“Chronic obstructive pulmonary disease (COPD) is an ongoing lung condition caused by damage to the lungs. The damage results in swelling and irritation, also called inflammation, inside the airways that limit airflow into and out of the lungs. COPD symptoms often don’t appear until a lot of lung damage has occurred.”

MAYO CLINIC (COPD – Symptoms and causes – Mayo Clinic)

   Usually due to smoking

This is Healthy Lung Month covering COPD.

What is Chronic Obstructive Pulmonary Disease (COPD)?

Chronic obstructive pulmonary disease (COPD) is a term that applies to patients with chronic bronchitis, bronchiectasis, emphysema and, to a certain extent, asthma. A brief review of normal functional anatomy will provide a background for the discussion of pathology.

The airway down to the bronchioles normally is lined with ciliated pseudo-stratified columnar cells and goblet cells. Mucus derives from mucus glands that are freely distributed in the walls of the trachea and bronchi. The cilia sweep mucus and minor debris toward the upper airway. Low humidity, anesthesia gases, cigarette smoking and other chemical irritants paralyze the action of these cilia. The mucociliary action starts again after a matter of time. This is why people awaken to “smokers cough.”

“Chronic obstructive pulmonary disease (COPD) is a term that applies to patients with chronic bronchitis, bronchiectasis, emphysema and, to a certain extent, asthma.”

Bronchi run in septal connective tissue, but bronchioles are suspended in lung parenchyma by alveolar elastic tissue. The elastic tissue extends throughout alveolar walls, air passages, and vessels, connecting them in a delicate web. Bronchiolar epithelium is ciliated, single-layered and columnar or cuboidal. Beyond the bronchioles the epithelium is flat and lined with a film of phospholipid (surfactant), which lowers surface tension and thereby helps to keep these air spaces from collapsing. Remember that the phospholipid develops during later gestation in utero. This is the reason why premature infant’s lungs cannot stay inflated without the addition of surfactant therapy. Macrophages are found in alveolar lining. Smooth muscles surround the walls of all bronchi, bronchioles, and alveolar ducts and when stimulated they shorten and narrow the passages. Cartilage lends rigidity and lies in regular horse-shaped rings in the tracheal wall. Cartilage is absent in bronchi less than 1 mm in diameter.

The terminal bronchiole is lined with columnar epithelium and is the last purely conducting airway. An acinus includes a terminal bronchiole and its distal structures. Five to ten acini together constitute a secondary lobule, which is generally 1 to 2 cm in diameter and is partly surrounded by grossly visible fibrous septa. Passages distal to the terminal bronchiole include an average of three but as many as nine generations of respiratory bronchioles lined with both columnar and alveolar epithelium. Each of the last respiratory bronchioles gives rise to about six alveolar ducts, each of these to one or two alveolar sacs, and finally each of the sacs to perhaps seventy-five alveoli. Alveolar pores (pores of Kohn) may connect alveoli in adjacent lobules.

Two different circulations supply the lungs. The pulmonary arteries and veins are involved in gas exchange. The pulmonary arteries branch with the bronchi, dividing into capillaries at the level of the respiratory bronchiole, and supplying these as well as the alveolar ducts and alveoli. In the periphery of the lung, the pulmonary veins lie in the interlobular septa rather than accompanying the arteries and airways. The bronchial arteries are small and arise mostly from the aorta. They accompany the bronchi to supply their walls. In some cases of COPD, like bronchiectasis, extensive anastomoses develop between the pulmonary and bronchial circulations. This can allow major shunting and recirculation of blood, therefore contributing to cardiac overload and failure. Lymphatics run chiefly in bronchial walls and as a fine network in the pleural membrane. The lumina of the capillaries in the alveolar walls are separated from the alveolar lining surfaces by the alveolar-capillary membrane, consisting of thin endothelial and epithelial cells and a minute but expansile interstitial space. This interface between air and blood, only 2 microns in thickness, is the only place where gases may be exchanged effectively.

Disease Specific Review

Chronic Bronchitis

Chronic bronchitis is a clinical disorder characterized by excessive mucus secretion in the bronchi. It was traditionally defined by chronic or recurrent productive cough lasting for a minimum of three months per year and for at least two consecutive years, in which all other causes for the cough have been eliminated. Today’s definition remains more simplistic to include a productive cough progressing over a period of time and lasting longer and longer. Sometimes, chronic bronchitis is broken down into three types: simple, mucopurulent or obstructive. The pathologic changes consist of inflammation, primarily mononuclear, infiltrate in the bronchial wall, hypertrophy and hyperplasia of the mucus-secreting bronchial glands and mucosal goblet cells, metaplasia of bronchial and bronchiolar epithelium, and loss of cilia. Eventually, there may be distortion and scarring of the bronchial wall.

