Japan and Potassium Iodide

Radiation and Potassium Iodide Dr. Stuart B. Weiss   Information UPDATE March 16, 2011  SUBSCRIBE: Click button at bottom or send email to: sbw1@MedPrepGroup.com People on the west coast of the US and Canada are snapping up Potassium Iodide pills and solutions, should you? We haven't sent out a general mailing to this list in over a year but I thought now might be a good time due to the ongoing events in Japan and the fear it is causing in the US and Canada.     Current Situation summary: All four reactors at the Fukushima Daiini facility are shut down safely and cooling operations are being maintained. The problems are at the Fukushima Daiichi facility. Restoration of electrical power to the site was under way as of 6:00 a.m. EDT today. Off-site electrical power has not been available at the site since the earthquake on March 11. Reactors 1, 2 and 3 at the plant are being cooled with seawater mixed with Boron. There is some level of uranium fuel damage at all three units, and containment structure damage is suspected at reactor 2. Before the earthquake, reactor 4 had been in maintenance mode and was completely defueled. Attempts to provide cooling water to the used fuel pool at reactor 4 by helicopter were not successful. Preparations are being made to inject water into the fuel storage pool using a high-capacity spray pump. There have been two fires inside the reactor containment building at reactor 4, but they have been extinguished. Although the reactor containment building at Unit 4 was damaged, the primary containment vessel remains intact. According to Reuters, the United States is urging its citizens within 80 kilometers (50 miles) of Japan's Fukushima nuclear power plants to evacuate or remain indoors. The U.S. Embassy in Tokyo had previously recommended U.S. citizens to take similar action if they were within 50 kilometers of the facilities. The United Kingdom is also urging its nationals in Tokyo and north of Tokyo to leave the area. Radiation levels in Tokyo, 150 miles to the south, are elevated but still below levels considered dangerous to human health. The situation is still unstable and evolving in the Fukushima Daiichi facility. There has been a spike in purchases of Potassium Iodide (KI) pills and solution (SSKI) in communities in the West Coast of the US and Canada as reported in multiple media sources.  ANALYSIS:    The situation in Japan continues to evolve and our thoughts and prayers go out to the people of Japan as they go through this difficult crisis. I want to focus on the issue of the radiation risk to people in the US and the use of Potassium Iodide. With 5000 miles of ocean separating the US and Japan, the risk of ANY significant amount of radiation coming to the US from Japan is almost zero. Something extremely bad (i.e. a huge prolonged radioactive material release) would have to occur and even then, the risk is still low. We are exposed to radiation everyday in our normal lives from our environment, it is a part of living on Earth and our bodies cope with this low level of radiation. So while it is understandable that people would be apprehensive about something like radiation which you cant see, smell or taste, the fear that people in the US would be affected is unfounded right now. So what does Potassium Iodide have to do with this? One of the early materials that is released from a reactor accident is radioactive Iodine. This material gets into the air, food or water and can be absorbed by our body. Once inside our body, the Iodine is absorbed by the thyroid gland and sits there causing thyroid damage and thyroid cancer. Our thyroid gland absorbs Iodine all the time to make thyroid hormone and it can't tell the difference between normal Iodine and radioactive Iodine. So the idea of Potassium Iodide is to "fill up" the thyroid with normal Iodine so it doesn't want to absorb any more Iodine that comes into our body (radioactive or normal). You have to fill it up quickly which is why people have to take Potassium Iodide within several hours of a reactor accident. Potassium Iodide only protects the thyroid gland and nothing else so if you are exposed to huge doses of radiation, you would still get sick. Potassium Iodide has side effects like any other medication. In a nuclear emergency, the benefits of taking it outweigh the risk of any possible side effects. In the US right now, there is NO RADIATION RISK from Japan so the benefits of taking it are zero and risks of side effects are still there. Side effects range from mild stomach upset to life threatening allergic reactions. You are also susceptible to thyroid problems. That is why people in the US should not be taking Potassium Iodide unless prescribed by a doctor for another problem. So the bottom line is if you want to buy Potassium Iodide to keep in your home, go ahead. It is an over-the-counter medication in the US. But don't take it unless advised to by public health and keep it and all medications away from young children. Don't spend hundreds of dollars on buying it either, there is no crisis in the US (some media are reporting price gouging for Potassium Iodide, it is a cheap medication). Lastly, this does not apply to any employees or families in Japan. Depending on where they live and how old they are, recommendations are different and they should be following the local public health guidance. ADVICE: So here is my advice to you at this point: Make sure that someone keeps watching this situation.  Discourage your employees from buying and taking Potassium Iodide at this time. Consider publishing some information for your employees. The CDC has good information on Potassium Iodide.        MedPrep Consulting Group is internationally recognized as a leader in pandemic, disaster and business continuity planning, training and exercising.     Stuart Weiss, MD, CBCP is the CEO of MedPrep Consulting Group. For more information, visit www.MedPrepGroup.com Stuart Weiss, MD, CBCP MedPrep Consulting Group LLC

