Fluish seasons.
Every year at around this time, the flu comes back – haunting some, infecting others. Just like taxes, death and nasty surprises, the flu bug has to be guarded against - kept at bay, lied about, exaggerated, emphasized, complicated and generally not well tolerated.
We have all had this bug in one of its forms, at some point in our lives. Some people get every bug that passes through town; others will tell that they never get sick. Everybody knows the story about the guy that died from ‘flu (“and he was so young”), or has some horrifying story about someone he knows that the flu hurt really badly. The bottom line is that we all know the virus is an evil little sucker, that will hurt you if you get it, and if you’ve been really bad and smoke a lot, then you’ll end up in hospital for two weeks in the care of a doctor that charges too much and likes to give injections...Hopefully, this article might get dispel some of the myths and folklore about the influenza virus, provide some scientific facts about the bug, and how to manage your symptoms should you get hit by this tyrannical beastie.
Firstly, proper flu is caused by a particular strain of flu virus. These strains of virus are genetic mutations of the same “mother virus” and all have their own characteristics, causing flu symptoms that vary from one strain to another. The basic virus has similar features that may vary from one strain to the other, but the genetic core of each strain has a lot in common. The analogy would be a bad guy (the core virus) who has a whole lot of different masks. Each time the bad guy commits a crime, he changes his mask, so that the criminal has a different “face” with each crime he commits, just like the flu virus, which changes its identity from one strain to the next.
Now, every year a variety of flu strains will appear. Each has its unique features (its own “mask”), but is still one of the flu family. By definition, flu is characterised by a high fever, muscle or joint pain, runny and stuffy noses and often some respiratory features (cough, sore throat) and headache. Some flu viruses affect the throat more that the chest, others may affect the chest to a greater degree, and so each flu strain has its own features, and can be characterised by those features. The flu is therefore characterised according to its symptom complex and genetic code, and then named after the place where it presented first or was identified first – hence the Sydney flu, Singapore flu etc. Some flu viruses are simply given a number, never to be named – just a number like the little criminal it is. The importance of differentiating each type or strain of flu virus, is so that statisticians can predict which type of virus will strike the southern hemisphere in the next season, and hopefully develop a vaccine against the flu strains that are predicted to affect us in the next year.
Now, next to politics, religion and SARS, nothing sparks a conflict like a discussion on the flu vaccine. Opinions on the flu vaccine are like belly buttons – everyone has one, and they’re all different. There is not even a consensus on the flu vaccine in the medical community. Some doctors say that they work, others say that they should be banned because of their effectiveness, and yet other doctors fly in the face of conventional wisdom and say they don’t work at all. The long and short of it all is that statistically, the flu vaccine works – maybe not all of the time, but statistically you have less chance of getting flu if you have been vaccinated against that particular strain, than if you just cross your fingers and hope that the wave of flu leaves you standing. The vaccine is a dead vaccine, which means that particles of the flu virus are injected into your system – there is no way it can make you get the flu because the stuff injected are just pieces of the flu virus, and not the living virus, so the vaccine itself doesn’t make you sick. The principle of the vaccine is that it exposes you to pieces of the virus, so that your body makes antibodies against the viral particles. This means that your immune system already has the ammunition to kill the virus that infects you before you are actually infected. In lay terms, the vaccine gives the soldiers in your body a photograph of the flu strain which you are likely to encounter, so that when your bodies defence system comes into contact with that viral strain, it can kill the virus that looks like the photograph before the virus has time to multiply and make you really ill.
The vaccination can suppress your immune system in a relative way, because your immune system starts to make antibodies against the virus, keeping your immune system busy whilst it makes ammunition against the flu strain. Whilst the body is busy with the process of making ammo, any other virus that infects you has a better chance of making you ill, because the bodies’ soldiers are busy elsewhere, and the new infection has less soldiers to fight and it can therefore cause illness easier than if your system was fully functional. It is therefore important to have your vaccine before you get sick. It is important to have the vaccine whilst you are well, and not on any drugs that suppress your immune system like cortisone or chemotherapy drugs. Every flu vaccine conveys the immunity to your body for about four strains of flu per year. The more types of flu viruses that you have been immunized against, the greater the chances of your body intercepting the virus before it makes you ill. After a number of flu vaccines have been given, your body has a whole library of viral strains that it recognizes, allowing your immune system to kill the virus before it takes hold of your system. In other words, the more flu vaccines you have the more viral strains your body will be prepared for and will kill those strains before you get the full brunt of the flu.
