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Recommendations for the upcoming flu season

October 15, 2011
By C. Paul Martin, M.D. , Marshall Independent

The recent outbreak of the bacterial infection Listeria associated with contaminated cantaloupes is a strong reminder of the role of infections in our daily lives and the need to protect ourselves from the serious complications which infections of all kinds (bacterial, viral, protozoan, and others) present to us.

It is again the time to try to ensure that we obtain increased immunity to the influenza viruses which all of us will undoubtedly experience in the upcoming winter months. As we have discussed in past columns, the medical profession does not have medications to optimally combat and treat certain viral illnesses.

Vaccination for active immunity is thus our best choice for control of these diseases in addition to the usual household and occupational preventive measures.

In past columns I have related the significant morbidity (illness) related to influenza and its sequelae. An interesting and entertaining book titled "Plagues and Poxes" by Yale physician Alfred J. Bollet (Demos Medical Publishing Co., New York, 2004) includes a remarkable historical medical discussion of influenza, the pandemic of 1918-19, World War I, and the role played by President Woodrow Wilson. The United States experienced nearly 550,000 deaths from influenza and pneumonia during that time. Dr. Bollet's summary of the disease and its present status and treatment is remarkably well stated and pertinent to contemporary health conditions.

His comments: "Influenza is a prime example of a disease that is spread readily from person to person, and thus can rapidly encompass the globe. It is also an example of a disease that people can acquire from domesticated animals. The ease of its spread makes it extremely difficult to prevent influenza through the usual public health measures, and the best means of prevention remains the development of the necessary vaccine for each outbreak, accompanied by rapid production and administration."

This flu season the vaccine formulated is similar to the vaccine used in 2011 due to the stability of the affecting viruses and a lesser phenomenon of antigenic shift. The same viral strains are anticipated so the antigens (immunological stimuli) in the present vaccine are A/California A/Perth/B/Brisbane. Adequate supplies of vaccine should be available this year. One should get his/her dose in the near future, but the vaccine will be available until next May; early vaccination is recommended. Two usual forms of influenza vaccines are available this year: the commonly used adult intramuscular dose and the nasally administered LAIV (Live Attenuated Influenza Vaccine) for those ages 2-49 years. Two newer forms are available but not widely used as yet in our area: a strengthened adult dosage and an intradermal dosage for patients ages 18-64.

In past columns I have outlined the ACIP (Advisory Commission on Immunization Practices) influenza vaccine recommendations. As Public Health officials have reviewed the vaccine and its use and effects, they have now recommended: " annual influenza vaccination for all persons, including school-aged children who want to reduce the risk of influenza or of transmitting influenza to others; all children aged 6 months to 4 years; all adults aged 50 years or older; individuals aged six months to 18 years at increased risk for Reye's Syndrome because of long-term treatment with aspirin; women who will be pregnant during the influenza season; persons with chronic pulmonary (including asthma), cardiovascular(excluding hypertension), renal, hepatic, hematological, or metabolic disorders (including diabetes); immunosuppressed persons; those with any condition that can compromise respiratory function; residents of nursing homes and other chronic care facilities; healthcare personnel; healthy household ; contacts and caregivers of children younger than 5 years and adults aged 50 years or older (especially contacts of infants younger than 6 months); and persons with medical conditions increasing their risk for severe complications from influenza." As one can see, nearly the entire population needs to be vaccinated! As with any medical condition, one should consult with his (her physician or healthcare center for personal guidance in these matters. Notably, here in the U.S., only about 50 percent of the recommended population obtains the vaccination!

Another wintertime preventive measure which I have found valuable for all persons is ensuring that your home humidity is about 35-40 percent. Such a level will help with all respiratory problems related to the warm dry air from our heating systems and may reduce the incidence of static electricity.

More cold weather health recommendations will be forthcoming later this winter.



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