Tuesday, 11 September 2018 17:02

Flu season 2018 has begun

Flu season has already begun, with three cases being reported in Western Massachusetts, and this year may be different from those past as the CDC has made multiple new recommendations and different options made available for the public. Let’s answer your questions.

When does flu season begin and how long does it last?

 

Flu season has begun already. It typically starts in the Fall, and ends late Spring.  So the range is described as October to May with it peaking December to March.

How bad will this flu season be?

 

It is difficult to predict, but already this early in the season we’ve had multiple flu related deaths reported by the CDC’s Flu View.

What is the flu?  How can one die from it?

 

The flu is caused by a virus. Multiple strains of virus’ can cause the flu.  The virus itself can be lethal, however the greatest risk comes with what it does to your immune system, thereby putting one at risk of secondary infections. Pneumonia is the number one cause of flu-related deaths.  Secondly, it can exacerbate existing conditions such as asthma, seizures, even promote preterm birth, hence those who are pregnant or have pre-existing medical conditions are urged to get vaccinated against the flu. Moreover those who qualify should get the pneumonia vaccine as well.

 

 

h1n1-swine-flu-virus

h1n1 virus

 

What does this year’s flu vaccine cover?

 

According to the CDC, the trivalent vaccine covers for these three strains of flu virus:

  • A/Michigan/45/2015 (H1N1)pdm09–like virus
  • A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus
  • B/Colorado/06/2017–like virus (Victoria lineage)

Quadrivalent influenza vaccines will contain these three viruses and an additional influenza B vaccine virus, a B/Phuket/3073/2013–like virus (Yamagata lineage).

These vaccines are aimed at providing protection against the Swine flu, and some influenza A and B strains.

What about older individuals?

 

This year, those over 65 will have two options for their flu vaccine.

Fluzone High-Dose – a higher dose flu vaccine that will hopefully allow their immunity to protect against the flu longer

FLUAD – the trivalent flu vaccine with an adjuvant to stimulate more of an immune response.

Flublock Quadrivalent – provides protection against 4 strains.

What about the nasal spray vaccine?

 

This year, the CDC does allow use of the nasal spray vaccine as it has shown improved  efficacy from  prior years. However it is only recommended for  those who are between the ages of 2 and 49 and cannot be given to those who are pregnancy or who have compromising medical conditions as outlined by the CDC.

Who should get the flu shot?

 

All individuals 6 months old and older unless specified by their medical provider.

What if I’m allergic to eggs?

 

Most individuals allergic to eggs can still get the flu vaccine, but if the allergy to eggs is severe (anaphylaxis, angioedema, difficulty breathing), the CDC recommends notifying your medical provider and being in a facility to monitor you if you do get the flu vaccine.

Will I get the flu from the flu shot?

 

No.  The flu vaccine has a “killed” version of the virus meaning it’s not an active virus (as opposed to a live attenuated vaccine, a weakened down version of it). A “killed” or “inactivated” vaccine merely has the pathogen particles to induce an immune response. Additionally, when one states they got the flu despite the flu shot it could be that the flu shot only protects against 3 – 4 strains and they were infected with a more rare strain not covered by the vaccine.

How effective is the flu vaccine?

 

The average effectiveness each year hovers around 60%. Last year’s efficacy was much lower and this year’s has not been predicted as of yet. Australia is still reporting active cases on their Department of Health website.

I feel sick after the flu shot, why?

 

For some, the immune response that ensues can make one feel mildly ill, but should not resemble the flu. Those who state they got the flu “immediately” after receiving the shot, might have already been exposed and had not had a chance to produce immunity prior to their exposure.

 

sneezing

 

What are symptoms of the flu? How is it different from a cold?

 

A cold comes on slower and less severe. Flu symptoms are more abrupt and can include:

  • Fever
  • Body Aches
  • Cough
  • Sneezing
  • Sore Throat
  • Shortness of Breath
  • Fatigue
  • Headache
  • Nausea
  • Vomiting

 

Are there medications to treat the flu? Will antibiotics work?

 

There are antiviral medications available, such as Tamiflu, to treat the flu.  Antibiotics, however, will not work since the flu is not caused by a bacteria but rather a virus. However if a secondary bacterial infection takes over, antibiotics may be used.

How can I prevent getting the flu?

 

Besides vaccination, avoid being around those who are sick, thorough hand washing, and take good care of yourself. A balanced diet, exercise and sleep regimen can help boost your immune system.

Wishing you health this season!

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, if expressed, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

Published in Health

The US Centers for Disease Control and Prevention advisory committee voted this week to return the FluMist, nasal spray flu vaccine, to the recommended options for the 2018-2019 flu season.

In 2016 it was not recommended and discouraged as they found its effectiveness against seasonal flu to be approximately 46%, when 65% efficacy was touted by the injectable flu shot.  However this flu season, the current flu vaccine was found to be only 35% effective with one of the worst flu seasons in years taking the lives of healthy young adults and children.

Why was this season so severe? The H3N2 strain was the predominant one, notorious for bad flu seasons, and is crafty, able to mutate before the vaccine is finalized. Hence our flu vaccine was not able to be as close a match as desired.

The panel voted 12-2 this week to include FluMist as an option for medical providers to recommend against the upcoming 2018-2019 flu season.

Why was FluMist removed?  Experts found it to be ineffective against one of the influenza A H1N1 strains. With its overall efficacy found to be lower than the flu shot it was deemed a less ideal option than the shot.

FluMist is a live attenuated vaccine that is not recommended in infants and pregnant women. It’s indicated for those between the ages of 2-49 and introduces a live, weakened version of the flu virus to incite an immune response. This differs from the injectable flu vaccine which uses killed versions of the flu strains to induce a flu response.

Children prefer the FluMist as the nasal spray offers a less painful option than an injection.

The FluMist Quadrivalent nasal spray, manufactured by MedImmune of AstraZeneca PLC, offers protection against 4 strains of flu including H1N1, H3N2 and two influenza B strains.  According to FluMist’s prescribing information, the FluMist proved 90% effective against H3N2 as opposed to influenza B where it scored 44.3% effectiveness. Another review found its efficacy against H3N2 to be 79%.

 

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Now that’s not to say the FluMist would have been immune to the vaccine issues experienced with this year’s flu shot as H3N2 is a highly virulent and mutable virus, and could have snowed the FluMist vaccine makers as well.

Yet we may need to consider that the FluMist may be more efficacious for some strains of the flu whereas the flu shot may better protect us against others. More research needs to be done in this area. As of now choosing which flu shot to get for the next flu season may be a crap shoot.

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Daliah Wachs is a guest contributor to GCN news. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

Published in News & Information