Tuesday, 26 July 2011

Flu - Tackling the Winter Menace

Published in Panorama

Tackling the winter menace….. FLU

Come winter and flu or influenza has begun making its rounds, causing minor irritations, some loss of productive manhours in workplaces and increased absenteeism amongst school children.

Flue is a respiratory infection transmitted by a variety of flu viruses, the orthomyxovirus being the most prominent, according to Dr.P.G.Jacob, Physician, Shams Specialist Medical Centre. Flu can "knock you off your feet" as it sweeps through entire populations of people with outbreaks usually beginning suddenly in late fall and winter. “The abruptness of symptoms, high fever, chills, headache, malaise, dry cough, nasal stuffiness, running nose, sore throat and aching muscles and body pain, is what differentiates flue from colds and viral fever, both of which have similar symptoms,” explains Dr.Jacob.

By its very nature and mode of spread, flu takes on epidemic proportions and half the population of a community may be affected at a time with it, school children and the elderly being most susceptible to it. The disease is highly infectious and can spread through cough, sneeze of the affected person. One can contract flu simply by touching an object or surface contaminated by a touch from an infected person. Hence the risk of contracting flu is increased in crowded places and schools.

Symptoms of flu may actually take between one to four days of getting infected by the flu virus, to manifest. Doctors diagnose it by clinical examination of the patient and chiefly on the basis of whether flu is epidemic in the community and whether the patient’s symptoms fit the current pattern of symptoms. Laboratory tests are rarely used to confirm diagnosis, says Dr.Jacob.

Though in most cases, the illness takes on a mild form, abating after a week of sickness and a further week or two of severe exhaustion, depression, in some instances, flu can cause serious complications, cautions Dr.Jacob. “Most people who get the flu get better within a week although they may have a lingering cough and tire easily for a while longer, elderly people, over the age of 50 or 60, newborn babies and some people with certain chronic ailments, flu can be life threatening.

What are these possible complications from the Flu?
Dr.Jacob explains that secondary bacterial infections may be the commonest complication from flu. This may cause pneumonia in the weakened lungs and by the flu virus itself. Symptoms of complications will usually appear after you start feeling better.

Other Flu Complications which mainly affects children includes Reye's syndrome, a condition that affects the nerves, sometimes develops in children and adolescents who are recovering from the flu. Reye's syndrome begins with nausea and vomiting. It leads to damage of the liver and is a difficult condition to treat. The syndrome often begins in young people after they take aspirin to get rid of fever or pain, says Dr.Jacob. However Dr.Jacob is quick to allay fears, saying that Reye’s Syndrome is a highly rare occurrence following flu.

Yet other complications from flu include pericarditis and myocarditis, heart conditions that could be directly caused by the flu virus, opines Dr.Jacob. Similarly Encephalitis and seizures – brain conditions are rare complications of flu. Other complications of the flu that affect children are Convulsions caused by fever, Croup, ear infections, such as otitis media. New born babies recently out of intensive care units are particularly vulnerable to suffering from flu complications, adds the doctor.

Are there certain groups of people who are at high risk of contracting flu? The answer again is in the affirmative. Dr.Jacob identifies certain categories of people who are at increased risk based on U.K and U.S research and recommendations. These are: Elderly people above the age of 50, those people suffering from chronic diseases of the heart, lungs, or kidneys, diabetics, asthmatics, those whose immune system does not function properly, people suffering from a severe form of anemia, pregnant women who are three months pregnant during the flu season and healthcare workers of all categories working in hospitals, clinics, old age homes. Children between 6 months to 18 years who have been getting long term treatment with aspirin for other conditions are also at increased risk of getting infected with flu.

Once a person gets infected with flu, what is the treatment? Drinking plenty of fluids and rest in bed would be the best course of treating simple flu, according to Dr.Jacob. “Of course analgesics like paracetamol rather than aspirin may be given to relieve the symptoms of pain and fever. Treatment is basically symptomatic in that cough suppressants may be given to alleviate the dry cough associated with flu. In specific conditions we may treat the patients with antivirals like Amantadine and Rimantadine. Similarly, antibiotics are given only if there are secondary bacterial complications.

Prevention may be the better course of action adopted, and this necessitates annual flu shots or vaccination, particularly for the high risk groups of people. Says Dr.Jacob, “Though we basically identify 3 main types of flu, A, B and C, A and B types are the more common ones affecting human beings. While Influenza A causes pandemics, being spread worldwide, Type B is localized and usually more mild than type A. However scientists make a different vaccine every year because the strains of flu viruses change from year to year. The vaccine preparation is based on the strains of the flu viruses that are in circulation at the time and includes those A and B viruses expected to circulate the following winter. Sometimes, an unpredicted new strain may appear after the vaccine has been made. Which means one may get infected with the flu even after being vaccinated against it! However, in such instances, the protection will still be there and the flu will most likely take on a very mild form.

The vaccine may be given to children as young as six months old and especially those children who have been on aspirin for long time must be given the vaccine, according to Dr.Jacob, since they are at increased risk for developing Reye’s Syndrome following a flu attack.

Since it takes about 2 weeks for the vaccination to act, Dr.Jacob advices that the vaccinated should be taken at least 2 weeks before the onset of winter.

Are there possible side effects from the flu vaccine?
The most common side effect in children and adults is soreness at the site of the vaccination, fever, tiredness, and sore muscles. These side effects may begin 6 to 12 hours after vaccination and may last for up to two days.

The vaccine, says Dr.Jacob, is contraindicated in people who are allergic to chicken eggs, persons with high fever and those with a low blood platelet count.


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