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What You Should Know About the Flu and Flu Shots The arrival of fall in southeastern Indiana reminds us all that the winter flu season is just around the corner. Using information from the US Centers for Disease Control and Prevention (CDC), the physicians of Partners in Health want you to be informed about the signs, symptoms and dangers of influenza and how you can prevent the flu by getting a flu shot. What is Seasonal Influenza? “Seasonal” Influenza is a potentially serious disease caused by an airborne virus that rapidly spreads from infected persons to others. The influenza season in the U.S. is from November through April each year. The peak of reported cases usually occurs in February (12 seasons of the last 26) or January (5 seasons of the last 26). The illness is more active in colder months: as outside temperatures drop, people tend to spend more “group time” indoors in confined spaces, facilitating the spread of the virus from person to person via coughing, sneezing, and touching of contaminated environmental surfaces. People of any age can get influenza. Influenza — commonly called “the flu”— is characterized by acute onset of fever (although it is important to note that not everyone with the flu will have a fever), headache, extreme fatigue, sore throat, dry cough, runny or stuffy nose, chills and/or muscle aches. Children can have additional gastrointestinal symptoms, such as nausea, vomiting and diarrhea, but these symptoms are uncommon in adults. Although the term “stomach flu” is sometimes used to described vomiting, nausea, or diarrhea, these symptoms are usually caused by other viruses, bacteria, or parasites, and are rarely related to influenza in adults. Influenza is transmitted when the virus is expelled from the body of an infected person who coughs or sneezes. Droplet particles containing the virus can remain in the air and be inhaled by others through the nose or mouth. Droplet particles can also fall and contaminate surfaces such as counters, desk or table tops, doorknobs or telephone handsets; the virus can live 2-8 hours on these surfaces. An uninfected person can contract the flu by touching these contaminated surfaces and then touching the eyes, nose, or mouth. Those infected with flu virus are able to infect others with it beginning one day before symptoms develop and up to 5-7 days after becoming ill. Children, especially younger children, and people with weakened immune systems might potentially be contagious for longer periods. Every year in the United States, outbreaks (higher than usual number of cases of an illness) of influenza typically lead to epidemics (when disease spreads rapidly and widely in a localized region or country). On average, 5-20% of the population gets the flu. Most people are ill for only a few days, but some become sicker and about 226,000 require hospitalization each year. Influenza causes an average of 34,000 deaths each year, mostly among the elderly. Influenza can, in some instances, make elderly and debilitated patients more susceptible to serious bacterial pneumonias, dehydration, and worsening of chronic conditions such as CHF, asthma, or diabetes. Children may get sinus problems and ear infections as complications of the flu. What is 2009 H1N1 Influenza (formerly called Novel H1N1 or Swine Flu)? A “novel H1N1 infection” was first identified in the U.S. in the spring of 2009. This new version of the H1N1 virus was found to be readily spread from person to person, and to have symptoms like those of seasonal flu, including fever, cough, sore throat, body aches, headache, chills and fatigue. The 2009 H1N1 influenza virus caused the first influenza pandemic (global outbreak of disease caused by a new flu virus) in more than 40 years. More than 70 countries had reported cases of the 2009 H1N1 influenza by June, 2009, when the World Health Organization (WHO) declared a global pandemic. By the time the pandemic was declared ended in Summer, 2010, it was estimated that more than 60 million people in the U.S. had contracted influenza due to the H1N1 virus, with more than 270,000 hospitalizations and over 12,000 deaths. While not certain, it is felt likely that the 2009 H1N1 influenza virus will continue to circulate and cause illness in the U.S. during the 2010-11 flu season. Why Get the Vaccine? The yearly flu vaccine is the first and most important step to take to protect against influenza. For one thing, it is highly effective in preventing you from getting the flu from the influenza viruses in circulation. In addition, it can give you limited protection against different, related viral strains that may appear during the season. Getting the flu vaccine for yourself also gives important benefits to your community. By reducing your own chances of getting the flu, you also reduce your chances of spreading the flu to others. Remember, some people cannot take the flu vaccine because of age or medical contra-indications. If you can take the flu vaccine, you should take it to protect loved ones and strangers who are unable to get this protection for themselves. For 2010-11, the seasonal influenza vaccine formulation contains the 2009 H1N1 virus strain. Because of the timing of its appearance, the 2009 H1N1 strain was not considered for inclusion in the 2009-10 seasonal vaccine. Health officials quickly recognized its potential to cause serious and widespread illness, and steps were immediately taken to manufacture a special monovalent (single component) H1N1 vaccine, which became available in December 2009. Persons wishing to get maximum vaccine protection against the flu in the 2009-10 season had to receive two injections—the regular seasonal flu shot and the H1N1 flu shot. Because of the inclusion of the H1N1 antigens in the 2010-11 seasonal flu vaccine formulation, only one shot will be necessary for adults this year. Infants and children, depending on their age and individual vaccine history, may require two doses of the seasonal influenza vaccine. Timing Protection from the flu vaccine develops about 2 weeks after the vaccine is administered and lasts about a year. In the past, patients were advised to received the vaccine starting October 1. However, in 2009, the peak of H1N1 activity occurred in late September-October. Therefore, for 2010, the CDC is recommending that the vaccine be administered as soon as it is available from the manufacturers. PIH plans to begin administering the vaccine soon after Labor Day in early September, 2010. Children nine years of age and older and adults need one shot. Infants age 6 months-35 months need two half-dose shots , one month apart, the first time they receive the vaccine. Children less than 9 years old need two shots, given one month apart, the first time they are vaccinated against influenza. Children