Q: I keep hearing about these outbreaks of Legionnaire’s disease caused by contamination in air conditioning units in hotels, apartment buildings, even hospitals. There’s no way to know where it will hit. What’s the smart move to avoid it?
Frankie J., Boise
A: New York has been in the news recently, with two rounds of Legionnaire’s that affected more than 120 people, but such outbreaks happen all around the country, sickening 8,000-18,000 people annually. Legionnaire’s (caused by the Legionella bacteria) can trigger high fever, chills, a cough and sometimes muscle aches and headaches. It can lead to pneumonia, but it cannot be spread from person to person. You get it by breathing the mist from contaminated environments such as air conditioning units.
Even in less-urban areas, there’s some risk: One of the main sources of infection is hot tubs! Because high water temperatures make it hard to maintain disinfectant levels needed to kill Legionella, making sure that the hot tub has the right disinfectant and pH level is essential. To determine whether a hot tub has been properly maintained, regularly use pool test strips (be sure to check the expiration date) to check water for adequate free chlorine (2-4 parts per million) or bromine (4-6 ppm) and pH (7.2-7.8) levels. If you’re using a hot tubs at a gym or hotel, you can still check before you take a dip!
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The good news is that most folks who are exposed to the bacteria do NOT develop symptoms. The most vulnerable are those 50 or older, smokers and people with chronic lung disease such as COPD, as well as anyone with a weakened immune system. But if you or anyone you know develop flu- or pneumonia-like symptoms, give the doc a call and find out if you need an office visit or to head to the hospital. (You need a lab test to ID the Legionella bacteria.) Most Legionnaire’s and pneumonia can be treated effectively with a round of antibiotics.
Q: I have a friend who’s still drinking, even though she knows she’s pregnant. She thinks that a drink here and there doesn’t hurt anything. Doesn’t it cause birth defects? What can I tell her?
Tracy D., Trenton, New Jersey
A: Unfortunately, drinking during pregnancy is not as uncommon as you would think. A recent Centers for Disease Control and Prevention survey found that among pregnant women in the U.S., “the prevalence of any alcohol use and binge drinking in the past 30 days were 10.2 percent and 3.1 percent, respectively.” (And participants may well have underreported their drinking.)
But, back to your friend. You can tell her that for her fetus, there is no known safe level of alcohol consumption, period. If a woman drinks when she’s pregnant, so does the fetus. The alcohol goes right through the umbilical cord. Birth defects due to an alcohol-exposed pregnancy are called Fetal Alcohol Spectrum Disorders (FASDs). They include everything from abnormal facial features, such as a smooth ridge between the nose and upper lip, a small head, short stature and low body weight, to poor coordination, and learning and speech difficulties. Fetal death is unusual, but it’s the most extreme result.
Not only should every woman stop drinking as soon as she knows she is pregnant, but she should refrain if there is a chance of pregnancy. That’s because a woman can get pregnant and not know for up six weeks -- during that time, a lot of damage can be done to the fetal brain.
So tell your friend that the sooner she stops drinking, the better off everyone will be; fetal brain growth takes place throughout pregnancy. If she’s having a hard time quitting, her problem may be one of addiction, and if so, she needs help now. Go with her to talk to her primary-care provider, her OB/GYN, Alcoholics Anonymous or a local alcohol treatment center; you’ll be a really good friend!
Mehmet Oz, M.D. is host of “The Dr. Oz Show,” and Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. Email your health and wellness questions to Dr. Oz and Dr. Roizen at firstname.lastname@example.org.