Influenza (flu) is a contagious respiratory illness caused by influenza viruses that infect the nose, throat, and lungs. Some people, such as older people, young children, and people with certain health conditions, are at higher risk of serious flu complications. There are two main types of influenza (flu) viruses: Types A and B. The influenza A and B viruses that routinely spread in people (human influenza viruses) are responsible for seasonal flu epidemics each year.
The best way to reduce the risk of flu and its potentially serious complications is by getting vaccinated each year.
CDC recommends a yearly flu vaccine as the first and most important step in protecting against flu viruses.
Flu vaccines help to reduce the burden of flu illnesses, hospitalizations and deaths on the health care system each year. (Read more about flu vaccine benefits.)
This season, all flu vaccines will be designed to protect against the four flu viruses that research indicates will be most common. (Visit Vaccine Virus Selection for this season’s vaccine composition.)
Everyone 6 months and older should get an annual flu vaccine, ideally by the end of October. Learn more about vaccine timing.
Vaccination of people at higher risk of developing serious flu complications is especially important to decrease their risk of severe flu illness.
Vaccination also is important for health care workers, and other people who live with or care for people at higher risk to keep from spreading flu to them. This is especially true for people who work in long-term care facilities, which are home to many of the people most vulnerable to flu.
Children younger than 6 months are at higher risk of serious flu illness but are too young to be vaccinated. People who care for infants should be vaccinated instead.
Take everyday preventive actions that are recommended to reduce the spread of flu.
Avoid close contact with people who are sick.
If you are sick, limit contact with others as much as possible to keep from infecting them.
Cover coughs and sneezes.
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. If soap and water are not available, use an alcohol-based hand rub.
Avoid touching your eyes, nose, and mouth. Germs spread this way.
Clean and disinfect surfaces and objects that may be contaminated with viruses that cause flu.
For flu, CDC recommends that people stay home for at least 24 hours after their fever is gone except to get medical care or other necessities. Fever should be gone without the need to use a fever-reducing medicine. Note that the stay-at-home guidance for COVID-19 may be different. Learn about some of the similarities and differences between flu and COVID-19.
If you are sick with flu, antiviral drugs can be used to treat your illness.
Antiviral drugs are different from antibiotics. They are prescription medicines (pills, liquid or an inhaled powder) and are not available over-the-counter.
Antiviral drugs can make flu illness milder and shorten the time you are sick. They may also prevent serious flu complications. For people with higher risk factors [308 KB, 2 Pages], treatment with an antiviral drug can mean the difference between having a milder illness versus a very serious illness that could result in a hospital stay.
Studies show that flu antiviral drugs work best for treatment when they are started within 2 days of getting sick, but starting them later can still be helpful, especially if the sick person has a higher risk factor or is very sick from flu.
If you are at higher risk from flu and get flu symptoms, call your health care provider early so you can be treated with flu antivirals if needed. Follow your doctor’s instructions for taking this drug.
Smoking during pregnancy can cause babies to be born too small or too early (preterm birth), certain birth defects, and stillbirth. Quitting smoking can be hard, but it is one of the best ways a woman can protect herself and her developing baby. For free help, call 1-800-QUIT-NOW (1-800-784-8669).
Many people know that smoking causes cancer, heart disease, and stroke. But women who smoke during pregnancy put themselves and their developing babies at risk for other health problems. Even being around tobacco smoke puts a woman and her developing baby at risk for health problems.
Smoking during Pregnancy Affects Your Developing Baby’s Health
Smoking during pregnancy can cause babies to be born too small or too early. Women who smoke during pregnancy are more likely to have a baby with a birth defect of the mouth and lip called an orofacial cleft.
Babies who breathe in other people’s tobacco smoke are more likely to have ear infections and lung infections, like bronchitis and pneumonia; if they have asthma, breathing in other people’s tobacco smoke can trigger asthma attacks. These babies are also more likely to die from Sudden Infant Death Syndrome (SIDS), a sudden and unexpected infant death that has no immediately obvious cause after investigation.
It Is Never “Too Late” to Quit Smoking During Pregnancy!
Quitting smoking before getting pregnant is best. But for women who are already pregnant, quitting as early as possible can still help protect against some health problems for their developing babies, such as being born too small or too early. It is never too late to quit smoking.
It is important to quit smoking for good. A women might think it is safe to start smoking again after her baby is born. But babies of mothers who smoke may breathe in the secondhand tobacco smoke that can harm their health. Although quitting for good can be hard, the benefits are worth it—a healthy baby and many more years of good health to enjoy with him or her.
If you or someone you know wants to quit smoking, talk to your healthcare provider about strategies. For support in quitting, including free quit coaching, a free quit plan, free educational materials, and referrals to local resources, please call 1-800-QUIT-NOW (1-800-784-8669); TTY 1-800-332-8615.
Planning for Pregnancy
If you are trying to have a baby or are just thinking about it, it is not too early to start getting ready for pregnancy. Preconception health and health care focus on things you can do before and between pregnancies to increase the chances of having a healthy baby. For some women, getting their body ready for pregnancy takes a few months. For other women, it might take longer. Whether this is your first, second, or sixth baby, the following are important steps to help you get ready for the healthiest pregnancy possible.
