Battle Against The Flu
http://thedianerehmshow.org/shows/2013-01-10/battle-against-flu
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.
Comments
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Greetings, everyone, Adam Possner here, assistant professor of general internal medicine at George Washington University in DC.
On January 8 I had a poem I wrote about the flu vaccine read on The Writer's Almanac. Here's the link: http://writersalmanac.publicradio.org/index.php?date=2013/01/08.
Keep fighting the good fight!
Best,
Adam
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?
Seriously Doctor, boiled chicken and herbs are more effective than the vaccine, and far cheaper. I guess if Tyson were still around to lobby for it, we might hear more about it.
I'm 65+ (former ICU/ER Rn of almost 2decades), blessed w/the notation as 'allergic to the flu shot'....I'm also a Veteran who was exposed to Agent Orange & can't tolerate most medications or many foods...so I use alternative health practices.
As far as I'm concerned, the flu shot is nothing more than a crap shoot sponsored by BigPharm, BigMed & BigBusiness. Get the flaming flu, get naturally immunized against it for the current season. I know that there are vectors where it is most helpful, but it's far far less than everyone in the world.
The main "worry" is that people who have the flu, miss work...and that is just not good business...so BigPharm makes the vaccine, BigMed pushes it, so BigBusiness can make more money for all of them
More effective, and far cheaper is to boil a whole chicken (take off the breast and leg/thighs for other use and boil the back and wings) loaded with fresh herbs, onions, garlic, celery and carrots. The boiled chicken has anti-viral qualities and the herbs are natural anti-biotics. The flu is a mercurial target and the vaccine seldom matches this year's model (of flu)
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?
Comment--When I had my first shot in 1960, it was a live virus and I got very sick. Not a concern today. I started up again about 7 yrs. ago with no problem..
Question--My wife got a shot 2.5 mos. 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 the storage of the vaccine at pharmacies may not be the best and it may have calcified.
Dr. Michael Osterholm implied that Dr. Milton's work was of poor quality. In fact, what he might have meant to say is that it was not relevant to the efficacy of a vaccine. This should be corrected on air.
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?
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?
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.
Can you talk about just how the vaccine works
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.
What Dr Patel said is very important - that Johns Hopkins and most US physicians use single dose vaccines which don't use Thimerosal. Please don't leave listeners with the idea that in US the vaccine contains thimerosal! Ask your physician!
my doctor never seems to take a swab or whatever to test if it is viral or bacterial and since it needs to be decided early in order to have anti-viral medication...why would he not test?
thanks
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?
Debbie
Vaccines represent a challenge to the innumerable system. 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?
Are there long term public health risks associated with the Flu Vaccines? Will the public develop a resistance . . . will the vaccine become less effective?
Vaccines represent a challenge to the immune system. 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?
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. Could I get a titer?
My church is resistant to adapting communion customs (common cup) and we have an high median age, many people with medical conditions which should cause them to be very cautious. What is the current medical opinion of these practices? I have many older friends obsessed with using cloth handkerchiefs instead of paper tissues. Isn't this an infection risk of some concern? Where can I go to document the current recommendations in these areas?? I know your guests are now off, but I need this information.
Perhaps health insurance should refuse to pay for flu hospitalization for people who refuse to get immunized. People allergic to eggs and such would be "immune".
It seems that more and more otherwise reasonable and rational people won't get the flu shot and they are putting us all at greater risk. Let them pay for their decisions.
hananchrista wrote:
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?
--
Isn't that exactly what the vaccine does - expose your cells to the virus in an amount enough to institute what you call the purging process, but not enough to make you sick.
Even if it were better for individuals to expose themselves to the flu, there are many dangers. First don't use this on elderly or vulnerable people. The flu does kill some people. Second anyone who might be around other people should consider that when they expose others to the flu, that person may have a weakened immune system, or may further spread it to their babies, their grandparents, or sick individuals in their family before they even know they have it. Third, viruses mutate very quickly. You may develop an immunity to one virus, but that same virus can mutate as it's passed around and can come back and infect you if it's changed enough that your body doesn't recognize it. Mutated viruses tend to become more deadly. Fourth, not all healthy people are able to fight off the virus.
Remember the swine flu that hit us in 2009? With that flu it appears that the healthiest individuals were the ones who died when they got the flu. It was hypothesized that this happened because the healthier people's bodies went into overdrive in trying to purge the virus. We don't know if that's the reason, but we do know that the swine flu killed young, healthy people.
Every year people die from the flu.
