7/12/2013

When encouraging patients to receive the flu vaccine every
fall, I always find it amazing that so many people have
misconceptions about the flu and the flu shot. If I were to
ask a group of patients what the flu is, I would get many
different answers, including descriptions of symptoms of a
viral gastrointestinal syndrome (nausea, vomiting,
diarrhea), a sinus infection, the common cold, or of true
influenza (flu) infection.



Influenza (referred to as flu in this article) is a serious
and extremely contagious viral respiratory illness.
Complications of the flu can lead to hospitalization and
death. According to the Centers for Disease Control (CDC):
Every year in the United States, 5% - 20% of the population
gets the flu, approximately 200,000 people are hospitalized
from flu complications, and approximately 36,000 people die
from the flu.



The symptoms of the flu include fever (usually >102F),
headache, extreme fatigue, sore throat, dry cough, runny or
stuffy nose, and muscle aches. Nausea, vomiting, and
diarrhea are uncommon with the flu. Although some flu
symptoms resemble those of the common cold, flu symptoms
have a much more abrupt onset and are more severe than those
of a cold. Possible complications of the flu include
bacterial or viral pneumonia, sinus infections, ear
infections, dehydration, and worsening of other medical
conditions such as diabetes, asthma, or chronic lung
disease. These complications can prolong the illness and may
lead to hospitalization.



The flu virus spreads from person to person through coughing
or sneezing. You may get infected by touching something
(such as a doorknob or telephone) that has flu virus on it
and then touching your mouth or nose. The best way to
prevent the flu is to get a flu vaccination each year
between October and December. The flu shot can be offered to
all healthy people who want to decrease their risk of
getting the flu. Certain people are at high risk for flu
complications and should be strongly encouraged to receive
the vaccine. These groups are: children (6 months-5 years
old), pregnant women, people over age 50, people with
chronic medical conditions such as diabetes, asthma,
emphysema, HIV infection, aids, heart disease), and people
living in long term care facilities such as nursing homes
and prisons. In addition, all healthcare workers and
household contacts of people in the high risk groups, as
well as household contacts of infants less than 6 months of
age, should be vaccinated to prevent the spread of the virus
to those people.



Let's clear up another very common misconception: The flu
shot does not give you the flu, and does not make you sick!
I can't even count the number of times that patients have
told me that they received the shot and got the flu. The
vaccine consists of killed influenza virus (killed virus is
not capable of causing illness), which causes the body to
respond by developing antibodies to protect against the flu.
It is this response that causes common side effects of the
vaccine, such as a slight fever, chills, headache, and
fatigue, for the first 24 hours after the vaccine is given.
Remember, this is not the flu.



Some people should not be vaccinated; they include: people
with a severe allergy to eggs, people who have had a severe
reaction to the flu shot in the past, children less than 6
months of age, and people with a history of Guillain-Barre
syndrome (a paralyzing neuromuscular disorder). If you have
a moderate or severe illness with a fever, you should wait
until those symptoms resolve before getting vaccinated.



If you are HIV positive, most healthcare providers will
recommend that you receive the flu vaccine each year.
Although there has been some debate and controversy over
this issue, it is generally thought that vaccination offers
significant benefits to the HIV positive person, including
the prevention of serious complications of the flu such as
bacterial pneumonia and activation of HIV replication
(leading to an increase in HIV viral load and a decrease in
the CD4 cell count). In addition, the flu may resemble
symptoms of an HIV or AIDS related opportunistic infection;
thus, avoiding the flu will avoid an unnecessary workup. The
vaccine itself is well tolerated by most people, including
those who are HIV infected. There may be a very slight and
temporary rise in the HIV viral load, but this will quickly
resolve after vaccination. Studies have shown that the
body's ability to respond to any vaccine and to build up
protective antibodies may be decreased when the CD4 cell
count is below 2oo, but it is still recommended to vaccinate
these people, as there may still be some protective
benefit.



You may hear about the Nasal-Spray Flu Vaccine, and think
that this would be a great alternative to getting another
injection. Sorry, but if you are HIV positive you cannot
receive this vaccine. The nasal spray vaccine is a live
vaccine, which contains weakened live virus (instead of
killed virus in the injection), and is capable of producing
severe illness in anyone with a weakened immune system. If
you are HIV positive, you should never receive any live
vaccines for this reason.



In conclusion, the flu vaccine is the best protection
against getting the flu. However, you may still get other
viral respiratory illnesses or even a strain of the flu that
was not included in the flu shot. Besides vaccination, the
next best defense against viral illness is frequent and
thorough hand-washing and the use of antibacterial hand gels
which can be carried in your pocket, purse, or car. This
will help to prevent you from transferring virus you come
into contact with to your mouth and nose.
Posted by Admin On 5:49 PM No comments

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