Menstuff® has compiled the following information about
battling the Flu. Fact: 10% to 20% of Americans get the flu each
year. 114,000 are hospitalized with flu complications. Whether or not
there's a flu shot in your future, find out what
you can do to keep yourself healthy.
Are Preschoolers
Driving Flu Epidemics?
Should You Get the
Shot?
Protecting Your Kids From Colds And
Flu
How to Dodge the Flu Without a Shot
Dirty
Desks May Foster Flu Spread
Parents Are Keeping Their Fingers
Crossed During Flu Vaccine Shortage; Only Smallest Or Sickest Get
Shots
Flu Schools Tips
Your Flu Questions Answered
Battling Flu: Disinfectants to
Shots
Are We Running Out of Flu
Vaccine?
Will This Year's Flu Shot
Work?
Are Preschoolers
Driving Flu Epidemics?
How to Dodge the Flu Without a Shot
Protecting Your Kids From Colds And
Flu
Parents Are Keeping Their Fingers
Crossed During Flu Vaccine Shortage; Only Smallest Or Sickest Get
Shots
How much do you really know about the flu?
This year, lots of fallacies are getting mixed with the facts. To help clear things up, WebMD spoke with Dennis Clements, MD, PhD, professor of infectious diseases and pediatrics at Duke University Medical Center. Clements also serves as medical director of PDC Primary Care.
Question: Should your wife stop nursing if she gets the flu?
Dr. Clements: If a mother has the flu, she is very likely to give it to her child. The child won't get any sicker from nursing. And nursing may help the child cut down on secondary bacterial infections. By the time you realize you have the flu, you have been viremic for a couple of days and have already transmitted it to the child. Obviously the youngest kids can get very sick, but you can't tell in advance which five out of 100 kids will get severe flu.
Question: How is the flu usually transmitted? What about handshaking? And if you do shake hands, should you immediately wash your hands?
Dr. Clements: Usually flu is spread by oral secretions -- most often by breathing in droplets expelled into the air by an infected person's cough. These droplets can land in your eye or nose; or they get on your face and you touch your face and then touch your mouth or rub your eyes or scratch your nose. If you shake hands with a person who is coughing or sneezing, it would be a good idea to wash your hands.
You can also get the flu from sharing cups, glasses, or other household objects used by a person who has the flu.
Question: What is the incubation period for the flu?
Dr. Clements: When you get infected with the flu virus, it multiplies quietly in body until you get symptoms of the disease and start excreting enough virus to give to someone else. That's the incubation period. For the flu, it is about two to five days. So if you are exposed today, you probably won't have any symptoms for three to five days. Then you have a little headache, maybe a few aches and pains and maybe a low fever. Then, the next day, you have a high fever and a runny nose.
Question: How long are you contagious?
Dr. Clements: Most adults are contagious for about five to seven days. With young children, it's longer. The youngest kids (1 to 2 year olds) can be contagious for 10-14 days. And they can also have diarrheal illness when they get the flu. They get more symptoms that we adults typically have.
Note: According to the CDC, people with lowered immune systems -- such as people with AIDS or people taking drugs to prevent transplant rejection -- can shed flu virus for weeks or months after infection.
Question: How soon after coming in contact with the flu virus are you contagious?
According to the CDC, a person begins shedding virus a day before symptoms appear. This can occur as soon as one day after exposure.
Question: How do you know when you're contagious?
When you get symptoms, the virus has multiplied in your body to the point you can give the flu to someone else. But you aren't likely to spread the infection -- except maybe to close household contacts -- until you start coughing or sneezing.
Question: How long does the virus live on the phone, desk, etc?
Dr. Clements: Maybe an hour. It depends on the moisture in the air and the temperature of the room.
Question: Can you kill the virus with disinfectants?
Dr. Clements: Yes. Alcohol or anything that kills other germs would work.
Question: If you come in contact with someone that has the flu, is it 100% certain that you'll get the flu?
