Seasonal flu is a respiratory disease a disease affecting the lungs caused by seasonal influenza viruses. These are viruses that spread in people and cause flu epidemics every year, usually in the fall and winter months in the United States. Flu is usually spread from close contact with people via coughing or sneezing. Seasonal flu viruses are constantly changing, which means that the flu viruses that infect people one year can be different from the flu people get sick with the next year.
This is one reason why you need to get a flu vaccine every season. Each season's vaccine is tailored to match what experts predict will be the most common viruses that season. Novel flu viruses are viruses that are not usually seen in people—these viruses normally only infect animals such as birds or pigs.
But they can infect people too, and even change in ways that let them spread between people like seasonal flu. Although novel flu virus infections are rare, they can be dangerous because seasonal flu vaccines usually don't protect against them and people usually won't have much natural immune protection against them.
Data You decide to interview the sick teenagers, with the consent of their parents. Based on the information you gathered, you see that they have a few things in common. Many of them played in or attended a state-wide baseball and softball tournament in Freemont, featuring teams from all across the state. Also, the county fair was recently in town, attracting big crowds. A few of the sick teenagers have traveled to other states and even other countries. In order to get a better idea of how the sick teens were first exposed to this particular novel flu virus, you need to take a closer look and see how they spent their time over the past few weeks.
You also need to interview a number of healthy teens who did those same activities. We call this a case-control study. Tip To figure out which activity most likely led to flu exposure, search through the data table to find the activity with the highest value for prevalence which means the proportion of a population that has a certain condition among sick teens AND the lowest value for prevalence among healthy teens.
Which of the following is most likely responsible for the outbreak? But take a look at the people who went to the county fair. Keep investigating! Answer 2: Going to the county fair [Correct] That's right! That may be where they got sick, but you still don't know how, or what it was that infected them.
Answer 3: Being a teenager [Incorrect] It is true that the data shows you that all of those who are sick in this group are teenagers, but that's because you were looking only at teenagers. So everyone in this data table is a teen, even the healthy people. Clue 3 The illness is spreading! There are now 54 sick people, including 9 adults.
According to a recent update, a year-old man and 3 kids are in the hospital. You meet with the fair organizers who say that more than 10, people came to the fair during the 5 day event. There were carnival rides, food stands, a concert, a barn dance, and a number of animal exhibits. Of course, many people who went to the fair are perfectly healthy. Since this is a novel flu virus with no other cases reported, you suspect that it may have come from an animal.
You take a closer look at what kinds of animals the sick people were exposed to. Data As you talk to the sick and healthy teens who went to the fair, you're especially interested in the types of animals they were around.
Some animals get the flu too, but their flu viruses usually aren't passed on to people. However, every now and then, an animal's flu strain or type of flu changes in a way that allows it to be spread among people easily.
You learn that many of the sick and healthy teens that you interviewed spent time around cows, chickens, and pigs. Some of them only spent an hour or two with animals, and some spent as many as 10 hours with them. Why did so many people at the county fair get sick? Answer 1: They spent a lot of time near pigs [Correct] That's right! You've discovered that the more time the teens you interviewed spent around pigs, the more likely they were to get sick.
That's a pretty strong link. Flu outbreaks can spread quickly, so you need to keep working before it spreads even more! Answer 2: They spent a lot of time near chickens [Incorrect] Sorry. The data do not seem to indicate that chickens were the source of infection. Instead, the more time the teens you interviewed spent around pigs, the more likely they were to get sick. Answer 3: We still can't tell [Incorrect] Take a closer look. The data show you pretty clearly that the more time the people you interviewed spent around pigs, the more likely they were to get sick.
Flu outbreaks can spread quickly, so you need to keep working before this spreads even farther! Clue 4 It's been 19 days since Laura and her friends first got sick from this novel flu. There are now at least 72 sick people in this county alone, 11 have been hospitalized, and one person has died! It also looks like the flu crossed the state line! You talk to health departments across the country and learn that there are at least 4, confirmed cases in 36 states, with dozens of people hospitalized.
From the looks of it, you have a large outbreak on your hands, which may even turn into a pandemic! With the number of cases quickly rising you begin to wonder whether all of these people attended the county fair or if they got infected somewhere else. Definition What's a pandemic? A pandemic occurs when a disease spreads and affects a very large number of people across the globe. Scientists monitor novel flu viruses carefully.
