseases-conditions/sars/expert-answers/what-is-mers-cov/faq-20094747)

“Currently, there is no cure for Creutzfeldt-Jakob disease (CJD). Researchers have tested many drugs, including acyclovir, amantidine, antibiotics, antiviral agents, interferon and steroids. None has shown consistent benefit.

“The best way to treat hemophilia is to replace the missing blood clotting factor so that the blood can clot properly. This is typically done by injecting treatment products, called clotting factor concentrates, into a person’s vein. Clinicians typically prescribe treatment products for episodic care or prophylactic care. Episodic care is used to stop a patient’s bleeding episodes; prophylactic care is used to prevent bleeding episodes from occurring. Today, it’s possible for people with hemophilia, and their families, to learn how to give their own clotting factor treatment products at home. Giving factor treatment products at home means that bleeds can be treated quicker, resulting in less serious bleeding and fewer side effects.”

Centers for Disease Control and Prevention – CDC (https://www.cdc.gov/ncbddd/hemophilia/treatment.html)

“One hundred years ago, at the time when Haematologica was first published, there was practically no treatment for the hemophilias or for the other inherited coagulation disorders. Whole blood was the only treatment approach available and this was of poor clinical efficacy, such that the life expectancy of hemophiliacs was 10-15 years, even in the most favorable circumstances.The success story of hemophilia care first began in the 1970s, when the availability of plasma-derived concentrates of coagulation factor VIII (FVIII) and factor IX (FIX) provided efficacious treatment of bleeding in patients with hemophilia A and B. This positive scenario was consolidated in terms of greater safety and availability in the 1990s, when the first recombinant coagulation factors were produced. This meant that, instead of only treating episodic bleeding events, prophylaxis regimens could be implemented as a preventive measure.  So, even until the 1960s, the life expectancy of patients with hemophilia was no more than 20-30 years.  Today success is way ahead.”

NIH – National Library of Medicine (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7049365/)

Treatment Breakthroughs

In the early 1900s, there was no way to store blood. People with hemophilia who needed a transfusion typically received fresh whole blood from a family member. Life expectancy was 13 years old.

In 1901, the US Surgeon General’s Catalogue listed lime, inhaled oxygen and the use of thyroid gland or bone marrow, or hydrogen peroxide or gelatin, as treatments for hemophilia. By the 1930s, it was discovered that diluting certain snake venoms caused blood to clot. These treatment  were used in patients with hemophilia.

By 1926, the US Surgeon General’s Catalogue contained an entire section on the use of blood transfusions to replace missing clotting factors. Physicians discovered that patients responded readily to infusions of plasma when given promptly after they sustained spontaneous joint and muscle bleeding.

In 1937 Harvard physicians Arthur Patek and FHL Taylor published a paper describing anti-hemophilia globulin found in plasma. It could decrease clotting time in patients with hemophilia.

By the late 1950s and early 1960s fresh frozen plasma was transfused in patients in the hospital. However, each bag of the plasma contained so little of the necessary clotting factor that huge volumes of it had to be administered. Many children experienced severe joint bleeds that were crippling. Intracranial hemorrhage could be fatal. By 1960, the life expectancy for a person with severe hemophilia was less than 20 years old.

A paper written by Robert Macfarlane, a British hematologist, in the journal Nature in 1964 described the clotting process in detail. The interaction of the different factors in blood clotting was termed the “coagulation cascade,” now called the clotting cascade.

In 1965, Dr. Judith Graham Pool, a researcher at Stanford University, published a paper on cryoprecipitate. In a major breakthrough, she discovered that the precipitate left from thawing plasma was rich in factor VIII. Because cryoprecipitate contained a substantial amount of factor in a smaller volume, it could be infused to control serious bleeding. Blood banks could produce and store the component, making emergency surgery and elective procedures for patients with hemophilia patients much more manageable.

By the 1970s, freeze-dried powdered concentrates containing factor VIII and IX became available. Factor concentrates revolutionized hemophilia care because they could be stored at home, allowing patients to “self-infuse” factor products, alleviating trips to the hospital for treatment.

By the mid-1980s, it was confirmed that HIV/AIDS could be transmitted through the use of blood and blood products, such as those used to treat hemophilia. Approximately half of the people with hemophilia in the US eventually became infected with HIV through contaminated blood products; thousands died. The overwhelming impact of HIV on the bleeding disorders community was felt into the next few decades.

