The Flu Season Isn’t a Pandemic – This Time

 

It’s been a pretty nasty flu season by most accounts. This article summarized the outbreak this way:

The flu is widespread, across 49 US states right now. Scientists at the Centers for Disease Control and Prevention say that’s the first time that’s happened in their 13 years of tracking the flu. The epidemic has been especially tough among baby boomers. CDC officials say that could be in part because they weren’t exposed to this year’s most aggressive H3N2 strain as children.

Thirty-seven children across the country have died from the flu this year, and experts think the real number could be double the official reports.

In California, at least 97 under the age of 65 have died. As of early January, most of those deaths were unvaccinated adults, the state’s Department of Health.

Do you realize the most recent pandemic was in 2009? Before that outbreak, the 1918 Spanish flu infected one in five people and killed as many as 50 million people.

The flu virus is highly contagious. Although people can pick up the virus by touching surfaces, person-to-person contact is the more likely way of catching the flu. In the published Proceedings of the National Academy of Sciences, one researcher behind the study said some people could “ . . . exhale or cough high quantities of live virus particles—up to 1,000 in 30 minutes. When we consider that an infectious dose is just one virus particle, that means potentially 1,000 people can be infected in short order.”

Please note that contagious people don’t have to cough near you; they only need to breathe nearby. Also, people can carry the virus for one to three days before they show symptoms, and they may be carriers and not show symptoms.

Especially noteworthy is that, although the vaccine is only 30 percent effective against this year’s virus, a 2017 study has shown that flu shots can significantly reduce a child’s likelihood of dying from the virus; that you are less likely to contract the flu and its intensity will likely be reduced; and pregnant women who can be hit hard by the virus may better protect their babies in their first months of life.

Every year we are encouraged to get flu shots, especially if we are in particular demographics, and every year people give reasons for not receiving the shot. But beyond our reasons for taking or not taking flu shots, we are having the wrong conversation about flu shots. We should be talking about a universal vaccine.

As most of us know, creating a flu shot is always a crapshoot (although those who create the shot do their best). The effectiveness of the vaccine can’t be determined until the flu emerges on the scene. Too often, the targeting is only partially successful. So what is going on regarding a universal vaccine, and why is it important?

Even though the Spanish flu epidemic of 1918 seems long ago, we are just as vulnerable to a pandemic as ever. A New York Times article gives some of the reasons:

The world has about four times the number of inhabitants it did in 1918, including hundreds of millions of people, poultry and pigs living close together. This provides a potent biologic mixing bowl and natural influenza virus mutation factory. What’s more, nearly any point on the planet is accessible to any other point within hours, and there are more than a billion international border crossings each year. The virus will spread rapidly.

Other reasons: our hospitals will have insufficient life-saving drugs on hand to treat the huge number of people who could be infected. The Times also likened the impact of a pandemic to the Black Death of the 14th century in Europe.

The solution to this threat is a universal vaccine. But the amount of funding for a universal vaccine is far behind funds raised for other high-profile diseases:

Although the National Institutes of Health has publicly declared developing a vaccine a priority, it has only about $32 million this year specifically for such research. The Biomedical Advanced Research and Development Authority, the other federal agency responsible for developing and making available new vaccines for emergency response, has in fiscal year 2017 only a single project for $43 million supporting game-changing influenza.

The Trump administration continues to fund other serious diseases, such as Ebola, Zika, and SARS, but the dangers of a flu pandemic are not yet on their radar. I think the time has arrived to take a closer look at the risk of a pandemic and the populations who could be affected. The results could be deadly.

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  1. Fred Cole Inactive
    Fred Cole
    @FredCole

    I’m sorry, but I don’t think the Spanish Flu is useful as a warning and invoking it always seems alarmist to me.

    The Spanish Flu pandemic came at the end of a world war, where nutrition was at a low ebb and public health systems were stretched to the breaking point.  Also, the germ theory and the discovery of viruses only a generation earlier, meaning half (or more) of doctors didn’t go through school learning about them.

    I just don’t think its an apt example.

    • #1
  2. Trink Coolidge
    Trink
    @Trink

    Hubby and I both have the drug Tamiflu with us.   I guess it’s pretty effective in moderating the severity of the symptoms if you start taking it as soon as symptoms occur. It’s scary.

