SIMPLY HEALTH: Unfluenza-Everything You Need to Know about Not Getting Influenza

posted 09/22/2008
Fall is in the air with crisp nights. The kids are back to school-and home with the newest round of viruses-coughing and sniffling and sharing their bugs with everyone. Flu season can start as early as October but typically starts in late fall or early winter, often peaking in February or March. But it is the flu that folks had in Australia a year ago that determines what our flu vaccine is this Fall.

Influenza, commonly known as "the flu " is a respiratory virus transmitted by droplets in a cough or sneeze. It starts with fever, aching, and fatigue then develops into runny nose and a wracking cough that can last up to two weeks. (It is not a stomach virus that causes vomiting and diarrhea).

Influenza results in many missed days of work and school, and adds to expensive medical costs. Often antibiotics are expected or mistakenly prescribed-they do nothing for the flu and worsen development of antibiotic-resistant bacteria "superbugs " like MRSA (methicillin resistant staphylococcus aureus). More on that in a later article.

Those at high risk for developing complications from the flu are children 6 months to 2 years, pregnant women, those over 65 years, and any adult or child with chronic illness like asthma, diabetes, emphysema or COPD, kidney or liver disease, hypertension, heart disease or people with HIV, those in cancer treatment or on immunosuppressant drugs.

Over 56,000 people in the U. S. died in 2006 of flu and pneumonia, the most common lethal complication from influenza. It is estimated that 47% of all persons at high risk were immunized against the flu in 2006. The ultimate goal is to immunize over 70% of the U.S. population.

This year, the American Academy of Pediatrics and the Center for Disease Control (CDC) have extended the recommendation that all children aged 6 months to 18 years be vaccinated for influenza. Children with underlying chronic illness-like asthma, diabetes or cardiovascular disorders are especially at risk. In addition, household contacts (parents and others) of children under age 5 years are advised to be vaccinated. Recent studies have indicated that if women are vaccinated when pregnant, newborn infants are protected from flu for the first six months of life.

Are You at High Risk for Influenza Complications?

Those over 65 yrs of age
Those with any chronic illness
Children aged 6 months to 2 years.
Pregnant women
Those with sickle cell anemia
Anyone undergoing cancer therapy or on chronic immunosuppressive medications

Influenza viruses A and B most commonly affect humans and these strains tend to drift or change in their form slightly every year. Other animals can be infected by various types of Influenza A viruses including pigs, whales, horses, and ducks and chickens-the source of the Avian flu. These viruses rarely do so but can make a direct jump from animal to human.

Outbreaks of influenza virus in humans are monitored all over the globe year round. The predominant strains are then identified and prepared into a vaccine tailored to give the best protection. Vaccines for the northern hemisphere are made based on the strains of flu virus that are found in the southern hemisphere during their winter months. Our vaccine this year contains strains identified in Brisbane, Australia last year. It takes at least six months from virus identification to get vaccines manufactured and delivered for use. No vaccine shortages are anticipated this year.

Periodically, the viruses shift or mutate and make a big change in their structure. If this occurs, even the best vaccine formulation cannot protect fully against this change. These are the years when there seem to be large flu epidemics even among those who were vaccinated. Though a viral shift may occur after the vaccine is prepared, cross protection provides some benefit and minimizes severity of the illness and reduces the rate of secondary pneumonia. Because the virus changes regularly, annual vaccination is necessary to maintain immunity to these new versions of the virus. After vaccination, immunity develops within a month and lasts for about a year.

The vaccine shot contains dead virus and cannot cause active infection. Mild side effects may include soreness at injection site, fatigue and achiness for a day or so, and a low grade fever (seen more in children under 2 years of age and rarely in adults). A live but disabled virus vaccine delivered via a nasal spray is also available for healthy people aged 2-49 years, with some restrictions. A severe egg allergy like hives or asthma is rare but it does preclude a person from receiving any type of flu vaccine as the viruses are grown on egg white protein.

Who Needs to be Immunized?

Children aged 6 months to 18 years
Contacts of children under age 5
Pregnant women
Teachers, and child care workers
Health care professionals
People over age 65 years
Healthy adults desiring protection

Questions have been raised about possible risks linking autism disorder with thimerosal, a preservative used in the development of some vaccine products. Although many studies have been conducted, none have confirmed this relationship.

As a precaution, the preservative has been removed from all vaccines for children and virtually all vaccine products produced since 2004. Fluzone and Fluarix are influenza vaccine brands that do not contain any thimerosal preservative. For an excellent reference on thimerosal and mercury content of all vaccine types by manufacturer, see the John's Hopkins University, School of Public Health, Institute for Vaccine Safety Web site at www.vaccinesafety.edu/thi-table.htm.

Get your flu shot soon and you can reduce your chance of getting the flu by up to 90%. Wash your hands frequently and remember to cough or sneeze into your elbow rather than your hand. Now if we just had a magic wand for that common cold...

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