Dr. Clements: No. Not necessarily, but droplets that land on your face are very contagious. If a person has the flu, they should at least turn away from others when they cough or sneeze. If you find yourself on an elevator with someone who is coughing or sneezing, the best thing you can do is turn away.
Question: Can you get the flu from the flu vaccine? What symptoms can you get from the flu vaccine?
Dr. Clements: No. The flu shot is just killed virus. The FluMist spray vaccine is a live, weakened form and when you get it you may have some mild symptoms as if you were starting to get flu. You might even briefly have a runny nose, but you won't get the flu.
Note: Some people may, by coincidence, get a cold or other respiratory infection soon after vaccination. This is not flu caused by the vaccine. According to the CDC, the most common flu vaccine side effect is a sore arm where you got your flu shot. Children and others who have never before had the vaccine may have some fever, muscle aches, or other flu-like symptoms after vaccination. These symptoms can begin as soon as six to 12 hours after vaccination and last for one or two days.
The CDC says that the influenza vaccine does not affect the safety of breast feeding mothers or their infants.
The flu vaccine is made in eggs. People allergic to eggs should not take the vaccine. Allergic reactions to the vaccine rarely occur, and are thought to be caused by egg protein remaining in the purified vaccine. Three reactions can include hives, skin redness, asthma, and/or shock.
Source: Dennis Clements, MD, PhD, professor,
contagious diseases and pediatrics, Duke University Medical Center;
medical director of PDC Primary Care, Duke Clinic. CDC, "Prevention
and Control of Influenza," Morbidity and Mortality Weekly Report
Recommendations and Reports, April 25, 2003; vol 52. http://my.webmd.com/content/article/78/95668.htm
Battling Flu: Disinfectants to Shots
A 3-year-old boy in Colorado, where at least five children have died, brought a can of spray disinfectant to his day care center, according to the Associated Press.
Indeed, what can we do to keep our families safe this year? WebMD asked health officials at the CDC and in Chicago -- people who know about fighting a long, hard flu season.
Llelwyn Grant, a CDC spokesman, saw the Science report predicting 70,000 deaths. "We don't know how they got those numbers," he tells WebMD. "We don't make those kinds of predictions. However, we do anticipate this being a severe flu season, more so than in the previous three years."
Annually, an estimated 36,000 Americans die from influenza; 114,000 more are hospitalized each year for flu-related complications, Grant says. The CDC's "flu map" this week shows activity in virtually every state, "but most of the activity is in the West."
States topping the list: Arkansas, Colorado, Idaho, Nevada, New Mexico, Pennsylvania, Tennessee, Texas, and Washington.
In fact, influenza viruses have been active in Chicago -- picking up momentum in just the past week, Julie Morita, MD, medical director of the immunization program of the Chicago Department of Public Health, tells WebMD.
"Given the activity in other parts of the U.S., we're really getting out into the community and recommending that people get vaccinated," says Morita. "The vaccine will prevent severe disease, even if it doesn't prevent all disease."
Their advice:
1. Get a flu shot; it's not too late. Children between 6 and 23 months old -- as well as older children with chronic illnesses -- should get flu shots. Their risk of severe illness and death is high, equal to an over-65 adult, says Morita.
Parents should also get flu shots, as should other adults with chronic illnesses who share a house with children, adds Grant. Medical professionals including doctors and nurses should get flu shots, too.
There is a variant of the flu going around -- called Fujian flu -- that surprised researchers and isn't covered in this year's version of the flu vaccine. However, even if you get the flu from this strain of the virus, the flu vaccine will help prevent you from getting as sick.
Try FluMist if your child has an aversion to shots. Children under age 5 should not use FluMist because studies showed that young kids were more likely to have asthma and wheezing side effects. Also, children with respiratory problems like asthma or with weakened immune systems should not use FluMist. "But for healthy children and adults under age 50, it's a good option," says Morita. FluMist has not yet been proven safe for people age 50 and older.