who received only 1 dose of a seasonal influenza vaccine in the first influenza season that they received vaccine should receive 2 doses, rather than 1, in the following influenza season. In addition, for the 2010-11 influenza season, children aged 6 months--8 years who did not receive at least 1 dose of an influenza A (H1N1) 2009 monovalent vaccine should receive 2 doses of a 2010-11 seasonal influenza vaccine, regardless of previous influenza vaccination history. Children aged 6 months--8 years for whom the previous 2009-10 seasonal or influenza A (H1N1) 2009 monovalent vaccine history cannot be determined should receive 2 doses of a 2010-11 seasonal influenza vaccine. Target Groups for 2010-11 Seasonal Flu Vaccine The CDC recommends a yearly flu vaccine for all persons age 6 months and up. The flu vaccine is especially important for certain high-risk groups, including: o Adults age 65 and older o Pregnant Women o People who have medical conditions including ... o Residents of long term care facilities (such as nursing homes or assisted living centers that house and care for persons with chronic medical conditions) o People who live with or care for those at high risk for complications from the flu, including ... Contra-Indications for the Flu Vaccine The flu vaccine should not be given under the following conditions: o To persons with allergy/hypersensitivity to eggs, egg products, or chicken products. Getting the Flu after the Vaccine Many patients refuse the flu vaccine because they are convinced that it will give them the flu. The viruses in the vaccine are killed, so you cannot get influenza from the vaccine. It is possible to experience a mild reaction to the vaccine, including soreness, redness, or swelling at the site where the shot was administered, fever, and aches, beginning soon after the shot and lasting 1-2 days. It is also possible to get influenza even if you are vaccinated. Influenza viruses mutate (change) often. The influenza virus is updated each year to include the three viruses expected to be the most prevalent that year. It is possible to contract influenza from a virus not covered in this year’s shot; however, studies have shown that vaccinated people who do get a related but different strain of influenza often have a milder case than those who did not get the shot. Also, many people call any illness with fever and cold symptoms “the flu,” and they may expect the influenza vaccine to prevent all such illnesses. But influenza vaccine is effective only against illnesses caused by the influenza virus, and not against other illnesses. Reactions to the Vaccine As noted above, many people receiving the flu vaccine experience mild problems, including soreness, redness, or swelling at the site of vaccine administration, fever, and aches, usually occurring soon after the shot and lasting 1-2 days. Life-threatening allergic reactions are very rare. If they do occur, they usually appear within a few minutes to a few hours after the shot. Patients who experience high fever or behavior changes, difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, rapid heartbeat, or dizziness following the shot should contact their physician immediately. In 1976, swine flu vaccine was associated with a severe paralytic illness called Guillain-Barre Syndrome (GBS). In GBS, the body damages its own nerve cells (outside of the brain and spinal cord) resulting in muscle weakness and sometimes paralysis. GBS can last for weeks to months. Most people eventually recover completely, but some people have permanent nerve damage and 5-6% of people with GBS die. GBS is not completely understood, but it is though it might be triggered by a virus, often preceded by an episode of respiratory or intestinal illness. In 1976, vaccination with the swine flu vaccine was associated with getting GBS. Influenza vaccines since then have not clearly been linked to GBS; however, if there is a risk of GBS from current influenza vaccines, it is estimated at 1-2 cases per million persons vaccinated, much less than the risk of severe influenza. It is recommended that persons who have already had GBS not take the flu vaccine. Influenza Prevention Take action to protect yourself and those you love from contracting the flu: 1) Receive the flu vaccine, your best protection against influenza. 2) Get plenty of rest and exercise, and eat a healthy diet 3) Take everyday precautions to prevent the spread of influenza germs
What To Do To Treat the Flu If you develop influenza-like illness (ILI), including fever, headaches, extreme fatigue, dry cough, sore throat, runny/stuffy nose, muscle aches), you should 1) Stay away from other people as much as you can to prevent spread of the disease to them. Stay home from work or school, and do not make trips to the store, pharmacy, mall, movies, sporting events, church, etc. You can spread the virus to others one day before symptoms appear, and up to 5-7 days after symptoms appear. If you have ILI with a fever, you should stay away from others until your fever has been gone for at least 24 hours without fever-reducing medications. 2) If you have an infant under 6 months of age, or share a household with persons who have not yet had the flu vaccine or who are unable to take the flu vaccine due to medical contra-indications, limit your contact with them as much as possible. If you must be in contact with them, consider wearing a face mask. 3) Rest 4) Take plenty of fluids to avoid dehydration. Stay away from alcohol and caffeine-containing liquids such as tea, coffee, or colas. Water, clear broths, or sports drinks are good choices to prevent dehydration. If you are too weak to drink from a cup, use a squeeze bottle or straw, or suck on ice chips or frozen popsicles. 5) Eat a light healthy diet 6) Cover your nose and mouth with a tissue when you cough or sneeze, and throw the tissue away after you use it. Tissues on the bed, nightstand, table or countertops can spread the virus to these surfaces, where they can live for 2-8 hours. Wash your hands after handling used tissues. 7) If you do not have a tissue handy, cough or sneeze into the “crook” of your arm or your upper sleeve, rather than into your hand. 8) To relieve a dry cough, try using a humidifier or cough drops/hard candy to soothe the throat. Your physician or pharmacist may also recommend an over the counter cough medication that is good for dry cough. 9) For sore throat pain, try gargling with warm saline solution (1 tsp salt in 1 cup of warm water). 11) Take antiviral drugs (such as Tamiflu or Relenza) if your doctor says you need them ...
In children, additional dangerous warning signs include ... For more information, go to www.cdc.gov/flu/ Flu shot information for Partners in Health patients. Click here. Payment and insurance information about your Flu Shot. Click here. |