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Subject: PREVENTING RESPIRATORY INFECTIONS INCLUDING CORONA AND INFLUENZA VIRUSES IN LARYNGECTOMEES

Because of the risks involved with the Corona virus laryngectomees and their health providers  may find this information useful:  

Laryngectomees are more susceptible to respiratory infection because the air they inhale is not filtered by passing through their nose. Consequently, they are at increased risk of inhaling respiratory pathogens (viruses, bacteria, and fungi) directly into their lungs. Therefore, laryngectomees have to vigilant and protect themselves from respiratory all pathogens during the influenza season and other viral epidemics.

Respiratory pathogens most commonly spread from an infected person to others through:

  • The air by coughing and sneezing and rarely, fecal contamination
  • Close personal contact, such as touching or shaking hands
  • Touching an object or surface with the pathogen on it, then touching the stoma, mouth, nose, or eyes before washing hands.

 

Laryngectomees can protect themselves by being vaccinated (when a vaccine is available) and:

  • Wearing HME 24/7 especially when being around other people. HME with greater filtering ability would work better in reducing the risk of inhaling the virus ( i.e., Provox Micron TM, Atos Medical's XtraMoist). Provox Micron, has an electrostatic filter and >99.9% filtration rate and it’s cover prevents direct finger contact of the stoma.
  • Wearing hands free HME (because it does not require touching when speaking) in those using trachea esophageal speech. Those who use a regular HME should wash their hands before touching their HME.
  • Wearing a face mask(preferably N95) over the stoma 
  • Washing hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water are not available. This especially important before managing their stoma, and touching their HME when speaking using tracheoesophageal speech.
  • Avoiding touching the stoma, HME, eyes, nose, and mouth with unwashed hands.
  • Avoiding close contact with sick people.
  • Cleaning and disinfect frequently touched objects and surfaces.

A facemask with four strings can be modified to fit over the stoma. One of the strings can be extended with extra string; and the lower pair of strings can be tied behind the back. (see pictures below)

If worn properly, a facemask can help block large-particle droplets, splashes, sprays or splatter that may contain germs (viruses and bacteria). Facemasks may also help reduce exposure of the wearer’s respiratory secretions to others.

While a facemask may be effective in blocking splashes and large-particle droplets, it does not filter or block very small particles in the air that may be transmitted by coughs, and sneezes.

 

Itzhak Brook MD

Professor of Pediatrics and Medicine

Georgetown University Washington DC

For updated recommendations and status of Corona spread, see the CDC website https://www.cdc.gov/coronavirus/2019-ncov/index.html  

Read more at https://dribrook.blogspot.com/2020/01/coronavirus-outbreak-in-china-and-how.html    and the Laryngectomee Guide Expanded Edition  http://bit.ly/2Si9TNm          

Diana Ayling