Experts urge prevention strategies to ward off dangerous influenza
The Rev. Gerry Juarez, chaplain at Highlands Hospital receives his annual flu shot during a health fair for staff at the hospital Wednesday.
Patty Vomish RN, coordinated the flu shots during a health and hold a syringe containing the flu vaccine Wednesday at Highlands Hospital in Connellsville.
As director of employee health and safety at Highlands Hospital, Patti Vomish leads an annual crusade to protect the hospital’s workers against the flu.
And as a registered nurse, Vomish knows the dangers of influenza. She knows that the flu kills thousands of Americans each year–as many as 49,000, by some estimates. She knows that a flu shot may prevent influenza infection or reduce its severity. She just wishes everyone else had the same respect for the flu.
Last year, she says, one employee refused to be vaccinated against influenza and then was sickened by the flu for two weeks. The employee could barely get out of bed to call off work, Vomish recalls. Just last week, that same employee got her flu shot the first day it was offered at the hospital.
“People don’t fully appreciate the flu because a lot of people don’t know the true flu. They might get a cold or a viral infection and call it the flu,” Vomish says. “People die from the flu. That’s scary. Once you know what the true flu is, you then know how dangerous it can be.”
As flu season approaches, Vomish and other medical experts encourage people to educate themselves about influenza, get the flu vaccine, and take other precautions to stop the spread of influenza and prevent its potentially deadly consequences.
Underappreciated risk
The flu is a respiratory disease caused by any number of influenza viruses that attack the lungs, throat and nose. Seasonal flu outbreaks may occur as early as October, but influenza activity usually peaks in January or February, according to the U.S. Centers for Disease Control and Prevention (CDC).
Experts can only estimate how severe a given flu season will be, primarily because the strains of influenza virus that cause flu outbreaks vary from year to year. For instance, the H3N2 virus behind last winter’s flu epidemic hadn’t been seen in high circulation since 2002-2003. As a result, many people were hit hard by the flu because their immunity to the virus had waned.
Children younger than age 5 (especially those younger than age 2), people age 65 and older and pregnant women are at high risk of developing complications from the flu, the CDC reports. Likewise the risk is elevated for people with the following medical conditions:
· Lung disease, such as asthma, chronic obstructive pulmonary disease and cystic fibrosis
· Heart disease, including heart failure, coronary artery disease, and congenital heart conditions
· Diabetes
· Kidney or liver disease
· Diseases that weaken the immune system, including HIV, AIDS and cancer
Other high-risk groups include the morbidly obese and people taking medications that suppress the immune system: cancer chemotherapy, chronic corticosteroids and immune-modifying drugs for rheumatoid arthritis, lupus and other inflammatory diseases.
Yet, many people don’t fully appreciate their risk of influenza and the dangers it poses, says Dr. John P. Martin, a family medicine physician with Southwest Regional Medical Center, in Waynesburg.
“Influenza kills thousands of Americans a year. If airplanes were dropping out of the sky at that rate, there would be a national outcry,” he says. “I repeatedly see elderly folks–and they’re at the highest risk–saying, ‘Well, I’ve never had the flu,’ and they’re not too worried about it. I try to emphasize to them that if you get this, there is a chance that you could die from it. They don’t truly understand what influenza is and how severe it can be.”
A shot of prevention
The influenza vaccine is one of the most proven ways to prevent the flu and/or reduce its severity, Martin says. The CDC recommends annual vaccination for everyone age 6 months or older, especially children six to 59 months old, anyone age 50 and older, people with chronic illnesses or immune deficiencies, pregnant women, nursing home residents, the morbidly obese, and health-care personnel or other people caring for high-risk patients. All children ages 6 months to 8 years who are receiving the vaccine for the first time (and certain others in this age range) require two doses, given at least four weeks apart, the CDC says.
Historically, the vaccine has protected against three strains of influenza, but newer, quadrivalent vaccines available this year offer protection against an additional strain. Traditional flu vaccines contain egg proteins, but a new type contains none, making it suitable for people ages 18 to 49 with egg allergies. For seniors, a stronger vaccine quadruples the standard vaccine dose to bolster older immune systems that don’t respond as well to standard flu shots.