1. Make a Plan and Take Action
Whether or not you’ve written them down, you’ve probably thought about your goals for having or not having children, and how to achieve those goals. For example, when you didn’t want to have a baby, you used effective birth control methods to achieve your goals. Now that you’re thinking about getting pregnant, it’s really important to take steps to achieve your goal [PDF – 764 KB]—getting pregnant and having a healthy baby!
2. See Your Doctor
Before getting pregnant, talk to your doctor about preconception health care. Your doctor will want to discuss your health history and any medical conditions you currently have that could affect a pregnancy. He or she also will discuss any previous pregnancy problems, medicines that you currently are taking, vaccinations that you might need, and steps you can take before pregnancy to prevent certain birth defects.
If your doctor has not talked with you about this type of care―ask about it! Take a list of talking points so you don’t forget anything!
Talk with your doctor or another health professional if you smoke, drink alcohol, or use certain drugs; live in a stressful or abusive environment; or work with or live around toxic substances. Health care professionals can help you with counseling, treatment, and other support services.
Medications
Taking certain medicines during pregnancy can cause serious birth defects. These include some prescription and over-the-counter medications and dietary or herbal supplements. If you are planning a pregnancy, you should discuss the need for any medication with your doctor before becoming pregnant and make sure you are taking only those medications that are necessary.
People may use opioids as prescribed, may misuse prescription opioids, may use illicit opioids such as heroin, or may use opioids as part of medication-assisted treatment for opioid use disorder. If a woman is pregnant or planning to become pregnant, the first thing she should do is talk to a healthcare provider. Some women need to take an opioid medication during pregnancy to manage pain or to treat opioid use disorder. Creating a treatment plan for opioid use disorder, as well as other co-occurring health conditions, before pregnancy can help a woman increase her chances of a healthy pregnancy. If you are struggling with an opioid use disorder, take a look at CDC’s and partner resources.
Vaccinations (shots)
Some vaccinations are recommended before you become pregnant, during pregnancy, or right after delivery. Having the right vaccinations at the right time can help keep you healthy and help keep your baby from getting very sick or having lifelong health problems.
3. Take 400 Micrograms of Folic Acid Every Day
Folic acid is a B vitamin. If a woman has enough folic acid in her body at least 1 month before and during pregnancy, it can help prevent major birth defects of the baby’s brain and spine.
4. Stop Drinking Alcohol, Smoking, and Using Certain Drugs
Smoking, drinking alcohol, and using certain drugs can cause many problems during pregnancy for a woman and her baby, such as premature birth, birth defects, and infant death.
If you are trying to get pregnant and cannot stop drinking, smoking, or using drugs―get help! Contact your doctor or local treatment center.
Alcohol and Drug Resources
Substance Abuse Treatment Facility Locator The Substance Abuse and Mental Health Services Administration (SAMHSA) has a treatment facility locator. This locator helps people find drug and alcohol treatment programs in their area.
Alcoholics Anonymous (A.A.) Alcoholics Anonymous® is a fellowship of men and women who share their experiences, strengths, and hopes with each other so that they can solve their common problem and help others to recover from alcoholism. Locate an A.A. program near you.
5. Avoid Toxic Substances and Environmental Contaminants
Avoid harmful chemicals, environmental contaminants, and other toxic substances such as synthetic chemicals, metals, fertilizer, bug spray, and cat or rodent feces around the home and in the workplace. These substances can hurt the reproductive systems of men and women. They can make it more difficult to get pregnant. Exposure to even small amounts during pregnancy, infancy, childhood, or puberty can lead to diseases. Learn how to protect yourself and your loved ones from toxic substances at work and at home.
People who are overweight or obese have a higher risk for many serious conditions, including complications during pregnancy, heart disease, type 2 diabetes, and certain cancers (endometrial, breast, and colon).1 People who are underweight are also at risk for serious health problems.2
The key to achieving and maintaining a healthy weight isn’t about short-term dietary changes. It’s about a lifestyle that includes healthy eating and regular physical activity.
If you are underweight, overweight, or obese, talk with your doctor about ways to reach and maintain a healthy weight before you get pregnant.
Violence can lead to injury and death among women at any stage of life, including during pregnancy. The number of violent deaths experienced by women tells only part of the story. Many more survive violence and are left with lifelong physical and emotional scars.
If someone is violent toward you or you are violent toward your loved ones―get help. Violence destroys relationships and families.
Collecting your family’s health history can be important for your child’s health. You might not realize that your sister’s heart defect or your cousin’s sickle cell disease could affect your child, but sharing this family history information with your doctor can be important.
Other reasons people go for genetic counseling include having had several miscarriages, infant deaths, trouble getting pregnant (infertility), or a genetic condition or birth defect that occurred during a previous pregnancy.
Mental health is how we think, feel, and act as we cope with life. To be at your best, you need to feel good about your life and value yourself. Everyone feels worried, anxious, sad, or stressed sometimes. However, if these feelings do not go away and they interfere with your daily life, get help. Talk with your doctor or another health professional about your feelings and treatment options.
