Beware the Flu, Part Two

The flu this year is so bad the CDC is postponing their much anticipated How to Prepare for Nuclear War training. I suppose it’s comforting the CDC considers the flu a more pressing threat than the potential for nuclear war. On the other hand, the NY Times reports that “Even in the absence of a pandemic, a severe flu year kills nearly 650,000 people worldwide, while a mild one kills just under 300,000…In recent years, the C.D.C. estimates, flu has killed about 12,000 Americans in mild years and 56,000 in moderately severe ones.” Sure, those numbers don’t compare to those predicted to be killed in a nuclear attack, but that’s a different article.

Emergency rooms all over the country have struggled to keep up with incoming patients, some of them even having to turn patients away. Though the flu shot this year is estimated to be about 30% effective, it’s still very much worth getting:

It’s not too late to get a flu vaccine, the CDC said, and there should still be plenty of vaccine supply. Sometimes there are second and even third waves of flu, so a state that’s been hit hard by H3N2 might see a fresh wave of H1N1 flu later and then influenza B may pass through even later.

In addition to the flu shot and perhaps somewhat compulsive hand-washing, I’d like to offer my other personal recommendations of more citrus, and more fresh air.

 

Beware the Flu

There were signs this year was going to be a worse than normal flu season based on the severity of the flu in Australia. Generally, the Northern Hemisphere gets a similar flu season to the Southern Hemisphere. So far, the flu is widespread in 46 U.S. states. The flu vaccine each year is basically just a “best guess” concoction at what the most prevalent strain will be. Sometimes, like this year, it’s not a great match. Anyway, you should still get a flu shot.

You still have time!

In California, “so many people have fallen sick with influenza…that pharmacies have run out of flu medicines, emergency rooms are packed, and the death toll is rising higher than in previous years.” The predominant influenza strain this year is H3N2, which is both particularly virulent and which the vaccine does not work well against:

 National health officials say the vaccine might only be about 32% effective this year, which could be contributing to the high number of people falling ill.

“It tends to cause more deaths and more hospitalizations than the other strains,” said Dr. Jeffrey Gunzenhauser, L.A. County’s interim health officer.

Of extra concern this year are large numbers of older patients who are showing up at hospitals with the flu and pneumonia, a potentially fatal combination.

Additionally, “27 people younger than 65 have died of the flu in California since October, compared with three at the same time last year,” adding evidence that this flu season is unusually dangerous. All I, and the CDC, can really recommend is that you obsessively wash your hands and get a flu shot. Eat oranges. Get some fresh air. Those last two are my personal recommendations.

Have You Gotten Your Flu Shot?

Scientific American has a great article about vaccinations and herd immunity. Herd immunity refers to “the level of immunity in a population that’s needed to prevent an outbreak from happening.” We all know those people that eschew the flu shot every year because they think it might make them sick, or they claim they never get the flu, or they just plain don’t trust what’s in that needle. I am not going to criticize those people. I am going to let this article do it for me.

What you might not realize is that these vaccination campaigns for flu and other diseases are about much more than your health. They’re about achieving a collective resistance to disease that goes beyond individual well-being—and that is governed by mathematical principles unforgiving of unwise individual choices.

Another point on herd immunity from Second Nexus:

Of course, the average young and healthy person probably has little concern of developing a dangerous side effect of the flu, but the benefits of herd immunity is not even directed at the young and healthy: it is for the more susceptible among us — the pregnant, the very young, the elderly and the immunocompromised. For these people, immunization is crucial, but only if the vast majority of the population is taking part…

hundreds of thousands of people saw hospitals during flu season, and thousands more have died from influenza. This is a reality.

This is not about the vast majority of Americans who will survive the 2017-2018 flu season and subsequent seasons; it is for those who have no decision in whether they get ill or not.

Kids Dying of Swine Flu at Alarming Rate

Sobering news indeed.

The Boston Globe reports that “of the 86 children who have died since the new swine flu arose last spring, 43 deaths have been reported in September and early October alone, the Centers for Disease Control and Prevention reported. That’s a startling number because in some past winters, the CDC has counted 40 or 50 child deaths for the entire flu season — and no one knows how long this swine flu outbreak will last.”

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Severe Respiratory Failure

I had a mild heart-stopping moment just now when I was reviewing the WHO’s update on H1N1, published today on their web site, which hints at the real possibility of impending doom:

Severe respiratory failure

Perhaps most significantly, clinicians from around the world are reporting a very severe form of disease, also in young and otherwise healthy people, which is rarely seen during seasonal influenza infections. In these patients, the virus directly infects the lung, causing severe respiratory failure. Saving these lives depends on highly specialized and demanding care in intensive care units, usually with long and costly stays.

During the winter season in the southern hemisphere, several countries have viewed the need for intensive care as the greatest burden on health services. Some cities in these countries report that nearly 15 percent of hospitalized cases have required intensive care.

Preparedness measures need to anticipate this increased demand on intensive care units, which could be overwhelmed by a sudden surge in the number of severe cases.

Vulnerable groups

An increased risk during pregnancy is now consistently well-documented across countries. This risk takes on added significance for a virus, like this one, that preferentially infects younger people.

Data continue to show that certain medical conditions increase the risk of severe and fatal illness. These include respiratory disease, notably asthma, cardiovascular disease, diabetes and immunosuppression.

When anticipating the impact of the pandemic as more people become infected, health officials need to be aware that many of these predisposing conditions have become much more widespread in recent decades, thus increasing the pool of vulnerable people.

Obesity, which is frequently present in severe and fatal cases, is now a global epidemic. WHO estimates that, worldwide, more than 230 million people suffer from asthma, and more than 220 million people have diabetes.

Moreover, conditions such as asthma and diabetes are not usually considered killer diseases, especially in children and young adults. Young deaths from such conditions, precipitated by infection with the H1N1 virus, can be another dimension of the pandemic’s impact.

Higher risk of hospitalization and death

Several early studies show a higher risk of hospitalization and death among certain subgroups, including minority groups and indigenous populations. In some studies, the risk in these groups is four to five times higher than in the general population.

Although the reasons are not fully understood, possible explanations include lower standards of living and poor overall health status, including a high prevalence of conditions such as asthma, diabetes and hypertension.

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