by Michele Rutledge, M.D.
Autumn has arrived, with its fall colors, cooler temperatures, and the promise of the holidays ahead. As you prepare for all the changes it brings with it- warmer clothing, getting the furnace ready, and getting a start on holiday preparations- remember to prepare yourself for cold and flu season, as well. Colder weather brings most of us indoors, where more time spent in close quarters with more people can lead to the rapid spread of viral illnesses and other infections. This, rather than the actual temperature outside, is the reason so many of us catch cold in the winter. Health care providers refer to colds as URIs (upper respiratory illnesses). We’ll have to save the common cold for a separate column- it’s worth a full article all on its own.
There’s a reason the phrase “cold and flu season” distinguishes influenza from colds. They are very different! If you’ve ever had influenza, you know it deserves all four syllables and probably a capital “I”. Symptoms typically include substantial body aches, fever to 102 (not always seen in older adults), headache, sore throat, watery eyes, slight runny nose, and substantial fatigue. Fortunately for us, influenza vaccination has dramatically reduced the number of people who die from this potentially fatal illness every year.
In 1918 the Spanish Influenza epidemic killed an estimated 30 to 50 million people worldwide, with 675,000 people dying in the US, more Americans than died in World War I. By comparison, from 1976 to 2007 with flu shots available, annual estimated fatality rates in the US ranged from 3,000 people to 49,000 people. An estimated 250,000 people are hospitalized annually in the US for influenza complications. Children and the elderly are especially susceptible; there were three pediatric deaths in Minnesota last year from influenza.
Influenza vaccination is recommended for all people ages 6 months and up, including pregnant women. Even healthy younger adults should be vaccinated to help protect the kids and older adults they love. There is a high-dose influenza vaccine available now for people over age 65, to give a little extra protection. The flu vaccine is updated every year to reflect the strains of influenza that are most likely to reach the US in the winter; some years it’s a great match, other years not as great. Any protection is better than none- don’t skip the flu shot just because you are concerned it’s not a good match! If your raincoat has a tear in the sleeve, it’s still going to keep you drier than going out in the rain without one! Overall, the flu shot protects us 80% of the time.
An important point: You can’t get influenza from a flu shot any more than you can get a mold infection from getting a penicillin shot. The flu shot is not a live vaccine. You may feel under the weather for a day or so after getting a flu shot, but this is the normal result of your immune system activating to respond to the vaccine. The flu shot won’t protect you against anything besides the strains of influenza included in the vaccine, so you can still get other viral illnesses like colds and strains of the flu that aren’t in the vaccine. You could potentially catch the strains of influenza that are in the vaccine, but if you do, the illness will likely be much shorter and milder than they would otherwise be, and you’re less likely to experience influenza complications like pneumonia and brain inflammation that can land you in the ICU. That’s still protection!
There is medication available to treat people who have influenza and underlying medical conditions that put them at high risk for complications. Because of concerns about the development of treatment- resistant strains of influenzas (some medications have already been rendered useless by the development of resistance) healthy people generally do NOT qualify for antiviral treatment. Please don’t be angry with your provider if you have influenza and are not a candidate to be treated. Take it as a compliment to your good health. The medications don’t actually make you feel better much sooner, but they reduce the risk of complications. Keep in mind, too, that you might qualify for preventive treatment if someone in your household has influenza and you are at high risk for complications yourself.
Along with getting a flu shot, remember to protect yourself by simply washing your hands, not touching your face, and covering coughs and sneezes. Influenza is usually spread by droplets in the air from sneezing and coughs, not through touch like the common cold is, so all of these are important. If you do get sick, rest at home so you don’t get others sick as well, and remember- this, too, shall pass!