A novel flu virus might cause a pandemic if the virus can spread efficiently from person to person and if most people don't have any immunity to the new virus. If the new flu virus can only be spread from animals to people or from one person to another, but no further, then it probably won't cause a pandemic. People can have some immunity to flu viruses that are similar to viruses they've had in the past.
If a new flu virus is very different from earlier flu viruses, it may be more likely to cause a pandemic. Though most people recover from seasonal flu after a week or two, a small percentage of people with flu die every year. A novel flu virus could be much more serious, and if a novel flu virus caused a severe pandemic, many people could die. This happened during the influenza pandemic, during which millions of people died.
Data After careful consideration, you rule out the possibility that all of the new cases that are popping up across the country are a result of people attending the county fair. You arrange a virtual meeting with health departments across the United States to get more information about the cases. Based on the information you gathered, you calculate the relative risk to figure out why so many people are getting sick.
Tip Relative Risk RR describes the likelihood of some event like getting food poisoning occurring in a group of people with a potential risk factor like eating spinach compared to a group without that risk factor in this example, not eating spinach. If the RR of getting sick after eating contaminated spinach was 5, then people who ate contaminated spinach would be 5 times more likely to get sick than people who did not eat contaminated spinach.
The closer the relative risk is to 1, the greater the likelihood that an event occurring like getting food poisoning is about the same for both groups. What do you think is the reason for the large increase in sick people? Answer 1: The sick people lived throughout the United States on farms with pigs [Incorrect] You can forget about pigs now.
It looks like people who live with someone that has this flu are at high risk of getting sick too! This means the new flu virus has developed the ability to be spread easily from person to person. It may have started by spreading from pigs to people at that county fair, but now it's spreading from person to person, and fast! Can you stop it from spreading even more?
I seldom, if ever, judge. I am quick to remind my friends of their virtues, telling them that they are beautiful, they are brilliant, they are superstars. I spend money on them. I often express my love. Most of my withered friendships can be chalked up to this terrible tendency of mine not to reach out. I have pals in Washington, D.
And yet I do. I have. This is, mind you, how most friendships die, according to the social psychologist Beverley Fehr: not in pyrotechnics, but a quiet, gray dissolve. And so you drift. At best, those dead friendships merely hurt; at worst, they feel like personal failures, each one amounting to a little divorce. Read: The Friendship Files You feel bereft, for one thing. As if someone has wandered off with a piece of your history. And you fear for your reputation.
Friends are the custodians of your secrets, the eyewitnesses to your weaknesses. Talking with her was like playing strip poker with someone in a down parka. There was the friend I lost to parenthood, utterly, though I was also a parent. Her child shortly consumed her world, and she had many child-rearing opinions. There was no operatic breakup. She moved away; I made zero effort to stay in touch.
But whenever I think of her, my stomach chirps with a kind of longing. She showed me how cognitive behavioral therapy worked before I even knew it was a thing, rightsizing my perspective each time I turned a wispy cirrus into a thunderhead. And her conversation was tops, weird and unpredictable. I miss her. Or who she was. Who we were. I lost a male friend once to parenthood too, though that situation was different.
In this instance, I was not yet a mother. I miss him a lot, and wonder to this day whether I should have just let the comment go. Yet whenever I think of him, a fiery asterisk still appears next to his name.
According to Hojjat, failures of reciprocity are a huge theme in broken friendships. I myself have been criticized for neglect and laziness, and rightly. I consider this a form of currency between women: You trade confidences, small glass fragments of yourself.
But not with her. Read: How friends become closer I mentioned this problem to Hojjat. She ventured that perhaps women expect more of their female friends than men do of their male companions, given how intimate our friendships tend to be. Which brings me to the subject of our Problem Friends. Most of us have them, though we may wish we could tweeze them from our lives.
Unfortunately, what the research says about these friends is depressing: It turns out that time in their company can be worse than time spent with people we actively dislike. You have to wonder whether our bodies have always known this on some level—and whether the pandemic, which for a long while turned every social interaction into a possible health risk, made all of our problem friends easier to give the slip.
They are bad for you. And—alas—always were. A great deal is dime-store wisdom crowned in the laurels of peer review, dispatches from the Empire of the Obvious. When I first wrote to Elisa about this topic, she replied with an implicit eye roll. So yes: Relationships really are good for u. Read: How friendships change in adulthood But friendship, generally speaking, is the redheaded stepchild of the social sciences.
