Cleaveland: Make your flu shot an annual habit

photo Dr. Clif Cleaveland

While Ebola viral disease dominates our headlines, prevention of seasonal influenza merits close, personal attention. Flu season typically runs from October to May with peak activity from December to February. We use the term "flu" lightly, but the disease can be severe or even fatal.

Influenza is transmitted by nasal secretions and droplets of mucus from the lungs. An infected person may cough into his hand, then pass the virus to the hand of another person, who then infects himself as he brings his hand to his own nose or mouth. For this reason, frequent hand washing or use of sanitizers reduces the spread of the virus.

Symptoms of influenza usually last several days and are characterized by fever, chills, muscular aches, cough and chest congestion. Days to weeks may be required to return to customary health. The illness may progress to pneumonia or set the stage for bacterial invasion of the lungs. Influenza also may lead to death from a pre-existing, chronic illness.

Calculating deaths due to influenza is complicated because states are not required to report such deaths among adults. But the U.S. Centers of Disease Control and Prevention say that, between 1976 and 2006, estimates of flu-associated deaths annually in the United States range from a low of about 3,000 to a high of about 49,000.

Certain people are at higher risks of serious complications of influenza. These include young children, especially those under 2 years of age, elderly persons, pregnant women, persons with asthma, emphysema and chronic heart disease and those with a compromised immune system. This group would include people with HIV/AIDS, recipients of certain chemotherapeutic drugs, as well as people on long-term steroid therapy.

The CDC recommends yearly flu vaccinations for everyone age 6 months and older, including pregnant women. The injectable vaccine contains inactivated virus or genetically engineered particles that protect against two strains of Influenza A and one of influenza B. These viruses are predicted to be the cause of most influenza attacks during the current season.

A more potent vaccine is recommended for people 65 and older. Because slight changes occur in the chemical makeup of influenza viruses from year to year, annual injections with an updated vaccine are essential.

A nasal spray with similar protection contains weakened or thinned virus and may be offered to children age 2 to 8 years. Either form of the vaccine is highly effective in preventing influenza.

Vaccination is deferred if a person is ill with or without fever or if she is allergic to certain components of the vaccine.

If major changes occur in the influenza virus, the result can be a pandemic - a rapid, worldwide spread of a potent virus. Since 1900, four flu pandemics have caused high death rates. The so-called Spanish influenza in 1918-1919 killed an estimated 50 million people worldwide. The Far East pandemic of 1957-1958 killed an estimated 69,000 Americans. In 1968-1969, the Hong Kong influenza outbreak killed 39,000 Americans. In 2009, a pandemic of H1N1 influenza may have killed up to 18,000 Americans.

A virus that causes a pandemic may continue to circulate alongside seasonal influenza viruses for several years after its initial onslaught. When a pandemic begins, scientists scramble to produce an effective vaccine for the new viral strain. A goal of researchers is to determine an unchanging chemical structure that is common to all influenza viruses so a vaccine might be developed that would protect against all variants of the disease.

Medicare and most health insurance plans offer flu vaccinations with no copayment. Vaccinations are often free at public health clinics and work sites. The vaccination itself is almost painless. The most common side-effect is slight soreness at the injection site and possibly a day or two of achiness.

Less than half our population bothers to be vaccinated against influenza. An unvaccinated person jeopardizes his own health as well as the health of infants, frail or elderly people that he might encounter, as well as co-workers, customers or fellow students. Include in the responsibilities of citizenship a yearly flu vaccination.

Contact Clif Cleaveland at cleaveland1000@comcast.net.

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