Flu Season to Be Bad But Not Pandemic, Experts Say

[DRMIZER]

by Maggie Fox

The current U.S. influenza outbreak may be unusually early and somewhat more severe than usual, but health experts said on Monday it is not the killer pandemic they have been warning will eventually come.

And while there is strong demand for flu vaccine, there are no signs that people who most need to be vaccinated -- the elderly, pregnant women, infants and those with weakened immune systems -- will be unable to find the vaccine.

"It's not the big nasty that everyone was worried about," said Richard Webby, an influenza virus expert at St. Jude Children's Research Hospital in Memphis.

There are no centrally collected figures on deaths so far this year but a handful have made headlines, including the flu deaths of at least six children in Colorado.

Influenza kills 36,000 people in the United States in a mild year -- twice as many in a bad year. Flu viruses, which cause respiratory symptoms, fever and muscle aches, kill anywhere between 250,000 and 500,000 people every year around the world.

People get the flu by breathing in bits of virus when a patient coughs or sneezes, or when a patient rubs his or her drippy nose and then touches a common area like a switch or doorknob. The virus can live for days and passes easily from fingertip to the nose or mouth.

New strains regularly pop up, with varying degrees of lethality. What experts fear -- and predict will eventually come again -- is something like the "Spanish flu" pandemic of 1918. It killed between 40 million and 50 million worldwide.

The "Asian flu" and "Hong Kong flu" pandemics of 1956-1957 and 1967-1968 killed a combined 4.5 million people.

This year the strain is called Fujian flu and it does not, so far, appear to be nearly as serious, although it has caused an early flu season in the United States.

NOT A PANDEMIC

"We have seen these before," Webby said in a telephone interview. "The big thing that everyone is worried about is a pandemic virus -- a completely new virus. That certainly is not what is happening."

Still, the Centers for Disease Control and Prevention (news - web sites) says the United States may be in for a severe season.

The current flu vaccine, a cocktail designed to protect against several different strains, is not expressly formulated to match the Fujian strain now circulating.

"But it's very close to one of the strains that is in the vaccine," CDC Director Dr. Julie Gerberding told CNN news.

"It might not be perfect, but it will protect people."

Because there are many different strains of flu, no influenza vaccine is perfect. In general the vaccines prevent the disease in most people and in the rest prevent the most deadly complications, such as pneumonia.

As with any virus, a person's individual risk depends on his or her health and genetic makeup.

This year, extra attention has been focused on flu because of the outbreak earlier in the year of the new Severe Acute Respiratory Syndrome or SARS (news - web sites) virus, experts said. And, as in three of the last four years, there is the threat of a flu vaccine shortage.

Only two companies make influenza vaccine -- Chiron and Aventis SA . Both said last week they had shipped out all their supplies -- hardly a shortage, but enough to make the CDC start looking to see if everyone who needs the vaccine can get it.

"I think the important thing is that we still do have vaccine out there and for those people who are at highest risk for the complications of influenza, you need to get persistent about finding it," Gerberding said.

A third vaccine, FluMist, can be taken nasally. Made by MedImmune, it is approved for adults up to the age of 50 and is more expensive than a shot but widely available.

[Missouri Mule]

This is serious business. My 2 1/2 year old niece was admitted to the hospital for the flu yesterday. She had received one of the two shots they give children and came down with the flu before the second shot.

[Blueangel]

Don't you just love virus experts! :rolleyes:

I've just recovered from the latest strain of flu (I think it's called Fujian flu) and I don't want anything like that again. My doctor said that no currently available vaccine would have protected me from it because it's a new strain.
It's extremely rare that I'm ill, but this flu hit me like an express train.
It's killed several children in the UK already.

[DRMIZER]

Originally posted by Missouri Mule
This is serious business. My 2 1/2 year old niece was admitted to the hospital for the flu yesterday. She had received one of the two shots they give children and came down with the flu before the second shot.

Very, very serious!

[PatriotChick]

I think all these news reports on the flu are making people panic. I haven't even gotten a flu shot this year, and I don't plan to.

[DRMIZER]

Originally posted by PatriotChick
I think all these news reports on the flu are making people panic. I haven't even gotten a flu shot this year, and I don't plan to.
I never do and I'm a diabetic!

[Simon666]

Originally posted by PatriotChick
I think all these news reports on the flu are making people panic. I haven't even gotten a flu shot this year, and I don't plan to.
Why not?

Misconceptions about the flu (http://www.cbc.ca/news/indepth/flu/)

Daphne Gray Grant | January 2000
Updated October 2002
Each flu season, usually from December to March, the disease cuts a swath through workplaces, schools and hospital emergency rooms.

Yet despite its big impact, the flu is poorly understood by most Canadians. We think of it as a nuisance, like the snow. But it's much more than that.