Asthma

Asthma is a disease characterized by increased responsiveness of the trachea and bronchi to various stimuli (intrinsic or extrinsic), causing difficulty in breathing due to narrowing airways. The narrowing is dynamic and changes in degree. It occurs either spontaneously or because of therapy. The basic defect appears to be an altered state of the host, which periodically produces a hyperirritable contraction of smooth muscle and hypersecretion of bronchial mucus. This mucus is abnormally sticky and therefore obstructive. In some instances, the illness seems related to an altered immunologic state.

Histological changes of asthma include an increase in the size and number of the mucosal goblet cells and submucosal mucus glands. There is marked thickening of the bronchial basement membrane and hypertrophy of bronchial and bronchiolar smooth muscle tissue. A submucosal infiltration of mononuclear inflammatory cells, eosinophils and plugs of mucus blocks small airways. Patients who have had asthma for many years may develop cor pulmonale and emphysema.

Emphysema

Pulmonary emphysema is described in clinical, radiological and physiologic terms, but the condition is best defined morphologically. It is an enlargement of the air spaces distal to the terminal non-respiratory bronchiole, with destruction of alveolar walls.

Although the normal lung has about 35,000 terminal bronchioles and their total internal cross-sectional area is at least 40 times as great as that of the lobar bronchi, the bronchioles are more delicate and vulnerable. Bronchioles may be obstructed partially or completely, temporarily or permanently, by thickening of their walls, by collapse due to loss of elasticity of the surrounding parenchyma, or by influx of exudate. In advanced emphysema, the lungs are large, pale, and relatively bloodless. They do not readily collapse. They many contain many superficial blebs or bullae, which occasionally are huge. The right ventricle of the heart is often enlarged (cor pulmonale), reflecting pulmonary arterial hypertension. Right ventricular enlargement is found in about 40% of autopsies of patients with severe emphysema. The distal air spaces are distended and disrupted, thus excessively confluent and reduced in number. There may be marked decrease in the number and size of the smaller vascular channels. The decrease in alveolar-capillary membrane surface area may be critical. Death may result from infection that obliterates the small bronchi and bronchioles. There is often organized pneumonia or scarring of the lung parenchyma due to previous infections.

Classification of emphysema relies on descriptive morphology, requiring the study of inflated lungs. The two principal types are centrilobular and panlobular emphysema. The two types may coexist in the same lung or lobe.

Centrilobular emphysema (CLE) or centriacinar emphysema affects respiratory bronchioles selectively. Fenestrations develop in the walls, enlarge, become confluent, and tend to form a single space as the walls disintegrate. There is often bronchiolitis with narrowing of lumina. The more distal parenchyma (alveolar ducts and sacs and alveoli) is initially preserved, then similarly destroyed as fenestrations develop and progress.

The disease commonly affects the upper portions of the lung more severely, but it tends to be unevenly distributed. The walls of the emphysematous spaces may be deeply pigmented. This discoloration may represent failure of clearance mechanisms to remove dust particles, or perhaps the pigment plays an active role in lung destruction. CLE is much more prevalent in males than in females. It is usually associated with chronic bronchitis and is seldom found in nonsmokers.

Panlobular emphysema (PLE) or panacinar emphysema is a nearly uniform enlargement and destruction of the alveoli in the pulmonary acinus. As the disease progresses, there is gradual loss of all components of the acinus until only a few strands of tissue, which are usually blood vessels, remain. PLE is usually diffuse, but is more severe in the lower lung areas. It is often found to some degree in older people, who do not have chronic bronchitis or clinical impairment of lung function. The term senile emphysema was formerly applied to this condition. PLE occurs as commonly in women and men, but is less frequent than CLE. It is a characteristic finding in those with homozygous deficiency of serum alpha-1 antitrypsin. It has also been found that certain populations of IV Ritalin abusers show PLE.

Bullae are common in both CLE and PLE, but may exist in the absence of either. Air-filled spaces in the visceral pleura are commonly termed blebs, and those in the parenchyma greater than 1 cm in diameter are called bullae. A valve mechanism in the bronchial communication of a bulla permits air trapping and enlargement of the air space. This scenario may compress the surrounding normal lung. Blebs may rupture into the pleural cavity causing a pneumothorax, and through a valve mechanism in the bronchopleural fistula a tension pneumothorax may develop.