But this lacuna in the literature is also a little odd, given that most Americans have more friends than they do spouses. And one wonders if, in the near future, this gap in quality scholarship may start to fill. In a book published in the summer of , Big Friendship , Aminatou Sow and Ann Friedman, the hosts of the podcast Call Your Girlfriend , argued that some friendships are so important that we should consider assigning them the same priority we do our romantic partnerships.
They certainly view their own friendship this way; when the two of them went through a rough patch, they went so far as to see a therapist together. I mentioned this to Laura Carstensen. Practically everyone who studies friendship says this in some form or another: What makes friendship so fragile is also exactly what makes it so special.
You have to continually opt in. That you choose it is what gives it its value. But as American life reconfigures itself, we may find ourselves rethinking whether our spouses and children are the only ones who deserve our binding commitments. When Sow and Friedman went into counseling together in their 30s, Sow was unmarried, which hardly made her unusual.
But we could reach a point where close friends do quit their jobs to care for you when you have dementia. I have three friends having babies. When we spoke, Perel was also preparing for her very first couples-therapy session with two friends, suggesting that Sow and Friedman were onto something. This has got to shift. Elisa and Rebecca nurtured each other as if they were family—and often in ways their own families did not.
When they met, Elisa was a new mother, and her parents were 3, miles away. There is no one I can talk to the way I can talk to her, and to you. Her intelligence is vast and curious and childlike and insatiable and transcendent, like yours.
When they met, Rebecca was still married. On one level, it appeared to be a significant difference in philosophy. Namely: how they each thought about depression. Rebecca struggles with major depression. Elisa has had experiences with the black dog too, going through long spells of trying to bring it to heel. But she hates this word, depression, thinks it decanted of all meaning, and in her view, we have a choice about how to respond to it.
I just want to get you down on the floor for a while. I want to get you breathing. I want to get you out of your head and into your hips, into your feet. I want to loosen you up. That is all. To Elisa, women have been sold a false story about the origins of their misery. Everyone talks about brain chemistry. What about trauma? Screwy families? The birth-control pills she took from the time she was 15, the junk food she gorged on as a kid?
The mind is a fucking joke … Remind me to tell you about the time they prescribed me Zoloft in college after my brother died. Pills for grief! I am endlessly amused by this now. But pills for grief—that is, in fact, exactly what Rebecca would argue she needed. Around and around the two went. The way Elisa saw it, Rebecca was using her depression as an excuse for bad choices, bad behavior. Neither party relishes her role. Eventually, Rebecca started taking medication.
And once she did, she pulled away, vanishing for weeks. E: Well, our dialogue has turned into a monologue, but I am undaunted. Weirdly, this explanation was not far off. When Rebecca eventually did reply, the exchange did not end well. Elisa accused her of never apologizing, including for this moment. She accused Rebecca of political grandstanding in their most recent correspondence, rather than talking about wellness. But Elisa was also forever complaining about her mother, saying that she hated her mother.
To which Elisa replied that this was exactly the manipulative, hurtful type of gaslighting in which her mother would indulge. If our friends become our substitute families, they pay for the failures of our families of origin. And on some level, both women knew this. Elisa said it outright. Something about mothers and children, and the unmothered, and human frailty, and imprinting. Something about friendship, which can and should provide support and understanding and company and a different sort of imprinting.
A different sort of imprinting. And in our marriages too, at least if you believe Freud? Improved versions of those who raised us? Trial and error? How do you ensure them? Read: Arthur C. Keeping up contact, ideally embodied contact, though even semi-embodied contact—by voice, over the phone—would probably suffice. Only when reading Elisa and Rebecca in atom-splitting meltdown did I realize just how crucial this habit is.
The two women had become theoretical to each other, the sum only of their ideas; their friendship had migrated almost exclusively to the page. According to a September survey by Pew , 38 percent of Americans now say they feel less close to friends they know well.
The problem is that when it comes to friendship, we are ritual-deficient, nearly devoid of rites that force us together. Emily Langan, a Wheaton College professor of communication, argues that we need them. Friendship anniversaries. Regular road trips. Sunday-night phone calls, annual gatherings at the same rental house, whatever it takes. They make contact a priority. They jump in their cars.
They appear at regular intervals in my inbox. Not hers, I should note—the term was popularized in the s, to describe the ideal therapist-patient relationship. Carstensen had the good sense to repurpose it. Her observation perfectly echoed something that Benjamin Taylor, the author of the lovely memoir Here We Are , said to me when I asked about his close friendship with Philip Roth.
