November 2011 - The Flu and You

Welcome to this month’s edition of the HCAM News medical segment, To Your Health. I’m Dr. Jim Kenealy. Fall is here and so is the flu season, so grab your tissues and O.J. while we discuss this yearly malady.

Seasonal flu, like the common cold, is a viral illness; but it’s much more virulent and its unique ability to mutate rapidly between each season is the reason we need yearly flu vaccinations. In essence, each year we are playing a game of “catch up” with the last year’s version of the flu virus. Flu seasons are unpredictable and can be severe. Over a period of 30 years, between 1976 and 2006, CDC estimates of flu-associated deaths in the United States range from a low of about 3,000 to a high of about 49,000.

Flu victims experience fevers, shaking chills, runny nose, draining eyes, sore throat, cough, muscle aches and fatigue. In short, they’re miserable for as long as two weeks. Although the vast majority of patients recover uneventfully, the flu can have severe complications such as bacterial pneumonia, ear infections, sinus infections, and dehydration. It can also exacerbate chronic medical conditions, such as congestive heart failure, asthma, and diabetes.

But, don’t despair, there are many things that you can do to beat the flu. Since the flu is spread by droplet infection – the mucous and secretions of infected people who cough, sneeze, talk, or shake their sneeze-contaminated hands– practicing basic hygiene techniques is the first step to prevention. Frequent and thorough hand washing or use of an alcohol-based hand sanitizer is a must. Don’t forget to cover your mouth and nose with your elbow, not your hand, when you cough or sneeze. Never touch your eyes after shaking another person’s hand, as this is a good way to transfer the virus from their hands to your body. And don’t share cups, plates or utensils. Remember, the flu virus patients may be able to infect others beginning 1 day before symptoms develop and up to 5 to 7 days after becoming sick.

However, the single best way to prevent the flu is to get a flu shot each season. The seasonal flu vaccine protects against the three influenza viruses that research suggests will be most common that year. Yearly flu vaccination should begin in September, as soon as vaccine is available, and continue throughout the flu season - which can last as late as May. While flu season can begin as early as October, seasonal flu activity peaks in January or February.

There are two basic types of flu vaccinations: Flu shots, consisting of killed viruses, are injected either into the muscles or under the skin, depending upon the type of vaccine. The nasal–spray flu vaccine — made with live, weakened flu viruses, so-called LAIV for “Live Attenuated Influenza Vaccine,” is given as a nasal spray. The weakened viruses in the nasal spray vaccine do not cause the flu. LAIV is approved for use in healthy people 2 to 49 years of age who are not pregnant.

Everyone 6 months of age and older should get flu vaccine each year. This recommendation has been in place since February, 2010 when CDC’s Advisory Committee on Immunization Practices voted for “universal” flu vaccination in the U.S. It is especially important that those at high risk for flu-related complications get yearly vaccinations. This includes children younger than 5 and adults over age 65; pregnant women; people who suffer from asthma, emphysema, or other lung diseases; people with chronic illness such as heart disease, neurological problems, kidney failure, anemia, or diabetes; and the extremely obese. Also, people at high risk for passing on the flu to vulnerable individuals should be vaccinated, such as health care workers or family and household contacts of young children, the elderly and chronically ill. But, children less than 6 months old or people with a history of severe allergic reactions to chicken eggs shouldn’t get a flu shot. Most primary care doctors provide flu vaccinations, but if you have trouble finding a flu shot, both the Commonwealth of Massachusetts and the CDC have flu clinic finder websites.

If you are unfortunate enough to contract the flu, remember the basics: get plenty of rest and drink lots of fluids. Take non-aspirin pain relievers such as acetaminophen (e.g. Tylenol®) or ibuprofen (e.g. Advil®, Motrin®, etc.). Children and teens with the flu should never take aspirin as they may develop a rare, but serious disease called Reye syndrome. Stay home and avoid public activities until your symptoms have resolved.
Prolonged fever or fever greater 103 degrees F or higher, fast breathing or trouble breathing, bluish skin color, prolonged vomiting or inability to drink enough fluids, mental changes or seizures, prolonged or recurrent illness, or worsening of underlying chronic medical conditions care signs of serious complications and require urgent further evaluation by your doctor or in the emergency room.

For more information on the flu the CDC, Massachusetts Department of Public Health, and the Massachusetts Medical Society all have great tips on their websites.

So stay well and get your flu shot – I’ve already had mine. For To Your Health, I’m Dr. Jim Kenealy.