Island Free Press ...Life and Lifestyles

The Island Doctor: Understanding and preventing influenza

By T. BENTLEY CRABTREE, JR.

Sunny beach days and warm water temperatures have truly perpetuated the “Endless Summer” here on Hatteras Island. However, recent rains have begun to usher in some cooler weather, and finally, fall has arrived. In the medical community that means influenza season. Fever, runny nose, body aches, headache, fatigue – all are common symptoms that can strike unsuspecting people, young and old alike.

Epidemics of influenza virus infection typically occur in the United States during this time of year. Approximately 36,000 deaths due to influenza and its complications will occur in the United States each year. Epidemiologic studies have confirmed that rates of infection are the highest in children, and rates of serious illness, or even death, from complications are highest in those persons 65 years and older, those children under the age of 2, and those with chronic health problems.

There are several things we, as a community, can all do to reduce the transmission and incidence of influenza virus illness.

The most effective strategy for reducing the spread of any communicable disease -- including influenza, strep throat, community-acquired MRSA, or the common cold -- is good hand-washing. Since it is well known that the spread of influenza is through direct person-to-person contact, personal attention to simple hygienic measures would most effectively reduce rates of disease dissemination.

The Center for Disease Control and Prevention (CDCP) recognizes the influenza vaccine as the most effective method for preventing infection from influenza virus exposure and reducing its potentially severe and lethal complications. The Advisory Committee on Immunization Practices (ACIP), a branch of the CDCP, earlier this summer released updated recommendations/ guidelines for vaccination against influenza for this season (2007-2008).

Vaccination is recommended for the following:

All persons, including school-aged children, who want to reduce the risk of becoming ill with influenza or transmitting influenza to others.
All children from 6 months – 5 years old. Children aged 6 months – 8 years should receive two doses of vaccine – if they have never been previously immunized against influenza. For those children who received only one dose in their first year – they should receive two doses the following year.
All persons 50 years of age and older.
Women who may become pregnant during influenza season.
Adults and children who have chronic health conditions including: pulmonary (including asthma), cardiovascular (except hypertension), kidney, liver, blood disorders, and diabetes.
Adults and children whom have depressed immune systems.
Residents of nursing homes or other chronic healthcare facilities
All healthcare personnel.
Healthy household contacts (including children) and caregivers of children under age 5 and adults over 50 – with particular emphasis on vaccinating contacts of children under 6 months old.
Healthy household contacts (including children) and caregivers of persons with medical conditions that put them at higher risk for severe complications from influenza.

The most obvious question that needs to be asked is this: If the influenza virus vaccine is so highly recommended by so many reputable medical authorities and is so well studied and deemed safe – even for infants 6 months old -- why isn’t everyone vaccinated?

The greatest obstacle to universal vaccination against influenza- aside from the obvious answer of lack of availability to all those who wish to have it – is public perception and misunderstanding of the vaccination.

First, and most importantly, getting an influenza vaccination or “flu shot” does not cause a person to get the flu. Let’s avoid getting into a detailed explanation of the exact science behind the vaccination. Simply understand that the vaccination or actual “shot” is derived from specific parts of the influenza virus, not the actual virus itself, which was the most prevalent the preceding year. People are not actually receiving injections of the influenza virus, only those parts which will allow the immune system to help prepare the body to fight infection. It is this same reason that explains why it is still possible to contract and get ill from exposure to influenza, despite having been vaccinated. However, great care and research go into the selection of the exact components of each year’s vaccination to ensure both the individual person and the public at large have the best chance of boosting their immunity.

The take-home message is quite simple. Everyone should recognize the potential health consequences that influenza can cause – both in terms of personal illness and a more widespread public health problem. The first line of defense against this threat is careful attention to personal hygiene – good hand washing! The next line of defense is encouragement of universal vaccination under current CDCP guidelines. The medical offices on the island (both Avon and Hatters) have an adequate supply of vaccine to ensure availability to all who request it.

Please protect yourselves and the ones you love and get your Flu Shot!

(T. Bentley Crabtree, Jr., is a physician with HealthEast Family Care clinics in Avon and Hatteras.)