Paracicatricial emphysema occurring adjacent to pulmonary scars represents another type of localized emphysema. When the air spaces distal to terminal bronchioles are increased beyond the normal size but do not show destructive changes of the alveolar walls, the condition is called pulmonary overinflation. This condition may be obstructive, because of air trapping beyond an incomplete bronchial obstruction due to a foreign body or a neoplasm. Many lung lobules may be simultaneously affected as a result of many check-valve obstructions, as in bronchial asthma. Pulmonary overinflation may also be nonobstructive, less properly called “compensatory emphysema”, when associated with atelectasis or resection of other areas of the lung.

Bronchiectasis

Bronchiectasis means irreversible dilation and distortion of the bronchi and bronchioles. Saccular bronchiectasis is the classic advanced form characterized by irregular dilatations and narrowing. The term cystic is used when the dilatations are especially large and numerous. Cystic bronchiectasis can be further classified as fusiform or varicose.

Tubular bronchiectasis is simply the absence of normal bronchial tapering and is usually a manifestation of severe chronic bronchitis rather than of true bronchial wall destruction.

Repeated or prolonged episodes of pneumonitis, inhaled foreign objects or neoplasms have been known to cause bronchiectasis. When the bronchiectatic process involves most or all of the bronchial tree, whether in one or both lungs, it is believed to be genetic or developmental in origin.

Mucoviscidosis, Kartagener’s syndrome (bronchiectasis with dextrocardia and paranasal sinusitis), and agammaglobulinemia are all examples of inherited or developmental diseases associated with bronchiectasis. The term pseudobronchiectasis is applied to cylindrical bronchial widening, which may complicate a pneumonitis but which disappears after a few months. Bronchiectasis is true saccular bronchiectasis but without cough or expectoration. It is located especially in the upper lobes where good dependent drainage is available. A proximal form of bronchiectasis (with normal distal airways) complicates aspergillus mucus plugging.

Advanced bronchiectasis is often accompanied by anastomoses between the bronchial and pulmonary vessels. These cause right-to-left shunts, with resulting hypoxemia, pulmonary hypertension and cor pulmonale.

Keeping a healthy lung prevents emphysema.  So for starters don’t smoke and exercise; which includes don’t be exposed to smoke frequently!

Walk Safety:

1. Cross the street at corners, using traffic signals and crosswalks. Look left, right and left again when crossing and keep looking as you cross.
2. Put electronic devices down, keep heads up and walk, don’t run, across the street.
3. Teach children to make eye contact with drivers before crossing in front of them.
4. Always walk on sidewalks or paths. If there are no sidewalks, walk facing traffic as far to
5. the left as possible.  Children should walk on direct routes with the fewest street crossings.
6. Watch for cars that are turning or backing up. Teach children to never dart out into the street or cross between parked cars.
7. Join kids under age 12 for trick-or-treating. If kids are mature enough to be out without supervision, tell them to stick to familiar areas that are well lit and trick-or-treat in groups.

“WASHINGTON, D.C. – As families across the nation prepare for festive Halloween fun, the U.S. Consumer Product Safety Commission (CPSC) is reminding consumers to focus on safety when selecting and creating costumes and home decorations.

Over the past three years, CPSC estimates that an annual average of 3,200 Halloween-related injuries were treated in U.S. hospital emergency departments.

Here’s how the injuries break down:

• 55% were related to pumpkin carving;
• 25% were due to falls while putting up or taking down decorations, tripping on costumes or walking while trick-or-treating;
• 20% of the injuries included lacerations, ingestions and other injuries associated with costumes, pumpkins or decorations, and allergic reactions or rashes.

Among the injured, 54 percent were adults 18 years and over, 46 percent were under 18 years old, and about 10 percent of all injuries were to children 6 years old or younger.

Fire safety is important year-round, with special awareness during holiday seasons.

Pumpkin Carving (If not done already):

• Leave pumpkin carving to the adults. Child helpers can grab a spoon and scoop out the inside or use a marker to trace the design.
• When your jack-o’-lantern masterpiece is ready, use battery-operated lights or glow sticks rather than an open-flame candle.
  • If using open-flame candles, keep them away from curtains, decorations and other combustibles that could catch fire.
  • Never leave burning candles unattended.

