Common pain medication literally turns woman’s blood blue

New England Journal of Medicine(NEW YORK) — The term “blue blood” took on a new meaning for a 25-year-old woman who checked into a Rhode Island emergency room with complaints of fatigue and shortness of breath, as well as a more unusual symptom: her blood was turned navy blue.

The patient, whose account was documented in a New England Journal of Medicine case study, told doctors she had used an over-the-counter medication to treat a toothache.

“I’m weak and I’m blue,” she told the ER doctors.

Dr. Otis Warren, the ER doctor on duty at Miriam hospital that night, diagnosed the woman with “acquired methemoglobinemia,” a rare blood disorder in which the body isn’t getting enough oxygen. While the disorder can sometimes be genetic, in the case of the Rhode Island patient it was triggered by taking large amounts of a medication containing benzocaine, a common ingredient in topical pain relievers and cough drops.

In 2018, the Food and Drug Administration issued a warning about benzocaine, advising that children younger than 2 should not take products that contained it. The agency also cautioned adults that benzocaine could cause methemoglobinemia, which can be “life-threatening and result in death.”

There have been over 400 cases of benzocaine-related methemoglobinemia since 1971, according to the FDA.

After running tests, doctors found that the Rhode Island patient’s hemoglobin and blood oxygen levels were low, which can put patients at risk for heart failure, coma or death. Doctors subsequently administered an antidote called methylene blue, which improved her breathing and bluish skin tone. By the time she left the hospital, her symptoms had completely subsided.

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President Trump issues executive order to improve flu vaccine

Pornpak Khunatorn/iStock(WASHINGTON) — President Donald Trump signed an executive order aimed at developing better flu vaccines to defend Americans against both seasonal influenza and the possibility of a future pandemic outbreak.

Seasonal flu “kills tens of thousands of Americans each year,” Alex Azar, secretary of Health and Human Services, said in a statement. A faster vaccine production process would help keep Americans safe from both types of flu outbreaks, Azar said.

Thursday’s executive action ordered the creation of a flu vaccine task force, with input from various federal agencies and headed up by Azar and the secretary of defense. For now, the executive order does not allocate any additional funding toward vaccine development or production.

Scientists develop each year’s flu vaccine months or even up to a year in advance, but vaccine efficacy can vary widely. In recent years, the flu vaccine has not been well-matched to that year’s virus. In 2018, for example, the flu vaccine was only 30% effective.

Regardless of efficacy in a given year, medical professionals still recommend getting the flu vaccine, which greatly reduces influenza hospitalizations overall.

“We’ve been struggling for about 10 years now,” Richard Webby, a faculty member in the infectious disease department at St. Jude Children’s Research Hospital, told ABC News.
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When manufacturers produce each year’s stock of vaccines, they either grow the virus in animal cells or in fertilized chicken eggs. Part of the problem in recent years, the virus has mutated when introduced into the chicken eggs.

“We pick a strain that we think is going to be well-matched, but when that virus goes into eggs, it changes a bit,” explained Webby. But that doesn’t mean that we should give up on eggs, which have long been the mainstay for flu vaccine production, Webby said, nothing that instead, we should diversify our vaccine portfolio.

Dr. Peter Hotez, professor and dean of the National School of Tropical Medicine at Baylor College of Medicine, told ABC News that while he appreciated the president highlighting “one of our greatest infectious disease threats,” he didn’t understand why flu vaccine development and innovation had been so sluggish.

It’s also not clear how Trump’s task force advances the flu vaccine efforts made by previous administrations, experts said. Past presidents had similarly prioritized and allocated funding for vaccines, including $91 million in 2013 to GlaxoSmithKline and the Texas A&M University System, to develop flu vaccine manufacturing facility.

Still, Hotez acknowledged barriers to rapid innovation. “The profit margin for flu vaccinations is not high,” he said. “It requires quite a lot of upfront investment to completely re-do an age-old manufacturing process.”

He also stressed the value in a national push to develop what he called the dream vaccine, a universal flu vaccine Americans could receive once and be protected in future years, instead of returning year after year for immunization against the latest virus.

“Why are we still tethered to 20th-century technology?”

