US COPD Coalition

RESOURCES

Jun
15

Post-COVID Conditions

The following is reprinted from the Centers for Disease Control & Prevention’s COVID-19 website.

Although most people with COVID-19 get better within weeks of illness, some people experience post-COVID conditions. Post-COVID conditions are a wide range of new, returning, or ongoing health problems people can experience more than four weeks after first being infected with the virus that causes COVID-19. Even people who did not have symptoms when they were infected can have post-COVID conditions. These conditions can have different types and combinations of health problems for different lengths of time.

CDC and experts around the world are working to learn more about short- and long-term health effects associated with COVID-19, who gets them, and why.

Types of Post-COVID Conditions

Long COVID

Long COVID is a range of symptoms that can last weeks or months after first being infected with the virus that causes COVID-19 or can appear weeks after infection. Long COVID can happen to anyone who has had COVID-19, even if the illness was mild, or they had no symptoms. People with long COVID report experiencing different combinations of the following symptoms:

  • Tiredness or fatigue
  • Difficulty thinking or concentrating (sometimes referred to as “brain fog”)
  • Headache
  • Loss of smell or taste
  • Dizziness on standing
  • Fast-beating or pounding heart (also known as heart palpitations)
  • Chest pain
  • Difficulty breathing or shortness of breath
  • Cough
  • Joint or muscle pain
  • Depression or anxiety
  • Fever
  • Symptoms that get worse after physical or mental activities

Multiorgan Effects of COVID-19

Multiorgan effects can affect most, if not all, body systems including heart, lung, kidney, skin, and brain functions. Multiorgan effects can also include conditions that occur after COVID-19, like multisystem inflammatory syndrome (MIS) and autoimmune conditions. MIS is a condition where different body parts can become swollen. Autoimmune conditions happen when your immune system attacks healthy cells in your body by mistake, causing painful swelling in the affected parts of the body.

It is unknown how long multiorgan system effects might last and whether the effects could lead to chronic health conditions.

Effects of COVID-19 Treatment or Hospitalization

Post-COVID conditions also can include the longer-term effects of COVID-19 treatment or hospitalization. Some of these longer-term effects are similar to those related to hospitalization for other respiratory infections or other conditions.

Effects of COVID-19 treatment and hospitalization can also include post-intensive care syndrome (PICS), which refers to health effects that remain after a critical illness. These effects can include severe weakness and post-traumatic stress disorder (PTSD). PTSD involves long-term reactions to a very stressful event.

Treatment

There are ways to help manage post-COVID conditions, and many patients with these symptoms are getting better with time. If you think you have a post-COVID condition, talk to your healthcare provider about options for managing or treating your symptoms and resources for support. Post-COVID care clinics are opening at medical centers across the United States to address patient needs.

The best way to prevent these long-term complications is to prevent COVID-19

Important Ways to Slow the Spread of COVID-19

COVID-19 and Vaccination

CDC recommends that people be vaccinated regardless of whether they already had COVID-19. Learn more about vaccination.

Although media articles have reported that some people with long COVID say their symptoms improved after being vaccinated, studies are needed to determine the effects of vaccination on post-COVID conditions.

What CDC is Doing

CDC continues to work to identify how common these longer-term effects are, who is most likely to get them, and whether symptoms eventually resolve. Multi-year studies are underway to further investigate post-COVID conditions. These studies will help us better understand post-COVID conditions and understand how to treat patients with these longer-term effects.

May
28

Finding & Evaluating Online Health Resources

The following information is excerpted from the National Center for Complementary and Integrative Health, a division of the National Institutes of Health.

What’s the Bottom Line?

How much do we know about online resources for complementary health approaches?

The number of Web and social media sites, along with mobile apps, offering health information about complementary and integrative health approaches (often called complementary and alternative medicine) grows every day.

What do we know about the accuracy of online health information?

  • Some online sources of information on complementary health approaches are useful, but others are inaccurate or misleading.
  • Don’t rely on online resources when making decisions about your health. If you’re considering a complementary health approach, discuss it with your health care provider.

Checking Out Online Sources of Health Information: Five Quick Questions

If you’re visiting an online health site for the first time or downloading a new app, ask these five questions:

  1. Who runs or created the site or app? Can you trust them?
  2. What is the site or app promising or offering? Do its claims seem too good to be true?
  3. When was its information written or reviewed? Is it up-to-date?
  4. Where does the information come from? Is it based on scientific research?
  5. Why does the site or app exist? Is it selling something?

