In late fall, scientists at the Centers for Disease Control started to become alarmed at a virus that was fast becoming responsible for one of the most devastating flu outbreaks in years in Australia. As 2017 drew to a close, the flu season in the southern hemisphere began to wrap up as the northern hemisphere began to brace for its turn.
What concerned immunologists the most was the fact that the most common flu strain heading north was the H3N2 variety which is known to be especially bad for seniors. The vaccine being used in the land down under was effective just 10% of the time and to date, it appears it is not meeting with much more success here in North America.
An infection by a flu virus directly damages cells, paving the way for secondary infections, which is why those with existing conditions are at risk. In the elderly, an older immune system struggles against new infections and they age, they also lose vaccine induced antibody protection faster than a younger people.
Another problem being reported by researchers is that the flu can also lead to heart attacks in the elderly. Although this knowledge is not earth shattering, what Canadian researchers are saying is new is that the risk is six times higher in the first week after the flu is diagnosed. They state that the flu causes swelling or inflammation in the coronary arteries which can shake loose plaque and cause blockages, cutting off blood flow.
Adding to that is the fact that this year's strain places an especially heavy burden on someone who already has a weakened heart. Lung infections make it harder for people to breathe meaning that the heart needs to work harder to get oxygenated blood out to every part of the body.
According to the Massachusetts Department of Health, the flu, which is short for
influenza, is a viral disease of the body’s breathing system, including the nose, throat and lungs. In New England, the yearly flu season usually begins in December and lasts through March. Flu that occurs every winter season is called “seasonal flu". New and very different flu viruses that appear every 30-40 years, like the H1N1 flu virus in 2009 (called the swine flu), result in something called a “pandemic flu.”
Seasonal flu and pandemic flu have similar symptoms, are spread the same way and are prevented the same way.
The most common symptoms of flu are fever, cough, and sore throat. Symptoms can also include body aches, headache, chills, runny nose and feeling very tired. Some people, especially young children, also have diarrhea and vomiting. Symptoms last from a few days to up to a week or more.
Just how widespread is the flu here in Southern New England?
In Rhode Island, the flu is “widespread” with the Department of Health reporting that there have been 11 flu related deaths with all but one of them being people aged 65 and over. Hospital records also report nearly 300 people being hospitalized with the illness.
In Connecticut, the State Department of Health reports that flu activity is high with 32 deaths reported so far, 28 of which were seniors over the age of 65.
Massachusetts also reports widespread flu illnesses across the commonwealth with multiple deaths. As of this writing, the highest rates of the flu appear in Essex County while Central Massachusetts is experiencing somewhat lower rates.
While making routine calls to nursing facilities and senior living centers to check in and chat with our clients, multiple facilities reported flu like illnesses with more than one medical professional telling me that the whole facility was being treating prophylactically with Tamiflu.
However, as the flu spreads, there are concerns that Tamiflu shortages may begin to appear. Todd King, of Wentworth-Douglass Hospital in New Hampshire says that should that occur, the Centers for Disease Control has clear guidelines for who should be treated.
“…people who are medically ill, or young or old or pregnant, immune-compromised, or have other conditions [will] clearly be treated with Tamiflu," he said.
Tamiflu is shown to lower a person’s illness by an average of a day but there are studies that show that the medication can also prevent the spreading of the flu.
There are also other problems that health care facilities are experiencing nationwide and that is a shortage of fluids to treat dehydrated patients. This shortage became even worse following the damaging hurricane in Puerto Rico where many of the manufacturing plants that make these products are located.
So, should those at high risk be vaccinated even though the vaccine is not highly effective? Absolutely.
The CDC estimates that between 71 and 85 percent of flu-related deaths occur in people ages 65 and older and 54 to 70 percent of hospitalizations occur in that group. So, you can see the seriousness for our seniors and the need for any help against the flu bug.
Besides getting the flu shot, seniors also should make sure they are up to date with the pneumococcal vaccination which prevents against diseases such as pneumonia, meningitis and bloodstream infections.
When I urge our clients to make sure they have their shots, I often hear the argument that when they get the immunization, they come down with the flu a few days later. Although what they feel is real, it is not the flu, according to health officials.
Dr. Andrew Pekosz, a professor of immunology at John Hopkins University Bloomberg School of Public Health said that getting the virus from such a shot is impossible.
“The flu shot is a killed virus that consists of only half of the virus – the part you need to make an immune response to. It’s also administered in the arm muscle which is not a place the flu virus normally goes to. So, there is no possibility you can get the flu from the flu shot,” he states.
“Most people have a little redness and soreness at the site of the inoculation. These are normal symptoms and due in part to your body’s immune system reacting to the vaccine,” says Dr. Pekosz. “Usually these don’t last for more than a day or two.”
Does this mean that people receiving the vaccine and reporting symptoms similar to the flu are imagining it? Not according to the CDC.
Medical professionals working there state that a low-grade fever and body aches are
indeed possible after receiving the shot but not because you have contracted the flu, but because your body’s immune system is reacting to the introduction of a foreign substance into the body.
So what precautions can you take against the flu?
People sick with flu should make sure to drink plenty of fluids, get plenty of rest, eat healthy foods, wash their hands often and stay home to avoid spreading the flu to other people. Over the counter pain relievers may help people with the flu feel more comfortable. Children and teens with the flu should never take aspirin, because a rare but serious disease called Reye's Syndrome can occur.
And just a note about Reye’s syndrome, it is a rare but serious condition that causes swelling in the liver and brain. Reye's Syndrome most often affects children and teenagers recovering from a viral infection, most commonly the flu or chickenpox.
Signs and symptoms such as confusion, seizures and loss of consciousness require emergency treatment. Early diagnosis and treatment of Reye's Syndrome can save a child's life. Aspirin has been linked with Reye's Syndrome, so it is recommended to use other fever and pain relievers with children and teens, but always consult with your doctor.
Seniors, if you have not gotten your flu shot yet, it is still worth getting, even if it has a low effectiveness rate.
Dr. Pardis Sabeti, a Harvard professor and infectious disease expert, recently said on CBS News, "Even 10 percent effective is better than nothing, and a lot of it has to do with herd immunity -- the more people are protected from it, the more other people will also be protected," she said. "In fact, in a year where it's low effectiveness, it's even more important that everybody get it so we can get as much resistance and we don't allow the virus to thrive and grow and keep changing."
Attorney Connelly practices in the area of elder law. This area of law involves Medicaid planning and asset protection advice for those individuals entering nursing homes, planning for the possibility of disability through the use of powers of attorney for the both health care and finances, guardianship, estate planning, probate and estate administration, preparation of wills, living trusts and special or supplemental needs trusts. He represents clients primarily in the states of Rhode Island, Connecticut and the Commonwealth of Massachusetts. He was certified as an Elder Law Attorney (CELA) by the National Elder Law Foundation (NELF) in 2008. Attorney Connelly is licensed to practice before the Rhode Island, Massachusetts, Connecticut, and Federal Bars.