NIH, NHLBI Obesity Education Initiative. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Available online: http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.pdf (PDF-1.25Mb)
Moos, Merry-K, et al. Healthier women, healthier reproductive outcomes: recommendations for the routine care of all women of reproductive age. AJOG Volume 199, Issue 6, Supplement B , Pages S280-S289, December 2008.
Pregnant woman sitting in childbearing center
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In 2020, a total of 1,579,885 cases of Chlamydia trachomatis infection were reported to the CDC, making it the most common notifiable sexually transmitted infection in the United States for that year. This case count corresponds to a rate of 481.3 cases per 100,000 population, a decrease of 13% compared with the rate in 2019. During 2019–2020, rates of reported chlamydia decreased among both males and females, in all regions of the United States, and, except for rates among non-Hispanic persons of multiple races, among all racial/Hispanic ethnicity groups.
Decreases in rates of reported chlamydia in 2020 are unlikely due to a reduction in new infections. As chlamydial infections are usually asymptomatic, case rates are heavily influenced by screening coverage. During the COVID-19 pandemic, many health care clinics limited in-person visits to patients with symptoms or closed entirely, and it is likely that preventive health care visits where STD screening usually happens, such as annual reproductive health visits for young women, decreased. During the initial shelter-in-place orders in March and April of 2020, the number of chlamydia cases decreased substantially when compared to the number of cases reported in 2019 and the deficit persisted throughout the year.
Rates of reported chlamydia are highest among adolescents and young adults. In 2020, almost two-thirds (61%) of all reported chlamydia cases were among persons aged 15–24 years. Decreases in rates of diagnosed and reported chlamydia during 2020 were most noticeable among females aged 15–24 years, one of the populations targeted for chlamydia screening. Although still high, rates of reported chlamydia decreased 15% among 15–19-year-old females and decreased 10% among 20–24-year-old females during 2019–2020.
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Excessive alcohol use was responsible for more than 140,000 deaths in the United States each year during 2015–2019, or more than 380 deaths per day. These estimates are from the CDC’s Alcohol-Related Disease Impact (ARDI) application, using a new methodology. The ARDI application shows estimates of alcohol-attributable deaths and years of potential life lost from 58 conditions by age, sex, and state. See how use of this methodology would affect previous ARDI estimates.
Each year, deaths from excessive drinking:
Shortened the lives of those who died by an average of 26 years, for a total of nearly 3.6 million years of potential life lost.
Usually involved adults aged 35 or older and males.
Were mostly due to health effects from drinking too much over time, such as various types of cancer, liver disease, and heart disease.
Led to premature deaths. Deaths from drinking too much in a short time (from causes such as motor vehicle crashes, poisonings involving substances in addition to alcohol, and suicides) accounted for more than half of the years of potential life lost.
Excessive drinking is a leading cause of preventable death in the United States, and it is also costly. It cost the nation $249 billion in 2010 (the most recent year of data available).
Everyone Can Help Prevent Excessive Alcohol Use
You can:
Choose not to drink or to drink in moderation by limiting intake to 2 drinks or less in a day (if you’re a man) and 1 drink or less in a day (if you’re a woman), on days when alcohol is consumed. Some people should not drink any alcohol, including if they:
Are pregnant or might be pregnant.
Are younger than 21.
Have certain medical conditions or are taking certain medicines that can interact with alcohol.
Are recovering from an alcohol use disorder or are unable to control the amount they drink.
Enforce existing laws and regulations about alcohol sales and service.
Partner with law enforcement, community groups, health departments, and doctors, nurses, and other health care providers to reduce excessive drinking and related harms.
Track the role of alcohol in injuries and deaths, with more routine alcohol toxicology testing among patients and people who have died.
Routinely monitor and report on measures of excessive alcohol use and the status of effective alcohol policies.
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Healthy eating features a variety of healthy foods. Fad diets may promise fast results, but such diets limit your nutritional intake, can be unhealthy, and tend to fail in the long run.
How much physical activity you need depends partly on whether you are trying to maintain your weight or lose weight. Walking is often a good way to add more physical activity to your lifestyle.
Managing your weight contributes to good health now and as you age. In contrast, people who have obesity, compared to those with a healthy weight, are at increased risk for many serious diseases and health conditions. See examples of programs that can help.
Helping people maintain a healthy weight is part of CDC’s work to achieve health equity.
Health Equity
In the United States, chronic diseases are leading causes of death and disability, and some groups are affected more than others. For example, obesity is a chronic disease that increases the risk of heart disease, type 2 diabetes, and many types of cancer. The US prevalence of obesity varies by racial and ethnic group, education, age, location, and physical ability.
What Is CDC’s DNPAO Doing?
CDC’s Division of Nutrition, Physical Activity, and Obesity (DNPAO) leads the nation’s public health efforts to promote good nutrition, regular physical activity, and a healthy weight for everyone. These priorities help improve overall health and well-being and prevent, delay, and manage many chronic diseases.
