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Page 20
THURSDAY, OCTOBER 20, 2016
The Rockaway Times
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By Peter Galvin, MD
Ask
the
DOC
The Flu
Influenza, aka the flu, is a
viral illness that is associated
with seasonal outbreaks during
the winter months in temper-
ate climates and during rainy
seasons in the tropics. The rea-
son for the seasonal nature of
epidemics is unknown but is
thought to be related to human
behavior. We humans tend to
stay indoors in closed spaces
during cold or rainy days. At un-
predictable intervals, pandem-
ics occur with very high attack
rates and severe illness. The
1918 flu epidemic is thought
to have killed about 20 million
people worldwide. These pan-
demics are associated with in-
fluenza A viruses that have dif-
ferent characteristics than the
usual subtypes and therefore
most people lack immunity to
these strains. These unusual
subtypes are carried by animals
like swine, waterfowl, and oth-
er animals.
The influenza virus has many
different forms and both in-
fluenza A and B have different
subtypes, differentiated by the
proteins found on the viral coat.
Symptoms of the disease are
fever, achiness, lethargy, and
cough and usually last five to
seven days, although the tired-
ness may last for weeks after the
disease. Complications, more
common in elderly or debilitat-
ed patients, include pneumo-
nia, myositis (heart infection),
meningitis, and toxic shock
syndrome. Seasonal flu epi-
demics in the U.S. are respon-
sible for up to 430,000 hospital-
izations and as many as 49,000
deaths. Factors associated with
severe illness include being age
five and under or over 65, dia-
betes, obesity, pregnancy, and
chronic diseases like HIV and
heart and lung diseases.
Influenza can be prevented
by annual vaccination. Most
common vaccines are grown in
hen eggs and contain an inac-
tivated virus. Many people be-
lieve that the vaccine can cause
the disease but this is incorrect.
A 24 to 36 hour-long period of
headache and feverishness may
occur following vaccination, but
this is rare. The most common
side effect is tenderness at the
injection site. Inactivated vac-
cines are either trivalent, mean-
ing they contain two strains of
the A virus and one strain of the
B virus (Fluvirin), or quadriva-
lentwhichcontains twoAstrains
and two B strains (Fluzone). A
recombinant trivalent vaccine,
not grown in egg protein (Flu-
blok), is available for those with
egg allergies. A live attenuated
quadrivalent vaccine, given in-
tranasally (Flumist), is available
but the CDC has recommended
that it not be used for the 2016-
2017 season.
The decision on what sub-
types to include in the annual
vaccine is made in February.
The decision is based upon the
strains that were seen since the
start of that season. The vac-
cine is usually different every
year. While no vaccine is 100
percent effective it is thought
that because all strains of influ-
enza are essentially the same
virus with minor variations in
the proteins coating it cross re-
activity does occur. This means
that even should a new strain
pop up, that is one that is not
included in the vaccine, the
vaccine will impart at least a
partial immunity making the
illness less severe.
So if you haven’t gotten your
vaccine yet get to your doctor
because now is the time.
Please direct questions and
comments to editor@rockaway-
times.com