DR. AUDREY Y. PARK JOINS NORTHWEST ASTHMA
Dr. Park will be working at our eastside offices, Redmond, Redmond Ridge and Issaquah starting July 23rd.
Dr. Park did her undergraduate work at Bryn Mawr College in Pennsylvanica. She obtained her PhD in immunology at the University of Pennsylvania. She then followed with a medical degree in pediatrics and a fellowship in allergy. She is Board Certified in pediatrics and Board Eligible in allergy and immunology.
You may make an appointment with her by calling any of our offices or by filling out the information on our website under the Contact Us tab.

OFFICE HOLIDAY CLOSURES
July 3, Friday Independence Day, All Offices Closed
September 7, Monday Labor Day, All Offices Closed

SWINE FLU INFORMATION FROM THE CDC
What is swine flu?
Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza viruses that causes regular outbreaks in pigs. People do not normally get swine flu, but human infections can and do happen. Swine flu viruses have been reported to spread from person-to-person, but in the past, this transmission was limited and not sustained beyond three people.
Are there human infections with swine flu in the U.S.?
In late March and early April 2009, cases of human infection with swine influenza A (H1N1) viruses were first reported in Southern California and near San Antonio, Texas. Other U.S. states have reported cases of swine flu infection in humans and cases have been reported internationally as well. An updated case count of confirmed swine flu infections in the United States is kept at http://www.cdc.gov/swineflu/investigation.htm CDC and local and state health agencies are working together to investigate this situation.
Is this swine flu virus contagious?
CDC has determined that this swine influenza A (H1N1) virus is contagious and is spreading from human to human. However, at this time, it not known how easily the virus spreads between people.
What are the signs and symptoms of swine flu in people?
The symptoms of swine flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and vomiting associated with swine flu. In the past, severe illness (pneumonia and respiratory failure) and deaths have been reported with swine flu infection in people. Like seasonal flu, swine flu may cause a worsening of underlying chronic medical conditions.
How does swine flu spread?
Spread of this swine influenza A (H1N1) virus is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing of people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.
How can someone with the flu infect someone else?
Infected people may be able to infect others beginning 1 day before symptoms develop and up to 7 or more days after becoming sick. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick.
What should I do to keep from getting the flu?
First and most important: wash your hands. Try to stay in good general health. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food. Try not touch surfaces that may be contaminated with the flu virus. Avoid close contact with people who are sick.
Are there medicines to treat swine flu?
Yes. CDC recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with these swine influenza viruses. Antiviral drugs are prescription medicines (pills, liquid or an inhaler) that fight against the flu by keeping flu viruses from reproducing in your body. If you get sick, antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious flu complications. For treatment, antiviral drugs work best if started soon after getting sick (within 2 days of symptoms).
How long can an infected person spread swine flu to others?
People with swine influenza virus infection should be considered potentially contagious as long as they are symptomatic and possible for up to 7 days following illness onset. Children, especially younger children, might potentially be contagious for longer periods.
What surfaces are most likely to be sources of contamination?
Germs can be spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth. Droplets from a cough or sneeze of an infected person move through the air. Germs can be spread when a person touches respiratory droplets from another person on a surface like a desk and then touches their own eyes, mouth or nose before washing their hands.
How long can viruses live outside the body?
We know that some viruses and bacteria can live 2 hours or longer on surfaces like cafeteria tables, doorknobs, and desks. Frequent handwashing will help you reduce the chance of getting contamination from these common surfaces.
What can I do to protect myself from getting sick?
There is no vaccine available right now to protect against swine flu. There are everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza. Take these everyday steps to protect your health:
Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
Avoid touching your eyes, nose or mouth. Germs spread this way.
Try to avoid close contact with sick people. If you get sick with influenza, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them. What is the best way to keep from spreading the virus through coughing or sneezing?
If you are sick, limit your contact with other people as much as possible. Do not go to work or school if ill. Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick. Put your used tissue in the waste basket. Cover your cough or sneeze if you do not have a tissue. Then, clean your hands, and do so every time you cough or sneeze.
What is the best way to keep from spreading the virus through coughing or sneezing?
If you are sick, limit your contact with other people as much as possible. Do not go to work or school if ill. Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick. Put your used tissue in the waste basket. Cover your cough or sneeze if you do not have a tissue. Then, clean your hands, and do so every time you cough or sneeze.
What is the best technique for washing my hands to avoid getting the flu?
Washing your hands often will help protect you from germs. Wash with soap and water. or clean with alcohol-based hand cleaner. we recommend that when you wash your hands -- with soap and warm water -- that you wash for 15 to 20 seconds. When soap and water are not available, alcohol-based disposable hand wipes or gel sanitizers may be used. You can find them in most supermarkets and drugstores. If using gel, rub your hands until the gel is dry. The gel doesn't need water to work; the alcohol in it kills the germs on your hands.
What should I do if I get sick?
If you live in areas where swine influenza cases have been identified and become ill with influenza-like symptoms, including fever, body aches, runny nose, sore throat, nausea, or vomiting or diarrhea, you may want to contact their health care provider, particularly if you are worried about your symptoms. Your health care provider will determine whether influenza testing or treatment is needed.
If you are sick, you should stay home and avoid contact with other people as much as possible to keep from spreading your illness to others.
If you become ill and experience any of the following warning signs, seek emergency medical care.
In children emergency warning signs that need urgent medical attention include: >br> Fast breathing or trouble breathing
Bluish skin color
Not drinking enough fluids
Not waking up or not interacting
Being so irritable that the child does not want to be held
Flu-like symptoms improve but then return with fever and worse cough
Fever with a rash
In adults, emergency warning signs that need urgent medical attention include:
Difficulty breathing or shortness of breath Pain or pressure in the chest or abdomen
Sudden dizziness
Confusion
Severe or persistent vomiting

