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        Coping with Influenza

 

 Adeze Ojukwu

New Brunswick, NJ

 

adezeo@yahoo.com

 

Friday, December 12, 2003

 

Influenza, a viral. infection has continued to spread like wild-fire  in the United States of America (USA) despite government’s efforts to contain the disease. In a briefing last Tuesday, Dr  Julie Louise Gerberding  of the Center for Disease Control (CDC), said ‘ some areas of the country are particularly hard-hit with influenza and it's been a very difficult and frightening thing for many people, particularly in the context of reports of vaccine shortages. We also know that many children have been affected. Some children and adults have already died this year, and that is of course something that we are very sad.’

 

She said the ‘influenza typically kills more than 36,000 Americans each year, and some of those are children, some of those are seniors. It can affect people of all ages. And it's also important to recognize that, although there are people who suffer the severe consequences from influenza, most people who get influenza will have that typical mild illness. It will be annoying; they might miss a day of school or a day at work, but they will recover without incident. And so we're hoping that most of the people affected this year will fall into that category. ‘

 

‘We also recognize that the heaviest-hit states were mostly in the west, and that we are waiting to see whether or not some of the eastern states with large populations will see more widespread infection. So the bottom line is that we have not peaked the flu season this year. We will expect more cases of flu. And we are watching very carefully to see where it's progressing and where the most cases are evolving so that steps can be taken to assure access to care, hospitalization, and so on and so forth,’ noted Dr Gerberding.

 

The main concern that we're facing at CDC right now is, of course, the gap between the demand for flu vaccine in the context of the outbreak and the supply of the influenza vaccine. I'm going to say more about supply and demand and how those pan out in flu season, but I also wanted to address where we are right now with what's happened this year.

 

This year, manufacturers created about 83 million doses of influenza vaccine. About 4 to 5 million doses were in the formulation of FluMist, which is for healthy people between the ages of 5 and 49. Another 4 or 5 million doses was a pediatric formulation for children between the ages of 6 months and 23 months. Seventy-three million doses were the inactivated trivalent vaccine for adult immunization. That vaccine is something that has largely been distributed at this point in time. The manufacturers have very few doses of the killed virus.

 

In addition, state and local health agencies are working on assessing the availability of vaccine in their jurisdictions and developing plan for redistribution, which we, of course, are helping to assist with. We have a number of data inputs and will be updating you with this information as we go forward, about the localized availability of vaccine.

 

Meanwhile the agency is  working with the state health association,  local and county health departments,  the American Medical Association and the American College of Physicians, American Association of Health Plans, managed care organizations, and several other groups who are serving practitioners, serving hospitals, serving member facilities trying to ascertain where there is vaccine for those who need it.  Death toll from the influenza which hit the country with the onset of winter, has continued to increase with the death of an 18 year old college student. And there are fears that there may be more casualties with reported shortages of the vaccine.

 

 Lisa a middle-aged  mother of three has spent close to $500 on drugs for her children down with fever and severe coughing. ‘ I have been in and out of hospital while the entire family has suffered   sleepless nights since last Friday when the  first snow storm hit New Jersey and other Northern states. The traumatized computer analyst   blamed it on winter which comes with extreme cold thus leading to diverse respiratory infections especially influenza otherwise called flu.

    

The CDC described  influenza,  as a contagious disease that is caused by the influenza virus which  attacks the respiratory tract in humans nose, throat, and lungs. The flu is different from a cold because it is not treatable by antibiotics. Influenza usually comes on suddenly and may include these symptoms:

  • Fever

  • Headache

  • Tiredness (can be extreme)

  • Dry cough

  • Sore throat

  • Nasal congestion

  • Body aches.

 

The apex health agency noted that most people who get influenza will recover in one to two weeks, but  warned that some people will develop life-threatening complications such as pneumonia as a result of the flu.’ Millions of people in the US — about 10% to 20% of U.S. residents — will get influenza each year. An average of about 36,000 people per year in the United States die from influenza, and 114,000 per year have to be admitted to the hospital as a result of influenza. Anyone can get the flu even healthy people, and serious problems from influenza can happen at any age. People age 65 years and older, people of any age with chronic medical conditions, and very young children are more likely to get complications from influenza. Pneumonia, bronchitis, and sinus and ear infections are three examples of complications from flu.