Yet everyone does not have access to affordable, nutritious food and safe places to be physically active. We work with partners and state, tribal, local, and territorial health agencies and organizations to remove environmental and systemic barriers to health. Health equity is when everyone has the opportunity to be as healthy as possible. Our health equity work focuses on three areas:
The conditions in which we are born, live, learn, work, play, worship, and age are social determinants of health (SDOH). Examples include access to safe and affordable housing, quality education, and quality health care.
Differences in SDOH contribute to persistent chronic disease disparities among racial, ethnic, and socioeconomic groups as well as in different geographies and among people with different physical abilities.
Racism
Racism is a system of structures, policies, practices, and norms that assigns value and determines opportunity because of the way people look or the color of their skin. This results in conditions that unfairly give advantages to some and disadvantages to others. These advantages and disadvantages are passed down through generations.
Racism, both interpersonal and systemic, limits the ability for some groups to build wealth by determining who owns land, buys houses, gets a quality education, and gets living wage jobs. Racism also affects access to quality health care.
Aligned Work
Within the CDC, DNPAO is part of the National Center for Chronic Disease Prevention and Health Promotion. Our work is aligned with the center’s focus on five social determinants of health: built environment, community-clinical linkages, food and nutrition security, social connectedness, and tobacco-free policies.
Along with more than 25 federal agencies, CDC participates in an Interagency Workgroup developing a Long-Term Recovery and Resilience plan [PDF-181KB]. The purpose is toalign federal actions, outline strategies to improve vital conditions, support community and individual recovery from the effects of COVID-19, and positively affect health and well-being over the next 10 years and beyond. Vital conditions are characteristics of places and institutions that communities and individuals need to reach their full potential and serve as the guiding framework for the federal plan. Vital conditions include basic needs for health and safety, life-long learning, a thriving natural world, reliable transportation, humane housing, and a community-centered environment with meaningful work and wealth.
Healthy People 2030, a Department of Health and Human Services project, offers measurable, objectives as well as developmental and research objectives to improve health and well-being. The social determinants of health objectives include economic stability, education access and quality, health care access and quality, neighborhoods that promote health and safety, and increased social and community support
The World Health Organization works to address social determinants of health by compiling and disseminating evidence on what works to address these determinants to help build capacity and advocate for more action.
If you notice any unusual changes in your skin, it’s important to see your doctor. Early diagnosis and treatment are key to preventing serious complications.
Did you know that diabetes can affect many parts of your body, including your skin? In fact, skin changes are one of the most common signs of diabetes. Learn about the signs of diabetes that can appear on your skin.
The skin is the largest organ of the human body. It’s packed with nerves and blood vessels that allow us to sense touch, temperature, pain, and pressure. Diabetes can affect the nerves and blood vessels in your body, including those in your skin. Changes in your skin can be a sign that something is going on beneath the surface.
When diabetes affects your skin, it’s often a sign that your blood sugar levels are too high over time. Some skin changes can appear even before you’ve been diagnosed with diabetes. Others could be a sign that your diabetes treatment needs to be adjusted. Either way, you’ll want to make an appointment with a doctor to be screened for diabetes or to talk about adjusting your treatment. They can help you prevent serious complications with your skin and other parts of your body.
Keep reading to learn about 9 skin conditions that can occur with diabetes and what you can do to treat or prevent them.
1. Acanthosis nigricans (AN)
This skin condition causes a dark patch or band of velvety skin that can appear in body creases such as your neck, armpits, or groin. Sometimes the patches can also appear on your hands, elbows, or knees.
What causes it: AN is a sign of insulin resistance and can be a sign of prediabetes or type 2 diabetes. It is common in people who have obesity.
What to do: Some creams can help make the spots look better, but the most effective treatment is to address the root cause, like obesity or insulin resistance. Lifestyle changes such as being physically active and maintaining a healthy weight can help reverse insulin resistance.
2. Diabetic dermopathy
This condition is also known as shin spots, and it’s harmless. The spots look like red or brown round patches or lines in the skin and are common in people with diabetes. They appear on the front of your legs (your shins) and are often confused with age spots. The spots don’t hurt, itch, or open up.
What causes it: Diabetes can cause changes in small blood vessels that reduce blood supply to the skin.
What to do: This skin condition is harmless and doesn’t need treatment. If you do have any concerns about shin spots, talk to your doctor.
3. Necrobiosis lipoidica
This condition causes yellow, reddish, or brown patches on your skin. It usually begins as small, raised bumps that look like pimples. As it gets worse, the bumps turn into patches of swollen, hard skin. This skin condition is rare, but if it does develop it can be itchy and painful.
What causes it: The cause of necrobiosis lipoidica isn’t completely clear, but women are more likely to have it than men. It usually develops when changes in fat and collagen (a fiber-like protein in your body) happen beneath the skin’s surface.
What to do: There is no cure for the condition, so treatment is focused on managing signs and symptoms. In the early stages, topical steroid creams can be used to keep it from getting worse. You’ll want to talk with your doctor so they can find the right treatment plan for you.
4. Bullosis diabeticorum (diabetic blisters)
This condition looks like burn blisters. They can develop on your lower legs and feet, and sometimes on your arms and hands. They can look scary, but they are painless and usually heal on their own.
What causes it: The cause of diabetic blisters is unknown. They can appear with no known injury to the skin. You’re more likely to get diabetic blisters if your blood sugars levels are high over time.