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FDA to consider ads targeting youth in applications to sell e-cigarette products

sestovic/iStock(WASHINGTON) — The Food and Drug Administration has proposed a new rule that outlines the process for tobacco companies to apply to sell e-cigarettes and vape products, as the number of vaping-related illnesses tracked by the Centers for Disease Control continues to increase.

The FDA has warned e-cigarette companies that they are illegally marketing products by selling them without going through the agency’s “premarket review” process, where the FDA evaluates information about the product to determine if it is appropriate for public health to have the product on the market.

The rule is not the enforcement plan discussed by the president and other officials that they say would effectively ban flavored e-cig or vaping products, but the FDA will likely use these requirements to take products off the market that don’t have the proper approvals. An agency spokesperson said the FDA had authorized no e-cigarette or vaping products currently on the market under this requirement.

The FDA, which regulates tobacco products, has been looking at the rules around e-cigarettes and vaping products since officials began raising concerns about rapidly growing e-cigarette use among young people, but the newly proposed rule would apply to any new form of tobacco product.

“This proposed rule follows our announcement last week that we intend to finalize a compliance policy in the coming weeks that would prioritize enforcement to clear the market of unauthorized, non-tobacco-flavored e-cigarette products,” Acting FDA Commissioner Ned Sharpless said in a statement. “These important regulatory actions are part of our ongoing oversight of e-cigarettes and other tobacco products that is critical to our public health mission and, especially, to protecting kids from the dangers of nicotine addiction and tobacco-related disease and death.”

The rule proposed Friday would add more detail to the requirement that tobacco companies submit information to the FDA about the health and safety of new tobacco products so the agency can decide if they should be sold and whether any additional restrictions are warranted.

The rule says the FDA will evaluate the marketing plans for specific electronic tobacco products to look at the potential for young people to access the product.

The FDA does have the authority to restrict companies marketing tobacco products to limit exposure of young people to the products, including blocking radio or television ads and requiring online and social media advertising to be targeted to adults.

In previous guidance to tobacco companies applying to sell e-cigarettes, the FDA only recommended they share marketing materials and demographics of the customer base. The FDA has required changes to marketing when it has approved new products in the past.

“FDA also recommends sharing your marketing plan to enable FDA to better understand the potential consumer demographic,” the agency says in guidance to companies released in June.

The new rule would add the marketing plan and information about how the company will avoid youth exposure to the product as part of the product application.

But the agency also said it did not plan to enforce requirements that all new e-cigarette or tobacco products have approval from the FDA to put those products on the market. That has recently shifted, and the FDA has warned companies that they can’t describe their product as safer than traditional cigarettes without their approval.

“FDA does not, at this time, intend to enforce these requirements for components and parts of deemed products that are sold or distributed solely for further manufacturing into finished tobacco products, and not sold separately to the consumer,” FDA said in the June document.

Lawmakers are expected to press officials from the FDA on the agency’s past approach to e-cigarettes, saying the lack of enforcement contributed to the current public health crisis. Members of a new bipartisan “End Youth Vaping” caucus said Thursday they plan to pursue legislative responses to the crisis like taxing e-cigarette products or raising the legal age to purchase tobacco if they aren’t satisfied with the administration’s response.

“The recent surge in the vaping related illnesses shows that we are desperate for more federal regulation of these dangerous products, Congress simply cannot afford to sit back and watch as these companies keep operating as if nobody is paying attention,” Rep. Diane DeGette, D-Colo., said Thursday.

“It’s frankly unfortunate that it takes so many people to get sick and even die across this country before we really pay the attention that we should. We need to get these products out of the hands of our kids, and we need to do it now.”

DeGette is the vice chair of the House Energy and Commerce Committee, which has a hearing on public health concerns around e-cigarettes next week. A House Oversight subcommittee also has a hearing scheduled on the outbreak of vaping-related illnesses.

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Video experiment tracking the lives of pre-teens shows confidence dips as kids age

Deborah Roberts sits down with several parents whose kids were featured in Samantha Skey’s new video series about pre-teens. (ABC News)(NEW YORK) — “I feel less confident than five years ago because now there’s a lot more pressure with what you wear, or even academically.”

“Five years ago I was steadily confident in what I was doing and now … it kind of changes but mostly depending on what I look like.”

