Category Archives: Health Promotion

Student Health never gives antibiotics!

chart from CDC showing bacterial infections and viral infections

Huh?

We hear it often, especially during cold and flu season. It is the most common reason parents call to talk to our Director. It leads to negative reviews on social media sometimes. It sounds something like this……

Students come in asking for a zpack by name because “that’s the only thing that works”

Parents call and are upset we didn’t “do anything” for their student

“My doctor at home just calls me in an antibiotic”

“Student Health told me I have a cold but I really have an upper respiratory infection!”

“My snot is green so I know it is bacterial”

“You told me I have a virus, but I went to another facility and got an antibiotic”

And finally………………………”Student Health never gives antibiotics!”

 

SO WHAT’S THE DEAL, STUDENT HEALTH?

Sore throat, cough, nasal congestion/drainage, fever, aches, ear pain, sinus pressure, and headache are some of the most common reasons for visits to Student Health. As you see from the chart, VERY few need antibiotics.

Some important facts to know:

  • 90-98% of sinus infections are viral (and even in bacterial cases, antibiotics do not necessarily help)
  • 90-95% of sore throats in adults are NOT strep
  • over 200 strains of the common cold exist
  • bronchitis should not be treated with antibiotics
  • most adults experience 2-4 colds annually, each lasting 7-10 days
  • colored snot means NOTHING in regards to whether the cause is bacterial or viral
  • high fever can be present in either bacterial or viral infections

chart from CDC showing bacterial infections and viral infections

 

So how do Providers know whether a patient needs an antibiotic or not?

Providers at Student Health follow national treatment guidelines, which aid diagnosis and treatment planning. The Centers for Disease Control has an excellent chart that you can check out here to see why we make the decisions we do. Part of the diagnosis is on patient reporting of symptoms, duration of illness, etc and the other is based on physical assessment, such as vital sign readings, visual inspection of eyes/throat/nose/ears, and listening to lungs (among other things depending on symptoms).

Do we give antibiotics? Of course we do–when it is the medically appropriate treatment.


Yeah, but wouldn’t an antibiotic help anyway????

NO. Incorrect antibiotic use causes a whole host of problems. People tend to forget that antibiotics can have side effects, some which may even make a patient feel worse than their original illness! Allergic reactions, stomach upset, diarrhea, yeast infections, and rashes are just some of the common side effects people can experience with antibiotics. Another issue is drug resistance–every time you take an antibiotic that you do not need, you are contributing to the fact that the antibiotic is less effective over time to bacteria. Did you know that by taking an antibiotic, you can actually help unleash a dangerous different bacteria into your gut, one that can lead to hospitalization and even death? (Don’t believe me? Check out  info on C.Difficile)

Superbugs like MRSA exist now because of incorrect use of antibiotics, and the scary thing is, our ability to fight these super infections is limited or in some cases, there is no way at all to treat them! And what about cost? Prescriptions are not always cheap. Why take a medication that won’t help, may hurt, leads to drug resistance, and costs money?

Health care providers have a duty to prescribe responsibly and to only use antibiotics in acute illness when a patient shows signs that a bacterial infection is present.


So you aren’t going to help.

Here is the part that comes into conversation with a lot of our patient/parent feedback about viral infections: if you are not giving an antibiotic, you are not doing anything to help. The hard truth is this: with most illnesses, including flu, bronchitis, upper respiratory infections, colds, sinus infections and most sore throats, THERE IS NO MAGIC FIX. We always advise patients on the best way to treat their symptoms to hopefully get some relief, but the only thing that cures is TIME. Illnesses can take days or WEEKS to resolve (yes, weeks.) Rest, good nutrition, light exercise, and increasing fluid intake help. We recommend which over the counter medications to take, and provide prescriptions for cough medications or inhalers if warranted; our on site pharmacists are also happy to help patients decide what may help their symptoms. Having a pharmacy right inside Main Campus SHS makes it easy for patients to pick up what they need to start feeling better.

 

“You told me I have a virus, but I went to another facility and got an antibiotic.”

Ah.

Our advice to patients would be to always ask why you are, or are not, receiving an antibiotic. Ask what guidelines are being used. Ask why a provider thinks an illness is viral or bacterial. Any high quality provider will be happy to share information and education about their clinical decision.