    • #2
  3. MarciN Member
    MarciN
    @MarciN

    The flu does not kill people. It is the pneumonia that travels with the flu bug that kills people. The flu weakens the patient; then the pneumonia goes in for the kill. The pneumonia moves fast.

    If someone you are caring for develops flu symptoms and then suddenly seems to be much sicker, get to a doctor as soon as possible. Tell the doctor you are concerned that a secondary infection has set in. If the doctor does not prescribe an antibiotic, ask the doctor what he or she needs to see in order to prescribe the antibiotic: the exact temperature and whether it rises and falls or stays steady; the color and consistency of the mucous; and the sound of the cough. Remember that a pneumonia cough is below the cough reflex. So what you may need to look for is actually less coughing.

    Be persistent and be bold in getting this information and these instructions as to whom to call or where to take the person you are caring for.

    Over and out .  .  .

    • #3
  4. Susan Quinn Contributor
    Susan Quinn
    @SusanQuinn

    MarciN (View Comment):
    My Annual Public Service Exhortation

    The flu does not kill people. It is the pneumonia that travels with the flu bug that kills people. The flu weakens the patient; then the pneumonia goes in for the kill. The pneumonia moves fast.

    If someone you are caring for develops flu symptoms and then suddenly seems to be much sicker, get to a doctor as soon as possible. Tell the doctor you are concerned that a secondary infection has set in. If the doctor does not prescribe an antibiotic, ask the doctor what he or she needs to see in order to prescribe the antibiotic: the exact temperature and whether it rises and falls or stays steady; the color and consistency of the mucous; and the sound of the cough. Remember that a pneumonia cough is below the cough reflex. So what you may need to look for is actually less coughing.

    Be persistent and be bold in getting this information and these instructions as to whom to call or where to take the person you are caring for.

    Over and out . . .

    Excellent information, @marcin! That helps explain why seniors and children are so vulnerable, too. I wonder if the type of pneumonia can vary with each case; some pneumonias are bacterial, others viral; if I’m not mistaken, the viral pneumonias are much more difficult to treat.

    • #4
  5. Susan Quinn Contributor
    Susan Quinn
    @SusanQuinn

    Trink (View Comment):
    Hubby and I both have the drug Tamiflu with us. I guess it’s pretty effective in moderating the severity of the symptoms if you start taking it as soon as symptoms occur. It’s scary.

    An excellent article, Trink! I’m encouraged to learn that they are working on vaccines that would provide protection against 4 types of virus. Let’s hope that this kind of research will gain more support!

    • #5
  6. Susan Quinn Contributor
    Susan Quinn
    @SusanQuinn

    Fred Cole (View Comment):
    The Spanish Flu pandemic came at the end of a world war, where nutrition was at a low ebb and public health systems were stretched to the breaking point. Also, the germ theory and the discovery of viruses only a generation earlier, meaning half (or more) of doctors didn’t go through school learning about them.

    I just don’t think its an apt example.

    I can see your point, @fredcole. Still, there was a pandemic in 2009, but of course many fewer people died.

    • #6
  7. SkipSul Inactive
    SkipSul
    @skipsul

    Susan Quinn (View Comment):
    Excellent information, marcin! That helps explain why seniors and children are so vulnerable, too. I wonder if the type of pneumonia can vary with each case; some pneumonias are bacterial, others viral; if I’m not mistaken, the viral pneumonias are much more difficult to treat.

    There are pneumonia vaccines out there, as well as flu shots.

    So far this year:

    • Best friend’s father had the flu, ended up in the ER with pneumonia
    • Best friend also got the flu, then bronchitis that nearly turned into pneumonia – put on steroids and a heavy duty antibiotics to clear up
    • Now his mother has it, and is on a ventilator (she’s a chain smoker, so this was really bad)
    • Both of my parents had it, mother recovered pretty well, but my father had bronchitis and was off work for a month while he recovered
    • Couple of my employees have had the flu too, thankfully no secondaries

    It’s a doozy this year for sure.

    • #7
  8. MarciN Member
    MarciN
    @MarciN

    Susan Quinn (View Comment):

    MarciN (View Comment):
    My Annual Public Service Exhortation

    The flu does not kill people. It is the pneumonia that travels with the flu bug that kills people. The flu weakens the patient; then the pneumonia goes in for the kill. The pneumonia moves fast.