These are just some of the words from teens echoed in a video project, Hatch Kids, that follows a group of 25 New York-based kids over the course of five years.

The project looks at how pre-teens between the ages of 9 and 14 change over time, ultimately eliciting conversations on parenthood, gender identity, self love and academic pressure.

“I want us to look at this particular age window, because I think it’s fundamental to long-term confidence,” said Samantha Skey, CEO of SHE Media, the digital media company that oversaw the Hatch Kids project.

“They’re going through puberty at the same time with perpetual feedback from social media,” she said. “I believe social media directly infringes upon confidence.”

In the opening of the video, a young child proudly says, “I am the awesome-ist.”

Another says, “If a boy says you can’t do it because you’re a girl, I’ll just be like, ‘I can do it if I want to and you’re not the boss of me.’”

Flash forward several years later, and the video shows several kids in their teens admitting they feel insecure or less confident.

Fourteen-year-old Jojo says in the video, “I focus a lot on what other people think of me and how other people view me instead of how I should be viewing myself.”

“This age, 14, is a very hard age,” said Skey. “It’s a hard age to feel ownership of your person hood, in terms of sort of integrating the different impulses and feelings you have.”

“It was a loss of innocence and it was a loss of confidence in a lot of cases,” she added.

Some parents of kids in the Hatch Kids project told Good Morning America they were surprised by how their kids felt after those five years.

“She seemed so confident,” said Felicia King, the mother of 14-year-old Gabrielle. “I was not fully expecting as big a dip.”

Skey too found that over the course of the five years, social media played a big role in how kids developed and saw themselves over time. King’s daughter Gabrielle is one example.

“I compare my posts to other people,” said Gabrielle. “Why don’t people like my posts? Is it because I’m not good enough? Whenever my picture doesn’t have a lot of likes or comments after the first hour, I just delete it.”

In 2017, Good Morning America set up a similar experiment in which a group of 15-to-17-year-old girls candidly discussed the stresses they face, especially as a result of how pervasive social media is in their lives.

The same year, the American Psychological Association (APA) released a report that found approximately 79 percent of parents said that their teens use social media. Additionally, 69 percent of the parents of teen girls reported that they worried about the influence of social media on their child’s health, compared to only 39 percent of parents of teen boys.

At least two parents of kids in SHE Media’s video project told GMA that knowing what they know now, they wish they had held off on giving their kid a phone and limited television time as well.

Skey plans to continue to explore the group of kids in the Hatch Kids project through their high school years.

The kids’ parents predict they’ll continue to experience life as a roller coaster, but want other parents to know that it’s going to be all right.

“I want parents to take away that the kids are gonna be OK,” said Peter McCabe, father of 14-year-old Jojo. “That everyone — all people go through stages, not just through adolescence but through the rest of your life.”

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Sophia Bush raises awareness to help end period poverty for young women in the US

ShotShare/iStock(NEW YORK) — When actress and activist Sophia Bush learned that nearly one in five girls in the United States are estimated to have missed school due to a lack of period products, she was aghast.

“So many girls lose out on their opportunity to get educated because they live in period poverty,” Bush told Good Morning America. “What period poverty means is that you don’t have access to the sanitary items that you need to manage your cycle.”

At least 500 million women and girls globally lack facilities for managing their periods, according to a 2015 report from the World Health Organization and UNICEF.

Bush is partnering with Always to raise awareness about the reality of period products and the impact it has on women.

“So they don’t go to school because they can’t,” Bush said. “They can’t sit in their clothes through a school day if they don’t have access to sanitary products and that’s heartbreaking that young women are losing out on their opportunity for education, that every month they’re missing days of school because they can’t afford to leave the house.”

“As a long time education access advocate, I truly believe nothing should stand in the way of a girl and her education. Nothing! Certainly not her period,” Bush wrote in an Instagram post.

“So many people are shocked when they learn about period poverty being so prevalent here,” Bush said. “I think that we often assume that something like that couldn’t happen in the U.S.”

It is estimated that 143,000 girls in the New York City area and 88,000 in the Los Angeles area have missed school because of period poverty, according to a 2019 study by Always.

“When a family has to choose between rent money or food money, that means that they don’t have the financial resources to buy packages of period products every month,” Bush said. “And it’s a devastating reality for a lot of people who just are not getting the support that they need in this country.”