We hear stories of “urgent care gave me an antibiotic for my bronchitis” (cringe) or “the ED diagnosed an upper respiratory infection and wrote me a zpack” (AKA, you have a COLD. Double cringe) or, possibly the most irresponsible, “I called my doctor at home and he called me in an antibiotic since that always helps” (ugh….)

Some outside facilities may not be willing to practice evidenced based medicine when it comes to antibiotic prescribing because that may mean a patient will be unhappy (and therefore will not pay to come back). We cannot control what other offices do, but we can insist that our facility follows recommendations and best practices. Just because you can walk out of another office with one or more prescriptions does not mean it was the medically sound thing to do.

 

Possibly the most important part…..that many patients miss…..

While most illnesses are viral in nature, we ALWAYS tell patients that if they are not getting better, something suddenly worsens, or if they have any emergency symptoms such as difficulty breathing, inability to put their chin to their chest, severe headache, chest pain, high fever that does not respond to medication, or prolonged vomiting, THEY NEED TO BE RE-EVALUATED. Infections that start out as viral, or appear early on as viral, can lead to bacterial infections that do need antibiotics or other treatments. Most patients will recover from viral illnesses on their own, but if that is not the case, we will always be glad to see patients for follow up appointments. The great thing about Student Health is that if you pay fees with your tuition, you do not have to pay to be seen and evaluated….so never hesitate to come back with any new concerns, symptoms that are not improving, or other questions about your care.

 

Our goal is help the ECU campus community be as healthy as possible. By communicating how we form diagnoses and treatment plans, we hope patients and others will feel more educated and confident that safe and appropriate antibiotic prescribing is a important part of the care we provide at Student Health Services. As always, feel free to drop us a line at gotquestions@ecu.edu with your health or service related questions.

Stay well, ECU!

 

Sources:

Antibiotics Aren’t Always the Answer https://www.cdc.gov/features/antibioticuse/infographic2.html

Appropriate Antibiotic Use https://www.cdc.gov/antibiotic-use/

CDC Treatment Guidelines https://www.cdc.gov/antibiotic-use/community/for-hcp/outpatient-hcp/adult-treatment-rec.html

Still on the fence about the flu shot?????

image states "keep health and get your flu shot"

image states "keep health and get your flu shot"

 

If you are opting out of a flu shot because of some rumors you have heard, let us help fact check the claims.

If you decide to change your mind and get vaccinated, call us at (252) 328-6841. We have a small supply of flu vaccine left….get it while you can! Our cases of people being sick with the flu are increasing, so don’t wait much longer to get your flu shot.

Is it too late to get my flu shot? No. We are starting to see an increase in influenza cases at SHS. This is likely to persist for the next 6 weeks or possibly longer. The flu shot offers full protection about a month after receiving it, so if you get it soon, you may still benefit from it.

I heard the flu shot wasn’t very good this year. Why should I get it? We don’t know how well the flu shot will work this year. The flu virus mutates quickly and that can make the vaccine less effective. Last year’s flu vaccine (2016-2017) was about 39% effective against all circulating types of influenza. The CDC is predicting that this year is likely to be similar. However, the flu virus mutates quickly and that means sometimes the vaccine is just not a good match for the types of virus that are floating around. That being said, the flu vaccine has been shown again and again to reduce complications of the flu such as pneumonia and to reduce hospitalizations and deaths. This suggests that those who get the vaccine are getting some protection from it, even if they do happen to catch the flu.

I got the flu shot one time and it made me sick. The flu shot cannot give you the flu. There is no live virus in the shot. It is not uncommon, though, for people to feel a bit achy after the shot. Sometimes they will develop some sinus drainage or headaches or mild elevations in body temperature. This is not the flu. The purpose of the flu shot is to put your immune system on guard against the flu. This mild ill feeling is likely an indicator that the shot is doing its job—your body is reacting to it. If you get the shot and then have fever (temp greater than 100.4), that would be an uncommon reaction and is more likely to be a different viral illness—not related to the flu shot.

There is excellent information (and much more detail) about the flu shot on the CDC website. The address is www.cdc.gov. Search:flu shot.

~Dr. Ashton Johnson, SHS Physician

STI/STD Awareness Month!

STI/STD Awareness Month

Know your status, Pirates!

April is STI/STD Awareness Month! This is a time to increase awareness and encourage testing for sexually transmitted infections or diseases (STIs or STDs) including HIV. The Centers for Disease Control and Prevention (CDC), estimates that of sexually active people in the US, 1 in 2 will get an STI by the time they’re 25. That could be you or the person sitting next to you in class. There are about 20 million new STIs diagnosed each year, half are among young people ages 15-24. While getting an STI is more common than you probably thought, people are still incredibly uncomfortable talking about it. Let’s change that now!

