Doctor’s Guide: Someone Sick Coughed on Me. Now What?

[ergophobe]

I don't know this guy's credentials and bias, but he tends to cite Cochrane reviews, which I would say essentially defines what is considered "mainstream" thinking in medicine.

https://brandonluumd.substack.com/p/doctors-guide-someone-sick-coughed

This is on my mind because between travel and various other things, I did not get my act together to get a flu shot last fall and now looking at flying to visit family next week (and flu vaccines take 3 weeks to reach full effectiveness, so even if I manage to get one on Jan 5, I won't be fully protected until the end of the trip). This is why you are supposed to do this well before flu season.

I'm less worried about the flying than the family, BTW. My last illness and my last Covid infection are easily attribuable to my hosts both times. Before Covid, I feel like I got sick half the times I flew. The rest of the times were noble co-workers who wanted to appear to be good employees, soldiering on despite illness.... and eventually infecting the entire office suite and costing the business 50-person-days of absences.

Since Covid and airlines coming under pressure to improve airflow to avoid the existential threat of total business collapse, my illnesses have been always traceable to a known person who infected me with something (Covid once, other things 2-3 times) while in the same room. In all but one case, the person either knew she was sick or felt "off" but not sick and then later got sick. The exception is when I spent the night at a friend's house who has a toddler and a baby petri dishes full of viruses imported from the daycare disease incubation facility.

[rcjordan]

My feeds are brimming with states & cities posting about large flu outbreaks.

Flu cases reach all-time weekly high in New York – NBC New York
https://www.nbcnewyork.com/news/local/new-york-flu-case-spike/6436547/

[rcjordan]

*sigh*

University of Maryland Medical facilities requiring masks amid surge in respiratory illness

https://www.wboc.com/news/university-of-maryland-medical-facilities-requiring-masks-amid-surge-in-respiratory-illness/article_eda2ca59-3866-4501-bb00-dfe69c96a133.html

[ergophobe]

BTW, on the original link, I'm surprised at the reductions they found with gargling and with carrageenan spray.

I wonder if those studies have been reproduced. It's intriguing since vaccines are great and all, but there are zillions of viruses for which there is no vaccine. And while I'm most concerned about Covid, flu, RSV, etc, I'm not a fan of catching the common cold either - sometimes it can knock you on your ass.

Meanwhile, RE Covid, my sister recently had Covid for the second time and said it was way worse than the first time she had it. Like me, her first (and my two) experiences with Covid were like a mild cold. She said this last one was more like a bad flu. Like me, she had gotten lackadaisical about keeping up on the boosters. Her advice: get the booster.

[rcjordan]

>surprised at the reductions they found with gargling

<slightly related>

I'll preface this by noting that the doc I was querying was head of the heart surgeons at the regionally famous heart center and was trained at the Mayo and subsequently was a fellow at the Cleveland Clinic. In short, he has a whole lotta street cred.

When I was being interviewed by him for possible TAVR, I told him that I had a colonized UTI with a serious pathogen.  Surprisingly, he waved it off. "Not a concern. Now tell me about your dental health. Also, we'll need to contact your dentist to get records." 

Whhaaaa?  It turns out that some of the relatively common dental pathogens do attack the heart after surgery.  Until just 4-5 years ago, docs thought the blood brain barrier was impenetrable. Nope.  Gingivitis worms its way through.

I've used hydrogen peroxide while brushing for 15+ years (after a root canal). Can't hurt.

Porphyromonas gingivalis-induced periodontitis promotes neuroinflammation and neuronal loss associated with dysfunction of the brain barrier
https://pmc.ncbi.nlm.nih.gov/articles/PMC12183281/

[ergophobe]

I think I've seen mention of dental health associated with dementia with the hypothesis being that inflammation from periodontitis can increase risk of Alzheimer's

e.g. https://www.dental.columbia.edu/news/cdm-researcher-finds-link-between-oral-health-and-dementia

My guess is that this is because dentists want to see oral health as a driver of general health. It seems to me from observing dementia patients that the causation runs the other way: people with dementia forget to brush.

However, this is interesting:

"This is the first epidemiological study to examine associations between clinical, microbial and serological features of periodontitis and structural MRI findings related to AD/ADRD" Papapanou says. Interestingly, specific subgingival bacteria were found to be either favorably or unfavorably associated with certain MRI features.

[rcjordan]

>want to see oral health as a driver of general health

Heh, When looking for the above article I saw dental clinics on the front page serp touting "may prevent dementia & alzheimer's"

IIRC, it was the discovery of gingivalis in brain plaques that first killed the med theory that the blood brain barrier was impenetrable. 

>the causation runs the other way: people with dementia forget to brush.

I fully agree. Regardless of the degree of dental hygiene, "gingivalis bacteremia increases the permeability of the blood-brain barrier."

Porphyromonas gingivalis bacteremia increases the permeability of the blood-brain barrier via the Mfsd2a/Caveolin-1 mediated transcytosis pathway - PubMed

My heart docs were particularly interested in long-term dental hygiene. Some of the questions on the first batch of forms piqued my interest as to why.
Here's one hot off the press from the American Heart Association

Unveiling the Impact of Porphyromonas gingivalis‐Associated Periodontitis on Stroke Outcome in Mice | Journal of the American Heart Association
https://www.ahajournals.org/doi/full/10.1161/JAHA.125.045997
https://pubmed.ncbi.nlm.nih.gov/36631446/

Maybe a nice, stiff gin & tonic after brushing?