 

 The flu can make chronic health problems worse. For example, people with asthma may experience asthma attacks while they have the flu, and people with chronic congestive heart failure may have worsening of this condition that is triggered by the flu.’ Flu shots are often available in hospitals and clinics but certain categories of individuals are advised not take the vaccine and they include these:

 

•  People who are have a severe allergy to hens' eggs

•  People who have had a severe reaction to a flu vaccine in the past

•  People who previously developed Guillain-Barré Syndrome (GBS) in the 6 weeks after getting a flu shot

 

The CDC release stressed that ‘ pregnancy can increase the risk for complications from the flu, and pregnant women are more likely to be hospitalized from complications of the flu than non-pregnant women of the same age.  In previous worldwide outbreaks of the flu (pandemics of 1918-19 and 1957-58), deaths among pregnant women were associated with the flu.  Pregnancy can change the immune system in the mother, as well as affect her cardiovascular system (heart and lung function).   These changes may place pregnant women at increased risk for complications from the flu’

 

‘Because the flu shot is made from inactivated viruses the viruses are killed, many experts consider flu shots safe during any stage of pregnancy.  However, since miscarriages (spontaneous abortion) most often occur in the first trimester of pregnancy, experts have traditionally not given a flu shot during the first trimester to avoid a coincidental association with miscarriage.’

 

‘Women who will be beyond the first 3 months of pregnancy during the flu season should get a flu shot.  Pregnant women who have medical problems that increase their risk for complications from the flu should get a flu shot before the flu season, no matter their stage of pregnancy. Same for lactating mothers. The nasal flu mist vaccine (LAIV) is not approved for use in pregnant women and children under 5 years. Because children aged 6-23 months are at substantially increased risk for influenza-related hospitalizations, vaccination of all children in this age group is encouraged when feasible. The flu shot is approved for use in children 6 months of age and older.’

 

The risk of getting the flu during travel depends on the time of year and where you are going. In the tropics, the flu can occur any time of year. In the Southern Hemisphere, most flu activity is from April through September, which is the winter period in the Southern Hemisphere. In the Northern and Southern hemispheres, travelers also can get the flu during the summer, especially when traveling as part of large tourist groups that include persons from areas of the world where the flu is active. 

 

In the Northern hemisphere, winter is the time for flu. In the US, the flu season can range from November through March, and even past March in some years. During the past 21 flu seasons, months with the heaviest flu activity peak months occurred in December in 4 years, January in 5 years, February in 9 years, and March in 3 years.

 

The flu is spread, or transmitted, when a person who has the flu coughs, sneezes, or speaks and sends flu virus into the air, and other people inhale the virus. The virus enters the nose, throat, or lungs of a person and begins to multiply, causing symptoms of influenza. Influenza may, less often, be spread when a person touches a surface that has flu viruses on it – a door handle, for instance – and then touches his or her nose or mouth.

 

A person can spread the flu starting one day before he or she feels sick. Adults can continue to pass the flu virus to others for another three to seven days after symptoms start. Children can pass the virus for longer than seven days. Symptoms start one to four days after the virus enters the body. Some persons can be infected with the flu virus but have no symptoms. During this time, those persons can still spread the virus to others.

 

  • Rest

  • Drink plenty of liquids

  • Avoid using alcohol and tobacco

  • Take medication to relieve the symptoms of flu

‘Never give aspirin to children or teenagers who have flu-like symptoms – and particularly fever – without first speaking to a physician. Giving aspirin to children and teenagers who have influenza can cause a rare but serious illness called Reye syndrome. Children or teenagers with the flu should get plenty of rest, drink lots of liquids, and take medicines that contain no aspirin to relieve symptoms.’

 

Many people use the term "stomach flu" to describe illnesses with nausea, vomiting, or diarrhoea. These symptoms can be caused by many different viruses, bacteria, or even parasites. While vomiting, diarrhoea, and being nauseous or "sick to your stomach" can sometimes be related to the flu – particularly in children – these problems are rarely the main symptoms of influenza. The flu is a respiratory disease and not a stomach or intestinal disease.

 

 

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