This flu season is BRUTAL. I hate influenza so much and this year I hate it more than usual because it’s personal. I have an unvaccinated 6 month old (today!) who couldn’t get the vaccine prior to the peak of the season. His age and inability to receive the vaccine places him into a group of people that are ‘at high risk for complications from influenza’. These ‘complications’ range from severe illness requiring hospitalization, pneumonia, multi-organ failure and death.
He recently had an exposure to influenza so now he is on Tamiflu prophylaxis to try to prevent him from getting it. Today is the first day he could get the vaccine and he was exposed earlier this week. It takes two weeks for antibodies to form after the vaccination is given. Yes, I know that the new estimates for the effectiveness of the vaccine is crummy for circulating virus. Yes, I will still be vaccinating him next week if he doesn’t have full blown flu by then. If I can reduce the chance that he gets a life threatening infection by even 5% I would do it. Is it guarantee? No, but it’s my job to protect him and I can’t crawl into a hole (with no outside visitors) with my entire family for the next 4-8 weeks until this dies down.
He’s at high risk and so are my patients. My patients are receiving chemotherapy that wipe out their infection fighting white blood cells. So when they get influenza, they can quickly deteriorate as the virus courses through their bodies without any defenses to slow it down. If they’ve had the vaccine and they fall into the 30-40% for whom it is effective, they may be able to mount a response….IF they are at a point in their treatment where their infection fighting white blood cells aren’t bottomed out. 25% of our hospital is currently full of children that are flu positive. My patients have to come to the hospital to get life-saving treatment. They come to the hospital to get that treatment and are surrounded by over 160 other children who are spewing virus and they share nurses, doctors, physical therapists, and hallways. They have to take the chance because skipping chemotherapy can certainly lead to adverse outcomes that can lead to death. Contracting the flu can lead to death. It’s an impossible situation. So yeah it’s personal on many levels for me.
- Let’s all do our part.
– Get vaccinated, this year and every year. Yes sometimes the vaccine is off, but like I said, I’ll take even a 5% chance of protecting the ones I love from complications and death.
– Wash your hands, OFTEN
– Cover your mouth when you cough and sneeze, ALL the time, then wash your hands again
– If you are feeling ill, stay home. Do not go to work or school. Send someone else who is not having symptoms to the store for supplies if you can.
– If you have symptoms of influenza, try to call your physician’s office before going in. Many offices have a phone triage system set up this year and may call in prescriptions without seeing you if you are an established patient, this reduces people spreading it around. - Symptoms are:
– Generally quick onset
– Fever, often high (102-104 F)
– Body aches and chills, often skin sensitivity (literally everything hurts)
– Cough
– Headache
– Fatigue, sometimes extreme
– Sometimes accompanied by vomiting and diarrhea (more common in younger patients) - Tamiflu can shorten the duration if started within 48 hours of symptom onset
- High risk patients should receive treatment and include:
- – Children less than 2 years of age should receive treatment
– Persons greater than 65 should receive treatment
– People with chronic lung conditions should receive treatment (including asthma and COPD).
– People that have poor immune systems should receive treatment (chemotherapy, organ transplants, primary immune deficiencies).
– Tamiflu can be used to prevent the spread to these high risk patients if they have a close contact exposure (family member, classroom contact, etc.) - Warning signs for severe illness include:
– Decreased level of awakeness
– Confusion, hallucinations, inability to arouse a loved one
– Significantly decreased urine output
– It is very important to keep up with fluids. The high fevers create a state of increased fluid needs and it may be difficult in some people to keep up (small children, developmentally delayed children, the elderly)
– Difficulty breathing
– If you have a loved one with the flu and they have any of the signs of severe illness, then please take them to the nearest emergency room. The flu can be deadly even in normal healthy individuals and it can be rapid.
Get a vaccine, wash your hands and let’s all pray this is peaking and we will see a decline in rates soon.