This STI Awareness Month (and all year long), take control of your sexual health. Start having open and honest conversations with your partner(s) and healthcare provider about sexual health and STIs. Here are some conversation starters that might help you when talking to your partner(s):

Talk before you have sex.

  • “Getting tested before we have sex will help protect both of us.”
  • “Many people who have an STI don’t know it. Why take a chance when we can know for sure?”

There are other things you may want to talk to your partner about, such as:

  • Sexual history – the number of partners you’ve had and what kind of protection you used
  • Risk factors – like whether you’ve had sex without a condom or used drugs with needles

Share the facts.

  • “STIs that are found and treated early are less likely to cause long-term problems.”
  • “Getting tested is easy. Doctors can test urine (pee) for chlamydia and gonorrhea, some of the most common STIs. And some HIV tests can give results in 20 minutes. You may not even have to give blood.”
  • “If you don’t feel comfortable talking about STIs with your regular doctor, you can get tested at a clinic instead.”

Show that you care.

  • “I really care about you. I want to make sure we are both healthy.”
  • “I’ve been tested for STIs, including HIV. Are you willing to do the same?”
  • “Let’s get tested together.”

Agree to stay safe.

  • “If we’re going to have sex, using condoms is the best way to protect us from STIs. Let’s use condoms every time we have sex.”
  • “We can enjoy sex more if we know it’s safe.”

Being a student is challenging on its own, we understand you are in the process of carving your own path in life. STIs don’t define you or what you can do in life. Sometimes you can feel alone with an STI diagnosis. You don’t have to be alone – speak to someone you trust, a friend, parent or healthcare provider and talk about it.

The only way to know your status is to get tested. At Student Health, you have two options for getting tested:

  • If you are symptom-free, you can schedule a visit with the Fast Track nurse to test for chlamydia, gonorrhea, HIV, and/or syphilis. Make sure not to urinate within 1 hour of your appointment time (if you want oral screening for chlamydia/gonorrhea, do not eat/drink/chew for 1 hour prior to your appointment).
  • If you have symptoms and need testing for possible warts or herpes, make a clinic appointment with one of our providers. They can also treat any other symptoms you may have like penile drip or discharge; sores, bumps or blisters around your genital or anal area; burning with urination; swollen or tender testicles; throat pain; rectal bleeding, discharge, itching, or bumps.

Remember, STIs are very common but most young people don’t know they are infected. If you do have an STI, work with your healthcare provider to get the proper treatment. It’s important to always wear a condom or use a dental dam to avoid getting an STI or infecting your partner(s).

Have a general question about STIs? E-mail us at gotquestions@ecu.edu.

Sources:

American Sexual Health Association (ASHA): Yes Means Test. www.yesmeanstest.org

Centers for Disease Control and Prevention (CDC): STD Awareness Month – Archive

https://www.cdc.gov/std/sam/archive.htm

Image source: https://www.healthypeople.gov/

Lots of people saying the “F” word around here lately…….FLU :(

woman holding tissue up to her nose

Flu is here!

We are seeing an increase of flu cases here at Student Health. Here is some important information about flu and what to do if you (or someone close to you) gets sick.

Signs of the flu: sudden onset of fever, body aches, fatigue, cough, sore throat, runny or stuffy nose, headache. Rarely it can cause diarrhea or vomiting, but influenza and the “stomach flu” are NOT the same thing. Flu makes you feel horrible, fast. Like hit by a truck horrible.

What to do if you are sick: stay away from others until you have been fever-free for 24 hrs without having to take fever reducing medication. Take ibuprofen/tylenol for aches and fever, drink a lot of fluids, rest, and cover your sneezes and coughs with a tissue that you throw away. WASH YOUR HANDS. Are you high risk for flu complications?  Read this and if applies, call us at (252) 328-6841.

  • Do you need a friend to pick up food for you at the dining hall?  You can fill out this form and let your buddy grab you something to eat.
  • Do you need to let your professors know you are sick?  Log onto Pirate Port and use the “Flu Self Reporting Form”.  Be advised:  this is NOT an excuse.  But, it lets your professors know you are ill and they may work with you on missed work.