    If someone you are caring for develops flu symptoms and then suddenly seems to be much sicker, get to a doctor as soon as possible. Tell the doctor you are concerned that a secondary infection has set in. If the doctor does not prescribe an antibiotic, ask the doctor what he or she needs to see in order to prescribe the antibiotic: the exact temperature and whether it rises and falls or stays steady; the color and consistency of the mucous; and the sound of the cough. Remember that a pneumonia cough is below the cough reflex. So what you may need to look for is actually less coughing.

    Be persistent and be bold in getting this information and these instructions as to whom to call or where to take the person you are caring for.

    Over and out . . .

    Excellent information, @marcin! That helps explain why seniors and children are so vulnerable, too. I wonder if the type of pneumonia can vary with each case; some pneumonias are bacterial, others viral; if I’m not mistaken, the viral pneumonias are much more difficult to treat.

    I have always known that the flu bug was not deadly to people, not even the flu that caused the pandemic. Mendel, @mendel,  who is an expert in this field, in a Ricochet conversation a few years ago, confirmed for me what I’ve always suspected. At the time of the pandemic in 1914-1917, there was a particularly virulent pneumonia strain that was traveling with the flu bug. Added to that was the militarization of a huge part of the world population and the sending of those troops and other personnel all over the world, and it was a perfect recipe for a pandemic.

    (I read somewhere that it was this flu bug on military bases that gave us Eisenhower–he was able to control it better on his base than was true for all the other bases. That’s how he came to the attention of the military high mucky mucks. :)  )

    It is true that some pneumonia bugs are not caused by bacteria and are not treatable with antibiotics.

    But doctors should assume that a patient has the bacterial pneumonia. And hospitals should certainly be testing patients routinely for this to identify it.

    • #8
  9. Fred Cole Inactive
    Fred Cole
    @FredCole

    Susan Quinn (View Comment):

    Fred Cole (View Comment):
    The Spanish Flu pandemic came at the end of a world war, where nutrition was at a low ebb and public health systems were stretched to the breaking point. Also, the germ theory and the discovery of viruses only a generation earlier, meaning half (or more) of doctors didn’t go through school learning about them.

    I just don’t think its an apt example.

    I can see your point, @fredcole. Still, there was a pandemic in 2009, but of course many fewer people died.

    Right.  The reason why we always hear about the Spanish Flu is because so many people did die.  2009 is a much better example, but far less dramatic.

    • #9
  10. MarciN Member
    MarciN
    @MarciN

    What is important to know with the flu-to-pneumonia course is that time is of the essence. Hours matter. Especially with children and disabled adults.

     

    • #10
  11. EHerring Coolidge
    EHerring
    @EHerring

    I have had the pneumonia shot.  Does that help?  How many years is it effective before you need another pneumonia shot?

    • #11
  12. Susan Quinn Contributor
    Susan Quinn
    @SusanQuinn

    EHerring (View Comment):
    I have had the pneumonia shot. Does that help? How many years is it effective before you need another pneumonia shot?

    This is what I found on WebMD:

    How It Works

    There are two vaccines for pneumonia that protect against different types of the infection.

    • PCV13 helps protect people from 13 of the most severe types of bacteria that cause pneumonia.
    • PPSV23 protects against an additional 23 types of pneumonia bacteria. Neither can prevent every type of pneumonia, but they work against more than 30 common, severe types.

    People who need a pneumonia vaccine should get both shots: first, the PCV13 shot and then the PPSV23 shot a year or more later.

    Either shot is supposed to be good for your lifetime, although some folks might need a booster.

    • #12
  13. cirby Inactive
    cirby
    @cirby

    MarciN (View Comment):
    The flu does not kill people. It is the pneumonia that travels with the flu bug that kills people. The flu weakens the patient; then the pneumonia goes in for the kill. The pneumonia moves fast.

    Except…

    One of the prevailing theories about the 1918 Spanish flu was that it had a different mechanism – something called a “cytokine storm” – that effectively turned the immune system into a weapon against the rest of the body. That’s why young adults were disproportionately affected by that strain. Add in the accompanying bacterial infections and other problems, and you get a lot more deaths than normal.

    If a modern strain of the flu did something similar, it could be pretty rough.

