Battle Against The Flu

Battle Against The Flu

This year’s flu season started early and is hitting hard. Diane and her guests discuss how it compares to previous years and what flu vaccines can and cannot do.

The influenza virus is spreading quickly across the U.S. More than half the states are reporting widespread outbreak of the disease. The Centers for Disease Control report the season started earlier and cases are more severe than last year. Just yesterday, Boston declared a public health emergency. And flu triage tents are being set up outside hospital emergency rooms to contain the outbreak. The main flu strain being reported appears to be a good match to flu strains in this year’s vaccine. But many who got vaccinated are still coming down with the flu. And many more weren’t vaccinated at all. Diane and her guests discuss this year’s battle against the flu.

Guests

Dr. Thomas Frieden

director, U.S. Centers for Disease Control and Prevention.

Dr. Michael Osterholm

director of the Center for Infectious Disease Research and Policy and director of the NIH-sponsored Minnesota Center of Excellence for Influenza Research and Surveillance; board member, National Science Advisory Board on Biosecurity.

Dr. Kavita Patel

internist, Johns Hopkins Medicine; fellow and managing director of Delivery System Reform and Clinical Transformation, the Engelberg Center for Health Care Reform, Brookings Institution.

Dr. Donald Milton

professor and director, Institute for Applied Environmental Health, University of Maryland School of Public Health

Dr. Leonard Friedland

V.P. and Head, GlaxoSmithKline North America Vaccines Clinical Development and Medical Affairs

Ask The Expert: Dr. Friedland Answers Your Flu Questions

Is this year's flu really that bad? How does herd immunity work? My church uses a common cup; what are the risks of infection? Dr. Leonard Friedland answered these listener questions and more. Some questions have been edited for space and clarity.

Dr. Friedland heads Clinical Development and Medical Affairs for GlaxoSmithKline Vaccines North America. Also a licensed pediatrician, Dr. Friedland played a key role in GSK’ s work with the U.S. FDA on the recent approval of Fluarix QIV, the first four-strain flu vaccine shot approved for U.S. use. It specifically is designed to help protect against the seasonal flu strains that have circulated in the U.S. for the past decade and should be available at the beginning of next year’s flu season.

Q: We have seen some antibiotics go useless over the years of using them and creating “super bugs” etc., that are resistant to our medicines. Do we risk the same issue by vaccinating people for the flu? Given that the vaccine needs to change year after year, what year does your panel think we will hit a wall where the tool of a flu vaccine will not work? Could this occur? – from willo via Web

A: This is not a concern with flu vaccines. People do not develop resistance from receiving annual influenza vaccines.

Q: My church is resistant to adapting communion customs (common cup) and we have a high median age and many people with medical conditions which should cause them to be very cautious. What is the current medical opinion of these practices? Also, I have many older friends obsessed with using cloth handkerchiefs instead of paper tissues. Isn't this an infection risk of some concern? – from Mountain molly via Web

A: The single best way to prevent seasonal influenza is to get vaccinated each year. Good health habits may also help protect the public against the flu. The CDC has resources on good health habits for preventing seasonal flu. Another very helpful website is Prevent Influenza, which includes a flu provider locater to help you find a healthcare provider near you who is offering flu shots. It’s not too late to get a flu shot today.

Q: Is this flu year really that bad? It sounds like it is being somewhat hyped. It is interesting that this hype coincides with the first commercials on television for Tamiflu, which in prior years was not advertised and seemed to be advised for severe cases or reserved for pandemic situations. Is the hype manufactured to sell Tamiflu? – from TR89001 via Web

A: The CDC has noted some elevated activities in certain areas of the country, but what’s most notable is that this has been an early flu season, catching many people by surprise before they’ve had a thought of getting a flu shot. It’s not too late, though, and people who have not already received a flu vaccine this season should do so now.

Q: My wife got a vaccine shot 2.5 months ago at a pharmacy and still has a sore arm. One said the shot may have been in or too close to the bone and I think her doctor said that the storage of the vaccine at pharmacies may not be the best and it may have calcified. Any thoughts? – from jhervitz via Web

A: Please have your wife speak to the pharmacist who administered the vaccine; not only to determine if follow-up care might be needed, but also because these type of issues are reported to the Vaccine Adverse Events Reporting System.