What to do if your roommate or someone you love is sickhttp://www.flu.gov/symptoms-treatment/caring-for-someone/index.html

If you aren’t sick, here are a few things to do to try to avoid the flu:

  • get a flu shot–although the best time to get vaccinated is early fall, it is not too late. Student Health has plenty of vaccine available or visit one of your local retail pharmacies, urgent care centers, or your primary medical provider’s office.
  • Avoid sick people–if your friend says they don’t feel well, maybe you should cancel that study session or lunch date.
  • Don’t eat, drink, or smoke after others.
  • Avoid touching your eyes, nose and mouth–we don’t realize how much we introduce germs into our system just by our habits.
  • Wash your hands way more than you think is necessary. Also, alcohol based sanitizers do work against flu, so get you a bottle to keep in your bag.
  • Surfaces are gross–doorknobs, chair rails, keyboards, money, pens, phones, etc all can harbor flu virus particles. Remember to clean your hands often especially after touching items others have used.

A few FAQ:

  • Does SHS test for flu?
    Yes, we can.  It is done by swabbing nasal secretions. But, in many cases, it is not helpful since the treatment for flu is based on symptoms, not test results, so your treatment is the same whether the test is performed or not if the provider suspects flu.
  • Should I see a doctor?
    In most cases, if you are healthy and have no underlying major medical issues like asthma, pregnancy, diabetes, HIV, heart conditions, cancer, etc, you do not need to see a health care provider since flu typically resolves on its own.  However, if you have severe symptoms or feel that you are not improving, you need to call your doctor or if you have an emergency, call 911.
  • Can SHS give me a note to miss class?
    No. SHS can not give class excuses.
  • If I have flu, do I need Tamiflu (antiviral medication)?
    Again, probably not.  Learn more here.  If you have a severe case, or are at high risk for complications, then your doctor will probably prescribe an anti-viral; however, low risk otherwise healthy people do not need prescription medication for flu.

Still have more flu related questions?  Email us at fluquestions@ecu.edu

Also, don’t forget: anytime we are not open, you always have the 24hr nurseline available to you for medical advice.  Call our main number, (252) 328-6841, and listen to the instructions for speaking with a nurse.

Student Health continually monitors the flu situation.  Look to www.ecu.edu/studenthealth for updates and please follow us on Twitter (@ECU_SHS) and Facebook (ECU Student Health Services) for the most up to date information for campus.

Source:

CDC                       http://www.cdc.gov/flu/

Get Smart About Antibiotics

ECU Student Health Services (SHS) is supporting Get Smart About Antibiotics Week, November 14-20, by sharing education and social media messages about when antibiotics are indicated, how to take them correctly, and why overuse contributes negatively to our health.  SHS and the Centers for Disease Control and Prevention (CDC) want you to know why antibiotics are not always the answer and why SHS providers are so careful about only prescribing antibiotics when indicated, not just because a patient requests them.

The CDC has news this cold and flu season:  antibiotics do not touch viruses—never have, never will!  And it is not really news—it is a long-documented medical fact. Antibiotics can only treat illnesses caused by bacteria. Colds, the flu, most sore throats, bronchitis, and many sinus and ear infections are caused by viruses, not bacteria. If you have a viral infection, antibiotics will not help you feel better or get well sooner. In fact, they can even be harmful.

Taking antibiotics when they are not needed is fueling an increase in drug-resistant bacteria, which cause infections that are more difficult, and sometimes even impossible, to cure. Almost all types of bacteria have become less responsive to antibiotic treatment. Heard of MRSA? These “superbugs” can quickly spread to family members, schoolmates and coworkers, and threaten our communities with illnesses that were once easily treatable. Combatting antibiotic resistance is a priority for CDC with estimates of more than 2 million resistant infections occurring annually in the United States alone.

When antibiotics are used for viral infections, you are not getting the best care. A course of antibiotics will not fight the virus, help you feel better, or lead to a quicker recovery. It may even be harmful. If you are diagnosed with a viral illness, SHS providers will give you advice on what to do to feel more comfortable while the immune system does its work. Suggestions might include drinking plenty of fluids, getting a lot of rest, using over the counter medications, using a cool mist humidifier, or gargling with salt water. Please help SHS continue its commitment to safe and smart antibiotic use by educating yourself about antibiotics.

antibiotic-usage

 

 

 

 

 

 

 

 

 

 

 

 

If an antibiotic is prescribed for you, take it as directed and complete the entire course of medication, regardless of when you start feeling better.  Partial doses of antibiotics should not be saved “for next time”—this increases resistance and allows the bacteria to possibly come back stronger.  You should also know to never take medication prescribed for others—even if you have similar symptoms as your roommate or think you have the same illness as a friend, it is NEVER okay to share prescriptions or take a dose of antibiotics from another person.

