By Dr. Roxanne Latimer
Fall means influenza season and as such, should be a reminder that prevention is always better than treatment.
It is transmitted, like most viruses, by inhalation of aerosolized secretions from infected people. Talking, sneezing or coughing aerosolizes these secretions.
Generally, two types are known to cause community outbreaks and even epidemics, influenza A and B. There is an influenza C, but it causes very mild disease.
The virus changes significantly enough from year to year that there is no immunity from previous vaccination.
Pandemics are luckily rare and have occurred four times since 1918. The one with which you are likely most familiar occurred in 2009. This was caused by an influenza type A virus (H1N1) or “swine flu.” This usually occurs when there is a novel gene rearrangement in the virus.
Epidemics usually occur from late fall to early spring. The Centers for Disease Control and Prevention publishes weekly updates on influenza outbreaks during flu season.
Like most viruses, the real complications occur with secondary infections. Influenza generally causes fever and muscle aches. If a productive cough and shortness of breath develop, concern for pneumonia is heightened. This secondary bacterial pneumonia accounts for 25 percent of deaths from influenza.
People who are over 65 have a higher rate of complication from the flu. People with medical conditions that include chronic pulmonary disease or cardiovascular conditions also experience more complications than healthy counterparts.
Other chronic conditions that may leave a patient vulnerable to serious sickness from influenza include kidney disease and diabetes. It is imperative that people in these categories receive vaccination to prevent influenza because of the possible devastating effects of a complicated course of illness with influenza.
Symptoms are very general and include an upper respiratory infection with fever and possible muscle aches. Generally sore throat and swollen glands are not necessarily typical of flu and may be a result of another type of viral or bacterial illness. Cough and shortness of breath that develops several days after the onset of cold symptoms with fever may be signs of a secondary bacterial infection.
Treatment is generally supportive (rest and fluids). There are antiviral medications, which may shorten the course of the illness by one- to- two days if instituted quickly (within two days of symptom onset). These medications do not help symptoms caused by non-influenza viruses. The typical use of these medications is for high-risk individuals who live in households with someone who was positively diagnosed with influenza. Use of these medications helps reduce the transmission of influenza in households.
The most important take home message regarding influenza is that prevention is key and vaccination can help save lives.
Dr. Roxanne Latimer is the lead physician at Doctors Express in Natick, a seven-day walk-in urgent care center. She can be reached at 508-650-6208. Visit their website, www.doctorsexpress.com/FraminghamNatick/about. Archives of articles from previous issues can be read at www.fiftyplusadvocate.com
