Flu and Flu Shot Advice
December 4, 2003

Dear HouseCall Docs: I have been hearing that this flu season may be a really bad one and that there have already been people dying from it. Is that true? Also, I haven’t gotten a flu shot yet. Is it too late?
Thanks, Stanley H. Cold Springs, Ca.

Dear Stanley,
Thank you for bringing up an issue that many of our readers most likely have questions or concerns about. Influenza, or “The Flu”, in most cases is nothing more than a minor nuisance that causes a few days of discomfort and makes children and grown men whine. A couple of days of rest, fluids, and anti-inflammatory medication will typically take care of it and you can get back on your feet.

But the same virus, under different circumstances, can be one of the most dangerous and deadliest infections known to mankind. Most of us have heard about the “Flu Epidemic of 1918” that killed more than 20 million people around the world and 675,000 Americans. In the last 100 years there have been other flu pandemics, though none that even remotely compared with this “Spanish Flu” of 1918-19. The development of vaccines to prevent influenza and medicines to treat it have gone a long way to reducing the likelihood of a pandemic of that magnitude, however, there is still a significant risk associated with the infection, especially if strict measures are not taken to prevent and contain the illness. This is why the Centers for Disease Control and local health departments work hard every winter to get as many people immunized as possible, and why physicians and other health care workers are encouraging immunization so strongly.

So, is “the flu” that we are seeing in this country more dangerous than previous years? There is a fairly aggressive strain of influenza spreading across Canada and the US, with a number of deaths associated with it, but not significantly more deaths than in recent flu seasons. The vast majority of people who get “the flu” will recover fully with no complications. However, a sense of heightened awareness may be needed to keep this strain of influenza from developing into a serious outbreak.
How do you catch influenza? Through exposure to someone else who has it and coughed or sneezed directly on you or onto an object that you then come into direct contact with. The symptoms typically develop within 1-4 days (average of 2 days) after contracting the infection. Good hand washing and attention to controlling secretions is very important in keeping the disease from spreading.

What are the symptoms of influenza? They may be a little different for everyone depending on underlying health factors, but there is typically the sudden onset of fever, chills, body aches, headache, sore throat, dry cough and extreme tiredness. Any or all of these symptoms may be present. These symptoms may not be significantly different from other types of viral infections, though if they come on very suddenly it may be worth contacting your doctor to see about getting on anti-influenza medication. The development of significant shortness of breath, chest pain, uncontrollable vomiting or changes in mental status should prompt an immediate call to your doctor or trip to the emergency department.

Is there any treatment for Influenza? There are no medications known that will actually kill the virus and cure the disease, though there are several medications that may shorten the time of the illness and allow you to get better and back to work, school or play faster. You should contact your doctor as early as possible as these medications must be started within 2 days of the first symptoms for them to be effective.

Is there any way to prevent Influenza? Yes there is, and this may be the most important part of this whole discussion. A widespread immunization policy is the only real way to effectively control the spread of this virus. The recommendations of who should be vaccinated against influenza are becoming broader all the time. Currently, the recommendation is that anyone over the age of 6 months who desires to be vaccinated against influenza should be, with the exception of those individuals with a history of severe allergic reactions to any of the components of the vaccine (Namely egg protein and the preservative thimerosol, though there are alternatives that can be used even in these cases.)

Following is the CDC recommendations of who should be vaccinated:
People 50 and older.
Residents of nursing homes and other long-term care facilities.
Anyone 6 months or older who has chronic heart or lung conditions, including asthma.
Anyone 6 months or older who needs regular medical care or had to be in a hospital because of metabolic diseases like diabetes, chronic kidney disease or a weakened immune system.
Children and teenagers who are on long-term aspirin therapy and could develop Reye's syndrome after the flu.
Women who will be more than 3 months pregnant during flu season.
Health care workers and those with regular exposure to any of the above groups.

Is it too late to get vaccinated and if not, where can I go? It is definitely not too late, and there is plenty of vaccine still available across the country. You may contact your own physician to schedule an appointment for a vaccination. You may also contact Tuolumne County Public Health at 209-533-7400. Visiting Nurses Association will be holding at least one more vaccination clinic and you can contact them at 209-533-6800. You can also contact Sierra Housecalls Medical Group at 209-532-4287 to arrange for your vaccine either at your home or their office in east Sonora.

Stay healthy and happy,
Dr. Matt and Dr. Bob

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