What, I wanted to know, made their relationship work? He thought for so long that I assumed the line had gone dead. The person is giving back to you the feelings you wish you could give to yourself. And seeing the person you wish to be in the world.
That might be a strange thing to say, because the book is not, on its face, about friendship at all, but about the birth of behavioral economics. Yet at its heart is the story of an exceptionally complicated relationship between two giants of the field. Amos Tversky was a buffalo of charisma and confidence; Daniel Kahneman was a sparrow of anxiety and neuroticism. The early years of their collaboration, spent at Hebrew University in the late s, were giddy and all-consuming, almost like love.
But as their fame grew, a rivalry developed between them, with Tversky ultimately emerging as the better-known of the two men. He was the one who got invited to fancy conferences—without Kahneman. He was the one who got the MacArthur genius grant—not Kahneman. There is envy! I hate the feeling of envy.
With the exception of envy, all of the deadly sins can be pleasurable in some way. Rage can be righteous; lust can be thrilling; greed gets you all the good toys. But nothing feels good about envy, nor is there any clear way to slake it. You can work out anger with boxing gloves, sate your gluttony by feasting on a cake, boast your way through cocktail hour, or sleep your way through lunch. But envy—what are you to do with that?
Die of it, as the expression goes.
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Take sharp abdominal pain quiz Ruptured ovarian cyst It is normal for one of the two ovaries to create a small follicle each month. This follicle contains an egg cell that is released as part of the menstrual cycle. In some cases, however, the egg cell fails to release. The follicle becomes overgrown and may eventually rupture, especially during sexual activity or strenuous exercise. Symptoms of a ruptured ovarian cyst may be mild and only require over-the-counter pain relievers.
However, sudden severe pain on one side of the lower abdomen, especially with vaginal bleeding, may indicate internal bleeding and is a medical emergency. Take the patient to the emergency room or call Diagnosis is made through patient history, physical examination, and ultrasound, as well as blood tests and urine tests to rule out any other cause for the symptoms.
Treatment may involve hospitalization for IV fluids and pain medications. Surgery may be done to control the bleeding and remove any clots, blood, or fluid in the abdomen. Rarity: Rare Top Symptoms: stomach bloating, pelvis pain, lower abdominal pain, being severely ill, severe abdominal pain Urgency: Hospital emergency room Ovarian torsion Ovarian torsion, also called adnexal torsion or tubo-ovarian torsion, is the twisting of the "stem," or supporting fleshy pedicle, of the ovary.
This condition can occur when a mass forms on the surface of the ovary and pulls it over. This is most often a complication of cystic ovaries. It is most common in women under thirty or past menopause. It can occur during pregnancy. Symptoms include severe, one-sided, lower abdominal pain with nausea and vomiting. Diagnosis is made by ultrasound. The ovary will appear enlarged due to the torsion cutting off the circulation. There will be free pelvic fluid and a twisted pedicle.
Ovarian torsion is a medical emergency. The ovary can die due to loss of circulation, causing infection, abscess, or peritonitis. Surgery must be done to prevent tissue death and subsequent complications. In the majority of cases the affected ovary must be removed, which also removes the cyst or mass that caused the torsion. Proper treatment of polycystic ovary syndrome PCOS can help prevent at least one cause of ovarian torsion. Rarity: Rare Top Symptoms: abdominal pain stomach ache , nausea or vomiting, nausea, moderate abdominal pain, loss of appetite Symptoms that never occur with ovarian torsion: diarrhea, pain below the ribs, mild abdominal pain Urgency: Hospital emergency room Kidney stone A kidney stone , also called renal lithiasis or nephrolithiasis, is a solid deposit that forms inside the kidney.
Stones may form if the urine becomes too concentrated for any reason, allowing the minerals in it to crystallize. There are several possible causes: Not drinking enough water. Family or personal history of kidney stones. Diets high in protein, salt, or sugar.
Digestive diseases and conditions, including gastric bypass surgery. Urinary tract infection. Diagnosis is made through blood test, urine test, and imaging. For smaller stones, the patient may only need to drink extra water and take over-the-counter pain relievers. Medication may be given to help pass the stone. Larger stones may require the patient to be hospitalized for surgical procedures.
Prevention involves drinking more water and restricting certain foods, including animal protein, calcium, and salt. Sometimes prescription medications will be used. Gallstones Gallstones are small, pebble-like, mineral deposits that can form inside the gallbladder. They may cause no symptoms unless they become lodged in a duct leading out of the gallbladder. Gallstones are thought to be caused by high cholesterol, which can form into crystals in the gallbladder; by cirrhosis, or scarring, of the liver; or by incomplete emptying of the gallbladder.