Did you know the night before Halloween has names like:

Mischief Night is an informal holiday on which people engage in jokes, pranks, vandalism, or parties.^[1] It is known by a variety of names including Devil’s Night (particularly in Detroit), Gate Night, Goosey Night, Moving Night, Cabbage Night, Mystery Night and Mat Night.

Halloween Candy Safety Tips

Parents should take precautions about Halloween candy safety, but its also important to have a realistic sense of harm. Its easy for the media to give us the sense that the world is a more menacing place than it really is. In the 1980s, a myth spread about the serious risk of troubled people using poison and razor blades to tamper with Halloween candy. Almost all reports were discredited.

But no amount of debunking can completely alleviate parent anxiety. After all, however rare, it could happen.  Some Halloween candy safety precautions include:

• For young children, remove any choking hazards such as gum, peanuts, hard candies, or small toys.
• Instruct your children to show you all their candy before eating it so that you can carefully inspect it for tampering.
• Tell your children not to accept or eat anything that isnt commercially wrapped.
• Throw out candy or treats that are homemade, unwrapped, or have torn wrapping.

And managing the Halloween candy craze? First, to reduce trick-or-treat munching, give your children a snack or light meal before you leave the house. Decide ahead of time how many pieces of candy they can eat on Halloween night.

Pumpkin Carving Safety Tips

• Carve pumpkins on stable, flat surfaces with good lighting.
• Have children draw a face on the outside of the pumpkin and then do the cutting yourself.
• Place lighted pumpkins away from curtains and other flammable objects, and do not leave lighted pumpkins unattended.
• If you set jack-o-lanterns on your porch with candles in them, make sure that they are far enough out of the way so that childrens costumes wont accidentally set on fire.
• Artificial lights and candles are a safer alternative to real candles.

Halloween Costume Safety Tips

• If possible, have your children wear clothing that is bright, reflective, and flame retardant.
• If your child is carrying a prop, such as sword or pitchfork, make sure that the tips are smooth and flexible enough to not cause injury if your child falls on them.
• Avoid long, baggy, or loose costumes to prevent tripping.
• Insist that your children wear well-fitting, sturdy shoes. Mom’s high heels are better for costume parties, not trick-or-treating.
• Securely fit hats and scarves to prevent them from slipping over your childrens eyes.
• Apply a natural mask of cosmetics rather than have your child wear a mask that might restrict breathing or obscure vision. If you use a mask, make sure it fits securely and has eyeholes large enough to allow full vision.

Have a happy and safe Halloween!

BE SAFE WITH YOUR ANIMALS!

“Halloween is one of the most popular days in the U.S. with people of all ages taking part in trick-or-treating, decorating homes, attending parties and other festivities. But while Halloween is filled with fun and excitement, there is one statistic that casts a shadow over the festivities:

Children are more than twice as likely to be struck and killed by a vehicle on Halloween than on any other day of the year.

It’s a sobering reality, and one the American Red Cross hopes to help change. Here are a few answers to commonly asked questions to help everyone have a fun and safe Halloween.

Trick-or-treaters need to be easily visible and able to see clearly. Try these tips to help keep them safe:

• Use face makeup instead of masks whenever possible.
• Choose light-colored clothing if you can.
• Add reflective tape to costumes and treat bags .
• Select flame-resistant costumes and wigs.
• Walk on sidewalks whenever possible.
• If there are no sidewalks, walk on the edge of the road facing traffic.
• Look both ways before crossing the street, and cross only at corners or crosswalks.
• Never cross between parked cars, cut across yards, or use alleys.’

American Red Cross (Q&A: How to Have a Fun and Safe Halloween)

Halloween pot lucks, parties, and trick-or-treating can be sneaky business—even for your young ones trying to keep them healthy with the neighbors and other family or friends kids. The scariest part is you trying to avoid the kids’ treat bags full of candy, chocolate, and chips but yet making it fun for all.

However, you can still get your great Halloween treats on without terrorizing your healthy diet if you infuse the holiday with these scary (good) tips and even more important for the young ones with even possibly having the kids ask you to tell their mom of the great recipe. It is all in your creativity and taking the time as opposed to picking up a bag of treats in a plastic bag you dump in a bowl.