Finding Health Information on the Internet: How to Start

  • To find accurate health information, start with one of these organized collections of high-quality resources:
    • MedlinePlus, sponsored by the National Library of Medicine, which is part of the National Institutes of Health (NIH)
    • healthfinder.gov, sponsored by the Office of Disease Prevention and Health Promotion in the U.S. Department of Health and Human Services.
  • If you’re looking for information about complementary and integrative health approaches:

Click here to see the full list of resources on how to find and evaluate health information.

May
26

Domestic Travel During COVID-19

The following is reprinted from the Centers for Disease Control & Prevention’s COVID-19 website.

Delay travel until you are fully vaccinated. If you are not fully vaccinated and must travel, follow CDC’s recommendations for unvaccinated people.

People who are fully vaccinated with an FDA-authorized vaccine or a vaccine authorized for emergency use by the World Health Organization can travel safely within the United States.

CDC will update these recommendations as more people are vaccinated, as rates of COVID-19 change, and as additional scientific evidence becomes available. This guidance applies to travel within the United States and U.S. territories.

Domestic Travel Recommendations for Fully Vaccinated People

  • During Travel
    • Wearing a mask over your nose and mouth is required on planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States and in U.S. transportation hubs such as airports and stations.
    • Follow all state and local recommendations and requirements, including mask wearing and social distancing.
  • After Travel
    • Self-monitor for COVID-19 symptoms; isolate and get tested if you develop symptoms.
    • Follow all state and local recommendations or requirements.

You do NOT need to get tested or self-quarantine if you are fully vaccinated or have recovered from COVID-19 in the past 3 months. You should still follow all other travel recommendations.

Domestic Travel Recommendations for Unvaccinated People

If you are not fully vaccinated and must travel, take the following steps to protect yourself and others from COVID-19:

  • Before you travel:
    • Get tested with a viral test 1-3 days before your trip.
  • While you are traveling:
    • Wear a mask over your nose and mouth. Wearing a mask is required on planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States and in U.S. transportation hubs such as airports and stations.
    • Avoid crowds and stay at least 6 feet/2 meters (about 2 arm lengths) from anyone who is not traveling with you.
    • Wash your hands often or use hand sanitizer (with at least 60% alcohol).
  • After you travel:
    • Get tested with a viral test 3-5 days after travel AND stay home and self-quarantine for a full 7 days after travel.
      • Even if you test negative, stay home and self-quarantine for the full 7 days.
      • If your test is positive, isolate yourself to protect others from getting infected.
    • If you don’t get tested, stay home and self-quarantine for 10 days after travel.
    • Avoid being around people who are at increased risk for severe illness for 14 days, whether you get tested or not.
    • Self-monitor for COVID-19 symptoms; isolate and get tested if you develop symptoms.
    • Follow all state and local recommendations or requirements.
  • Visit your state, territorial, tribal or local health department’s website to look for the latest information on where to get tested.

Do NOT travel if you were exposed to COVID-19you are sick, you test positive for COVID-19, or you are waiting for results of a COVID-19 test. Learn when it is safe for you to travel. Don’t travel with someone who is sick.

Apr
19

Pulmonary Rehab is Severely Underutilized – Help Spread the Word!

Over 16 million people in the US have COPD and up to 60% of COPD cases go undiagnosed. According to the World Health Organization, COPD is the third leading cause of death globally. COPD continues to be a leading cause of disabling symptoms and suffering. Pulmonary Rehabilitation (PR) is the standard of care for persons with COPD and is associated with improved physical function, symptoms, mood and quality of life. Although PR is well established as a highly effective treatment for COPD and other chronic respiratory diseases in the United States only 3–4% of Medicare beneficiaries with COPD receive pulmonary rehabilitation! Similarly low estimates exist for the rest of the world.

A recent study by Peter Lindenauer and colleagues found that, in persons hospitalized due to acute exacerbation of COPD, PR within three months of discharge vs. later or no PR, was associated with a highly significant lower risk of mortality at one year (hazard ratio, 0.63; i.e., a 37% lower risk of death over the year following discharge). The study utilized claims data of 197,376 Medicare beneficiaries discharged after hospitalization for COPD.8 The findings support PR as a high priority following hospitalization for COPD.