The hepatitis C virus (HCV) infection was also transmitted through contaminated factor products, pooled from the blood of hundreds of thousands of donors. Before testing for HCV began in 1992, an estimated 44% of all people with hemophilia had contracted it. With the advent of more sophisticated screening methods and purification techniques, the risk of contracting HCV through factor products is virtually nil.

Treatment for hemophilia and other bleeding disorders advanced in the 1990s. Factor products became safer as tighter screening methods were implemented and advanced methods of viral inactivation were used. In addition, synthetic (not derived from plasma) factor products were manufactured using recombinant technologies. In 1992, the first recombinant factor VIII product was approved by the Food and Drug Administration (FDA). In 1997, the first recombinant factor IX product was granted FDA approval. Additional synthetic drugs, such as desmopressin acetate (DDAVP), were also introduced to treat mild-to-moderate hemophilia A and von Willebrand disease.

By 1995, prophylaxis, a preventive treatment regimen performed 2-3 times weekly in children with hemophilia, became more common. Since the advent of prophylaxis, most children in the developed world live with  less pain, without the orthopedic damage associated with chronic bleeding. As a result, most children born with hemophilia in the US today can look forward to long, healthy and active lives.

However, some children develop inhibitors, or antibodies, to infused factor product. The development of a bypassing agent in 1997 offered these patients an alternative product to help stop bleeds and joint damage.

The early years of the 21^st century have brought new recombinant products made without human or animal plasma derivatives, lowering the possibility risk for  allergic reactions to the products or inhibitors? New longer-lasting products promise to decrease regular  infusion rates from 2-3 times per week to once-weekly or even less.

In 2013, three separate gene therapy trials were begun at institutions across the country. They are testing the use of viruses as vector, or vehicles, to deliver factor IX genes into patients’ livers, correcting their hemophilia. Because the factor VIII gene is larger and more complicated to use, gene therapy clinical trials have not yet begun for patients with hemophilia A.

TIMELINE

1828 – Term “haemorrhaphilia” first used. Later shortened to “haemophilia.”

1926 – Erik von Willebrand identifies a bleeding disorder, later called von Willebrand disease (VWD)

1940s – whole blood transfusions given at hospital

1948 – National Hemophilia Foundation (NHF) opens as The Hemophilia Foundation, Inc.

1952 – Researchers describe what is now called factor IX clotting protein

1954 – NHF establishes a Medical Advisory Council, later called Medical and Scientific Advisory Council (MASAC)

1955 – First infusions of factor VIII in plasma form

1957 – Researchers in Sweden identify von Willebrand factor as the cause of VWD

1958 – First use of prophylaxis for hemophilia A

1964 – Dr. Judith Graham Pool discovers cryoprecipitate

1968 – First FVIII concentrate available

1970s – Primary prophylaxis therapy experiments begin

1970s – Freeze-dried plasma-derived factor concentrates available

1977 – Desmopressin identified to treat mild hemophilia and von Willebrand disease

1980s – Factor VIII, FIX and von Willebrand factor genes cloned

1982 – CDC reports first AIDS cases among people with hemophilia

1985 – First inactivated factor concentrates available

1992 – FDA approves first recombinant FVIII products

1995 – Prophylaxis becomes standard of treatment in US

1997 – FDA approves first recombinant FIX products

1998 – First human gene therapy trials begin

2000s – FDA approves first recombinant factor products made without human or animal plasma derivatives

2009 – FDA approves RiaSTAP to treat factor I deficiency

2011 – FDA approves Corifact to treat factor XIII deficiency

2013 – Gene therapy trials underway at three sites in the US

Check out a decade later 2023 treatments, tomorrow!

“Hemophilia is usually an inherited bleeding disorder in which the blood does not clot properly. This can lead to spontaneous bleeding as well as bleeding following injuries or surgery. Blood contains many proteins called clotting factors that can help to stop bleeding. People with hemophilia have low levels of either factor VIII (8) or factor IX (9). The severity of hemophilia that a person has is determined by the amount of factor in the blood. The lower the amount of the factor, the more likely it is that bleeding will occur which can lead to serious health problems.”

Centers for Disease Control and Prevention (https://www.cdc.gov/ncbddd/hemophilia/facts.html)