How serious is swine flu infection?
Like seasonal flu, swine flu in humans can vary in severity from mild to severe. Between 2005 until January 2009, 12 human cases of swine flu were detected in the U.S. with no deaths occurring. However, swine flu infection can be serious. In September 1988, a previously healthy 32-year-old pregnant woman in Wisconsin was hospitalized for pneumonia after being infected with swine flu and died 8 days later. A swine flu outbreak in Fort Dix, New Jersey occurred in 1976 that caused more than 200 cases with serious illness in several people and one death.

NEW STUDIES ON PEANUT ALLERGIES
There have been some exciting studies that show promise for the treatment of food allergies. It is important to remember that the peanut oral desensitization study only included a small number of children (30) and nearly everyone reacted during the desensitization. This is still considered very new and experimental but your physician would be happy to discuss this and other studies at your next appointment.

REDMOND RIDGE OFFICE TO OPEN APRIL 13th
Due to the strong demand for appointments on the eastside, we will be opening a new office that is about 10 miles northeast of our current Redmond office. Address: 22635 NE Marketplace Dr, Redmond. This is 1 block south of Novelty Hill Road.
Dr. Tilles will move his practice to this location. You may receive your shots at this site. There will be some expanded hours. From April-July, the office will be open on Mondays, Tuesdays and Thursdays.
Dr. Audrey Park will be joining our group in late July and the Redmond Ridge office will then be open either four or five days per week.

