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There's no shortage of the vaccine this year, so roll up your sleeve


Cox News Service

Thursday, November 08, 2007

You may not consider yourself to be at much risk of coming down with the flu. But if you are a parent, a co-worker or part of a household where someone has a chronic disease, you may be more vulnerable to its complications than you realize.

Unlike some past years, flu vaccine supplies this year are plentiful. And regional health-care experts are urging people to take advantage of it, preferably in the next few weeks.

"Not only do you not lose as many days of work or school, but we know that schoolchildren are more likely to spread it among themselves and bring it home to younger siblings," said Joyce Allers, manager of school health for child health promotion at Children's Healthcare of Atlanta.

"We also know that when you have a flu vaccine, you can decrease the incidence of even ear infections by 30 percent."

Particularly troubling to health experts is that last year fewer than half the 218 million people considered at higher risk — primarily infants and small children, seniors, people with chronic conditions and their caregivers — actually received the flu vaccine. As a result, more than 200,000 people were hospitalized with the flu, and 36,000 people died of complications from the virus.

Some of the people who are most lax about getting vaccinated are the very ones who should know best: health-care providers. Last year, only about 41 percent were vaccinated, even though they are at greater risk of being exposed to flu and passing it on to their patients and colleagues. As a result, there is a major push this year among health-care organizations to make sure their employees are vaccinated. "We don't need to have any of our staff absent during the flu season because we need everybody present and accounted for to take care of our patients," Allers said.

WHO SHOULD

NOT GET VACCINATED?

People who are allergic to chicken eggs or egg products.

People who have had a severe reaction to the vaccine in the past.

People who have developed Guillain-Barre syndrome, an inflammatory disorder that affects the peripheral nerves, within six weeks of getting the flu vaccine in the past.

Children younger than 6 months of age.

Anyone who is sick with a fever should wait until his or her symptoms clear up before getting the flu vaccine.

WHO NEEDS THE VACCINE THE MOST?

People at higher risk of being exposed to the flu or of developing complications from the virus should definitely be vaccinated, according to health officials. And this recommendation applies to a large group of people including:

Children ages 6 months to 5 years of age;

People older than 50;

Women who will be pregnant during the flu season;

Adults and children with chronic conditions or immune deficiencies;

Caregivers of young children or adults older than 50;

Household contacts of any person who is at heightened risk of complications from flu;

Residents of nursing homes or other chronic-care facilities.

COLD OR FLU?

It can be tricky to tell the difference between a severe cold and the flu because both are respiratory illnesses and many of the symptoms are similar. A cold tends to impact the nose, throat or chest. The flu affects the entire body and tends to be more severe than a cold. Flu can lead to more serious illnesses such as pneumonia or bronchitis. A typical case of the flu will run its course in five to seven days. A cold can last for three weeks or longer, but people usually begin to feel better in seven to 10 days.

SHOULD YOU SEE A DOCTOR?

Infants should definitely be seen by a physician. Most healthy people do not require a doctor visit if they suspect they are coming down with the flu. Health experts, however, recommend getting plenty of rest and consuming clear liquids. If you are not getting better within a week, then schedule a visit with your doctor.

Whether you have the flu or not, it is a good idea to wash your hands frequently and thoroughly. This not only will help to protect you, it also will help prevent the flu virus and other bugs from spreading.

WHEN TO GIVE IT A REST

If you suspect that you are coming down with the flu, stay home. Not only is this the best way to guard against spreading the virus, but rest is essential to recovering, said Joyce Allers of Children's Healthcare of Atlanta. Other symptoms that should trigger a decision to stay home include persistent coughing, vomiting, fever, body aches or irritability.

When any of these symptoms are present, it is a good idea to nix participation in any strenuous exercise or sports. "For a mild cold, (exercise) is probably not a problem, but if you have a severe or moderate cold, you will speed your healing by resting, and you will also be less likely to pass (the illness) on," Allers said.TREATMENT OPTIONS

Antiviral agents. There are prescription drugs that can potentially speed recovery from the flu if they are taken within two days of the appearance of symptoms. They also can be used to prevent the flu in the case of a recent outbreak or exposure to the flu.

There are two antiviral medications recommended by the Centers for Disease Control and Prevention: Oseltamivir (Tamiflu), which is recommended for people ages 1 and older, and zanamivir (Relenza), recommended for people ages 7 and older. These medications are appropriate for individuals who cannot receive the flu vaccine because of an allergy or other reasons, and people who are particularly vulnerable to complications from the flu, said Mitchel Rothholz, chief of staff of the American Pharmacists Association in Washington.