Patients suffering from COPD should know that PR not only has potential for helping them feel better and being more independent, but also to live longer. We are asking for your support in communicating these important findings of improved survival after PR to providers and patients.

Click on the link below to view or download an infographic that you can use to help spread the word.

Apr
6

Are You Caring for Someone Living with COPD?

Join the Caring for COPD Caregivers Study

Respiratory Health Association is seeking caregivers of people living with COPD to participate in a new study, Caring for COPD Caregivers!

WHAT WILL PARTICIPANTS BE ASKED TO DO?

As a project participant, caregivers wll receive a free copy of the COPD Caregiver’s Toolkit, a resource designed to ease the caregiving process. The toolkit is based on caregiver, patient, and provider input.

We ask that participants:

  • Use the Toolkit for one year.
  • Give updates every few months on how it is being used, which sections are most helpful, and if the Toolkit is helping in the caregiving role.
  • Complete a brief survey at the start and end of the project.

WANT TO LEARN MORE OR SIGN UP?

CONTACT THE COPD TEAM AT: 312-229-6186 or COPDToolkit@resphealth.org

Click on the link below to view or download a shareable PDF of the above information

Jan
12

What to Expect After Getting a COVID-19 Vaccine

The following is reprinted from the Centers for Disease Control & Prevention’s coronavirus website.

COVID-19 vaccination will help protect you from getting COVID-19. You may have some side effects, which are normal signs that your body is building protection. These side effects may affect your ability to do daily activities, but they should go away in a few days.

Common side effects

On the arm where you got the shot:

  • Pain
  • Swelling

Throughout the rest of your body:

  • Fever
  • Chills
  • Tiredness
  • Headache

Helpful tips

If you have pain or discomfort, talk to your doctor about taking an over-the-counter medicine, such as ibuprofen or acetaminophen.

To reduce pain and discomfort where you got the shot:

  • Apply a clean, cool, wet washcloth over the area.
  • Use or exercise your arm.

To reduce discomfort from fever:

  • Drink plenty of fluids.
  • Dress lightly.

When to call the doctor

In most cases, discomfort from fever or pain is normal. Contact your doctor or healthcare provider:

  • If the redness or tenderness where you got the shot increases after 24 hours
  • If your side effects are worrying you or do not seem to be going away after a few days

If you get a COVID-19 vaccine and you think you might be having a severe allergic reaction after leaving the vaccination site, seek immediate medical care by calling 911. Learn more about COVID-19 vaccines and rare severe allergic reactions.

Scheduling your second shot?

If you need help scheduling your vaccine appointment for your second shot, contact the location that set up your appointment for assistance. For questions or if you are having trouble using vaccine management or scheduling systems, reach out to the organization that enrolled you in the system. This may be your state or local health department, employer, or vaccine provider.​

About your second shot

Both COVID-19 mRNA vaccines will need 2 shots to get the most protection. The timing between your first and second shot depends on which vaccine you received. You should get your second shot:

  • for the Pfizer-BioNTech 3 weeks (or 21 days) after your first shot,
  • for the Moderna 1 month (or 28 days) after your first shot.

You should get your second shot as close to the recommended 3-week or 1-month interval as possible. However, there is no maximum interval between the first and second doses for either vaccine. You should not get the second dose earlier than the recommended interval. ​

Remember

  • Side effects may feel like flu and even affect your ability to do daily activities, but they should go away in a few days.
  • With most COVID-19 vaccines, you will need 2 shots in order for them to work. Get the second shot even if you have side effects after the first shot, unless a vaccination provider or your doctor tells you not to get a second shot.
  • It takes time for your body to build protection after any vaccination. COVID-19 vaccines that require 2 shots may not protect you until a week or two after your second shot.

It’s important for everyone to continue using all the tools available to help stop this pandemic as we learn more about how COVID-19 vaccines work in real-world conditions. Cover your mouth and nose with a mask when around others, stay at least 6 feet away from others, avoid crowds, and wash your hands often.​

Click here to learn more about COVID-19 vaccines.

