A few years ago, the flu season started early and was responsible for a cluster of deaths among previously healthy children. The early deaths sounded an alarm for parents and health care providers alike, fearful of an unusually lethal influenza virus. Parents across the country scrambled to have their children vaccinated well into the season, and vaccine supplies were soon in short supply.
Fortunately, the flu season was less deadly than first feared. The early start was countered by a shorter-than-normal season, possibly the result of a long holiday break in December that slowed the spread through school contacts. When all the numbers were in, the flu season was well within the normal range.
But, that's not to be taken lightly.
In a normal year, an estimated 36,000 Americans die from the flu and 114,000 are sick enough to be hospitalized, according to the Centers for Disease Control. The very young and the very old are the most vulnerable.
Influenza is a respiratory illness spread by a virus that infects the nose, throat, bronchial tubes and lungs. The highly contagious virus is spread via airborne droplets from coughing and sneezing. Incubation takes two to three days.
There is no cure for influenza, but vaccination can provide substantial protection. Because different flu strains circulate each year, a new vaccine has to be formulated annually and flu shots repeated each fall. Vaccinations are relatively inexpensive and widely available at health clinics, pharmacies and community centers, usually starting in October.
Health officials meet early each year to decide on the makeup of the next season's vaccine. The decision has to be made in spring so the vaccine can be manufactured during the following months to be ready for fall.
Flu season typically starts in late fall or early winter and can run through winter into spring. The committee that decides on the current vaccine chooses two or three strains. In some years, the panel's educated guess is off the mark and a strain not covered by the vaccine becomes dominant. Even when that happens, however, those who were vaccinated usually get a milder case of flu than those not vaccinated at all.
New childhood guidelines
Both the Centers for Disease Control and Prevention and the American Academy of Pediatrics have now added routine annual influenza vaccination to the recommended childhood and adolescent immunization schedule.
Annual influenza vaccination is now recommended for healthy children between 6 and 23 months and for children older than 6 months with medical conditions that put them at high risk, including diabetes, asthma and HIV. The vaccine is approved for all children who want to obtain immunity from flu.
Although infants under 6 months of age are too young to be vaccinated, experts recommend vaccinating people in the household who will come in contact with the baby.
Adults older than age 50 should also get flu shots and public health officials now encourage flu vaccination for the public at large. The more people who are protected against infection, the more of a damping effect there is on an outbreak.
Seniors, as well as those with chronic diseases such as diabetes, heart and kidney disease are all susceptible to complications and need protection.
Pneumonia is the most serious complication of flu responsible for many thousands of death annually.
In a typical season, 10 to 20 percent of Americans come down with the flu. Most feel miserable for a week or two and then recover without complication.
A bout of flu can be severe enough to send most people to bed for at least a few days. Fever chills, aches, pains and cough are common symptoms. Bed rest, over-the-counter flu medications and plenty of liquids help most people on the road to recovery.
Prescription medications are available that can shorten the length of time a person is sick by a day or two, but to be effective they must be started within a day or two of the onset of illness. Tamiflu (a pill) and Relenza (a nasal spray) attack the flu virus at the cellular level and are effective against both type A and type B influenza.
As well as shortening the duration of the illness, Tamiflu and Relenza cut the risk of complications, including pneumonia and bronchitis.
Public health officials worry about the possibility of a pandemic, a large-scale, especially severe flu outbreak with the potential for killing millions worldwide.
In 1918, the Spanish flu, carried home by troops returning from the First World War, killed an estimated 20 million people worldwide. The death toll was greater than that for the war itself. The Asian flu in 1957 and the Hong Kong flu in 1968 both killed tens of thousands of Americans. Experts believe it is only a matter of time before another pandemic hits.
Experts are worried about the crossover of avian influenza, a strain that infects and kills birds. A number of cases have surfaced in humans in Asia, but these have occurred in people who have direct contact with infected poultry. The bird strain is not normally passed from one human to another, but there is a concern that if a human already infected with a human strain of influenza is also infected with an avian strain, the virus could mutate into a hybrid to which humans have little resistance. Antiviral drugs may be the only weapon we have in the event of a large-scale outbreak.
Although we might worry about the devastation of a pandemic, we already possess an effective weapon against the flu strains that crop up every year after year: immunizations. If Americans heed the recommendations for getting immunized against the flu this fall, many thousands of lives will be saved and much illness prevented.