Q: What about the principle that viral infections are good for us in that our weaker cells succumb to viral invasion and are purged from the body, and the same viral process serves to teach our bodies to resist? – from hananchrista via Web

A: I am a scientist and physician. In this case, I’m going to think like a physician: Influenza illness can be a serious; thousands of people are hospitalized right now because of it. The bottom line is that the U.S. is currently experiencing an early influenza season, with activity elevated nationally. People who have not already received a flu vaccine this season should do so now.

Q: If I am healthy and if I can isolate myself if I get sick, is it better for "herd immunity" that I NOT get the vaccine? – from Bonnie Raymond via Web

A: The term “herd immunity” typically refers to when a sufficient number of the population is vaccinated against certain diseases that it becomes more unlikely that those who haven’t or can’t be vaccinated still see a lesser risk of getting the disease. So while it is smart to avoid others when you are ill, this influenza illness can be a serious – complications can include hospitalization and in some cases, even death. I can’t stress enough that the U.S currently is experiencing an early influenza season, with activity elevated nationally. Bottom line: People who have not already received a flu vaccine this season should do so now.

Q: I am highly allergic to egg yolk. Is there a flu shot that I can get? Each time I go and tell them of my allergy, they say that I should not get the vaccine. – from Ben via Facebook

A: Do continue to discuss this with your healthcare provider; don’t think it’s a waste of time to ask – a good healthcare provider should be able to help just about any patient develop a winning strategy to help protect oneself against the flu!

Q: Why do doctors refuse to test for the flu virus? I have an 8-year-old child and she was never tested for the flu virus when I brought her in with the symptoms, even during the swine flu outbreak. – from edcosta via Web

A: I’m neither endorsing nor discouraging a test here. I just want to confirm that testing is available. Never hesitate to ask your healthcare provider, “Why…”

Q: Can you talk about just how the vaccine works? – from Kathleen via Web

A: Flu vaccines cause antibodies to develop in the body around two weeks after vaccination. These antibodies provide protection against infection with the viruses that are in the vaccine.

Q: I had Guillian Barre syndrome in 1994-95. I was told that I could never get a flu shot because of this. Is that still true today? Or have guidelines changed? – from Hanerty from Web

A: People with a history of Guillain-Barré Syndrome that occurred after receiving influenza vaccine and who are not at risk for severe illness from influenza should generally not receive vaccine. Make sure to always alert your healthcare provider of your medical history. Regardless of if you should get a vaccination, healthcare providers can help you develop a personal strategy that may help prevent you from getting the flu!

Q: Regarding people getting the flu shortly after getting the vaccine-- seems like they might be more susceptible perhaps to the non-vaccine strains (and other things!) in that immune response window after they receive the shot. Thoughts? – from Pmichelle via Web

A: How well the flu vaccine works (or its ability to prevent influenza illness) can range widely from season to season and also can vary depending on who is being vaccinated. At least two factors play an important role in determining the likelihood that influenza vaccine will protect a person from influenza illness: 1) characteristics of the person being vaccinated (such as their age and health), and 2) the similarity or "match" between the influenza viruses in the vaccine and those spreading in the community.

Q: Are there long term public health risks associated with the flu vaccines? Will the public develop a resistance and make the vaccine become less effective? – from mstilp via Web

A: Over the years, hundreds of millions of Americans have safely received seasonal flu vaccines. People do not develop resistance from receiving annual influenza vaccines.

Q: What is the best vaccination for someone who does not have a full blown anaphylactic reaction to eggs, but a mild egg allergy? My employer has determined that my reaction is not severe enough, and will require me to get the vaccine or be fired. My son has a severe allergy to eggs, but mine is not that bad. I'm 50, in otherwise good health, unvaccinated RN for 20 years and have not had the flu. – from Gwen via Web

A: I’m sorry to hear of your dilemma, but I’m confident that your best path forward lies in discussing this matter with your healthcare provider.

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