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Influenza

This time of the year is known for its festive holiday cheer, parties, gifts and decadent treats. It is also a time of the year known for seasonal coughs, colds, runny noses, and yes, influenza.

In November, the Louisiana Department of Health and Hospitals officially kicks off its annual “Fight the Flu” campaign urging Louisianans across the state to get their annual flu vaccine. We are seeing an uptick of flu activity across the state particularly in northwest and central Louisiana reporting increased numbers of people infected with the flu. Influenza is a very contagious respiratory illness. Influenza or the “flu” is spread by influenza viruses that are spread via respiratory droplets from an infected person who is coughing or sneezing, or by touching your eyes, mouth or nose after making contact with other contaminated objects that contain the virus---such as doorknobs, phones, computer keyboards,toys, faucets, etc.

Nearly 5-20% of Americans are infected with the flu each year. Influenza can cause mild to severe disease and in some cases can lead to death. The number of seasonal influenza-associated deaths varies from year to year because flu seasons are unpredictable and often fluctuate in length and severity. During the past three decades, the estimated number of annual influenza-associated deaths from respiratory and circulatory causes ranged from a low of 3,349 to a high of 48,614 deaths.

This year the CDC is recommending that everyone ages six months to adults receive the influenza vaccine to protect as many people as possible from contracting the flu. Caretakers of infants less than 6 months of age are also strongly encouraged to receive the influenza vaccine as these infants are not yet able to receive the influenza vaccine.

Typically the influenza vaccine is comprised of viral particles (or antigens) that are present in the current year’s circulating influenza viruses. Once the vaccine is administered, it takes approximately two weeks to develop immunity or protection against the current year’s influenza viruses. This year’s vaccine is known as a trivalent vaccine and will provide protection against influenza type A and B and also the 2009 pandemic H1N1 virus. This year’s vaccine can be given by either an injection or a nasal spray. The nasal spray can be administered to healthy people ages two to 49 years who are not pregnant and do not have any underlying chronic illnesses. The injection can be administered to anyone regardless of age or underlying medical problems.

There are many vulnerable patients who are particularly at risk for complications related to the influenza infection. These persons are strongly encouraged to obtain their vaccine. These vulnerable groups include:

• Children under two years old
• Children and adolescents under 19 years of age receiving aspirin therapy
• Pregnant women
• Elderly persons ages 65 and older
• Patients with underlying chronic conditions such as Diabetes, Heart Disease, Lupus, Kidney Disease, Rheumatoid Arthritis, Asthma, Emphysema, etc
• Patients with weakened immune systems due to medications or diseases such as AIDS, HIV, or cancer, or those who are on chronic steroid therapy

The signs and symptoms of influenza infection can be variable and can range from mild to severe. These include: fever, chills, cough, sneezing, fever, muscle and joint aches, fatigue, headache, loss of appetite and runny nose. There is no cure for the flu, however, antiviral medications may shorten or reduce the length and severity of symptoms in patients and are most effective when taken within 48 hours of symptoms.

There are some people who should not receive the vaccine such as: those persons with an allergy to eggs, people with a prior history of Guillian Barre’ Syndrome after a previous influenza vaccination, and children less than 6 months of age. Persons with a moderate to severe acute illness (with or without fever) should not receive the vaccine until their symptoms are improved.

Some of the ways to prevent infection from influenza are:

• Frequent hand washing with warm soap and water; or you may use an alcohol based hand sanitizer when soap and water is not available.
• After hand washing, dry hands with a paper towel or air dry them and remember to use a paper towel to turn off the faucet.
• Avoid sharing personal items such as cups, toothbrushes, and utensils.
• Try to stay 6 feet away from someone who is coughing or sneezing.
• If a tissue is not available to use, remember to sneeze or cough into your elbow and not your hands.
• If you are sick, with flu-like symptoms, remember to stay home for at least 24 hours until after your fever has resolved.
• Wipe down all hard surfaces frequently with disinfectants especially commonly shared objects, such as phones, keyboards, toys, door handles, etc.

The best and most effective way of preventing the flu is vaccination. Influenza vaccines have been available for most providers since September. The peak months of influenza activity are generally in January and February, so it’s not too late to get vaccinated for this year’s influenza season. Remember it takes about two weeks to develop full immunity or protection from the influenza virus once you have received the vaccine. Therefore, in the midst of the wonderful holiday cheer, please don’t forget to protect yourself and your loved ones and get vaccinated to protect against influenza.

Constance M. Gistand, MD, MPH
Adjunct Assistant Professor,
Tulane School of Medicine
Medical Director Region 3
Office of Public Health