Influenza Update - January 28

Pandemic H1N1 Update Dr. Stuart B. Weiss INFLUENZA UPDATE Jan 28, 2010 SUBSCRIBE: Click button at bottom or send email to: sbw1@MedPrepGroup.com We seem to have dodged the pandemic bullet for now so what should you be doing? Pandemic H1N1 activity in the U.S. and around most of the world continues to decline. There are still areas with widespread influenza activity (North Africa and South Asia) but activity in the U.S. is LESS than a normal seasonal year. Current Situation: In the CDC briefing last week, it was reported that most signs of flu activity in the U.S. are declining with no states reporting widespread activity and only 7 reporting regional flu activity. Current rates of outpatient visits for flu are at 1.8%. There were nine pediatric influenza deaths that week and seven the week before. The WHO reports that influenza activity is decreasing in much of the world with intense activity remaining in South Asia and North Africa. The inevitable finger pointing has begun with various groups accusing the WHO of being influenced by vaccine manufacturers and for instigating a "fake" pandemic. The WHO has vigorously denied any wrongdoing (see below for comments). Vaccine: Several countries are either reducing their vaccine orders or trying to get out of existing vaccine purchase contracts as unused amounts of vaccine pile up. Governments around the world are trying to encourage people to get vaccinated. In Mexico City, they began to offer vaccination in the 26 busiest subway stations. College and Universities in the U.S. have vaccine but its been an uphill battle getting students to come in to be vaccinated. A study published last week in the British medical journal Lancet found that 10 times more young people had been infected with the H1N1 pandemic virus during the first wave than had been picked up by traditional surveillance. The researchers also found the many more older people had pre-existing antibodies. The may explain the mild pandemic experience we are having. The CDC warned people not to be fooled like they were in the 1957 pandemic when it was declared over in Dec-Jan 1957 only to return a few months later with increased numbers of deaths. ANALYSIS: Its been an interesting few weeks. It seems that we are not only having mild pandemic flu season but actually this flu season is turning out to be more mild than even a normal flu season. The CDC reported the usual outpatient visits to a doctor for ILI (Influenza-like Illness) during a flu season is 2.3% and we are experiencing only 1.8%. Who could have predicted that. Its no wonder that we don't hear about H1N1 anymore and that the finger pointing has begun. I have to say that the accusations of a "false" or "fake" pandemic are completely incorrect. This was and is a pandemic and we have luckily dodged the pandemic bullet probably having to do with what the British study found. Looking back at the WHO's behavior, I have to say that if anything, they delayed announcing a pandemic in order to be absolutely certain. If you think back to my Pandemic Alerts from the spring, I was saying the new disease had reached pandemic status weeks before the official WHO announcement. Its also important to remember that there are significant lead times on vaccine development and actions governments can take so public health officials are constantly looking to be proactive. I am not sure where all this finger pointing will go but it seems completely unjustified. The British study is interesting and may be the reason that we are seeing such a mild January. When they looked at the number of people who had antibodies to H1N1 (2009) they found ten times as many as were reported by surveillance. Surveillance only picks up people who seek medical care so there must have been a huge population of people who had mild or minimal symptoms and never sought medical care. This huge population of people is now immune. In addition, they found that more older people than previously thought had pre-existing antibodies. Since the virus has not mutated significantly, the combination of the two factors has led to a large number of people who can not catch this disease and has caused it to wane. The bottom line here is that we have been lucky so far. Influenza viruses are notorious for mutating and this one has not. Influenza viruses don't usually cause large numbers of people to have minimal or no symptoms of infection, this one apparently has. But, the winter flu season is not over. Folks in 1957 were fooled by a mild December-January and the virus came back with an increased mortality. Many of our clients are taking this opportunity to ask us to help them review their infectious disease plans to incorporate lessons learned and look for gaps. They realize that although we may have dodged the bullet this time, something else will pop-up. We also continue to help clients develop new and more useful triggers for their corporate response. On the other hand, a few of our clients have disbanded their pandemic teams and have taken their eye completely off this ball. That is a mistake that I hope you will not make. ADVICE: So here is my advice to you at this point: Make sure that someone keeps watching this situation. It is too soon to declare this over. De-escalate your response for the moment. You may want to decrease the frequency of conference calls or meetings but do not disband your pandemic team. Keep them in the loop until the Spring when we can say with certainty that flu is over for the time being. Use this opportunity to learn from what you have done and augment your current infectious disease plans and update your triggers, if need be, Develop an after action report reviewing actions taken since last April to help you with future infectious disease outbreaks. Keep your eye on H5N1 as it continue to be a problem in parts of the world. TOOLS: We are infectious disease planning experts and can assist you with your infectious disease / pandemic flu plan development and analysis. We are one of the few physician led firms that bridge the gap between business continuity and disaster medicine. I am proud to have both an MD and CBCP after my name. So send me an email or call if you think we can assist you. My team would be happy to develop a very reasonable proposal for a plan review and after action report. I can be reached at sweiss@MedPrepGroup.com or call us at 212-875-8888. MedPrep Consulting Group is internationally recognized as a leader in pandemic, disaster and business continuity planning, training and exercising. We have resources and expertise that you can count on. Ask us about our Virtual Medical Director Program for companies without in-house medical direction. Stuart Weiss, MD, CBCP is the CEO of MedPrep Consulting Group. For more information, visit http://rs6.net/tn.jsp?t=6oilehdab.0.k8wpj8cab.ksb4ircab.0&ts=S0452&p=http%3A%2F%2Fwww.medprepgroup.com%2F Stuart Weiss, MD, CBCP MedPrep Consulting Group LLC