What to do: Most blisters heal on their own without leaving a scar. Daily inspection of your feet and skin is the best way to find early signs of blisters. The best way to prevent them from developing or getting worse is to bring your blood sugar down to normal levels.
5. Eruptive xanthomatosis
This condition causes small, reddish-yellow bumps on the back of your hands, feet, arms, legs, and buttocks. They can be tender and itchy.
What causes it: This condition is rare. It’s caused by having high levels of cholesterol and triglycerides (fat in the blood).
What to do: The best treatment is to bring blood fat levels under control. Your doctor may also want to prescribe medicine to help lower your cholesterol. Talk to your doctor about having your cholesterol checked so that you can take steps to prevent high cholesterol.
6. Digital sclerosis
This condition starts with tight, thick, waxy skin on your fingers and can cause your finger joints to become stiff and hard to move. If blood sugar levels remain high, digital sclerosis can cause your skin to become hard, thick, and swollen and can spread throughout your body.
What causes it: This condition is more common in people with type 1 diabetes who have high blood sugar levels.
What to do: The only treatment for digital sclerosis is to bring blood sugar levels down into the normal range. Physical therapy may help improve the range of motion of affected joints.
7. Bacterial infections
Bacterial infections cause tissue (cells that make up organs and other body parts) to become inflamed, hot, swollen, red, and painful. Common bacterial infections include those on the eyelids, hair follicles, and fingernails.
What causes it: Anyone can get a bacterial infection, but people with diabetes tend to get more than people without diabetes. Bacteria thrive when there is too much glucose (sugar) in the body. A common type of bacteria responsible for bacterial infections in people with diabetes is staphylococcus (staph).
What to do: Bacterial infections usually can be treated with antibiotics. Keeping your blood sugar levels within the normal range can help you avoid infections. Healthy eating, getting physical activity, and taking your medicine as instructed can help you manage your blood sugar.
8. Fungal infections
Fungal infections create itchy rashes surrounded by tiny red blisters and scales. They usually develop in warm, moist folds of the skin. Common fungal infections include jock itch, athlete’s foot, ringworm, and vaginal infections.
What causes it: Like bacterial infections, anyone can get a fungal infection, but they are common in people with diabetes. Fungal infections are more likely to occur when blood sugar levels are high.
What to do: Talk to your doctor about prescription or over-the-counter medicine that can help treat fungal infections. Keeping blood sugar levels within the normal range by checking your blood sugar often, eating healthy, and getting regular exercise is the best way to prevent fungal infections.
9. Dry, itchy skin
This skin condition is common, even for people who don’t have diabetes. But dry, itchy skin can be a result of poor circulation, which is more likely when you have diabetes.
What causes it: Too much sugar in the blood causes the body to pull fluid from its cells so that it can produce enough urine to remove the excess sugar. This can make your skin dry.
What to do: You’ll want to monitor your blood sugar levels and keep them in your target range as much as possible. It also helps if you limit your time in the shower, use mild soaps, and use lotion after showering. Exercise is one of the best ways to improve circulation—and has many other health benefits.
Be Good to Your Skin
Skin is a good indicator of health. If you notice any unusual changes in your skin, it’s important to see your doctor. Early diagnosis and treatment are key to preventing serious complications from skin problems caused by diabetes.
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Monkeypox is a rare disease caused by infection with the monkeypox virus. Monkeypox virus belongs to the Orthopoxvirus genus in the family Poxviridae. The Orthopoxvirus genus also includes variola virus (which causes smallpox), vaccinia virus (used in the smallpox vaccine), and cowpox virus. Monkeypox is not related to chickenpox.
Monkeypox was first discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research. Despite being named “monkeypox”, the source of the disease remains unknown. However, African rodents and non-human primates (like monkeys) may harbor the virus and infect people.
The first human case of monkeypox was recorded in 1970. Since then, monkeypox has been reported in people in several other central and western African countries. Prior to the 2022 outbreak, nearly all monkeypox cases in people outside of Africa were linked to international travel to countries where the disease commonly occurs, or through imported animals.
Sign & Symptoms:
Monkeypox is a rare disease caused by infection with the monkeypox virus. Monkeypox virus is part of the same family of viruses as smallpox. Monkeypox symptoms are similar to smallpox symptoms, but milder; and monkeypox is rarely fatal. Monkeypox is not related to chickenpox.
Symptoms of monkeypox can include:
Fever
Headache
Muscle aches and backache
Swollen lymph nodes
Chills
Exhaustion
A rash that can look like pimples or blisters that appears on the face, inside the mouth, and on other parts of the body, like the hands, feet, chest, genitals, or anus.
The rash goes through different stages before healing completely. The illness typically lasts 2-4 weeks.
Sometimes, people get a rash first, followed by other symptoms. Others only experience a rash.
Prevention:
There are number of measures that can be taken to prevent infection with monkeypox virus:
Avoid contact with animals that could harbor the virus (including animals that are sick or that have been found dead in areas where monkeypox occurs).
Avoid contact with any materials, such as bedding, that has been in contact with a sick animal.