“We pretty much have everyone covered now, so there’s really no good reason not to get the immunization,” Martin says.
The flu vaccine is administered as an injection containing an inactivated (dead) virus, or as a nasal spray containing an attenuated (weakened) live virus. The CDC does not recommend one vaccine over another; however, the nasal spray vaccine is indicated only for healthy people ages 2 to 49, and should not be given to pregnant women.
Ideally, everyone should be vaccinated against influenza by October, the CDC recommends, but people can still gain protection against the flu even if they’re vaccinated later. Those infected by the influenza virus usually develop symptoms within five to seven days, while most people need about two weeks after they’re vaccinated to build up immunity to the flu, Martin says.
“If you’ve been exposed to the virus at that point, you very well could get influenza, especially if you were exposed to it a week or a few days before you got the shot,” Martin says. The CDC is encouraging everyone to get immunized as soon as possible. People end up waiting, and then you have that two-week lag before you build up any immunity, so you’re not preventing as much as you’d want to.”
Although some people receiving report fatigue and other symptoms after they’re immunized, the flu vaccine is safe, says Dr. Amy Crawford-Faucher, an assistant clinical professor of family medicine at the University of Pittsburgh Medical Center.
“There are minimal side effects. The biggest myth is that you can actually get influenza from the flu vaccine, and there’s no way you can,” she says. “With both the flu shot and nasal vaccine, some people for a day or so do feel a little achy and a little more tired. Folks sometimes blame the shot for causing the flu when they get a little achy for a day or so. That’s probably the biggest misperception that people have.”
Vomish says that in the 20-plus years she’s been immunizing the Highlands Hospital employees against influenza, “I’ve never had an employee come back and be off duty or on workers comp because of the flu shot.”
Still, her colleague Michele Blazek, an emergency room nurse at Highlands, says fear about the flu vaccine–and vaccines in general–has prevented some people from getting the flu protection they need. “People are afraid to get the vaccine because they don’t want something put into their body,” she says. “But then they get the flu and end up in the ER asking for everything to be put into their body so they don’t feel so bad. I don’t understand it.”
Fight the flu
Vaccines can bolster the body’s immunity against influenza and other viruses, but flu prevention starts with the individual, Martin says. Eating a well balanced diet and getting ample exercise and sleep (about seven to eight hours a night for most people) can strengthen the immune system in its fight against infection.
“Exercising and staying healthy, not smoking, and maintaining an appropriate weight are all things that can help boost immunity,” he says. “They won’t necessarily keep you from getting sick, but they should decrease the severity.”
Fruits are generally rich in vitamin C, an important nutrient for immune function, but Martin and other experts say that high-dose vitamin C supplements typically offer little protection against the flu.
What can slow the spread of influenza, Crawford-Faucher says, is good hygiene. The hands are the instruments of infection, she explains, but keeping them clean with soap and warm water may help prevent them from delivering influenza to the mucus membranes in the eyes, nose and mouth, the virus’s gateways to the body.
“Unless you’re sneezed on directly, the way you tend to pick up these viruses is by touching something or someone who has the virus and then rubbing your eyes, nose or mouth,” she explains. “That’s how it gets into your body quite handily.”
Most people who do get the flu need only to rest, stay hydrated, manage their symptoms (see sidebar article for flu and cold remedies) and allow the infection to run its course, a process that can take a week or two.
However, Crawford-Faucher says people with chronic medical conditions and others at high risk of flu complications should call their doctor within 24 hours after developing symptoms, to allow for early treatment with anti-viral medications such as Tamiflu. “The vast majority of people who get the flu don’t need Tamiflu,” she says. “Still, you need to start treatment with those medicines ideally within 24 to 48 hours to have the most effect.”
Additionally, she says, flu sufferers should call their physician if they start to feel better (usually by the fourth or fifth day) and then take a turn for the worse, or if at any point they have difficulty breathing–a potential sign of flu complications such as pneumonia or bronchitis.