Most susceptible are women over age Other risk factors are obesity, lack of exercise, poor diet, and rapid weight loss as with gastric bypass surgery. Symptoms include sudden sharp pain in the center or upper right abdomen, in the right shoulder, and in the upper back. There may also be nausea and vomiting, yellowing of skin and eyes, and fever and chills.
It's important to see a medical provider for these symptoms. Gallstones can lead to pain, infection, and further complications. Diagnosis is made through physical examination, CT scan, blood tests, and sometimes specialized scans to examine the gallbladder system. Treatment usually involves surgery to remove the stones and sometimes the gallbladder itself. Gall bladder infection cholecystitis Gallbladder infection , also called cholecystitis, means there is a bacterial infection of the gallbladder either with or without gallstones.
The gallbladder is a small organ that stores bile, which helps to digest fats. If something blocks the flow of bile out of the gallbladder — gallstones, damage to the bile ducts, or tumors in the gallbladder — the bile stagnates and bacteria multiplies in it, producing an infected gallbladder. Risk factors include obesity, a high-fat diet, and a family history of gallstones. Symptoms include fever; chills; right upper quadrant abdominal pain radiating to the right shoulder; and sometimes nausea and vomiting.
A gallbladder infection is an acute sudden illness, while the symptoms of gallstones come on gradually. Spleen Problems The two most common spleen problems are splenomegaly and a ruptured spleen. Splenomegaly, known as an enlarged spleen, is caused by liver diseases and infections. On the other hand, a ruptured spleen is caused by trauma on the abdomen, usually through sports or a car accident.
Discomfort on the ribs is also characteristic of splenomegaly. Abdominal pain is not a common symptom of a ruptured spleen and only occurs in rare cases. When experienced, alongside pain in the left shoulder, patients are recommended to immediately seek medical help. The LES serves as a valve between the esophagus and stomach. When it relaxes, stomach juices are regurgitated up the esophagus, creating a burning sensation accompanied by a sour or bitter taste.
Pain from GERD is described as a sharp, acidic pain that radiates from the stomach to the esophagus. Bad breath is a common symptom of GERD. Other symptoms include chest pain and heartburn. Gastritis Excessive alcohol use and the presence of bacteria are leading causes of an inflamed stomach lining, leading to gastritis. Chronic gastritis has been characterized into three distinct types: Type A: Caused by immune system reacting with stomach cells Type B: Caused by bacteria Helicobater pylori Type C: Caused by chemical interactions with drugs specifically nonsteroidal anti-inflammatory drugs , excessive bile production, and alcohol abuse Pain that can be described as a gnawing sensation, one that typically worsens after meals or at night, is a telling sign of gastritis.
Nausea, loss of appetite, and bloating are other symptoms of gastritis. Pain is usually located in the upper left area of the stomach or the center of the abdomen. Pancreatitis Pain from pancreatitis is often situated in the middle or upper left side of the abdomen, and is described by patients as a pain that radiates towards the back.
Eating excessive amounts of food, especially foods with high-fat content, and alcohol abuse are known triggers of pancreatitis. Pancreatitis occurs when digestive juices are activated in the pancreas. The small intestine is responsible for breaking down fat with the use of digestive enzymes. However, these enzymes can be activated while in the pancreas, leading to inflammation and possibly infection. Hepatitis Hepatitis describes five types of liver inflammation caused by different viruses.
Hepatitis is a viral disease that can be transmitted through blood transmission, sexual contact, and hereditation. The five different types of hepatitis are: Hepatitis A: Contracted through the consumption of unclean food and water. Hepatitis A is curable through medication and immunization, which helps prevent the spread of hepatitis A. Poor sanitation is the primary cause of hepatitis A.
Hepatitis B: Contracted through infective bodily fluids including blood and semen. Can also be acquired through hereditation, from mother to child during birth. Blood products contaminated with Hepatitis B, from needles to blood samples, can spread the virus. Hepatitis C: Commonly contracted through faulty blood transmission.
Needles, blood samples, and injections can spread the virus. There are no known vaccines for Hepatitis C. Hepatitis D: Can only be contracted by patients with Hepatitis B. Considered a super-infection, patients with hepatitis B are recommended to get vaccinated for HDV. Hepatitis E: Contracted through the consumption of unclean food and water, particularly organs such as the liver.
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