1. Use your creativity on healthy foods alone or with candy in place of the “Classic Halloween Candy”

It’s fairly easy to give classic Halloween candy the creativity of using fruit. For example take the PUMPKIN – the maskcot of Halloween, which happens to be a cultivar of a squash plant, most commonly of Cucurbita pepo, that is round, with smooth, slightly ribbed skin, and deep yellow to orange coloration. The thick shell contains the seeds and pulp. This kind of creativity is to make a healthier, more natural form of candy corn layer a wedge of pineapple, a wedge of cantaloupe, and a piece of banana on wooden skewers. You can also make healthy apple monsters by using a melon baller to carve out eyes, mount them on toothpicks, and use a large apple slice as a mouth with slivered almonds to create the toothy grin. Again it’s all in your creativity. Without making all fruit you could even add dark chocolate on the fruits or any candy that mixes with the taste of the fruit you use. Again make it fun and delicious so its utilized with decreasing everything being candy, which isn’t good for anyone’s else.

2. Create homemade candy treats that are healthier than the store

In the store you find candy trans fat or refined sugars or high processed or even regular milk chocolate as opposed to dark chocolate (healthier). Make homemade candy treat bags at the parties with these creations of yours. I know it takes time but making it know your helping a another individual which should make you feel could and trust me many will appreciate you like the other moms.

3. Add Just a Touch of your Creativity Sweetness

Sometimes there can be just too much sinfully sweet ingredients in Halloween desserts. One of my favorites is chocolate chunks in double chocolate tombstone brownies. However, you can satisfy a sweet tooth without killing your entire diet by creating a healthy dessert with just a touch of sweetness. You can either make those dark chocolate brownies and cutting them into finger size pieces as opposed to a regular size brownie with making them have a Halloween effect look on them. Another idea going more health wise is creating spooky bananas by using 2 dark chocolate chips for eyes and a dark chocolate kiss as a surprised mouth on ½ of bananas or make witches caldrons by coring apples and filling with quick oats, raisins, and a touch of maple syrup. Take oranges or mandarins putting celery sticks in the top center to make pumpkins. For a sweet treat that will satisfy your haunted Halloween cravings—try whipping up batches of pumpkin inspired cookies, brownies, cakes, and muffins. Pumpkin is actually a nutritionally fuelled substitute for butter, margarine, and oil in a lot of lower fat recipes. Use your minds depth in making Halloween creations.

5. Carve Up Spooky Veggies

Who says that vegetables can’t be festive? In addition to buckets of candy and chocolate at your Halloween party, feature a platter of carrots, cucumbers, and pepper pieces cut into spooky shapes—such as ghosts, witches hats, bats, cats, and pumpkins for dipping into healthy hummus, salsa, and guacamole. Or spoon salads into cored peppers carved into mini Jack-o-lanterns.

6. Make healthy creative dips

With fruit, healthy chips, vegetables with salads and create healthy dips. For blood effect salsa, for green goblin effect guacamole dips, orange effect from carrot veggie dip to bean veggie dip. Than there is fruit cherry dip to green apple dip to orange or mandarin or pumpkin dips.

7. DIY Your Favorite Halloween Snacks

If there’s one snack I just can’t resist, it’s peanut butter rice crispy treats! However, instead of getting mine from a box, I choose to make a healthier version in my own kitchen, and I use nutritious ingredients—like raw almond butter and whole-wheat rice crisps—to redeem my Halloween sins.

8. Air Pop Your Halloween Treats

Air popped corn (especially if it’s whole grain) can provide a filling foundation for sweets and snacks without haunting you for weeks after. Indulge your taste for something sweet by air popping corn; rolling it into balls using a bit of honey or maple syrup, raisins, and chopped nuts; and drizzling with dark-chocolate and melted almond butter. Or simply serve an air popped bowl of corn sweetened with a bit of maple syrup for a healthier version of caramel corn.

Treats: Warn children not to eat any treats before an adult has carefully examined them for evidence of tampering.

Flame Resistant Costumes: When purchasing a costume, masks, beards, and wigs, look for the label Flame Resistant. Although this label does not mean these items won’t catch fire, it does indicate the items will resist burning and should extinguish quickly once removed from the ignition source. To minimize the risk of contact with candles or other sources of ignition, avoid costumes made with flimsy materials and outfits with big, baggy sleeves or billowing skirts.

Costume Designs: Purchase or make costumes that are light and bright enough to be clearly visible to motorists.

For greater visibility during dusk and darkness, decorate or trim costumes with reflective tape that will glow in the beam of a car’s headlights.

Bags or sacks should also be light colored or decorated with reflective tape. Reflective tape is usually available in hardware, bicycle, and sporting goods stores.

To easily see and be seen, children should also carry flashlights.