NEW RISKS LINKED TO ASTHMA RISE
A decline in aspirin use, exposure to household sprays and cleaners and lack of vitamin D may all help explain surging asthma rates in the past few decades.
For years the hygiene hypothesis has been used to explain stark differences in asthma rates around the world. In Western countries, asthma rates are about 50 times higher than in rural Africa, for instance. The hygiene hypothesis suggests that Westerners have less exposure to bacteria, viruses and parasites, altering the immune response and increasing risk for allergic diseases.
But Dr. Harold S. Nelson, professor of medicine at the asthma and allergy specialty hospital National Jewish Health in Denver, says the hygiene hypothesis doesn’t fully explain rising asthma rates in the United States and industrialized countries. The incidence of asthma has doubled in the United States since the 1980s.
In a recent talk at National Jewish Health’s annual Pulmonary and Allergy Update conference, Dr. Nelson noted that lower levels of vitamin D, exposure to spray cleaning compounds, and a wider use of acetaminophen in place of aspirin have contributed to the asthma epidemic.
The concern with household cleaners is that the spray mist can be inhaled and irritate the lungs, increasing risk for asthma. The biggest culprits appear to be glass cleaners and air fresheners. A major European study of cleaning product use in 10 countries found that people who used the cleaners four days a week faced double the risk of adult asthma. Weekly use increased risk by 50 percent. Australian researchers have also found a link with household cleaning sprays and asthma in children.
In a November 2007 article in The Journal of Allergy and Clinical Immunology, researchers from Brigham and Women’s Hospital in Boston reviewed the evidence showing a link between low vitamin D levels in mothers and childhood asthma. The authors wrote:
We hypothesize that as populations grow more prosperous, more time is spent indoors, and there is less exposure to sunlight, leading to decreased cutaneous vitamin D production. Coupled with inadequate intake from foods and supplements, this then leads to vitamin D deficiency, particularly in pregnant women, resulting in more asthma and allergy in their offspring.
Declining aspirin use may also help explain rising asthma rates. Young children should not be given aspirin because it increases risk for Reye’s syndrome. But a common alternative, acetaminophen, the ingredient in Tylenol, may increase a child’s risk for asthma when used in very young children or in high doses. The drug lowers levels of the antioxidant glutathione, which can help protect against lung damage caused by oxidants. In a study of more than 200,000 6- and 7-year-olds, use of acetaminophen in the first year of life was associated with a 46 percent increase in prevalence of asthma symptoms. Children using higher doses of acetaminophen had three times the risk of asthma.
Dr. Nelson notes that the research isn’t conclusive, but that people can take simple measures to lower their exposure to these new risk factors. Use liquid cleaners or pump sprays that don’t generate a fine mist. Eliminate use of spray air fresheners. Pregnant women and mothers should talk to their obstetricians and pediatricians about whether they should consider vitamin D supplements. And parents should discuss pain relievers with the pediatrician. Every pain reliever carries risks, and alternatives to Tylenol like ibuprofen can increase risk for gastrointestinal complaints. However, doctors may recommend switching between pain relievers or limiting exposure to acetaminophen in certain cases.
“There is a lot of supporting evidence for all three of these new risk factors,” Dr. Nelson said.
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LONG-LASTING COLD SYMPTOMS MAY BE SINUSITIS
If your stuffy nose and headache last for more than two weeks, it may be more serious than a cold. Winter is prime season for sinusitis, as the condition most often results from the common cold. Allergy sufferers are also more likely to develop sinusitis.
An estimated 31 million Americans develop sinusitis each year, leading to 18 million physician visits and $5.8 billion in overall health expenditures according to the American Academy of Allergy, Asthma & Immunology (AAAAI).
“Early on, the symptoms of colds and sinusitis are similar,” said Anju Peters, MD, Chair of the AAAAI Rhinosinusitis Committee. “But if symptoms are worsening after 3-5 days, or if they are present for more than 10 days, then sinusitis is the likely culprit.”
Sinusitis occurs when drains in the sinus cavities – hollow areas behind the forehead and cheeks – become blocked due to inflammation caused by a cold or allergies. The blockage prevents mucous from draining normally, leading to infection.
Sinusitis is easily recognized by a green or gray nasal discharge, foul tasting post-nasal drip, facial pain/pressure or light fever.
Sinusitis can last for months, or even years, if not properly treated. A physician will typically prescribe antibiotics to treat the infection and patients may also use decongestants to relieve stuffiness.
An allergist/immunologist is the best-qualified medical professional to diagnose and treat underlying allergies that contribute to sinusitis. Use the AAAAI Physician Referral Directory at www.aaaai.org to find an allergist/immunologist near you. For more information about sinusitis and controlling allergies, visit www.aaaai.org.

QUESTIONS ABOUT YOUR BILL?
You will be able to have quick access to our Patient Accounts staff via the internet. They will contact you within 48 hours.
ptaccounts@nwasthma.com