THE FLU UPDATE

 Hylton Lightman, MD, DCH (FAAP), DCH

Here’s a scary fact.

As we start February 2018, The Centers for Disease Control and Protection (CDC) report that 53 children have died from the flu this flu season alone.  More than half who died from the flu were otherwise healthy children.  Please G-d, there should be no more deaths.

Note the following quote from Dr. Dan Jernigan, director of the CDC’s influenza branch:  “Flu is everywhere in the US right now. This is the first year we’ve had the entire continental US at the same level (of flu activity) at the same time. It has been an early flu season that seems to be peaking now, with a 5.8% increase in laboratory-confirmed cases this week over last.”

In New York State alone, as of the week ending January 20th, hospitals admitted 1,759 patients with confirmed cases of the flu.  This was a 5% increase over the previous week.  In the same time period, 7,779 people tested positive for the flu.

Again, this is just in New York State.  This scenario is being repeated across the United States as this year’s flu strain – H3N2 – is rampant.  Newspaper headlines like hospital emergency rooms face a “war zone” (because of the flu only make us more fearful.

Flu season arrived early in 2018.  

This means the above listed numbers are a moving target and will continue to grow.

There are no surprises here.  Australia and the Southern Hemisphere are good predictors as their flu season precedes ours.  During the H1N1 pandemic in 2009, Australia had 59,022 cases in its sparsely populated country.  This last season, they had 215,280 H3N2 cases.  Australia has the same vaccine as the United States and it was only about effective against the dominant strain in about one-quarter of the population.  This is why Dr. Anthony Fauci of the National Institute of Allergy and Infectious Diseases is predicting a “relatively severe influenza season”. In Australia, the problem did not appear to be a mismatch between the flu strains that were circulating and those that the available vaccine protected against.  Instead, Dr. Fauci explains, it seemed to be the mutant proteins introduced as the vaccines were being produced in eggs.

“The very process of how we make the vaccine creates an unanticipated, almost accidental mismatch, which is what happened in Australia this year,” Dr. Fauci said in a recent interview.

I’m leaving it the scientists and epidemiologists to deal with developing the “perfect” flu vaccines. More on updates in this research at the end of this article.

Immediate Steps You Can Take in a Severe Flu Season:

1. Make sure that you and your loved ones are vaccinated.

In other words — Get the flu shot even if you haven’t already done so for you and your family and especially for “vulnerable” people, i.e., babies and children under 5 years of age, those over 65, pregnant women, people with chronic conditions like asthma and diabetes and people on immunosuppressive medications.

Yes, the shot is not perfect.  Yet don’t be discouraged by the reports of low vaccine effectiveness for the flu shot.  It has proven that, in most cases, if someone contracts the flu, its symptoms and severity are mitigated because of the shot.  Babies under six months of age can’t receive the flu shot.  But pregnant women can and should; they are at higher risk for flu complications.  Also, getting the vaccine gives them an immunity they can pass on to their newborns.  Babies age 6 months and older and all other people should get the flu shot as well.  None of the precious children who’ve died from the flu had received this season’s flu vaccine.

2. Yes, it’s possible to contract the flu even if you’ve been immunized. The good news is that the flu shot tends to mitigate the symptoms so the flu is less severe.

Let’s clear up a misconception:  The flu vaccine does NOT give you the fluYou might have been exposed to the flu before getting vaccinated or doing the period it takes the body to gain protection after getting vaccinated; it’s approximately a two week period to gain the protection.  And there are other reasons as there are viruses that can mimic the common cold.  You may read more from the CDC on effectiveness of flu vaccine for 2017-2018 flu season.

3. Good and consistent hygiene habits

Simple steps you can do daily can and do help prevent the flu.

First, keep your hands clean.  Children and adults should wash their hands before eating meals.  They should keep their hands away from their eyes, nose and mouth.  Make it a routine for each family member to wash their hands properly when they walk in the house from school, work or errands.  What’s proper hand washing?  At least 20 seconds with soap and water.

4. Cough the right way to avoid spreading germs. 

Teach your children how to cough into their sleeves and use tissues to cover the sneezes.   

What if you or your child gets sick with the flu?  

Flu symptoms include fever, cough, sore throat, runny nose, head or body aches, and fatigue.  Children are more likely than adults to experience vomiting or diarrhea with the flu.

Most children recover from the flu within a week or ten days.  It requires rest, fluids and medications to reduce fever.  Some kids, children under 5 years of age and/or those with underlying medical conditions may benefit from treatment with prescription antiviral drugs.  But these medications needs to be started within 48 hours of the start of flu symptoms for maximum effectiveness.  So if you suspect the flu, call you doctor right away.

What’s the protocol for babies under 60 days old?  Any rectal fever higher than 100.5 degrees is deemed an emergency.  You must call your pediatrician immediately who will guide you to the next steps, which include hospitalization.

When is a trip to the emergency warranted for children of any age? 

Fever with rash, difficulty breathing, dehydration, seeming unresponsive, severe vomiting, pain or pressure in the abdomen or chest, and confusion.

Also, if an illness has been subsiding and then suddenly worsens again through a newly high fever or cough, you must contact your doctor or make a trip to the ER.  These symptoms could be signs of a secondary infection such as pneumonia.

If you or your child test positive for the flu, then stay home and keep your children home, especially if they have symptoms and are coughing on and around others.  Some schools throughout the country have closed and are “de-fumigating” which will hopefully halt the spread of the flu.

How do I begin figuring out whether it’s the common cold or flu?  

There is a similarity between flu and cold symptoms.  The CDC’s chart below is an excellent starting point for monitoring and tracking symptoms.

 

As doctors struggle with the worst flu season in nearly a decade, some are racing to answer a question: Can they find a more permanent solution than variably successful annual vaccines? While this remains to be answered what we do know is active research is on the forefront for creating a flu vaccine as sighted in this recent article in the Wall Street Journal Feb 5, 2018.

In summary, practice what’s written above.  Keep in touch with your doctor.

As always, daven.

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