The "flu" has started to hit Montgomery County. We've been seeing cases for the last two weeks or so and it's starting to accelerate. Most people use the term "flu" in a very generic sense. It can mean anything from cold symptoms to having a case of vomiting and diarrhea. This time of year "flu" means respiratory influenza.
The majority of influenza infections are caused by two particular types of influenza viruses, Type A and Type B. Type B typically does not cause severe disease whereas Type A can be deadly. Type A virus can be broken down further into different subtypes or "serotypes" based on the proteins the viruses contain. These serotypes are often given common names, usually from their region of origin, such as Influenza A "Hong Kong."
Influenza viruses are constantly changing or mutating slightly so that each flu season brings new serotypes that cause human infections. Usually the changes are small from year-to-year and people with healthy immune systems can fight off the infection without much difficulty. Scientists make an educated guess each year on what serotypes of virus might occur the following year. The guess is used by vaccine manufacturers to produce vaccine for the following year's flu season.
Influenza vaccine contains two subtypes of A and one subtype of B. This year the scientists guessed right for the most part. There is, however, a type of Influenza A that is causing infections that was not included in the vaccine. We are therefore seeing some cases of influenza in people who received the vaccine last fall.
It's important to note that receiving flu vaccine each fall can't give you influenza. The vaccine is made up of killed virus parts that can't cause an infection. Rarely, some people do have a reaction to the vaccine with some fever and aches, but it is not an infection with the virus. The vaccine is commonly given in late fall which is when the common cold is being spread. Often people catch a cold at the time of their vaccine or shortly thereafter and blame the symptoms on the vaccine.
I also occasionally hear another concern from patients that receiving influenza vaccine will "weaken" their immune systems and they won't be able to fight the disease when they are exposed to it. Quite the opposite is true - by receiving the vaccine, you are exposing your immune system to the killed virus and your body will be prepared to react immediately to the virus if and when you are exposed to it. Without receiving the vaccine, it takes your body days to produce antibodies to fight off the infection which prolongs the illness and can also make you more susceptible to other infections like pneumonia.
Type A virus can also exist in other species of animals. Avian influenza or "bird flu" is a Type A virus. The concern with this virus is that it will undergo major change in birds and then spread to humans. This could result in a serotype that human immune systems have not seen before. When this is the case, the virus can overwhelm the immune system and can lead to large numbers of deaths. When such an infection occurs it is termed a pandemic since it can cause worldwide devastation.
Symptoms of influenza usually include a rapid onset, fever (typically 100-103), dry cough, runny nose, chills, headache and body aches. Most people describe it as being hit by a truck. This is in contrast to the common cold which usually has a slow onset, low grade fever (usually 100 or less), cough, runny nose and mild body aches. Both illnesses usually last around ten days.
Since influenza is caused by a virus, antibiotics are useless. There is medication available to shorten the course of influenza, but it must be started in the first 48 hours of illness to be of any benefit. The most commonly used drug is Tamiflu® that is taken twice a day for five days. Many people choose not to take the medication since it is expensive and only shortens the course by a day or two.
Most healthy people who develop symptoms of influenza do not necessarily need to see their doctor. People who should see their physician include those with heart or lung conditions or weak immune systems. These people are more likely to develop secondary infections such as pneumonia.
If you get the flu, the best thing to do is stay home to avoid infecting others, drink plenty of fluids and get as much rest as possible. Over-the-counter cold medications offer some relief and pain relievers can also be helpful if you do not have an allergy or other medical problems that limit your ability to take them. As always, you should wash your hands frequently to avoid catching the flu from, or spreading it to others.
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Dr. John Roberts is a local family physician and a Wabash College graduate. He is also one of the owners of The Paper of Montgomery County. You can contact him at thedoctor@thepaper24-7.com, or c/o The Paper of Montgomery County, 101 W. Main St., Crawfordsville, Ind.
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