IT'S HERE...FLU SEASON
by Dr. Randall M. Suzuka
1998

As the summer ends and kids head back to school, it's time to start thinking about the flu season. "Flu" is short for influenza. There are two types of influenza- influenza A and influenza B. Both types cause high fever, sore throat, cough and body aches for a week.

Influenza remains an important cause of hospitalization and death.There have been 11 epidemics in the United States from 1972-1995 resulting in >20,000 deaths. Six of these 11 epidemics resulted in >40,000 deaths. The most famous flu epidemic was the Influenza A epidemic of 1918. The epidemic hit North America in March and April of 1918. It then traveled to Europe and was known as the "Spanish flu." It encircled the globe in less than 5 months and resurfaced in the United States in August 1918. During this epidemic 20 million people died.

Flu can be prevented by an inexpensive vaccine. The vaccine is given between September and December each year.

Who should get the vaccine?

• All people over 65 years old.
• People living nursing homes or chronic care facilities.
• Adults and children with chronic lung and heart conditions.
• Adults and children who have required regular medical follow-up or hospitalization during the preceding year because of chronic illnesses such as diabetes, kidney trouble, blood disorders, and illnesses or medications that weaken the immune system.
• Children and teenagers 6 months to 18 years old on chronic aspirin therapy.
• Women who will be in the 2nd or 3rd trimester of pregnancy during the
  flu season
• People who live or work with people at risk of having serious illness from the flu (the list above).
• Those who provide essential community services.
• Students living in dormitories or others who live in institutional settings.

Who should not get the vaccine?

• People with severe (anaphylactic) allergic to eggs.
• People who have had a serious allergy reaction from a previous flu shot (not including
  fever or muscle aches).
• People with an acute febrile illness.

Will the vaccine make me sick? The vaccine contains only nonifectious virus and cannot cause influenza. The most common side effect is soreness at the site of the injection that lasts up to 2 days. Fever, muscle aches, and feeling lousy can occur in those who have low immunity to the flu. The symptoms start 6-12 hours after the shot and can last for 1-2 days.

What if I already had the vaccine last year? You should still get the vaccine this year if you are in the high risk groups. The flu virus strains change a little every year. This year the vaccine contains Influenza A Sydney, Influenza A Beijing, and Influenza B Harbin (a strain like Influenza B Beijing).

Are you telling me that I won't get sick if I get the flu shot?  No. The flu shot is not 100% effective. It prevents the flu in 70-90% of healthy persons <65 years and 30-40% of frail elderly. The flu shot does not protect against colds, parainfluenza, respiratory syncytial virus (the viruses that cause croup), or enterovirus (stomach flu).

What if I can't take the flu shot? Amantidine and rimantidine are 70-90% effective in preventing illness from inluenza A (but not influenza B). Also, both medicines can reduce the duration and severity of the illness when started within 48 hours of the onset of symptoms. Amantidine is indicated for prevention and treatment of influenza A for adults and children aged >1year. Rimantidine is indicated for prevention and treatment of influenza A in adults but only for prevention in children. Both medications can cause central nervous system side effects (nervousness, anxiety, difficulty concentrating, lightheadedness) and gastrointestinal side effects (nausea, decreased appetite). Central nervous system side effects occured in 14% taking amantidine, 6% of healthy adults taking rimantidine, and 4% taking placebo. Gastrointestinal side effects occured in 3% of those taking either medication compared with 1-2% of persons taking placebo. Severe side effects (marked behavioral changes, hallucinations, extreme confusion, agitation and seizures) have been reported. These generally occur in those with bad kidney disease, seizure disorders, psychiatric disorders, and in the elderly.

Final comments - Influenza vaccination is covered by Medicare. For more information you can check with the Center for Disease Control (http://www.cdc.gov). Many people such as those >65 years and those with chronic illness should also check with their doctors about getting a pneumonia shot. The pneumonia shot is also covered by medicare.

Editor: Dr Randall M. Suzuka is a graduate of the John Burns School of Medicine. He can be contacted at 637-5087 or by email.