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New study reveals what’s behind the shrinking black-white cancer mortality gap

CasPhotography/iStock(NEW YORK) — It’s been a topic addressed by Democratic presidential candidates Senators Elizabeth Warren, Kamala Harris and Cory Booker: racial disparities in health care. A new study reveals that in at least one area of health, that disparity is starting to change.

The disparity in cancer mortality rates between black and white Americans shrunk significantly in recent decades, according to a new report published by the American Association for Cancer Research.

The report, which utilized data from an American Cancer Society study published in February, found that in 1990, the cancer death rate was 47 percent higher for African American men than it was for white men. By 2016, however, that gap had shrunk to 19 percent. For women, the black-white cancer death gap shrunk from 19 percent in 1990 to 13 percent in 2016.

Carol DeSantis, lead study author and cancer epidemiologist at the ACS, chalked the shrinking mortality disparity up to plummeting death rates for African Americans with lung, prostate and colorectal cancers, which are the three most common forms of the disease.

Declining lung cancer deaths mirror smoking patterns, DeSantis explained, noting that “smoking prevalence has also decreased faster in blacks than whites.”

The shrinking disparity is “exciting,” said Dr. Joseph Ravenell, an associate professor of population health at NYU Langone. Ravenell was not involved with the study or the report.

“The closing of the gap speaks not only to better therapies for treating cancer, but it is also the result of better access to these therapies and advances for groups who often have worse outcomes from cancer, including black patients, and patients who are uninsured or under-insured,” he said.

Efforts at targeted screening and detection likely played a part in identifying and treating cancer early, thus improving health outcomes for black Americans over time, Ravenell added.

Still, African Americans have “higher death rates than all other groups for many, although not all, cancer types,” according to the National Cancer Institute. Roughly 73,000 black Americans are expected to die from cancer this year alone, according to the ACS study.

The black-white cancer mortality disparity is a relatively new phenomenon. As DeSantis and her coauthors detail in their study, death rates were lower among black Americans than among white Americans until the early 1950s. That changed because while white Americans had access to health insurance, early cancer screenings and treatment, many black Americans did not, and in the decades that followed, the African American cancer death rate continued to rise, until peaking around 1990.

Ravenell pointed to colorectal cancer mortality as an example, which fell for black men during the course of the study. Despite those gains, “black men still have the highest incidence and mortality from colorectal cancer, in large part due to lower rates of timely screening in black men compared to white men,” he explained.

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International team sends life-saving insulin to a remote island via drone

iStock(NEW YORK) — An international team of scientists and health care workers have completed the world’s first drone insulin delivery — dropping off the life-saving medicine to a remote island in Ireland.

Spearheaded by researchers at the National University of Ireland, Galway, the team oversaw the takeoff and landing of a drone carrying insulin and glucagon prescription medicines as well as a collection of blood samples between the Connemara Airport in Galway; to Inis Mor in the Aran Islands.

“Insulin is essential for my survival and having a diabetes drone service in an emergency situation would ensure this survival while living on an offshore island,” Marion Hernon, a patient living with diabetes on the Aran Islands, said in a statement.

The successful landing of the drone last Friday shows that this technology could be used in the future of health care to transport medicine and other supplies via the unmanned aircraft even to remote regions or in times of natural disaster, NUI Galway said in a statement.

“Climate change means that these types of severe weather events are becoming more prevalent. Individuals and communities in rural locations can become isolated for days after a severe weather event and an emergency may arise where patients can run out of their medicine,” Derek O’Keeffe, the project lead and a professor at NUI Galway as well as a physician at Galway University Hospitals, said in a statement.

Dr. Spyridoula Maraka, an assistant professor at the University of Arkansas for Medical Sciences and a staff physician at the Central Arkansa VA who worked on the project, told ABC News Thursday that this delivery had two milestones in that it was “autonomous” and that the drone flew “beyond the visual line of site.”

It delivered medication and collected blood samples to bring back, Maraka added, calling it “a full circle of care.”

Maraka said her research background lies in improving health care delivery, so she was brought on the project to outline different delivery issues that could arise.