Costumes should be short enough to prevent children from tripping and falling.

Children should wear well-fitting, sturdy shoes . Mother’ s high heels are not a good idea for safe walking.

Hats and scarfs should be tied securely to prevent them from slipping over children’s eyes.

Apply a natural mask of cosmetics rather than have a child wear a loose-fitting mask that might restrict breathing or obscure vision. If a mask is used, however, make sure it fits securely and has eyeholes large enough to allow full vision. Swords, knives, and similar costume accessories should be of soft and flexible material.

Pedestrian Safety: Young children should always be accompanied by an adult or an older, responsible child. All children should WALK, not run from house to house and use the sidewalk if available, rather than walk in the street.

Children should be cautioned against running out from between parked cars, or across lawns and yards where ornaments, furniture, or clotheslines present dangers.

Choosing Safe Houses: Children should go only to homes where the residents are known and have outside lights on as a sign of welcome.

Children should not enter homes or apartments unless they are accompanied by an adult.

People expecting trick-or-treaters should remove anything that could be an obstacle from lawns, steps and porches.

Candlelit jack-o’-lanterns should be kept away from landings and doorsteps where costumes could brush against the flame. Indoor jack-o’-lanterns should be kept away from curtains, decorations, and other furnishings that could be ignited.

Even though it’s not an official holiday, Halloween is much beloved by children and adults alike. What could be more fun than trick-or-treating, apple bobbing, or costume parties?

To make sure treats are safe for children, follow these simple steps:

Snacking: Children shouldn’t snack on treats from their goody bags while they’re out trick-or-treating. Give them a light meal or snack before they head out – don’t send them out on an empty stomach. Urge them to wait until they get home and let you inspect their loot before they eat any of it.

 Safe treats: Tell children not to accept – and especially not to eat – anything that isn’t commercially wrapped. Inspect commercially wrapped treats for signs of tampering, such as an unusual appearance or discoloration, tiny pinholes, or tears in wrappers. Throw away anything that looks suspicious.

 Food Allergies: If your child has a food allergy, check the label to ensure the allergen isn’t present. Do not allow the child to eat any home-baked goods he or she may have received.

 Choking hazards: If you have very young children, be sure to remove any choking hazards such as gum, peanuts, hard candies, or small toys.

 Bobbing for apples is an all-time favorite Halloween game. Here are a couple of ways to say “boo” to bacteria that can cause foodborne illness. Reduce the number of bacteria that might be present on apples and other raw fruits and vegetables by thoroughly rinsing them under cool running water. As an added precaution, use a produce brush to remove surface dirt.

Try this new spin on apple bobbing from FightBAC.org: Cut out lots of apples from red construction paper. On each apple, write activities for kids, such as “do 5 jumping jacks.” Place a paper clip on each apple and put them in a large basket. Tie a magnet to a string. Let the children take turns “bobbing” with their magnet and doing the activity written on their apple. Give children a fresh apple for participating.

If your idea of Halloween fun is a party at home, don’t forget these tips: 

• Beware of spooky cider! Unpasteurized juice or cider can contain harmful bacteria such as Salmonella. To stay safe, always serve pasteurized products at your parties.
• No matter how tempting, don’t taste raw cookie dough or cake batter that contain uncooked eggs.
• “Scare” bacteria away by keeping all perishable foods chilled until serving time. These include finger sandwiches, cheese platters, fruit or tossed salads, cold pasta dishes with meat, poultry, or seafood, and cream pies or cakes with whipped-cream and cream-cheese frostings.

Bacteria will creep up on you if you let foods sit out too long. Don’t leave perishable goodies out of the fridge for more than two hours (1 hour in temperatures above 90°F).

“Flu is a contagious respiratory illness that infect the nose, throat, and sometimes the lungs. Some people are at higher risk of developing serious complications from flu. If you are at higher risk, flu vaccination is especially important. When you get vaccinated, you reduce your risk of getting sick with flu and possibly being hospitalized or dying from flu. CDC recommends prompt flu antiviral treatment for people at higher risk of serious flu complications who have flu infection or suspected flu infection.

Here are some factors putting people at higher risk of getting the flu:

• Adults 65 years and older
• Children younger than 2 years old
• People with asthma
• People with chronic lung disease (such as chronic obstructive pulmonary disease [COPD] and cystic fibrosis)
• People with neurologic and neurodevelopment conditions”

Center for Disease Control and Prevention – CDC (People at Increased Risk for Flu Complications | Influenza (Flu) | CDC)