Did I hear the expert's answer correctly?? something to the effect that flu is so prevalent early this season due to flu virus(es) becoming immune to last year's flu shot??! Regardless, I fully agree with all of you who advocate natural immunity. Please add vitamin D3 and probiotics to your defenses! And ditch the factory farmed meat and dairy.
Did I hear the expert's answer correctly?? something to the effect that flu is so prevalent early this season due to flu virus(es) becoming immune to last year's flu shot??! Regardless, I fully agree with all of you who advocate natural immunity. Please add vitamin D3 and probiotics to your defenses! And ditch the factory farmed meat and dairy.
For those concerned about creating super bacteria or the possibility that the vaccine will become less resistant: Vaccines work differently & don’t raise the same concerns as antibiotics about resistance.
Vaccines work by exposing your body to the virus in a controlled way so your own body learns to recognize the virus & fight it. You’re right that viruses mutate & may become stronger. That's why this year's vaccine may not help you much with next year's virus. The virus may change enough that your body doesn't recognize it.
Scientists look at the viruses spreading in other parts of the world. Then they do the best they can to predict which virus strains are likely to do the best job to help your body recognize the viruses that are coming around. Because it’s a prediction, a virus may develop that’s not affected by the strains in the vaccine. You may have the flu shot but still be hit by this new virus strain. However, there are lots of viruses being spread each flu season & the vaccine will protect you against some of them.
Have you ever had the flu more than once during flu season? That’s because your body now recognizes one virus strain, but you get infected with a different virus. The vaccine MAY not work against a particular virus strain, but it WILL protect you from the other flu strains.
You won't know the vaccine worked to keep you from getting the second flu, because nothing happens when your body recognizes the strains covered by the vaccine. You don't get sick. You may notice that you aren't getting sick while others around you are. But public health authorities in your state & the CDC will know that the vaccine worked because there will be a lot fewer patients coming down with the flu & being hospitalized (or for those who are tested, not having that flu strain). In other words, they can quantify when there's a lot more of nothing happening than would have been the case.
As to the possibility that a super virus strain will develop, that is more likely to happen when no one is vaccinated because there will be more sick people and thus more individual viruses spreading out there. More actual instances of a virus spreading, means more opportunities for mutations of that virus to develop.
Dr. Patel responded to a question of how flu causes/contributes to death. Her response was that flu weakens the immune system thereby allowing other infections to take hold. There was little mention of flu prevention and no information on how to strengthen the immune system.
Having complementary care providers present to talk about lifestyle choices that enhance the immune system would have contributed comprehensive coverage of this particular topic. Such a guest could have spoken about measures to prevent the flu, beyond hand washing and window opening. We expect to hear responsible reporting from the Diane Rehm Show.
We hope that the Diane Rehm Show will hear the growing call for access to complementary care and invite experienced professionals in the field of complementary medicine into the conversation.
On December 11, 2012, we posted a blog, To Vaccinate or Not To Vaccinate (that is the question) if you'd be interested to read a complementary medicine perspective on preventing and treating flu. http://www.possibilitiesofwellbeing.com/POWR_Blog-_Complementary_He.html
Thank you for considering complementary medicine.
Margot Rossi M. Ac., L. Ac.
Geraldine Plato, HHC, AADP
Possibilities of Wellbeing
www.possibilitiesofwellbeing.com
I found this show so disturbing. Please do a show that highlights the other side of the debate. There is so much research that states vaccines are a danger to our health. Dr's Suzanne Humphries drsuzanne.net and Tenpenny, drtenpenny.com are remarkable sources to the other side of the debate. Please do not let this go as unbalanced reporting.
Having vaccine makers and vaccine dr's who benefit from selling vaccines do this show is absolutely disheartening.
cause viruses run their course, and most doctors simply treat the symptoms. If you'll do that and drink chicken stock you'll respond just as well as with Tamiflu. Further, if you've been sick for 48 hours, it's too late anyway. I found the show disturbing. She should have had a simple family doc there to balance out the concerns. Every doc is a paid lobbyist or advocate for expensive prescription medication. Great infomercial Diane. Somethings being compromised at NPR.
I am not against vaccines, and am not a Luddite. Just as we don't really need to get an x-ray for a broken toe, cause we ain't gonna put our foot in a cast, much of this is overblown and after the fact. Some people certainly need vaccines, but seldom has the flu vaccine matched that year's strain. I have three kids in elementary school and the flu already ran through our house, a day of real issues, and 5 of PND. Eat healthy, you'd be surprised what fresh herbs and "Jewish Penicillin" (Chicken Soup) can do.