October 27, 2006

Doctor’s Corner:

What You Should Know About the Flu

By Eduardo Grunvald, M.D.

The nipping wind and diving temperatures remind people that summer has been pushed aside by autumn. The change of season welcomes warmer clothing, a metamorphosis of nature’s colors, and anticipation of the holidays. Sadly, ‘tis also the season of the flu.

The flu —or influenza in technical terms— is a respiratory infection, commonly spread by coughing, sneezing, and close contact. It is difficult to predict when exactly the flu will hit.

The feared germ can strike anytime between the months of October and March. For most people unlucky enough to fall victim to the virus, this means misery – fevers, chills, headaches, sweats, and muscle aches.

What about people whose immune systems have been weakened by age (at both ends of the life span spectrum), chronic illness, medications, or cancer, or age (at both ends of the life span spectrum)? Infection with the influenza virus can be deadly. In fact, every year over 35,000 people die in the United States from complications related to the flu.

Each year scientists develop vaccines against different strains of virus. However, this endeavor is a game of trying to predict which is the most likely strain to attack in the upcoming season and mimicking its “molecular fingerprint”.

So who should get the flu vaccine?

Really, almost anyone who wants it, provided there is an adequate supply. But, who is more likely to develop complications and benefit more from vaccination? According to guidelines by the Centers for Disease Control (CDC), the following persons are at increased risk and should be vaccinated:

• Children between the ages of 6 months and 5 years.

• Adults older than 50 years.

• Women who are planning to become pregnant during the flu season.

• Persons who have mental or neurological conditions that impair their ability to swallow or use their muscles that control breathing.

• Persons with chronic diseases that require regular medical visits or hospitalizations, such as diabetes, chronic liver disease, kidney disease, or blood diseases.

• Persons with immune systems weakened by disease (leukemia, HIV/AIDS), medications (corticosteroids, medications for autoimmune diseases or transplant recipients), or treatment for cancer.

• Persons with respiratory diseases such as asthma or emphysema.

• Children between the ages of 6 months and 18 years who need to take aspirin for certain medical conditions (the combination of aspirin and the flu can lead to a serious complication called Reye Syndrome).

• Persons who live in nursing homes or other chronic care facilities.

• Students who live in dormitories should also consider vaccination.

The flu is highly infectious, so those in contact with people in any of the above categories should be vaccinated. These include:

• Health care workers.

• Employees of health care facilities, including hospitals, nursing homes, and other chronic care institutions.

• Persons caring for or living with children younger than 5 years.

• Persons caring for or living with elderly, frail, or ill patients.

One obstacle to vaccination is the myth that getting the shot can cause the flu. This is false. Immunizations work by revving up the immune system, which can cause mild fevers, chills, and related symptoms, but it is not the Flu. On a similar note, the flu vaccine does not protect against other viruses that cause colds and respiratory infections.

If you are absolutely fearful of shots, there is a vaccine that can be inhaled through the nose, called Flumist. It can only be given to people between the ages of 5 and 49 years, but cannot be given if you or a close contact has a weakened immune system.

There are many opportunities in the community to get the flu shot. If you have any concerns about getting the vaccine, consult your doctor or a healthcare provider. As they say, an ounce of prevention is worth a pound of cure.

For more patient information about the flu, prevention, and treatment, go to www.cdc.gov/flu. For information, available in English and Spanish, about getting the flu shot in San Diego, go to www.sdchip.org, or call 1-877-358-0202.

Dr. Grunvald is Assistant Clinical Professor, Department of Medicine at the Perlman Internal Medicine Group, UCSD Medical Center.

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