Here are the top 10 misconceptions about the flu.

1) No one ever died from the flu.

Wrong. Although statistically the flu is unlikely to kill young, healthy individuals, it's still the leading infectious cause of hospitalization and death in Canada. That's because it attacks and weakens the elderly and the ill – people with heart and lung conditions, diabetes, kidney disease, HIV and cancer. The flu will kill about 4,500 Canadians in this year alone. That number climbs to 6,000 if you include those who will die from complications, such as pneumonia.

2) For most people it's not a serious illness.

That depends how you define serious. It makes about five million Canadians sick every year – that's one in every six of us. If you're one of the unlucky, you can count on being off work for as much as a week and feeling pretty lousy for much longer than that, perhaps up to a month. About 1.5 million workdays are lost each year and the estimated cost to the Canadian system – in terms of health care costs and lost productivity – is a cool $1 billion.

3) I've had the flu three times this year.

Fortunately, that's just not the case. What you've probably had is a cold, or repeated colds – most people can expect to get two to four of them a year. Here's what sets the flu apart from the common cold: It comes on suddenly. While the total incubation period is usually about two days, you can go from feeling perfectly fine to death warmed over in a matter of hours. That's because the flu virus is a profligate little bug. "It replicates in just four hours," says Dr. Danuta Skowronski, a physician epidemiologist with the B.C. Centre for Disease Control.
You have a fever. With a cold, you may be sneezing and uncomfortable, but your temperature isn't likely to rise. With the flu, the alternating fever and chills may make you feel as though your body's thermostat has gone completely wacky.
You're exhausted. "The technical term is 'prostration'," says Skowronski. "What that means is flat out fatigue." With a cold you feel as though you can carry on. With the flu, you just want to crawl into bed.

4) I can't have the flu – I'm not nauseated.

Contrary to common belief, stomach and intestinal complaints aren't generally a feature of the flu, except in small children. "The flu is a respiratory illness," says Skowronski, "and the lungs are the major site of symptoms." You might be surprised to learn that the virus doesn't even spread throughout your body. Your headache, fever and aching muscles are actually an "inflammatory response" – that is, your body is working overtime to try to kill off the virus in your lungs. A small number of people (fewer than 10 per cent) may have some intestinal problems with the flu, but that's not the main feature of the bug. If you were nauseated and vomiting, it's far more likely you had food poisoning or gastroenteritis. As for the term "stomach flu", well, there's no such thing.

5) I'm so sick – I need a doctor!

Unless you're elderly or have other health problems, resist the urge to see your doctor. Antibiotics are powerless in the face of the flu virus, and you'll only be spreading your germs to others in the waiting room. Dr. Louise Sourisseau, a family practitioner in Richmond, B.C. says that during flu season, somewhere between five and 10 per cent of her patients are suffering from the flu. "I think the degree of respiratory symptoms they have really surprises them," she says. "A lot of them feel so sick they can't believe it's the flu." Nevertheless, she's pleased that fewer and fewer patients are demanding antibiotics. "I think more people understand that it's a viral illness." The time to see your doctor is if symptoms start to worsen after the illness should have peaked (about three days) or if you start coughing up a thick, green sputum.

(PART 1 OF 2)

[Simon666]

6) There's nothing I can do to prevent the flu.

Wrong, on three counts. First, steer clear of people who have the bug. Second, wash your hands frequently. "It doesn't need to be super hot water – you're not trying to sterilize your hands," says Skowronski, "you're just trying to wash the virus away." Nor do you need the fancy new anti-bacterial soaps. The soap isn't meant to kill the bug, it's purpose is to make your hands slippery, so the virus slides off under water. Third, and most important, get immunized. "Immunization is a modern miracle," Skowronski says. The immunization does many things – it reduces the incidence of the flu, its severity, its duration and your level of infectiousness. Many people can get the shot for free (if you're elderly, a health care worker or have a health condition) and a growing number of companies are offering them to their employees. Even if you have to pay for the shot yourself it's a bargain – about $10 at your doctor's office or local public health clinic. Still not convinced? Here are the numbers showing the vaccine's efficacy, from the Mayo Health Clinic:

70 to 90 per cent prevention rate in healthy recipients
30 to 50 per cent prevention in elderly recipients
50 to 70 per cent reduction in total hospitalizations
50 to 85 per cent reduction in deaths
The only reason to avoid the vaccine is if you're allergic to eggs (it's grown in an egg base).

7) I never get sick – I don't need a flu shot.

Trouble is, you may be sick and just not know it. About one in five people can have the virus and have no symptoms whatsoever. That means you may be unwittingly passing the bug along to your co-workers – or, worse, your baby, your diabetic friend or your elderly grandmother. Dr. Alison McGear, director of infection control at Toronto's Mount Sinai Hospital, says the day is coming when all of us will get flu shots. "I think that's where we're going," she says. Bottom line now: it's worth considering paying for the shot yourself, even if you're young and healthy.