Dec
16

Información de Salud en Español

The National Institutes of Health’s National Center for Integrative and Complementary Health offers information on complimentary health and other important healthcare topics in Spanish:

Esta página brinda enlaces a recursos del NCCIH en español sobre medicina complementaria e integral. Además, incluye enlaces a otros recursos en español relacionados con la salud.

Si usted utiliza medicina complementaria e integral, recuerde mencionárselo a su médico o al profesional de la salud que lo atienda. Algunos métodos de medicina complementaria e integral pueden afectar los tratamientos médicos convencionales. Hable con su médico para asegurarse de que el uso de medicina complementaria e integral con métodos de medicina convencionales está coordinado y es seguro.

Nov
19

Considerations for Wearing Masks

The following article is reprinted from the Centers for Disease Control & Prevention’s Coronavirus Disease 2019 (COVID-19) website.

Evidence for Effectiveness of Masks

Your mask helps protect those around you

COVID-19 spreads mainly from person to person through respiratory droplets. Respiratory droplets travel into the air when you cough, sneeze, talk, shout, or sing. These droplets can then land in the mouths or noses of people who are near you or they may breathe these droplets in.

Masks are a simple barrier to help prevent your respiratory droplets from reaching others. Studies show that masks reduce the spray of droplets when worn over the nose and mouth.

You should wear a mask, even if you do not feel sick. This is because several studies have found that people with COVID-19 who never develop symptoms (asymptomatic) and those who are not yet showing symptoms (pre-symptomatic) can still spread the virus to other people. The main function of wearing a mask is to protect those around you, in case you are infected but not showing symptoms.

It is especially important to wear a mask when you are unable to stay at least 6 feet apart from others since COVID-19 spreads mainly among people who are in close contact with one another (within about 6 feet).

Your mask offers some protection to you

A cloth mask also offers some protection to you too. How well it protects you from breathing in the virus likely depends on the fabrics used and how your mask is made (e.g. the type of fabric, the number of layers of fabric, how well the mask fits). CDC is currently studying these factors.

Who should or should not wear a mask

Who should wear a mask

Everyone 2 years of age and older should wear a mask in public settings and when they are around people who do not live in their household.

Wear a mask when caring for someone who is sick with COVID-19 (whether at home or in a non-healthcare setting). If you are sick with COVID-19 or think you may have COVID-19, wear a mask when you need to be around other people or animals, even in your own home.

CDC recognizes there are specific instances when wearing a mask may not be feasible. In these instances, consider adaptations and alternatives.

Who should not wear a mask

Masks should not be worn by

  • Children younger than 2 years old
  • Anyone who has trouble breathing
  • Anyone who is unconscious, incapacitated or otherwise unable to remove the mask without assistance
  • Wearing masks may be difficult for some people with sensory, cognitive, or behavioral issues. If they are unable to wear a mask properly or cannot tolerate a mask, they should not wear one, and adaptations and alternatives should be considered

Types of masks

Some masks work better to help stop the spread of COVID-19 outside of healthcare settings. Medical masks and N-95 respirators should not be used because they should be conserved for healthcare workers.

Cloth masks

The most effective fabrics for cloth masks are

  • Tightly woven fabrics, such as cotton and cotton blends
  • Breathable
  • Two or three layers

Less effective fabrics for cloth masks are

  • Loosely woven fabrics, such as loose knit fabrics
  • Difficult to breathe through (like plastic or leather)
  • Single layer

CDC is currently studying the effectiveness of various cloth mask materials. We will update this guidance as we learn more.

Non-medical disposable masks

Disposable face masks are single-use masks. They are sold online and through large retail stores. These are not the same as surgical or other medical masks.

You may prefer using disposable masks in situations where your mask is likely to get wet or dirty. As with cloth masks, make sure your disposable mask fits close to your face without large side-gaps and completely covers your nose and mouth. Bring extra disposable masks with you in case you need to change out a dirty or wet mask.

mask considerations disposable mask no check

Masks with exhalation valves or vents

CDC does not recommend using masks with exhalation valves or vents because this type of mask may not prevent you from spreading COVID-19 to others. The hole in the material may allow your respiratory droplets to escape and reach others. Research on the effectiveness of these types of masks is ongoing.

mask considerations vent mask

Surgical masks and respirators

Do not use surgical masks and respirators that are meant for healthcare workers. Currently, surgical masks and respirators are critical supplies that should be reserved for healthcare workers and other medical first responders to prevent supply shortages.