Isolate infected patients from others who could be at risk for infection.
Practice good hand hygiene after contact with infected animals or humans. For example, washing your hands with soap and water or using an alcohol-based hand sanitizer.
Use personal protective equipment (PPE) when caring for patients.
Practice good hand hygiene after contact with infected animals or humans.
JYNNEOSTM (also known as Imvamune or Imvanex) is an attenuated live virus vaccine which has been approved by the U.S. Food and Drug Administration for the prevention of monkeypox. On November 3, 2021, the Advisory Committee on Immunization Practices (ACIP) voted to recommend JYNNEOS pre-exposure prophylaxis as an alternative to ACAM2000 for certain persons at risk for exposure to orthopoxviruses.
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You can get sick with diarrhea if you swallow contaminated recreational water—water in pools, hot tubs, water playgrounds, or oceans, lakes, and rivers. In fact, diarrhea is the most common illness reported for outbreaks linked to recreational water.
These germs can survive in properly chlorinated water for minutes to days, depending on the germ.
How do germs that cause diarrhea spread in recreational water?
If someone is sick and has diarrhea in the water, millions of germs can contaminate the water. These germs can make other people sick if they swallow even a small amount of contaminated water. Swallowing 10 or fewer germs can make people sick. Germs can also get in the water if swimmers have poop, even tiny amounts, on their bottoms.
Pool chemicals and filters help kill germs
Filters and disinfectants (chemicals that disinfect the water, such as chlorine or bromine) work together to help kill germs in pools, hot tubs, and water playgrounds. Filters remove debris (such as leaves), which use up the disinfectant in the water. Pool staff make sure chlorine or bromine is at the level needed to kill most germs in the water within minutes. You can still be exposed to germs during the time it takes for the water to go through filters and for the disinfectant to kill germs. You can also get diarrhea from germs that are hard to kill, such as Crypto. Crypto stays alive for more than 7 days, even if water is properly filtered and disinfected.
Many places with pools use one filtration system for more than one pool, which causes water from multiple pools to mix. This means germs from one person’s body could contaminate the water in more than one pool.
How do I protect myself and those I care about?
We all share the water we swim, play, or relax in. Each of us can help protect ourselves, our families, and our friends from germs that can cause diarrhea.
Take the following steps when swimming in any type of water:
Stay out of the water if you are sick with diarrhea.
If you have Crypto, don’t go in the water until 2 weeks after diarrhea has completely stopped.
Don’t poop in the water.
Don’t swallow the water.
Take kids on bathroom breaks and check diapers every hour.
Change diapers away from the water’s edge to keep germs from getting in the water. Wash your hands after.
Before going in pools, water playgrounds, and hot tubs, also take these steps:
Use test strips to make sure the water has proper free chlorine (amount of chlorine available to kill germs) or bromine level and pH.
Free chlorine level: at least 1 part per million (ppm) in pools and water playgrounds and at least 3 ppm in hot tubs
Bromine level: at least 3 ppm in pools and water playgrounds and at least 4 ppm in hot tubs
pH (affects how well chlorine and bromine can kill germs): 7.2–7.8
Most superstores, hardware stores, and pool supply stores sell test strips. Follow the directions on the test strip package.
Shower before you get in the water.
A 1-minute shower removes most of the dirt, sweat, and oils on your body that use up chlorine or bromine needed to kill germs.
Follow these and other healthy swimming steps to help protect you and those you care about from getting sick.
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Social isolation was associated with about a 50% increased risk of dementia and other serious medical conditions.
Loneliness and social isolation in older adults are serious public health risks affecting a significant number of people in the United States and putting them at risk for dementia and other serious medical conditions.
A report from the National Academies of Sciences, Engineering, and Medicine (NASEM) points out that more than one-third of adults aged 45 and older feel lonely, and nearly one-fourth of adults aged 65 and older are considered to be socially isolated.1 Older adults are at increased risk for loneliness and social isolation because they are more likely to face factors such as living alone, the loss of family or friends, chronic illness, and hearing loss.
Loneliness is the feeling of being alone, regardless of the amount of social contact. Social isolation is a lack of social connections. Social isolation can lead to loneliness in some people, while others can feel lonely without being socially isolated.
Health Risks of Loneliness
Although it’s hard to measure social isolation and loneliness precisely, there is strong evidence that many adults aged 50 and older are socially isolated or lonely in ways that put their health at risk. Recent studies found that:
Social isolation significantly increased a person’s risk of premature death from all causes, a risk that may rival those of smoking, obesity, and physical inactivity.1
Social isolation was associated with about a 50% percent increased risk of dementia.1
Poor social relationships (characterized by social isolation or loneliness) was associated with a 29% increased risk of heart disease and a 32% increased risk of stroke.1
Loneliness was associated with higher rates of depression, anxiety, and suicide.
Loneliness among heart failure patients was associated with a nearly 4 times increased risk of death, 68% increased risk of hospitalization, and 57% increased risk of emergency department visits.
Immigrant, LGBT People Are at Higher Risk
The report highlights loneliness among vulnerable older adults, including immigrants; lesbian, gay, bisexual, and transgender (LGBT) populations; minorities; and victims of elder abuse. It also points out that the literature base for these populations is sparse and more research is needed to determine risks, impacts, and appropriate actions needed.