2. Wash your hands frequently. Cover your mouth when you cough. Cover your nose when you sneeze. Teach your children these simple rules, and set a good example for them. "The simple things we do everyday are the best preventives," Morita says.
3. Use hand-cleaning alternatives. When soap and water aren't nearby, use hand wipes and hand-cleansing gels, advises Grant.
4. Keep sick kids at home. If children are sick, whether it's flu, a cold, or other contagious illness, keep them at home so they won't give it to others, says Grant.
Note to teachers: Wipe tables and other common-area surfaces with a disinfectant. Do it often during cold and flu season.
But most of all, get a flu shot. "The vaccine is safe and it is effective, and we strongly encourage people to get it," urges Morita. "It's not too late. It takes two weeks to take effect. The CDC advises us to continue vaccinating through the flu season. Now is the optimal time to get vaccinated."
Source: Llelwyn Grant, CDC spokesman. Julie
Morita, MD, medical director of the immunization program, Chicago
Department of Public Health. http://my.webmd.com/content/article/78/95654.htm
Are We Running Out of Flu Vaccine?
"There is flu vaccine out there in the marketplace," CDC spokeswoman Karen Hunter tells WebMD. "We are working to see what the actual status of the flu vaccine in the U.S. really is. But it is not unusual at this time of year for all flu supplies to be distributed by their manufacturers. A lot of places already are winding down their flu vaccination programs. But if we find pockets of places that are short of flu vaccine, we would see that vaccine shipments go to them."
Media reports have made much of the fact that Chiron Corp. and Aventis Pasteur Pharmaceuticals have already shipped all 83 million doses of the killed flu vaccines they make. Together with 4 million to 5 million doses of MedImmune's FluMist nasal vaccine, that's the entire U.S. supply.
But just because the vaccines have been shipped doesn't mean state, local, and private healthcare providers have run out.
"It is like we are a turkey farm," Chiron spokesman John Gallagher tells WebMD. "Just because we shipped all out our turkeys by Thanksgiving doesn't mean there aren't any in the stores."
MedImmune spokeswoman Lori Weiman says her company still has more of the nasal FluMist vaccine. Even though it was approved only last June -- for people aged 5 to 49 -- the company was able to produce some 4 million to 5 million doses.
"We are not out," Weiman tells WebMD. "We still have supply and would love to help protect people this year."
It's Now or Never
But if you still haven't had a shot or mist of flu vaccine, don't wait. The maximum number of doses for this year, counting FluMist, adds up to 88 million at most. The CDC estimates there are 180 million Americans -- children, elderly people, and healthcare workers -- who really should get vaccinated. Fears of a more severe flu this year are greatly increasing demand, says Michael Decker, MD, MPH, Aventis vice president for scientific and medical affairs.
"I'd be surprised if people don't run out of vaccine. It is easy for that to happen this year," Decker tells WebMD. "Nobody knows how much is sitting in doctors' refrigerators. But the best guess so far is there is probably not a lot out there."
Decker's advice for people who still want the vaccine: Get moving.
"If you move quickly, you can still get yourself a flu shot," he says. "But it is like shopping on Christmas Eve. The first one or two places you go may be sold out."
Why isn't there more flu vaccine? There's actually more flu vaccine this year than last year -- and last year, Decker says, demand was so low that some 10 million doses got thrown out. If everyone who is supposed to get their flu vaccine every year would get it, there would always be financial incentive for manufacturers to make more.
And more for this year is out of the question. The entire process takes about four months. This year's vaccine supply was started in February and began shipping in August.
Source:: Karen Hunter, senior press officer, CDC.
John Gallagher, Chiron Corp., Emeryville, Calif. Michael Decker, MD,
MPH, vice president for scientific and medical affairs, Aventis
Pharmaceuticals Inc., Bridgewater, N.J. http://my.webmd.com/content/article/78/95674.htm
Will This Year's Flu Shot Work?