mask considerations medical masks

Clear masks or cloth masks with a clear plastic panel

Clear masks or cloth masks with a clear plastic panel are an alternative type of mask for people who interact with

  • People who are deaf or hard of hearing
  • Young children or students learning to read
  • Students learning a new language
  • People with disabilities
  • People who need to see the proper shape of the mouth for making appropriate vowel sounds, e.g., in singing
mask considerations see through mask

If you use this type of mask, make sure

  • You can breathe easily
  • Excess moisture does not collect on the inside of the mask
  • You remove the mask before sleeping, since the plastic part could form a seal around your mouth and nose and make it hard to breathe

The FDA recently cleared a transparent medical mask. These transparent medical masks should be reserved for use by healthcare workers and patients who require them.

Other Types of Face Protection

CDC does not recommend using face shields or goggles as a substitute for masks. Do NOT put a plastic face shield (or a mask) on newborns or infants.

Face shields and goggles are primarily used to protect the eyes of the person wearing it. Goggles do not cover the nose and mouth. Face shields have large gaps below and alongside the face, where your respiratory droplets may escape and reach others around you. At this time, we do not know how much protection a face shield provides to people around you. However, wearing a mask may not be feasible in every situation for some people.mask considerations face sheild-goggles

Face sheilds and goggles

For example, people who interact with those who are deaf or hearing impaired may find that a face shield is better than a mask when communicating. If you must wear a face shield instead of a mask:

  • Choose a face shield that wraps around the sides of your face and extends below your chin or a hooded face shield. This is based on the limited available data that suggest these types of face shields are better at preventing spray of respiratory droplets.
  • Wash your hands before and after removing the face shield. Avoid touching your eyes, nose, and mouth when removing it.
  • Clean and disinfect reusable face shields according to the manufacturer’s instructions or by following CDC face shield cleaning instructions. If you use a disposable face shield, wear it once and throw it away according to the manufacturer’s instructions.

Mask adaptations and alternatives

CDC recognizes that wearing masks may not be possible in every situation or for some people. Those who cannot wear a mask are urged to prioritize virtual engagement when possible. For in-person activities, we have provided a few examples of what you can do to make wearing a mask more feasible and how to reduce the spread of COVID-19 if you cannot wear a mask.

Situations where wearing a mask may not be possible

  • Make sure to maintain physical distance from others when you cannot wear a mask.

Dining

  • CDC recommends wearing a mask while dining in a restaurant except when actively eating or drinking.

Water activities

  • Do not wear a mask when doing activities that may get your mask wet, like swimming at the beach or pool. A wet mask can make it difficult to breathe and may not work as well when wet.

High intensity activities

  • Masks should be used in public settings, but if you are unable to wear a mask because of difficulty breathing during high intensity activities, choose a location with greater ventilation and air exchange (for instance, outdoors versus indoors) and where you can keep at least 6 feet from others during the activity.
  • If you are able to wear a mask, remove your mask if it gets moist from sweat and replace it with a clean mask.
  • Opt for an activity that does not require using mouth guards or helmets. Wearing a mask with these types of protective equipment is not safe if it makes it hard to breathe.
  • Supervise children who are wearing a mask while playing sports.

Certain groups of people who may find it difficult to wear a mask

Some children 2 years and older, and people of any age with certain disabilities

Appropriate and consistent use of masks may be challenging for some children and for people of any age with certain disabilities, including cognitive, intellectual, developmental, sensory, and behavioral disorders.

When deciding if children and people with certain disabilities should wear a mask, determine if they can:

  • Use a mask correctly
  • Avoid frequent touching of the mask and their face
  • Limit sucking, drooling, or having excess saliva on the mask
  • Remove the mask without assistance

If children and people with certain disabilities are unable to wear a mask properly or cannot tolerate a mask, they should not wear one.

Those caring for children and people with certain disabilities who may not be able to wear a mask should

  • Ask their healthcare provider for advice about their wearing a mask
  • Ensure proper mask size and fit
  • Remove their mask before sleeping, napping, when they may fall asleep (such as in a car seat or stroller), and in situations when continual supervision is not possible
  • Consider prioritizing wearing a mask when it is difficult to keep at least 6 feet from others (for example, during carpool drop off or pick up, or when standing in line at schools or stores)

Masks should not be worn by:

  • Children younger than 2 years old
  • Anyone who has trouble breathing
  • Anyone who is unconscious, incapacitated, or otherwise unable to remove the mask without assistance

People who are deaf or hard of hearing, and those who will interact with people who are hearing impaired

If you interact with people who rely on reading lips, you may have difficulty communicating while wearing a mask.