Current research suggests that immigrant, and lesbian, gay, bisexual populations experience loneliness more often than other groups. Latino immigrants, for example, “have fewer social ties and lower levels of social integration than US-born Latinos.” First-generation immigrants experience stressors that can increase their social isolation, such as language barriers, differences in community, family dynamics, and new relationships that lack depth or history, the report states. Similarly, gay, lesbian, and bisexual populations tend to have more loneliness than their heterosexual peers because of stigma, discrimination, and barriers to care.
What Can You Do If You Are Experiencing Loneliness?
Your doctor can assess your risk for loneliness and social isolation and get you connected to community resources for help, if needed. The following national organizations also offer helpful resources:
AARP—Provides helpful information to seniors to help improve quality of life and provides access to Community Connection Tools.
Area Agencies on Aging (AAA)—A network of over 620 organizations across America that provides information and assistance with programs including nutrition and meal programs (counseling and home-delivered or group meals), caregiver support, and more. The website can help you find your local AAA, which may provide classes in Tai Chi and diabetes self-management.
Eldercare Locator—A free national service that helps find local resources for seniors such as financial support, caregiving services, and transportation. It includes a brochure that shows how volunteering can help keep you socially connected.
National Council on Aging—Works with nonprofit organizations, governments, and businesses to provide community programs and services. This is the place to find what senior programs are available to assist with healthy aging and financial security, including the Aging Mastery Program® that is shown to increase social connectedness and healthy eating habits.
National Institute on Aging (NIA)– Provides materials on social isolation and loneliness for older adults, caregivers, and health care providers. Materials include health information, a print publication available to view or order no-cost paper copies, a health care provider flyer, and social media graphics and posts.
Health Care System Interventions Are Key
People generally are social by nature, and high-quality social relationships can help them live longer, healthier lives. Health care systems are an important, yet underused, partner in identifying loneliness and preventing medical conditions associated with loneliness.
Nearly all adults aged 50 or older interact with the health care system in some way. For those without social connections, a doctor’s appointment or visit from a home health nurse may be one of the few face-to-face encounters they have. This represents a unique opportunity for clinicians to identify people at risk for loneliness or social isolation.
NASEM recommends that clinicians periodically assess patients who may be at risk and connect them to community resources for help. In clinical settings, NASEM recommends using the Berkman-Syme Social Network Index (for measuring social isolation) and the three-item UCLA Loneliness Scale (for measuring loneliness).
But patients must make their own decisions. Some people may like being alone. It is also important to note that social isolation and loneliness are two distinct aspects of social relationships, and they are not significantly linked. Both can put health at risk, however.
Old lonely woman sitting near the window in his house with flowers
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It’s important to keep your blood sugar levels in your target range as much as possible to help prevent or delay long-term, serious health problems, such as heart disease, vision loss, and kidney disease. Staying in your target range can also help improve your energy and mood. Find answers below to common questions about blood sugar for people with diabetes.
Use a blood sugar meter (also called a glucometer) or a continuous glucose monitor (CGM) to check your blood sugar. A blood sugar meter measures the amount of sugar in a small sample of blood, usually from your fingertip. A CGM uses a sensor inserted under the skin to measure your blood sugar every few minutes. If you use a CGM, you’ll still need to test daily with a blood sugar meter to make sure your CGM readings are accurate.
When should I check my blood sugar?
How often you check your blood sugar depends on the type of diabetes you have and if you take any diabetes medicines.
Typical times to check your blood sugar include:
When you first wake up, before you eat or drink anything.
Before a meal.
Two hours after a meal.
At bedtime.
If you have type 1 diabetes, have type 2 diabetes and take insulin, or often have low blood sugar, your doctor may want you to check your blood sugar more often, such as before and after you’re physically active.
What are blood sugar targets?
A blood sugar target is the range you try to reach as much as possible. These are typical targets:
Before a meal: 80 to 130 mg/dL.
Two hours after the start of a meal: Less than 180 mg/dL.
Your blood sugar targets may be different depending on your age, any additional health problems you have, and other factors. Be sure to talk to your health care team about which targets are best for you.
What causes low blood sugar?
Low blood sugar (also called hypoglycemia) has many causes, including missing a meal, taking too much insulin, taking other diabetes medicines, exercising more than normal, and drinking alcohol. Blood sugar below 70 mg/dL is considered low.
Signs of low blood sugar are different for everyone. Common symptoms include:
Shaking.
Sweating.
Nervousness or anxiety.
Irritability or confusion.
Dizziness.
Hunger.
Know what your individual symptoms are so you can catch low blood sugar early and treat it. If you think you may have low blood sugar, check it even if you don’t have symptoms. Low blood sugar can be dangerous and should be treated as soon as possible.
How can I treat low blood sugar?
If you’ve had low blood sugar without feeling or noticing symptoms (hypoglycemia unawareness), you may need to check your blood sugar more often to see if it’s low and treat it. Driving with low blood sugar can be dangerous, so be sure to check your blood sugar before you get behind the wheel.