“About a year ago, there was a severe weather incident in Ireland that prevented patients from being able to go to their usual medical care, so that kind of made us think what would happen in the event of severe weather if those events happen more often with climate change,” Maraka said. “That’s how the idea came that drones could be used.”

“For example, if there is flooding and no airport lanes for planes to land, then drones could be a viable solution,” she added.

The drone they used, however, was “not the kind of drone that you buy on the internet,” Maraka added, saying they worked closely with a company to create a custom drone.

The drone they made could travel up to 100 kilometers with a top speed of 200 kilometers per hour, she added. For this journey, it traveled across 18 kilometers of water and 130 meters high. The duration of the flight was 32 minutes.

“This was an important milestone,” Maraka said. “The way we envision it, drone delivery can be used during emergency situations, and in the future maybe even in regular situations.”

“Drone delivery has endless possibilities, it can help us connect with our patient communities,” she added.

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New single pill combines blood pressure and cholesterol medicines

DNY59/iStock(NASHVILLE, Tenn.) — Two medicines for high blood pressure, another two to lower cholesterol – what if you could take just one pill for all of them? That new all-in-one medication, also known as a polypill, worked just as well to prevent and treat elevated blood pressure and high cholesterol, according to a new study by researchers at Vanderbilt University Medical Center and Franklin Primary Health Center. The pill could be a game changer for lower-income patients.

“We have made a lot of progress in preventing and treating cardiovascular disease but that progress hasn’t reached everybody,” said Dr. Daniel Muñoz, an assistant professor of medicine at Vanderbilt University Medical Center, in an interview with ABC News. Munoz was involved in the study testing the pill.

If the benefits seen in this study continue, the researchers predict that the polypill would lead to a nearly 25 percent reduction in the number of new cardiovascular events in the lower-income population — which is particularly at risk.

Cardiovascular disease is a leading cause of death in the United States, especially in minorities and those with low socio-economic status. Two major contributors to cardiovascular disease are high blood pressure and high cholesterol. The CDC reports that 75 million American adults have high blood pressure and nearly 29 million American adults have elevated cholesterol.

In an interview with ABC News, Dr. James De Lemos, a professor of medicine at the University of Texas Southwestern, said “We have evidence that these polypills create meaningful patient outcomes.”

He described polypills as low-cost medications containing “low dosages of medications that have very good side effect profiles and don’t require lab monitoring.” De Lemos was not involved in the study.

The study polypill was formulated to include four low-dose medications that are already standard treatments for high blood pressure and high cholesterol. The pill includes generic formulations of Lipitor, Norvasc, Cozaar and HydroDiuril. The combination pill– four medicines in one –was manufactured at the low cost of $26 per month, per person. What’s more, patients would only have to take one pill instead of four, making it easier to stay on track with taking the medicine.

People in the trial were treated with either the polypill or with traditional medications. After the trial was over, systolic blood pressure (the top number) decreased by nine points in the polypill group, whereas it only went down two points in the standard treatment group. LDL cholesterol level (“bad cholesterol”) decreased by 15mg/dL in the polypill group, while the comparison group went down by just 4 mg/dL.

Only 1 percent of patients had side effects: muscle pain, light-headedness or low blood pressure.

Another recent study in Iran showed that a different polypill led to prevention of major cardiovascular events.

“Fundamentally, we need to better understand what works and doesn’t work in these settings so that we can improve outcomes for our fellow citizens who may be the most vulnerable….In this era of precision medicine and individualized therapies and care, an approach like the polypill could be labeled as a one-size-fits-all approach,” Muñoz explained.

“We think that a population-based approach like the polypill can be used together with individualized therapy. It doesn’t have to be either or,” he added.

The pills aren’t available yet. Further work is needed to get approval for polypills and for optimizing treatment for underserved Americans.

De Lemos imagines that both of the recent studies on polypills “should give momentum to develop these products and get them used.”

“That would be our hope,” he added.

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Bipartisan bill proposes banning flavored e-cigarettes amid vaping crisis

HAZEMMKAMAL/iStock(WASHINGTON) — As public health concerns over vaping continue to build, two congressmen are introducing bipartisan legislation aimed at curbing the habit, especially among underage users.

