Tuxford Health Matters – September 2010 – Influenza – Seasonal & Pandemic
This month we re-visit flu (influenza), both seasonal and pandemic (swine flu), as a further wave of swine flu is expected this year (much like the two years – 1968-1969 affected by Hong Kong flu). Seasonal flu currently seems to remain a more severe viral infection, with swine flu being a much milder illness, and fortunately the media seems to have come to its senses, and not scaring people unnecessarily. Pandemic in simple terms means that the virus is causing illness in a number of countries at the same time – it does not mean that it is causing more deaths than seasonal flu. It is called swine (H1N1) flu as it is a type of flu that usually affects pigs, but can be transmitted to humans, and from human-to-human. Seasonal flu causes a number of deaths each year despite an active vaccination program, but these never seem to hit the headlines. Indeed it is believed that up to 36,000 people die annually in the United States from seasonal flu (of a population of 250 million = 1 death in 7,000). Last year pandemic flu caused 138 deaths in 540,000 cases out of a population of 61,792,000 (1 death in 448,000), so significantly lower than seasonal flu. It has just been announced that swine flu has currently been downgraded globally from a pandemic by the World Health Organisation (WHO) as the reported cases and number of countries affected has reduced considerably.
Flu is of course an unpleasant experience for anybody, but to those who are ‘at risk’, flu can be a major health concern. ‘At risk’ means anyone over 65 (yes you might still feel 25 inside, but unfortunately your immune system is 65 years old), or anyone with asthma, diabetes, a serious heart, chest or kidney condition, or lowered immunity due to disease or treatment such as steroid medication or cancer treatment. Anyone in this group is more susceptible to flu, and the virus is more likely to lead on to an even more serious illness such as bronchitis or pneumonia, and can lead to hospitalisation or in some cases, death. With pandemic flu, the majority of those that died had a significant underlying illness. Both vaccines are safe in pregnancy and breast-feeding, but should not be given to anyone with a severe allergy to eggs or a documented allergic reaction to the flu vaccine.
Flu is an illness caused by the influenza virus, and there are many different strains of the virus. Symptoms include a high temperature (fever), muscle aches, cough, headache and extreme tiredness – very much like a simple cold, but more severe, often incapacitating a normally healthy individual to bed for a few days. Swine flu causes much the same symptoms but is more likely to causes nausea and diarrhoea as well. Most people fully recover, but the viral infection makes the sufferer more prone to secondary bacterial infections, such as pneumonia. Antibiotics do not kill viruses so are useless against flu itself, but if you develop a secondary bacterial chest infection, then they may be used. Green sputum does not necessarily mean you have developed a secondary bacterial infection – symptoms to look out for include a recurrence of the high temperature, worsening of the cough (which in flu can persist for a couple of weeks of so), shortness of breath, and increase in your rate of breathing, or chest pain. If you are in an at risk group and develop symptoms of flu, then anti-viral medications such as Tamiflu, may be advised, but these need to be taken as soon as possible (within 48 hours of onset of symptoms) to have any beneficial effect. Tamiflu can cause nausea, vomiting, diarrhoea, abdominal pain and headache, but these side effects are usually temporary.
Flu reappears every winter, usually over a short period of a few weeks, so a lot of people get ill around the same time. Flu epidemics result in widespread illness and disruption to health and other services. The flu virus moves quickly, spreading from person to person in no time at all. The average sneeze travels at around 80 miles per hour, and can cover distances of up to 30 feet. Last year, the Government issued a widely distributed pamphlet on how to minimise your chances of passing on the flu virus to others – this is the same whether it is seasonal or pandemic. The advice slogan – Catch It, Bin It, Kill It – is worth remembering. Covering your nose and mouth when coughing or sneezing, preferably with a disposable tissue, will contain the virus. Tissues should be disposed of promptly and carefully, and hands should be washed frequently to avoid spread of the virus from hands to face and then on to other people. Hard surfaces such as door handles should be cleaned frequently using normal cleaning products.
The flu jab is currently the only way to protect yourself from seasonal flu. If you are ‘at risk’ you are entitled to a flu vaccination free of charge. You can also claim your free flu jab if you are a carer for elderly people or anyone deemed to be ‘at risk’. The viruses that cause flu change every year so a different vaccine is produced every year based on the strains of virus expected to be circulating, before the flu season starts. To stay covered you need to have an up-to-date flu vaccine every year. Getting the jab is safe, quick and effective, and available from the Surgery. It takes about a week to ten days for your body to start making antibodies to the flu virus after the injection – these only protect against flu and won’t stop you catching the many other viruses that appear every winter. But because flu is generally more serious, it makes sense to have a flu jab. The flu jab does not contain any live virus, so it CANNOT cause flu – the mild symptoms that may occur are a sign that your body is priming itself ready to fight the flu virus!
We are expecting delivery of this year’s seasonal flu vaccine at the beginning of October. Those in the at risk group under 5 years of age (very few, if any, fall into this category in Tuxford) will require an alternative flu vaccine. As soon as we have had confirmation of the delivery dates we will allocate some of the nurses sessions exclusively for flu jabs and will keep you posted with prominent notices in the surgery. If you are housebound please ensure that you call us, so we can record your need with the District Nurses who will be able to give your flu jab to you at home. We are going to be especially busy this year so please be patient and do not panic - we do expect high demand, but should have ample vaccines for all those who need it!