Influenza is a real threat each and every year during the winter months. The influenza viruses that are different from the common cold viruses inflict significant morbidity and even mortality and should be taken seriously. The Influenza virus of which there are generally three types (A, B & C) causes the Flu. Type A is the most common and it is the subtypes of A and B that cause the seasonal outbreaks. The constant mutations of these viruses make it necessary to vaccinate annually with updated strains.
Everyone is affected, from the very young to the older adult. Most outbreaks or epidemics occur in late fall and early winter. It has been reported that as many as 20,000 deaths and over 100,000 hospitalizations occur each year in the USA due to the flu. Those deaths are highest in the elderly (over 65), folks with diabetes, HIV, nursing home residents, pregnant women and those with chronic diseases of the lung, heart and kidneys. A person is contagious for up to 5 days after onset with symptoms that include high fever, aches in joints, muscles and around the eyes, weakness, headache, dry cough, sore throat and watery discharge from nose and eyes. Annually, there are many that miss considerable time from work in the winter months due to infection with this virus. You acquire the flu virus through contact with contaminated aerosols or droplets found on surfaces referred to as fomites (such as doorknobs, countertops and telephones.) So prevention is crucial. Of course maintaining a health lifestyle (not smoking, eating right, plenty of exercise & sleep) is important as is taking care not to come in contact with potential contaminants (good hand washing, not sharing cups with others, etc.) And vaccinations are of critical importance especially to those high-risk individuals. They may even be considered as lifesaving therapy. The flu vaccine (shot) is unique each year, being made up of inactivated A & B viruses. It is injected into the upper arm and should be taken in early fall (from October to mid-November) because it takes two weeks to confer immunity. But once injected (it is considered 70 – 90% effective), it can protect you from the symptoms of the flu, lost work, hospitalization and even death.
Who should get the flu shot? Anyone over 50, those with chronic diseases, those with HIV/AIDS, women over 14 weeks pregnant, residents of nursing homes, health care workers, bank tellers, waitresses, students especially those living in dormitories, and those people interested in reducing risk for the flu. Side effects to the shot are rare but include soreness and mild muscle aches or low-grade fever for only a couple of days. These untoward effects are most often noticed in children. Life threatening allergic reaction and something called Guillain-Barre syndrome are extremely rare reactions to the vaccine. But those allergic to eggs should probably avoid the shot. Myths about the flu shot such as getting the flu from it are unfounded. Since it contains the killed form of the virus, it is impossible to actually acquire the syndrome. Another myth is that one shot in you life will do, but since the virus mutates from season to season, revaccination with new strains must occur each season. For those needle-phobes, there is an investigational nasal spray “inoculation” is available under the name FluMist. The nasal-spray flu vaccine (called LAIV for Live Attenuated Influenza Vaccine) was licensed in 2003. It is different from the typical flu shot because it contains weakened live influenza viruses instead of killed viruses and is administered by nasal spray instead of injection. Only indicated for health folks from 5 to 45 years of age.
There is a lot of talk about a particular virulent type of emerging flu called Avian Influenza. Other animals can become infected with flu viruses such as birds and pigs (remember the swine flu?) but zoonotic viruses (or species-jumping viruses as they are called) are usually restricted to a few bad players that may mutate and infect humans. While avian viruses can attach easily to bird cells they must first genetically mutate before becoming able to attach and thus infect human cells. The A (H5N1) Strain (Avian Flu) is designated because it comes from the “A” type virus and there are subtypes defined by the proteins that constitute the outer layer. The two outer proteins “H” (of which there are 16 subtypes) and “N” (of which there are 9 subtypes) are used to identify a specific virus.
Scientist are concerned that a human form of H5N1 will cause a pandemic like flu virus in the 1918 world wide epidemic that killed 25 to 50 million people. The flu of 1918 was identified using DNA technology as being a mutation of the avian virus. We can never be sure if the mutation will ever occur, but some experts believe it will within the next 2 years and could spark a pandemic. To date there are about 200 reported human cases and those being from China, SE Asia and Turkey. Transmission has only been from bird-to-human and occurred mostly in those that handle poultry or live in close proximity to birds. The cases have been quite virulent with mortality approximating 50%. A vaccine that protects birds is in use in high-risk areas but to develop a vaccine for humans can take up to 6 months.
What happens should you get the flu? Well, there are standard medications that should be started within 24 hours of symptoms such as Amantadine, Rimantadine (Flumadine), Zanamivir (Relenza) and Oseltamivir (Tamiflu). The prescription usually lasts 5 to 7 days and it may cut short the course of infection and prevent serious complications such as pneumonia. Currently H5N1 is sensitive to these drugs, but mounting evidence has shown some resistance developing to these drugs. Availability of these drugs in a pandemic may also be problematic. Decongestants such as phenylephrin and pseudoephedrin are helpful with symptoms. Antibiotics are not indicated unless there is a secondary bacterial infection. Antibiotics are useless against the flu virus. Nutritional medicine offers high doses of vitamin C, and Zinc. Herbal remedies include Echinacea (E. purpurea root extract) and Goldenseal (H. candadesis root extract). Other immune boosting compounds are extract of maitake and reishi mushrooms, garlic extracts, and olive leaf extract. Effects remain to be seen by a direct hit by the avian flu.
A powerful tool in the early treatment of the flu is something called the Myers’ Cocktail. This is a rapid intravenous infusion of high dose vitamins and minerals given over 10 minutes. It has proven effects in reduction of symptoms, viral spread and getting you back on your feet quickly after being infected. Myers’ cocktails must be administered in the doctor’s office and depending on how severe the illness, one to three treatments during a course may be indicated. If caught early, a Myers’ Cocktail may be the most effective remedy in the treatment of the flu. The Myers’ Cocktail is also useful in many other maladies, but for acute respiratory and viral infections, it stands heads above other treatments. I am currently working on an Oral/IM combination to make this therapy more accessible and easily to administer without IV access.
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JP Saleeby, MD is co-director of the ER at LRMC, adjunct professor at GSU in Statesboro, GA and a medical / health writer for several regional and national journals. He maintains a blog at: www.docsaleeby.blogspot.com.
Reference:
http://www.cdc.gov/
http://docsaleeby.blogspot.com/
http://www.patientcareonline.com/
www.defra.gov.uk/science
http://www.thehealthierlife.co.uk/