However, Rothholz cautioned that you should not take an antiviral medication if you plan to receive the LAIV vaccine (FluMist) in the next 48 hours. Also, he said people should stay away from antiviral medications for at least two weeks after they have received the LAIV vaccine.

Analgesics. A number of other medications can provide relief from symptoms of the flu. For example, analgesics such as acetaminophen and ibuprofen will reduce fever and ease the pain associated with headaches, body aches and sore throat. Make sure the dosages you use are appropriate, particularly with respect to children. Also, children should not be given aspirin because of its association with Reye's syndrome. Be careful about the use of some stomach-coating medicines because many of them contain aspirin.

Other cold/flu remedies. Decongestants can be used for a stuffy nose or congestion, and antihistamines are appropriate for sneezing or a runny nose. However, Children's Healthcare of Atlanta does not recommend the use of these medications in children, especially kids younger than 2. In fact, just weeks ago, manufacturers voluntarily pulled cough and cold medications aimed at infants and toddlers off the market. A Food and Drug Administration advisory panel voted to ban scores of over-the-counter cough and cold products intended for children younger than age 6. The FDA has not yet made a final decision. As an alternative, a steamy bathroom or a warm bath can provide children with some relief from congestion. A humidifier can be helpful as well.

Combination products. Be careful about the use of any multisymptom cold and flu remedies. "The important thing is to look at the ingredients on whatever product the patient is taking," stressed Rothholz, noting that many people take products that have combinations of different classes of drugs, and then will take a second medication not realizing that they already have taken the maximum recommended dose in the combination product. "Particularly with a younger child ... talk to your pharmacist or physician about what best meets your needs rather than taking the gunshot approach."

Sources: Centers for Disease Control and Prevention, the American Pharmacists Association, Children's Healthcare of Atlanta.

Five misconceptions about the flu vaccination

Misconception No. 1: The flu vaccine can actually give you the flu.

The flu shot consists of an inactivated vaccine that includes killed virus that will trigger your body to produce antibodies against certain strains of the flu, but it will not cause you to come down with the virus. Sometimes people coincidentally come down with a bad cold after they have received the vaccine. But the two conditions involve different germs, Joyce Allers of Children's Healthcare of Atlanta said. And while some people experience a runny nose, muscle aches, a slight fever or some redness or soreness around the injection site, these side effects are usually mild and rarely last more than two days.

Misconception No. 2: One flu vaccination protects you for life.

Unfortunately, this is not the case because the flu strains likely to be most prevalent tend to change every year. In February, scientists evaluate the evidence to determine which flu strains people will need to be protected against in the coming year, and then drug manufacturers begin to produce the vaccine based on these findings. "There are years when the strains that are circulating don't match the strains in the vaccine. However, when that happens, it is still a good idea to be vaccinated because there is still some cross-protection from the other strains," said Curtis Allen, a spokesman for the Centers for Disease Control and Prevention.

Allen said that scientists really can't predict how mild or severe flu season will be, or when the flu season will peak. "Over the past three years, the seasons have been less severe than in the past, but that in no way predicts what will happen this year," he said.

Misconception No. 3: No one needs more than one dose a season.

For the first time this year, children younger than age 9 who are receiving the flu vaccine for the first time are being advised to receive two doses within the same flu season, spaced at least 30 days apart. Given the already low rates of flu vaccination, getting people to adhere to this recommendation is particularly challenging, according to Angie Matthiessen, coordinator of Immunize Georgia at Children's Healthcare of Atlanta. "Now is really the best time to start (getting) that first shot so that (these children) can get their second shot by the end of the year," she said. "The research shows that the second shot is actually providing greater protection for the child."

Misconception No. 4: The only way to be vaccinated is with a needle.

Some people decline flu vaccinations for themselves or their children because they are averse to needle sticks. However, for many of these individuals, there is an alternative called LAIV or live attenuated influenza vaccine (FluMist), that comes in the form of a nasal spray. LAIV consists of weakened forms of live viruses, but as with the shot, the nasal spray will not give you the flu. The CDC recommends the nasal spray for healthy people from age 2 (the minimum age was just lowered this year from age 5) to 49 who are not pregnant and people who do not have breathing or respiratory problems.

The shot and the nasal spray are about equally effective in preventing the flu, but neither prevents the flu 100 percent of the time. However, if you are vaccinated and you do come down with the flu, the virus will be less severe than if you had not been vaccinated.

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