Sunday, February 24, 2013

More on the flu

This year's influenza outbreak has been a significantly more active one than in years past.  And I have been asked more questions about it by the press.  Here is another media piece,

Seasonal Flu Q&A: Top Questions Answered

No, I'm not the only "expert" on board, but I do have some nice quotes in the piece.  In the interview, I responded to quite a few questions, here is some more of what I had to say...

Does this flu season appear to be worse than in recent years and does the flu shot seem to be effective this season? 
According to the CDC, this year’s flu season is among the highest in recent years.  Peak levels have been observed in the moderately severe range, similar to the 2003-2004 and 2007-2008 seasons.  It may yet worsen, as the season appears to still be on the uptick.  The typical flu season peaks in March or April, still several months away.  
The vaccine appears to be about 60% effective in preventing influenza infections, comparable to other years.  At this level, the vaccine clearly reduces morbidity and mortality from the influenza virus.

What constitutes a flu emergency? 
A region typically declare a flu emergency in consideration of the severity and number of cases in the area.  This year, both New York and Boston, among others, have felt the need to declare such a state of emergency.  Flu vaccination, increase awareness of hygiene, and curtailment of public assembly may be impacted by such a pronouncement.  

Which strain of flu is the worst and are different strains treated differently? 
The A(H3N2) seems to be a particularly severe strain, along with several other strains that have been around before, such as A(H1N1).  

How can I take care of a loved one who is suffering from the flu, without getting sick myself? 
First and most important, wash your hands!  The flu virus can sit on your hands, and gain entry when you eat, rub your nose, or eyes.  As much as you want to share each other’s company, try to stay apart when not necessary, and use disposable dishes and utensils or wash them promptly in a dishwasher.  Bathroom surfaces and the like which may be contaminated should be cleaned with a disinfectant cleaner.  Tissues and other such material need to be disposed of promptly in a sanitary manner.  And wash your hands!

If someone in my household gets the flu, is it likely that everyone else in the house will become infected? 
If appropriate precautions are taken, including influenza vaccination for all in the household, proper hand washing, avoiding undue contact with the ill individual and sanitary handling of contaminated material, you should be able to minimize your risk.

What types of complications from the flu occur? For instance, pneumonia, sepsis that type of thing. Who is most at risk? 
Pneumonia, bronchitis, sinus infections and ear infections are some complications of the flu.  People with chronic health conditions, such as asthma or congestive heart failure, may experience worsening of their underlying condition with the flu.  The very young, under 2 years old, older individuals, over 65, and pregnant women are at a higher risk for developing complications.  Any of a raft of medical conditions, including asthma, diabetes, heart or lung conditions, kidney or liver problems, many neurologic disorders, and immune suppression, such as with cancer, HIV infection, or organ transplantation all increase the possibility of complications.  Being morbidly obese, with a BMI over 40, also puts one at an increase risk.

In addition to a flu shot, how can the public protect themselves from the flu? 
Did I mention to wash your hands?  It is hard to underestimate how important that is.  Being cautious around people who are coughing or ill, insisting that ill co-workers or students stay at home until recovered, and observing common sense sanitary techniques won’t hurt, either.

How can you tell the difference between the flu and a cold? 
Briefly, a cold is an upper respiratory infection, with symptoms primarily above the neck; the flu is more systemic and severe.  Fever is rare with a cold, common and often high with the flu.  Aches, chills, and fatigue are more signs of the flu than a cold.  The secretions of a cold produce the runny or stuffy nose, sneezing, sore throat, and productive cough; all of which are rare with the flu.  A severe headache and chest discomfort, however, are more typical of influenza.

Are what point should you see your doctor if you have the flu? What are the danger signals? 
First of all, if you do have the flu, there are medications that, if started within the first few days, can lessen the severity and duration of the illness.  Contacting your health care provider early may be of benefit.  You can also review your symptoms with your medical professional, to be sure that you do have “just” the flu, and to be sure you are treating it correctly.  Signs of worsening include a very high fever that is not going away, a change in mental status, rapid breathing or trouble with breathing, decreased voiding, a bluish or gray skin color, or increasing cough and fever following some resolution of symptoms.  As always, anything which represents a significant change from the baseline should at least be reported to your health care provider.

Any other comments are welcome. 
There is a rare but reported complication of influenza called “Reye’s Syndrome,” which is associated with younger people taking aspirin while having the flu.  Current guidelines are that aspirin not be given to those under 19 years old with a fever-causing illness to lessen such risk.  A potentially fatal disease with widespread target organ pathologies, avoiding aspirin seems a small price to pay to help prevent this possible complication.

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