As always, if you have ANY questions about their diagnosis, treatment plan, or how to help your symptoms, call us at 252-328-6841 or email us at gotquestions@ecu.edu.   For more information about the right way to use antibiotics, visit www.cdc.gov/getsmart.

Article adapted from CDC’s educational materials for Get Smart About Antibiotics week.

World AIDS Day, 2014

aids_ribbon1Today SHS is observing World AIDS Day.  Do you know your status?  Interested in HIV testing?

SHS has HIV testing available every day, Monday-Friday, for FREE.  Testing is quick, easy, and private.  We utilize blood testing and results are usually available within 1 week.  There are 3 ways to make an appointment:

  • in person, by visiting the “Appointments” office inside of SHS, 8am-5pm Monday-Friday
  • by phone, by calling (252) 328-6841 option 1, from 8am-5pm Monday-Friday
    or
  • online, by visiting our online SHS portal starting at 5am each day Monday-Friday (https://shs.ecu.edu/)

HIV can take up to 3-4 months to be detected after exposure, so test often.

Want to learn more about HIV/AIDS?  Visit the CDC HIV info page.

Stay healthy Pirates, and know your status!

What is Fast Track?

What is the Fast Track Clinic?

The Fast Track Clinic has been created to provide quick visits for STI (sexually transmitted infection) screening—we want to help & get you on the “fast track” back to your busy day.  There is no physical examination—just a few quick questions asked by a Registered Nurse, a trip to our lab & that is it!  Most visits take 15 minutes or less.

Who can use the Fast Track STI Clinic?
Because we want to keep visits very short and simple, we only perform STI screening on those students who are NOT experiencing any symptoms.  If you have bumps, sores, discharge, abdominal pain, pain with urination or other medical problems, or if you need a prescription for birth control, you need to make an appointment with a provider though our general clinic.  However, if any of the following applies, Fast Track is for you:

  • No symptoms, but you want a routine STI screen to help keep yourself healthy
  • No symptoms, but you are concerned about a sexual encounter that has occurred or you have a new partner (keep in mind, it takes at least 7 days for gonorrhea, chlamydia or syphilis to show up on a test and can take 3 months to detect HIV so make sure you do not test too early)
  • You were treated for gonorrhea/chlamydia with antibiotics and symptoms are gone but you want to make sure the medication was completely effective

What STI tests are done during a Fast Track screening visit?
Gonorrhea/Chlamydia                         obtained by urine sample                            $ 30.00
Syphilis                                                    obtained by blood sample                           $   9.00
HIV                                                           obtained by blood sample                                 free

 (we do not test for herpes or HPV/genital warts through Fast Track as those tests are only done if a person is having symptoms of those particular STIs.  If you think you have herpes or HPV, please make an appointment for our general clinic)  

How and when do I get my results?
Your results are confidential.   A notification will be sent through your Pirate email with directions on how to access your test results using your secure online Student Health account.  Typically results are available for gonorrhea/chlamydia and syphilis testing in 3- 5 business days.  HIV test results may take up to 1 week.

How do I use the Fast Track STI Clinic?
To make an appointment, call 328-6841, come in to our appointment office inside SHS, or go online to https://shs.ecu.edu to schedule.  It is important that you do not urinate for at least 60 minutes prior to your appointment.  

If you have any further questions or concerns, call us at 328-6841 or visit www.ecu.edu/studenthealth

 

Flu shots now available!

Flu shots are available now to ECU students, by appointment.  Please call (252) 328-6841 to schedule.  Shots are $10–if you have the Student Health Insurance Plan, you pay nothing.  SHIP is the only insurance we file, so if you carry any other type of third party insurance, you’ll pay $10; we can send you a walk out statement if you’d like to try to file it on your insurance yourself.

We’ll be planning flu clinics out on campus soon too, so if you don’t make an appointment for your flu shot, catch us at a clinic near you.  Watch for dates/times on this blog, and our webpage!

Think it is too early to get your flu shot?  Think again.  Watch this: http://www.cnn.com/video/?hpt=he_mid#/video/health/2012/09/03/hm-early-flu-shots.cnn