8) The last time I had a flu shot, it gave me the flu.

Impossible. While the flu shot may give you a sore arm or make you feel a bit achy for a day or so, it can't actually give you the flu. That's because it's made from a dead form of the virus that "tricks" your body into thinking it's the flu, and jump starts your immune system into producing antibodies. "Some people may come down with the flu after getting the shot but that's either coincidence or they were already incubating it," Sourisseau says. It's also worth remembering that the flu shot is highly specific (it only protects you against the strains of the flu for which it was developed) and it won't protect you against the common cold

9) If I get the flu, I can just take one of the new anti-flu drugs on the market.

Bonus points if you're aware that there are two new anti-viral drugs now licensed in Canada to fight the flu. They're known by the trade names Relenza, which is inhaled, and Tamiflu, which is taken orally. That's the good news. The bad news is that they have to be taken in the first 24 to 48 hours of illness – when many people may not realize they have the flu. "The horse is out of the barn after that," says Skowronski. What's more, the drugs require a prescription. That fact has the potential for dramatically driving up health care costs if people whisk themselves to the doctor at the first sign of a fever. Health officials have yet to come up with recommendations for the public on that question, Skowronski says.

10) Science will soon have the flu beat.

Well, not likely. The flu is a tricky virus; it mutates all the time, getting tougher and smarter. And every 10 to 40 years it mutates so radically, it leads to a pandemic. The most famous recent one, which occurred in 1918, killed somewhere between 30 and 50 million people worldwide. There was another frightening bout in 1968. Scientists were worried that the avian flu of 1997 was going to be the next big pandemic, but fortunately, the virus didn't transmit itself very well – and officials took quick action, wiping out the chicken population in Hong Kong. "The big question," says Skowronski, "is whether that virus is still in hiding somewhere, mutating." No one knows the answer to that one.

(PART 2 OF 2)

======================================

Concerning 10), Belgian scientists are working on that, I've just posted a thread on that in the science forum. (http://www.whistlestopper.com/showthread.php?s=&threadid=1625)

[Locke]

I have somthing intereresting to think about..
Does the flu shot really help?
I mean, is it worth the money, time, and quick sharp pain (ok, not as much pain, but hey) to get one?

Do you know how they pick the flu shot out? Really, its just guess, and hit or miss. You cant predict the flu, and to have enough of the quantity needed they have to produce the vaccine in advance.

Well, I dont think its worth it, but I just dont like needles anyways, and I dont think I've had the flu in a long time, just lots of colds. Oh well...

[Simon666]

Originally posted by Locke
I have somthing intereresting to think about..
Does the flu shot really help?
I mean, is it worth the money, time, and quick sharp pain (ok, not as much pain, but hey) to get one?

Do you know how they pick the flu shot out? Really, its just guess, and hit or miss. You cant predict the flu, and to have enough of the quantity needed they have to produce the vaccine in advance.

Well, I dont think its worth it, but I just dont like needles anyways, and I dont think I've had the flu in a long time, just lots of colds. Oh well...
Don't they give it free at work? I think it is cheaper for employers to hand out free vaccines to those who want to work than to pay sick leave, I got mine free. It also doesn't cost much I believe.

[Locke]

Hey, depends where you work. Yeah, they dont cost much... but, it is money you're using. And chances are, it isn't gonna work anways, that's my point.

[RepublicanGal]

The injected flu vaccine is a killed virus and cannot cauze the flu. Too often, people who are vaccinated have already been exposed to the flu and wil contract the illness, because it has already been incubating in the body.

FluMist, the immunization that is applied nasally, is a modified live virus. There is still some contention regarding whether it can cause the flu. (Any modified live virus can potentially cause the disease, if the controls over the lot have slipped somewhere.) It is also contraindicated for people with respiratory problems, immunocompromised, etc. (just the type of people who should protect themselves against the flu).

FluMist (the nasal immunization) is not covered by any insurance yet. The killed virus, the injectible, is covered by most insurance, but if you have a policy which excludes preventative procedures, it may be denied.

FluMist will cost you $60-$70 dollars. The injectable will cost probably about $22, or may be less (or free) at county clinics, or a simple copayment or perhaps nothing if your insurance allows it.

The flu shot will protect you against that particular strain. If the CDC (Center for Disease Control) has not identified the exact strain of flu, which some are saying has happened this year, then you may still be susceptible to the particularly virulent strain of flu that is killing children.

Definitely less expensive for employers to offer the shot for free. That's a no-brainer. Any business which has contact with the general population would benefit from corporate flu clinics..