The move comes as the Trump administration has proposed banning all flavored e-cigarettes and at least two states — New York and Michigan — have taken action to do the same. At least 360 cases of severe lung disease in 36 states and one territory are being tracked by the Centers for Disease Control and Prevention.

And while a cause for the lung disease is not known, “most” of the patients have a history of using THC-containing vape products, the CDC said.

Rep. Tom Suozzi, D-N.Y. and Rep. Pete King, R-N.Y. are behind the “Quell Underage Inhaling of Toxic Substances (QUITS) Act,” which proposes a federal ban on flavors in e-cigarette and tobacco products, creating a federal tax on e-cigarettes, raising the existing federal taxes on cigarettes and other tobacco products and increasing the budget for the CDC’s Office on Smoking and Health. The legislation is the most comprehensive of its kind to be introduced in Congress.

Underage use of aping products has long been a concern of both federal and state government officials, especially fruit-flavored products marketed towards youth.

According to the CDC’s latest report, the agency has confirmed six deaths linked to lung disease associated with e-cigarettes, and a seventh death was reported this week. The CDC has also activated its “emergency operations center” to coordinate a national response.

Earlier this week, New York became the first state to ban the sale of e-flavored cigarettes, approving an emergency ban on the products. Michigan approved a ban on some flavors, but that ban has not yet taken effect.

Vaping has also caught the attention of the White House. Last week, President Trump said his administration would move to ban flavored e-cigarette products.

“We are looking at vaping strongly, it’s very dangerous, children have died and people have died,” Trump told reporters in the Oval Office. “We’re going to have some very strong rules and regulations.”

At the time of the announcement, Health and Human Services Secretary Alex Azar said that the FDA plans to finalize a guidance document to start enforcing removing flavors other than tobacco from the market.

It’s unclear how effective this would be: the FDA has issued warnings already about using flavors to target young people and companies have said they made changes to address the FDA’s concerns.

Previously, a spokesperson for industry leader JUUL Labs said in a statement to ABC News: “We strongly agree with the need for aggressive category-wide action on flavored products. We will fully comply with the final FDA policy when effective.”

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How to best protect against the flu this season

ljubaphoto/iStock(NEW YORK) — Some experts have already predicted a severe flu season so it’s time to take the proper health precautions and understand the best ways to protect against the virus.

ABC News’ chief medical correspondent Dr. Jennifer Ashton weighed in on Good Morning America to share her take on this year’s strain, the vaccine and how to stay healthy.

“It’s so difficult to predict, we only know in hindsight,” she explained. “You can’t predict it.”

The Centers for Disease Control and Prevention releases a weekly influenza surveillance report which has shown a spike in the number of new cases currently above the national baseline.

Why is the flu expected to be so bad this year?

Ashton said that much of what we use as an indicator comes from the southern hemisphere, which saw a busy flu season this year with the H3N2 strain.

There are two main groups of influenza viruses: influenza A and influenza B. The H3N2 strain belongs to the influenza A family.

“We look to the southern hemisphere, what has gone on there because they tend to be ahead of us and they had a tough season,” she said. “The predominantly-circulating strain was the H3N2. People may remember from last year, it causes particularly severe symptoms.”

The good news, Ashton added, “is that type of strain is included in this year’s vaccine.”

How does this year’s flu vaccine differ?

Last year’s vaccine was only about 30% effective, which Ashton explained is of course, “better than zero” but to think of it as a seat belt.

“It’s not a great vaccine,” Ashton said candidly. “It won’t guarantee that you won’t get the flu but it can reduce the symptoms and lower your risk of complications.”

What does the hand sanitizer study show?

A recent study out of Japan compared the use of alcohol-based hand sanitizers to regular soap and water in an effort to look at hand hygiene in terms of its efficacy to kill the influenza virus.

Ashton said that the study found “that the germs on the hand actually have to be dried for the alcohol-based hand sanitizers to work at maximum efficacy.”

Best practices for flu season

The flu is transmitted via droplets and contact, so Ashton recommended “good old hot water and soap with vigorous rubbing is still the best.”

  • Get plenty of sleep. Doctors recommend at least 6-8 hours of sleep per night.
  • Stay hydrated and stay active. Exercise is a great way to stay healthy.
  • Fuel your body with healthy foods.

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