Flu Breeds ‘Winter of Discontent’

Perhaps it was a bout of flu that King Richard III remembered when he spoke of “the winter of our discontent.” Flu tends to be a memorable event with a cluster of symptoms that includes fever, headache, cough, upper respiratory distress, exhaustion and all over aches and pain. Last winter was a relatively mild flu season. A less severe outbreak one season can lead to complacency the next year with fewer people lining up for shots. But our heightened awareness of SARS should give us pause to reflect on the dangers of flu. SARS killed several hundred people worldwide. Complications of the flu kill between 30,000 and 40,000 Americans each year and hundreds of thousands worldwide. Unlike the SARS virus, we have an effective weapon against influenza. Unfortunately, many even in high-risk categories fail to take advantage of a simple shot than can help avoid a week of misery and, in some cases, save lives. Influenza is a viral illness with a number of active strains circling the world at any given time. The flu vaccine is composed of the two or three strains health experts predict will be dominant in North America in the coming winter. The strains selected for the 2003-2004 vaccine are A New Caledonia virus, A Moscow virus and B Hong Kong virus. There are a number of false assumptions about the flu vaccine. Because it’s made with inactivated virus, it can’t give you the flu. It does, however, take a couple of weeks before your body builds up enough antibodies to be protective. So it’s possible to get the flu in the period shortly after having the shot before you are protected. It’s also possible that the strains selected in the annual vaccine may not adequately reflect the most common strain in your area. And because the dominant strains vary from year to year you have to have the flu vaccine every year to maintain protection.

 

Seniors Are at Greatest Risk

      Seniors are the highest risk group during flu season and health experts recommend flu vaccines for all adults over age 50, and especially those over age 65. Because the immune system weakens with aging, the body is less able to mount an effective immune response to the vaccine, making the vaccine less likely to fully protect older adults. Despite this fact, seniors reap enormous benefit from the flu vaccine. During the 2000 flu season, those over age 65 who were vaccinated for flu were 52 percent less likely to become infected with the flu and 50 percent less likely to die from any cause. Interestingly, the flu vaccine seems to protect seniors on multiple fronts. It’s easy to understand the lower death rates related to the fact that vaccinated seniors were 29 percent less likely to have pneumonia, a common complication of flu. But those who were vaccinated were also 23 percent less likely to suffer a stroke and 19 percent less likely to be hospitalized for heart problems. Yet many seniors are missing out on this simple preventive measure. According to the U.S. Centers for Disease Control and Prevention in 2001 only 63 percent of adults over age 65 received the flu vaccine. It’s not just seniors who benefit from flu shots. Although officially recommended for those over age 50, flu shots can be a boon for people of any age who want to avoid the downtime and illness associated with flu. The more school age children, college students and working adults who get the vaccine, the less likely the flu is to spread. For those who would rather endure a week of the flu than a shot, there’s a new, painless option. FluMist is an influenza vaccine delivered as a nasal mist. The Food and Drug Administration approved FluMist in June for healthy children and adolescents between the ages of 5 and 17 and for healthy adults between 18 and 49. It’s not currently recommended for children under age 5 or adults over age 50. The painless spray comes at a price, however. It’s expected to be more expensive than standard shots.

 

When Flu Strikes

      Common cold viruses cause sneezing, sniffles, a cough and congestion. Most people with a cold feel sick but generally manage to soldier on, dragging through the normal routine. Flu is more debilitating, usually sending the patient to bed with chills, fever and bodily aches that can last for a week. In the past bed rest, plenty of fluids and medication to relieve pain and fever were the mainstay of treatment. New medications available since 1999 don’t provide an instant cure but have been shown to shorten the duration of flu by at least a day, and by several days if taken early enough in the course of the illness. The drugs, zanamivir (Relenza) and oseltamivir (Tamiflu) are  antivirals that attack the virus. They are, however, more expensive than over-the-counter preparations. Many people with the flu feel so sick they lose their appetite. Skipping a few meals won’t hurt most people, but it’s important to drink plenty of fluids. Dehydration is a potentially serious side effect. Mom’s chicken soup may not provide a miraculous cure for flu but it certainly offers a way of staying hydrated, a comforting hot drink and a nutritious source of energy for a patient not interested in regular food. The flu virus attacks the airways–nose, throat and lungs. Most people recover in a week or two but when secondary complications develop, they’re likely to take the form of sinus infections, bronchitis or pneumonia. When patients have difficulty or pain breathing, it’s important to seek medical advice. Young children under age two, older adults and younger adults with other medical conditions are at greatest risk of developing serious complications such as pneumonia. Don’t underestimate the value of a flu shot this fall for you or loved ones who might be in high risk groups. Winter has enough challenges without adding flu to the sources of discontent. A flu shot (or spray) is quick, readily available and inexpensive. It’s a smart move to ensure a healthier winter season. 

 

REFERENCES:

“Flu Vaccination Reduces Deaths in Over-65s By More than a Quarter,” Pulse, June 2, 2003.

“FluMist Is Latest Entry in Vaccine Market,” Chemical Market Reporter, June 30, 2003.

“Influenza Vaccine,” American Family Physician, February 15, 2003.

Louis Kuritzky, “Influenza Vaccination and Reduction in Hospitalizations,” Clinical Cardiology Alert, July 2003.

“Report Highlights Vaccination Benefits,” Australian Nursing Journal, June 2003.

“Research Shows Benefits of Vaccination for Elderly,” Vaccine Weekly, April 30, 2003.

“Vaccination is Best Strategy Against Influenza,” Vaccine Weekly, February 12, 2003.

“Update: Influenza Activity – United States and Worldwide, 2002-03 Season, and Composition of the 2003-04 Influenza Vaccine,” Morbidity and Mortality Weekly Report, June 6, 2003.

Richard K. Zimmerman et al, “Vaccines for Persons at High Risk Due to Medical Conditions, Occupation, Environment, or Lifestyle,” Journal of Family Practice, January 2003.