Flu season is around the corner

Flu season is around the corner

By Elaine Thompson TELEGRAM & GAZETTE STAFF
elaine.thompson@telegram.com

Like it or not, Old Man Winter and the annual flu season are just around the corner.

And, as with other illnesses, prevention is the best cure.

The Centers for Disease Control and Prevention and other health care agencies recommend that everyone 6 months of age and older be vaccinated, ideally by October.

The sooner people are vaccinated, the sooner it will ensure that as many people as possible are protected before the flu season begins, said Benjamin N. Haynes, a spokesman for the CDC Infectious Disease Team. It takes about two weeks for the vaccine to give the maximum benefit.

"Getting vaccinated by October is ideal, but for people who have not gotten vaccinated by Thanksgiving, getting vaccinated later can still be protective during most seasons because flu activity continues into the spring," said Mr. Haynes. He pointed out that National Influenza Vaccination Week, Dec. 7-13, was established to highlight the importance of continuing influenza vaccination after the holidays.

The flu season usually begins near the end of December and peaks by early February.


Dr. Richard T. Ellison III, hospital epidemiologist at UMass Memorial Medical Center, said last year's flu season was unusual in that it lasted from December through March.

"We had seven to eight weeks more than we normally would have," he said, noting that the brutally cold weather was probably a contributing factor. "The winter just lasted and lasted and lasted. There's evidence that shows when there's cold dry air, the flu virus is more readily transmitted."

According to the CDC, flu vaccine manufacturers will provide 151 million to 159 million doses of vaccine this season. That's up from 134.5 million last year, and 70.4 million in 2000. The state Department of Public Health expects to provide 820,000 doses this year. About half of the doses have already been distributed.

Most health agencies don't start flu clinics until next week, but some pharmacies, including CVS, offer flu vaccination every day of the year.

Mike DeAngelis, spokesman for CVS, said prior to 2010, the pharmacy had scheduled clinics. But after the 2009 H1N1 pandemic, states authorized pharmacies to offer the vaccines regularly.

It's not possible to predict what the upcoming flu season will be like, because it varies from one season to another. Each year, the CDC looks at data from the previous year and early information available in the Southern Hemisphere, where winter is just now ending, to develop a new flu vaccine.

This year's vaccine consists of two strains of influenza A, including H1N1, and one strain of influenza B. About 77 million doses available this year contain protection against a second B virus. These are called quadrivalent vaccines because they guard against four types of viruses.

The nasal spray vaccine is recommended for healthy children ages 2 through 8. The spray can also be taken by healthy individuals through age 49 who don't like needles.

A high-dose vaccine, first approved by the Federal Drug Administration in 2009, is designed specifically for people older than 65.

Neither the spray nor the shot can cause a person to get the flu, but some people can have a reaction, according to the CDC. Information about that is available at www.cdc.gov/flu/about/qa/misconceptions.htm.

Individuals who get a reaction, such as hives, when they eat scrambled eggs could also be allergic to the regular flu vaccine, which contains a tiny amount of egg protein. There is a new vaccine that does not include any egg protein.

The reason people have to get a flu shot every year is that a person's protection declines over time and there are mild changes in the flu virus each year. About every 20 years, there's a big change, which is what happened in 2009 with the H1N1 flu, also the predominant strain last season.

The CDC is working on a universal flu vaccine that protects against all strains. If one is developed, a person would only have to get a flu shot every 10 years. But that's years away, said Dr. Ellison.

In addition to the vaccine, people should take the usual preventive measures, including washing hands and staying away from those who are sick, to avoid the flu. Drinking plenty of fluids and getting lots of rest are recommended when people have the flu. Children under 18 can take acetaminophen, but not aspirin because it can cause Reye's syndrome, which has detrimental, sometimes fatal, effects on the brain and liver.

It's easy to determine when one has the flu. "The flu is a total body infection," said Dr. Ellison. "You feel like you've been run over by a truck. Everything hurts. Your legs, back, arms all hurt. And you have a fever." 

Dr. Anthony Esposito, epidemiologist at St. Vincent Hospital, said efforts by hospitals, physician practices and health departments have increased vaccination acceptance rates. But while more people are getting vaccinated, the overall vaccine effectiveness rate was 52 percent last year. Dr. Esposito said the efficacy rate is much higher for healthy individuals under 65.

"The federal government is aware that the current vaccines need enhancements, and they're working to make that happen," he said.
Still, getting the vaccine is better than getting the flu, which can cause serious problems, including pneumonia and even death. From 2010 to Aug. 14 of this year, 436 flu-related pediatric deaths were reported to the CDC. Two pediatric flu-related deaths were reported in Massachusetts during the 2013-2014 season. Both children were unvaccinated. The victims had underlying health issues, including developmental delay, premature birth, autism and seizure disorder. The state DPH does not track deaths of adults related to the flu.

Derek Brindisi, director of public health for the city of Worcester and the Central Massachusetts Regional Public Health Alliance, said there were 472 deaths related to pneumonia/flu in hospitals, nursing homes and other places in Worcester last year. Some were residents, but some originated from other communities.

Dr. Esposito said the occupancy rates in hospitals go off the charts during flu season.

"For the well-being of individuals, families and the health care system, we encourage everyone to receive the seasonal flu vaccination," he said. "All hospitals get filled up and the ability of health care systems to care for the surge of patients gets quite strained."

Contact Elaine Thompson at elaine.thompson@telegram.com. Follow her on Twitter@EThompsonTG