That depends on what you mean by "protect." The CDC says flu vaccine will offer "some" immunity against the Fujian flu that's going around this year. Some people are expected to get the flu even though they got vaccinated. But they won't get as sick as those who didn't get the vaccine.
Fujian flu is what scientists call a "drift variant." It's nearly the same virus as the Panama flu included in this year's vaccine. But it's not exactly the same, notes Jennifer Wright, DVM, an officer in the epidemic intelligence service at the flu branch of the CDC.
"We just don't really know how well the vaccine will protect against the Fujian variant," Wright tells WebMD. "In the past, where a drift variant didn't match the vaccine strain exactly, some vaccinated people didn't get sick, and those who did, had a milder illness. We'll be looking to see if that's true this year."
It would be great if scientists could look at a virus and guess how bad it would be. That's just what the CDC is doing. And "guess" is a big part of it.
"We're doing tests on Fujian viruses coming from infected people," Wright says. "Those tests are showing protection in laboratory studies. But we don't know how that translates into a living human body."
Drift and Shift
The Fujian flu is one kind of new flu virus. If you've got to have a new flu, this kind -- a drift variant -- is probably the best kind. Drift variants arise when a lot of people become immune to a circulating flu virus. They're just different enough to be able to spread more than their parent strain.
But a drift variant is nothing compared to a shift variant. Shift variants are flu bugs that have managed to change one or both of their two kinds of surface molecules. This lets them entirely escape any immunity because of prior vaccination or infection, says Harry L. Keyserling, MD, director of pediatric infectious diseases at Emory University in Atlanta.
"Antigenic shift that occurs when there is a new virus derived from animal strains," Keyserling tells WebMD. "That's what resulted in the swine flu pandemic of 1918 and the 1957, 1968, and 1977 influenza pandemics."
Shift variants aren't always as bad as feared. The swine flu scare of 1976 happened because a shift variant looked like the reappearance of the horribly deadly 1918 swine flu. Despite the failure of a mass vaccination effort, this shift variant never broke out as an epidemic. Instead, a drift variant called type A Victoria caused much more illness and death in the 1976-1977 flu season.
Why No Fujian Vaccine?
The Fujian flu outbreak in the U.S. this year isn't totally unexpected. By last June, the virus was spreading during Australia's flu season. Unfortunately, that's not enough warning for vaccine makers.
"The vaccine strains have to be selected about six months in advance of flu season," Wright says. "A WHO committee met in February to decide on the Northern Hemisphere vaccine. Australia didn't have its flu season until summer, when our vaccine already was in production. And just because a drift variant is in Australia is no guarantee it will show up here."
Flu vaccines are weakened viruses grown in eggs and then processed. Each egg can grow only two doses of vaccine. We're talking millions and millions of eggs here -- and lots of human effort to make the viruses into flu shots and flu nasal sprays.
"It takes months just to get all the vaccine viruses grown," Wright notes.
Tips on Protection
Wright and Keyserling agree that there's simply no way to tell how dangerous this year's Fujian flu outbreak is going to be. But the early signs aren't good: An early start to the season, and already several child deaths in the western U.S.
The good news is that it's not too late to get vaccinated. The vaccine takes about two weeks to work -- but flu season lasts until April.
Because the vaccine may not totally protect against infection, some people may need extra precautions -- even if they've had their flu vaccine. Wright says these high-risk people include:
If exposed to someone with the flu, Wright says these people should see a doctor right away. Doctors can prescribe antiviral drugs that -- if given soon after exposure -- can prevent the flu or make it milder.
Source: Jennifer Wright, DVM, epidemic
intelligence service officer, flu branch, National Center for
Infectious Diseases, CDC, Atlanta. Harry L. Keyserling, MD, director,
pediatric infectious diseases, Emory University School of Medicine,
Atlanta. "Influenza Summary Update," CDC. my.webmd.com/content/article/77/95576.htm
The diseases which destroy a man are no less natural than the instincts which preserve him. - George Santayana
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