Pregnant women and extremely obese people at high risk of flu complications

Source:https://www.idsociety.org/ Reviewed by James Ives, M.Psych. (Editor)Dec 19 2018Pregnant women and the extremely obese are among those at high risk for complications from the flu – including death – and should be tested and begin antiviral treatment promptly if they are sick enough to be hospitalized with flu symptoms, according to updated guidelines released by the Infectious Diseases Society of America (IDSA). Outpatients who have been diagnosed with the flu and are at high risk for complications should also be provided antiviral treatment as soon as possible, note the seasonal influenza guidelines, which are published in Clinical Infectious Diseases.The guidelines recommend using newer and highly accurate molecular tests that deliver results in 15-60 minutes instead of rapid-influenza diagnostic tests (RIDTs), which produce quick results but can be falsely negative in at least 30 percent of outpatients with influenza. While antiviral treatment is recommended within two days after the start of flu symptoms in people who aren’t at high risk for complications, the guidelines note they should be prescribed to those at high risk even if they have been sick for more than two days.People who are extremely obese have a body mass index (BMI) of 40 or more. Others in the high-risk category include: young children (especially those younger than 2 years old); women who have recently given birth; those with a weakened immune system due to disease or medication (such as people with HIV or AIDS, cancer, who have had an organ transplant or who are on chronic steroids); people younger than 19 years old who are receiving long-term aspirin therapy; those with chronic medical conditions including asthma, neurological or neurodevelopmental disorders (such as cerebral palsy, epilepsy and stroke), heart or lung disease, kidney, liver or metabolic disorders; and nursing home residents; American Indians and native Alaskans.”Influenza can be serious, especially for the sizable group of people at high risk,” said Timothy M. Uyeki, MD, MPH, MPP, co-chair of the guidelines committee and chief medical officer of the Influenza Division of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention (CDC). “Annual influenza vaccination is the best way to prevent influenza, but it is not 100 percent effective. Those at high risk need to be encouraged to seek medical care right away if they develop influenza symptoms during influenza season.”Related StoriesLow humidity could be flu virus’ best friend$3.1 million NIH funding awarded to develop universal flu vaccineAustralian doctors are overprescribing flu antivirals, study revealsTypical flu signs and symptoms include fever, cough, muscle aches, chills, runny nose and sore throat. Other symptoms can include headache and chest pain.The guidelines note antiviral treatment should be started immediately in people at high risk of flu complications who are being admitted to the hospital with suspected influenza, without waiting for the results of molecular influenza testing. Influenza testing is important because physicians are more likely to treat patients with antiviral medications if they have a definitive diagnosis, further reducing the likelihood of prescribing antibiotics inappropriately, especially in outpatients.If people at high risk become seriously ill with influenza, health care providers should turn to infectious diseases (ID) doctors to provide expertise, the guidelines note.”High-risk individuals who are hospitalized with flu complications are at an increased risk for serious bacterial infections and infectious diseases physicians’ expertise is critical to ensuring they receive the best care,” said Andrew T. Pavia, MD, FIDSA co-chair of the guidelines committee and chief of the Division of Pediatric Infectious Diseases at the University of Utah, Salt Lake City. “ID doctors also can provide guidance when a patient who has the flu is not responding to antiviral treatment or is getting worse.”The previous guidelines were published just before the 2009 H1N1 influenza pandemic, the fourth pandemic in the past 100 years. Other pandemics occurred in 1918 (killing an estimated 675,000 people in the United States), 1957 and 1968. A pandemic is a worldwide outbreak of a new influenza A virus that is very different than seasonal influenza A viruses circulating in people. Once it begins circulating, the pandemic virus becomes a seasonal flu virus in subsequent years. Last season the flu was responsible for an estimated 49 million illnesses in the United States, including 960,000 hospitalizations and 79,000 deaths.”We are always concerned about preparing for the next pandemic, but we also are focused on preventing and controlling seasonal influenza,” said Dr. Uyeki. “While pandemics aren’t predictable, we know that every year we’re going to have seasonal influenza and we need to improve how we prevent and control it through influenza vaccination, better diagnosis and early antiviral treatment of patients.” read more

Singapore cautions wealth managers on aggressively courting HK business

first_imgSINGAPORE/HONG KONG: Singapore has cautioned wealth managers against aggressively marketing their services or making other efforts to woo clients to the city state by capitalising on rival Hong Kong’s political turmoil, people with knowledge of the matter said.Officials from the Monetary Authority of Singapore (MAS) made the request last month to wealth managers, including DBS and a unit of Oversea-Chinese Banking Corp, the people said, declining to be identified given the sensitivity of the matter.The central bank told bankers it wanted to ensure wealth managers in Singapore were sensitive to the situation in Hong Kong and did not design campaigns specifically targeting business from Hong Kong, the people said.The move comes as Hong Kong has been thrown into turmoil by a proposed extradition bill – declared dead this week by its CEO Carrie Lam – that for the first time would have allowed China to seek extraditions from the city, sparking demonstrations that attracted at least a million protesters. Corporate News 28 May 2019 Asia’s billionaires develop taste for boutique wealth managers Related News Related News World 28 Jun 2019 Wealth managers head to Singapore as China concerns dim Hong Kong’s lure Tags / Keywords:center_img Business News 10 Jul 2019 Hong Kong’s penny stock enigma remains unsolved {{category}} {{time}} {{title}} Some tycoons in the Chinese-controlled territory have moved funds, or considered doing so, given provisions in the bill that would have allowed China to potentially freeze funds or other assets in the city.The unrest has also encouraged some wealth managers to choose to set up in Singapore after also considering Hong Kong, the main offshore hubs for wealth management in Asia, Reuters has reported.When asked for a comment for this story, MAS referred to comments last month by its managing director, Ravi Menon, that there were no signs of “any significant shift of business or funds” from Hong Kong to Singapore.He had said that any upheaval in Hong Kong could actually be negative for Singapore.It was not immediately clear how many banks had received the MAS guidance. Private banks routinely and legally help clients to move and manage their assets in different parts of the world.”The message was that we shouldn’t be taking undue advantage of what’s going on in Hong Kong,” a senior banking source said on condition of anonymity.”We have to act responsibly and not launch campaigns to convince clients that this is a good time for them to move their assets,” he said, adding he was not aware of any banks making a big push to get business from Hong Kong in the current climate.”We are getting a lot of enquiries. What can we do if clients are looking to moving money here? We can’t stop the flows,” the Singapore-based banking source added.DBS and OCBC declined to comment.Offshore moveHong Kong and Singapore compete fiercely to be considered Asia’s premier financial centre. Global private banks including Credit Suisse and UBS, as well as Asian wealth managers have their regional operations in the two hubs.The riches held by Hong Kong’s tycoons have until now made the city the larger private wealth base, with 853 individuals worth more than $100 million – just over double the number in Singapore, according to a 2018 report from Credit Suisse.Singaporean banks, including DBS and OCBC, have been rapidly expanding their businesses in Hong Kong and China over the past few years, and the Greater China region accounts for a significant portion of their revenue.Like their global peers, Singaporean wealth managers also have Greater China desks in Singapore dedicated to clients in China, Hong Kong, and Taiwan and help them open bank accounts and set up family offices or trusts.”The fact is that we are getting inquiries from clients in Hong Kong. They want to know how this will impact their assets and the Hong Kong markets,” an industry executive said.”If they really want to move offshore, we have to help them with that,” the executive added. – Reuters Bankinglast_img read more