While not a fundamentally dangerous condition, CSU can have a significant impact on a patient’s quality of life and can be challenging to manage. Symptoms can be prolonged and can recur even after a long symptom-free period. Escalate and taper non-sedating H1-antihistamines, encourage daily antihistamine use, and add corticosteroids or refer to an allergist if needed.
Despite being a fairly common problem, with an estimated prevalence of 0.5–5%, chronic spontaneous urticaria (CSU) is often a challenging condition for health-care providers to diagnose and for patients to accept as a diagnosis. A diagnosis of CSU does not equate to a diagnosis of a systemic autoimmune disease. We do not routinely recommend dietary modification for CSU. We advise patients with CSU to limit alcohol intake and to take a higher dose of antihistamines prior to receiving vaccinations.
We are hearing from many of our medical colleagues about their distress in this time of COVID-19. Many are troubled by the fact that most of the people admitted to hospitals and intensive care units are not vaccinated. Faced with yet another variant and uncertainty, we hear that our colleagues are exhausted, frustrated, and angry. Both authors, being interested in supporting physicians to thrive in their work, have been studying compassion and its role in practitioner well-being for the last few years. As looking at this issue (and other challenges of the pandemic) through the lens of compassion has been personally helpful to both of us, we wanted to share our learnings with you.
It is prudent to reduce the risks of pneumococcal illness during this time of potentially severe respiratory sequelae of COVID-19, and the newly introduced BC Care Bundle Incentive payment includes a focus on ensuring eligible people receive this vaccine.
Vaccines are safe, but sometimes adverse events following immunizations do happen, and can be very concerning to families. If your patient has an AEFI, there is a voluntary reporting system. Public Health Officers in your local Health Authority will be able to answer most questions or concerns.
In December, 2013, Health Canada approved a 4- component Meningitis type B (4CMenB) vaccine. The vaccine approved in Canada utilizes technology based on ‘outer membrane vesicles. These are unique capsular identifiers that comprise fingerprints for a serogroup B strain. The challenge has been that over 8000 MenB strains exist!
Rotavirus vaccines can prevent important morbidity for young infants, and the associated physician visits, emergency department visits, hospitalizations and related parental stress and missed work days due to rotavirus infection.
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