Having a flu vaccine does not guarantee that you won’t get the flu. What it will do is allow your body to kill the virus quickly, so that you are less sick, for a shorter period of time. Flu vaccines are beneficial in all institutions (nursery school, school, old-age homes, workplaces) and to all people who get flu often or those who have underlying illnesses (smokers, asthmatics, the elderly)..
How do you treat flu? If you acquire a dose of flu, you may want to treat yourself with products that are available over the counter. You might need a paracetamol or aspirin based drug for the fever and sore muscles, a sinus preparation to stop the runny nose, and possibly an expectorant for your chest. Bed rest in a constant environment, with lots of sleep (your immune system is much more functional whilst you sleep), lots of fluids and more sleep is essential. Try to avoid heaters and air conditioners, because they dry out your mucous membranes. Which then takes longer to heal.
When do you need a doctor? Some flu viruses do kill people, especially those who have an underlying physical problem (e.g. cystic fibrosis, asthma, the elderly). If you persist in getting worse despite the medications you got from the pharmacist, then it is possibly best to see your doctor soon. Other helpful tips would be a fever that persists or is very high, if you are sick for longer that seven days, or if you are ticking along, not too sick, but not that well, and you should suddenly deteriorate, then you may have contracted a secondary infection which may require antibiotics.
Antibiotics themselves do not kill the flu virus. Antibiotics kill the secondary infective bugs that complicate flu. We see lots of people with flu who get over it well with very little intervention from us. But we also see the guys with pneumonia or a bacterial sinusitis, which has complicated the flu he had, and here an antibiotic may be useful in treating the secondary infection. Your doctor is trained to know when to give an antibiotic, and when one if not necessary. He is not supposed to give an antibiotic script telephonically, unless he knows exactly where the infection is, and has examined the patient thoroughly in the short time before the patient needs the antibiotic. It is sometimes difficult to predict which antibiotic would be the most effective, and this choice of an appropriate antibiotic is often only gleaned by the doctor during a physical examination. Your doctor will probably give you a better antibiotic after he/she has examined you, that if you phone him asking for a broad-spectrum antibiotic.
People pick up the flu virus from the community. The virus may be spread in micro-droplets in the atmosphere, which arise from sneezing and coughing. The unfortunate patient who has no immunity then inhales these micro-droplets, and he will get flu when the virus re-activates on the new hosts’ mucous membranes. Hands can also become contaminated by the virus, and a hand with the flu virus on it may easily rub the virus into a mucous membrane by such simple acts as rubbing an eye or scratching the inside of a nose. Sharing straws, cups and unwashed cutlery with sick people also spread the virus, as does kissing a sick person spread the virus. Sharing a closed room with lots of other people in the winter as we are want to do, rather that being outside where the virus can’t be trapped, or sharing an office or aircraft cabin with air-conditioning will also expose lots of healthy people to the flu virus.
The first trick in avoiding the flu virus is prevention.
- Have the flu vaccine – scientifically proven that you will get the flu less badly and for a shorter period
- Avoid people with flu. Encourage sick people to go home and get better – that way you might be exposed to their bugs less in a work or school environment.
- Maintain a healthy lifestyle – fruit, balanced diet, lots of Vitamin C, good sleeping patterns and a healthy sporting lifestyle make one less prone to flu. Smokers are more prone to flu, and also more prone to the secondary infection that complicates flu – like pneumonia
- If you get sick, stay home, treat the symptoms with medication. Sleep as much as possible. Avoid heaters and air-conditioners. If your condition worsens, you start running really high fevers or are sick for longer that 7 days, it is possibly best to visit your doctor, as an antibiotic may be required..
The flu vaccine for this year was available, but all stocks have been depleted. We anticipate new stock in early May. This is not too late to have your vaccine, because we are only seeing the first of the flu viruses now. You should have some protection against the others that follow later in the year, so get yourself vaccinated soon.
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