Carry supplies for treating low blood sugar with you. If you feel shaky, sweaty, or very hungry or have other symptoms, check your blood sugar. Even if you don’t have symptoms but think you may have low blood sugar, check it. If your blood sugar is lower than 70 mg/dL, do one of the following immediately:
Take four glucose tablets.
Drink four ounces of fruit juice.
Drink four ounces of regular soda, not diet soda.
Eat four pieces of hard candy.
Wait for 15 minutes and then check your blood sugar again. Do one of the above treatments again until your blood sugar is 70 mg/dL or above and eat a snack if your next meal is an hour or more away. If you have problems with low blood sugar, ask your doctor if your treatment plan needs to be changed.
What causes blood sugar to be high?
Many things can cause high blood sugar (hyperglycemia), including being sick, being stressed, eating more than planned, and not giving yourself enough insulin. Over time, high blood sugar can lead to long-term, serious health problems. Symptoms of high blood sugar include:
Feeling very tired.
Feeing thirsty.
Having blurry vision.
Needing to urinate (pee) more often.
If you get sick, your blood sugar can be hard to manage. You may not be able to eat or drink as much as usual, which can affect blood sugar levels. If you’re ill and your blood sugar is 240 mg/dL or above, use an over-the-counter ketone test kit to check your urine for ketones and call your doctor if your ketones are high. High ketones can be an early sign of diabetic ketoacidosis, which is a medical emergency and needs to be treated immediately.
What are ketones?
Ketones are a kind of fuel produced when fat is broken down for energy. Your liver starts breaking down fat when there’s not enough insulin in your bloodstream to let blood sugar into your cells.
What is diabetic ketoacidosis?
If you think you may have low blood sugar, check it even if you don’t have symptoms.
When too many ketones are produced too fast, they can build up in your body and cause diabetic ketoacidosis, or DKA. DKA is very serious and can cause a coma or even death. Common symptoms of DKA include:
Fast, deep breathing.
Dry skin and mouth.
Flushed face.
Frequent urination or thirst that lasts for a day or more.
Fruity-smelling breath.
Headache.
Muscle stiffness or aches.
Nausea and vomiting.
Stomach pain.
If you think you may have DKA, test your urine for ketones. Follow the test kit directions, checking the color of the test strip against the color chart in the kit to see your ketone level. If your ketones are high, call your health care provider right away. DKA requires treatment in a hospital.
DKA happens most in people with type 1 diabetes and is sometimes the first sign of type 1 in people who haven’t yet been diagnosed. People with type 2 diabetes can also develop DKA, but it’s less common.
How can I treat high blood sugar?
Talk to your doctor about how to keep your blood sugar levels within your target range. Your doctor may suggest the following:
Be more active. Regular exercise can help keep your blood sugar levels on track. Important: don’t exercise if ketones are present in your urine. This can make your blood sugar go even higher.
Take medicine as instructed. If your blood sugar is often high, your doctor may change how much medicine you take or when you take it.
Follow your diabetes meal plan. Ask your doctor or dietitian for help if you’re having trouble sticking to it.
Check your blood sugar as directed by your doctor. Check more often if you’re sick or if you’re concerned about high or low blood sugar.
Talk to your doctor about adjusting how much insulin you take and what types of insulin (such as short-acting) to use.
How do carbs affect blood sugar?
Carbs in food make your blood sugar levels go higher after you eat them than when you eat proteins or fats. You can still eat carbs if you have diabetes. The amount you can have and stay in your target blood sugar range depends on your age, weight, activity level, and other factors. Counting carbs in foods and drinks is an important tool for managing blood sugar levels. Make sure to talk to your health care team about the best carb goals for you.
What is the A1C test?
The A1C test is a simple blood test that measures your average blood sugar levels over the past 2 or 3 months. The test is done at a lab or your doctor’s office in addition to—not instead of—regular blood sugar testing you do yourself.
A1C testing is part of the ABCs of diabetes—important steps you can take to prevent or delay health complications down the road:
A: Get a regular A1C test.
B: Try to keep your blood pressure below 140/90 mm Hg (or the target your doctor sets).
The A1C goal for most adults with diabetes is between 7% and 8%, but your goal may be different depending on your age, other health conditions, medicines you’re taking, and other factors. Work with your doctor to establish a personal A1C goal for you.
What else can I do to help manage my blood sugar levels?
Keep track of your blood sugar levels to see what makes them go up or down.
Eat at regular times, and don’t skip meals.
Choose foods lower in calories, saturated fat, trans fat, sugar, and salt.
Track your food, drink, and physical activity.
Drink water instead of juice or soda.
Limit alcoholic drinks.
For a sweet treat, choose fruit.
Control your food portions (for example, use the plate method: fill half your plate with non-starchy vegetables, a quarter with lean protein, and a quarter with a grain or starchy food).
How can I pay for tests and diabetes supplies?
Medicare, Medicaid, and most private insurance plans pay for the A1C test and fasting blood sugar test as well as some diabetes supplies. Check your plan or ask your health care team for help finding low-cost or free supplies, and see How to Save Money on Diabetes Care for more resources.