    I had the “regular” flu a couple of weeks ago, and it was bad enough. It wasn’t that hard for me, but I can certainly understand how it would nuke someone with a wonky immune system.

    • #13
  14. MarciN Member
    MarciN
    @MarciN

    cirby (View Comment):

    MarciN (View Comment):
    The flu does not kill people. It is the pneumonia that travels with the flu bug that kills people. The flu weakens the patient; then the pneumonia goes in for the kill. The pneumonia moves fast.

    Except…

    One of the prevailing theories about the 1918 Spanish flu was that it had a different mechanism – something called a “cytokine storm” – that effectively turned the immune system into a weapon against the rest of the body. That’s why young adults were disproportionately affected by that strain. Add in the accompanying bacterial infections and other problems, and you get a lot more deaths than normal.

    If a modern strain of the flu did something similar, it could be pretty rough.

    I had the “regular” flu a couple of weeks ago, and it was bad enough. It wasn’t that hard for me, but I can certainly understand how it would nuke someone with a wonky immune system.

    That’s an interesting theory. I haven’t heard it before.

    It might explain a lot.

    The number of children who are succumbing this year (the number is increasing) is a real tragedy.

    From a cursory look through the current crop of news stories, it is still pneumonia that is the deadly complication. People should watch for fever:

    Which symptoms should trigger immediate concern? “In general, worrisome signs are a very high, persistent fever, difficulty breathing or shortness of breath, significant tiredness, or confusion,” she said.

    ”Getting better and then getting worse can indicate a secondary bacterial infection,” Schuchat said. Seek help if that happens, she said.

    I am familiar with that common pneumonia scenario of the patient’s seeming to get better briefly. That’s when the lungs are filling up at the bottom, below the cough reflex.

    Pediatricians should be ordering chest x-rays if they suspect a secondary infection. Parents should ask for x-rays if they suspect their child is sicker than he or she should be.

     

    • #14
  15. The Reticulator Member
    The Reticulator
    @TheReticulator

    MarciN (View Comment):
    Remember that a pneumonia cough is below the cough reflex.

    Could you explain this statement? (Had a touch of pneumonia ten years ago. Took me four years to completely get over the antibiotic.)

    • #15
  16. Nicegrizzly Inactive
    Nicegrizzly
    @Nicegrizzly

    MarciN (View Comment):
    My Annual Public Service Exhortation

    The flu does not kill people. It is the pneumonia that travels with the flu bug that kills people. The flu weakens the patient; then the pneumonia goes in for the kill. The pneumonia moves fast.

    If someone you are caring for develops flu symptoms and then suddenly seems to be much sicker, get to a doctor as soon as possible. Tell the doctor you are concerned that a secondary infection has set in. If the doctor does not prescribe an antibiotic, ask the doctor what he or she needs to see in order to prescribe the antibiotic: the exact temperature and whether it rises and falls or stays steady; the color and consistency of the mucous; and the sound of the cough. Remember that a pneumonia cough is below the cough reflex. So what you may need to look for is actually less coughing.

    Be persistent and be bold in getting this information and these instructions as to whom to call or where to take the person you are caring for.

    Over and out . . .

    Car crashes DO NOT kill people. It’s the organ damage from the sudden impact that kills people. Avoid getting into the car crash in the first place, and the organ damage won’t kill you.

    Avoid getting the flu in the first place, and the pneumonia won’t kill you.

     

    • #16
  17. MarciN Member
    MarciN
    @MarciN

    The Reticulator (View Comment):

    MarciN (View Comment):
    Remember that a pneumonia cough is below the cough reflex.

    Could you explain this statement? (Had a touch of pneumonia ten years ago. Took me four years to completely get over the antibiotic.)

    Pneumonia fills up the lowest parts of the lungs. The cough reflex is higher up. :)

    • #17
  18. EHerring Coolidge
    EHerring
    @EHerring

    As a grandma with grands under 2 to almost 7, I am worried.  Two of them have had issues with asthma in the past.  They had flue shots and one had the flu but seems to have recovered.  I will watch for complications.

    • #18
  19. Susan Quinn Contributor
    Susan Quinn
    @SusanQuinn

    Today’s WSJ had an article that in spite of reaching the “peak” of the season, the numbers are still going up. Everyone take good care of yourself and your loved ones.

    • #19
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