  • Consider wearing a clear mask or a cloth mask with a clear panel
  • If you are not able to get a clear mask, consider using written communication, closed captioning, or decreasing background noise to make communication possible while wearing a mask that blocks lips

People with certain underlying medical conditions

Most people with underlying medical conditions can and should wear masks.

  • If you have respiratory conditions and are concerned about wearing a mask safely, discuss with your healthcare provider the benefits and potential risks of wearing a mask.
  • If you have asthma, you can wear a mask. Discuss with your healthcare provider if you have any concerns about wearing a mask.

Outdoor workers

If you work in a setting where masks could increase the risk of heat-related illness or cause safety concerns (for example, straps getting caught in machinery):

  • Discuss with an occupational safety and health professional about what mask would be suitable.
  • Prioritize wearing masks when in close contact with other people, like during group travel or shift meetings, and remove masks when social distancing is maintained. Some localities may require wearing masks in public outdoors, and these requirements should be followed.

Mask use and carbon dioxide

Wearing a mask does not raise the carbon dioxide (CO2) level in the air you breathe

A cloth mask does not provide an airtight fit across the face. The CO2 completely escapes into the air through and around the sides of the cloth mask when you breathe out or talk. COis small enough to easily pass through any cloth mask material. In contrast, the virus that causes COVID-19 is much larger than CO2, so it cannot pass as easily through a properly designed and properly worn cloth mask.

Nov
6

An In-depth Look at Colds and Flu

The following is excerpted from the National Institutes of Health’s National Center for Complementary & Integrative Health

What’s the Bottom Line?

What do we know about the effectiveness of complementary approaches for flu and colds?

  • No complementary health approach has been shown to be helpful for the flu.
  • For colds:
    • Complementary approaches that have shown some promise include oral zinc productsrinsing the nose and sinuses (with a neti pot or other device), honey (as a nighttime cough remedy for children), vitamin C (for people under severe physical stress), probiotics, and meditation.
    • Approaches for which the evidence is conflicting, inadequate, or mostly negative include vitamin C (for most people), echinaceagarlic, and American ginseng.

What do we know about the safety of complementary approaches for colds and flu?

  • People can get severe infections if they use neti pots or other nasal rinsing devices improperly. Tap water isn’t safe for use as a nasal rinse unless it has been filtered, treated, or processed in specific ways.
  • Zinc products used in the nose (such as nasal gels and swabs) have been linked to a long-lasting or even permanent loss of the sense of smell.
  • Using a dietary supplement to prevent colds often involves taking it for long periods of time. However, little is known about the long-term safety of some dietary supplements studied for prevention of colds, such as American ginseng and probiotics.
  • Complementary approaches that are safe for some people may not be safe for others. Your age, health, special circumstances (such as pregnancy), and medicines or supplements that you take may affect the safety of complementary approaches.

Some Basics About Flu and Colds

Each year, Americans get more than 1 billion colds, and between 5 and 20 percent of Americans get the flu. The two diseases have some symptoms in common, and both are caused by viruses. However, they are different conditions, and the flu is more severe. Unlike the flu, colds generally don’t cause serious complications, such as pneumonia, or lead to hospitalization.

No vaccine can protect you against the common cold, but vaccines can protect you against the flu. Everyone over the age of 6 months should be vaccinated against the flu each year. Vaccination is the best protection against getting the flu.

Prescription antiviral drugs may be used to treat the flu in people who are very ill or who are at high risk of flu complications. They’re not a substitute for getting vaccinated. Vaccination is the first line of defense against the flu; antivirals are the second. If you think you’ve caught the flu, you may want to check with your health care provider to see whether antiviral medicine is appropriate for you. Call promptly. The drugs work best if they’re used early in the illness.

Click here to read the full article and learn what the science says about complimentary health approaches to colds and flu.

To find out more about flu and colds, visit the National Institute of Allergy and Infectious Diseases Web site.

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