Saturday, October 18, 2008

Influenza, a.k.a. "The Flu"

In general the biggest misconception about "the flu" seems to be that it is a gastrointestinal (stomach) illness, when actually influenza is a serious respiratory (lung) virus. Where I grew up if you were suffering from a bout of vomiting and diarrhea--that was "the flu." I know that the distinction between (what I now call "stomach flu") acute gastroenteritis and influenza has not often been explained by public health professionals.

Basically, it's important to know that the real "flu" or influenza is the manifestation of a viral illness that we've all suffered from at some point in our lives. I'll bet you can remember suffering from a high fever (102 or above) that alternated with teeth-chattering chills, profound fatigue, and was accompanied by oh-so-aching muscles (especially large muscles, like those of the thighs.) If those symptoms alone aren't enough, the flu causes a sore throat, respiratory congestion, a cough with phlegm, and usually an awfully bad headache. I think we can all remember being sick-as-can-be with the real flu at some point in our lives.

Here is a fact sheet created by the World Health Organization which explains influenza: World Health Organization Influenza Fact Sheet. Click for the "printable version" if you want to make a paper copy of this document.

The U.S. Centers for Disease Control (CDC) offers a wealth of information on "the flu" at

As a former U.S. Army soldier--"government property" for ten years--I've had my share of required flu shots, so I can really appreciate the experience of receiving this vaccine. Based on personal and professional experience, no one LIKES getting a shot. After the Army, I went into nursing, and often worked as a flu shot nurse during the vaccination season for VNA in El Paso, TX. I studied the flu in order to gain knowledge that would enable me to answer my patients' questions at the flu shot clinics.

Some points off the top of my head that I think most people want or need to know about the flu:

  • Influenza is a serious respiratory illness . . . it can actually kill people who have certain underlying health conditions that weaken them--particularly conditions of the lungs, heart, and immune system. The weak and the frail are also particularly vulnerable.
  • Influenza caused more deaths than a world war. The 1918 influenza epidemic was responsible for a death toll that exceeded the numbers of soldiers killed in World War I (FYI for the non-history buffs out there: the great flu epidemic and WWI occurred simultaneously.)
  • There are at least three known Influenza viruses: Influenza A, B, and C.
  • Influenza viruses A and B are so contagious that they are the ones that cause epidemics, and sometimes even pandemics (infection that is so contagious it goes around the world).
  • Each year the influenza vaccine is changed slightly--however, the vaccine is always manufactured to fight against two separate strains of the Influenza A virus, and one strain of Influenza B virus.
  • Scientists use statistics to predict which flu strains are most likely to occur and the vaccine for that year is manufactured to fight a total of three strains from the two types of Influenza viruses. Sometimes the scientists predict wrong--leaving the population vulnerable to infection with a flu strain that wasn't included in the vaccine.
  • Antibiotics kill bacteria--but viruses like the flu--are NOT bacteria, and are therefore ineffecitive in treating influenza. There are a few anti-viral medications that can be used as an alternative to the injected influenza vaccine (flu shot).
  • Influenza is more prevalent during the winter months. Flu shots are typically given from September through January in the U.S.
  • When travelling abroad, to areas in the lower hemisphere, remember that seasons are "flipped" from the Northern Hemisphere; seek advice from your public health department regarding vaccine guidelines specific to your travel destination.

About the flu shot:

  • The injectable flu vaccine is a "killed virus," the one that is squirted up the nose is a very mild, live virus.
  • You don't "catch the flu" from the flu shot--but if you were already infected (within 24 hours before getting the shot)--the illness is already in your system--you may have a "milder case" of the flu.
  • You do often get a mild systemic response to the flu shot that might make you believe you "got sick from the flu shot." Because so many people are computer literate, I like to use the computer as an analogy for explaining this influenza post-vaccine-malaise: Your computer is working just fine, but you want to add an "anti-virus" software. This requires a "download" from the internet. You click on "start" to download your new anti-virus software, the computer runs a bit slower and (what I call "glitchier") for those few seconds/minutes it takes for the computer to incorporate all of the new information from the download. When the download is complete--the computer is protected by the new software which will happily defeat the intercept the viruses it's programmed to recognize.
  • For humans and the flu vaccine--same concept as above only with different "hardware." We get the flu vaccine injected into our system, our immune system starts to analyze the vaccine so that it will know how to fight a "live" version of those viruses. The immune system responds to the vaccine in a way that makes us feel (possibly) a BIT tired, achy, and "blah." Within 24 hours after the vaccine--we should be back to normal. Personally, when I get the vaccine on a regular yearly basis, I don't really notice the symptoms. If I skip a year or two, I tend to feel a bit "yucky" when I do get around to being vaccinated. But it's not the kind of "yucky" that keeps me from doing anything I need or WANT to do.

What if you get sick? Here's what the CDC has to say about that:

"If You Get Sick

Most healthy people recover from the flu without
complications. If you get the flu:

  • Stay home.
  • Get lots of rest, drink plenty of liquids, and avoid
    using alcohol and tobacco.
  • There are over-the-counter (OTC) medications to
    relieve the symptoms of the flu [but
    never give aspirin to children or teenagers who have flu-like symptoms, particularly fever because of the risk of developing Reye's Syndrome.]***
  • Remember that serious illness from the flu is more likely in certain groups of people including people 65 and older, pregnant women, people with certain chronic medical conditions and young children.
  • Consult your doctor early on for the best treatment, but also be aware of emergency warning signs that require urgent medical attention."

Some additional suggestions:

  • When you have the flu--cover your mouth with a tissue when coughing and sneezing . . . and stay away from vulnerable individuals when you are ill.
  • Wash your hands with soap and water before and after dealing with any "secretions" from your nose or mouth.
  • Drink plenty of fluids while convalescing from the flu . . . high fever speeds up metabolism and causes significant dehydration . . . you'll feel worse if you aren't replacing your fluid losses.
  • When appetite wanes due to the illness, force yourself to consume calories in chicken soup, hot tea with honey & lemon, and flavored popscicles.

*** Influenza vaccines are recommended for children on long-term aspirin therapy for treatment of Juvenile Arthritis or Kawasaki's Syndrome

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