Posted in disease, flu, Health, news

This Year’s Flu Season Has Begun

Although flu season officially starts in October, public health officials in Riverside, California have already reported the first “flu-related” death this year, a 4 year-old child.

And being that Australia’s flu season began a couple weeks early and was more “severe” than previous years, US health experts are bracing for a rough one of our own.

We still, however, cannot predict how “severe” this year’s flu season will be, but here are answers to the most commonly asked questions about the flu.

When does flu season begin and how long does it last?

Flu season has begun already. It typically starts in the Fall, and ends late Spring.  So the range is described as October to May with it peaking December to March.

How bad will this flu season be?

It is difficult to predict, but already this early in the season we’ve had a flu-related death.  As the season unfolds, more cases will be reported by the CDC’s Flu View.

What is the flu?  How can one die from it?

The flu is caused by a virus. Multiple strains of virus’ can cause the flu.  The virus itself can be lethal, however the greatest risk comes with what it does to your immune system, thereby putting one at risk of secondary infections.  Pneumonia is the number one cause of flu-related deaths.  Secondly, it can exacerbate existing conditions such as asthma, seizures, even promote preterm birth, hence those who are pregnant or have preexisting medical conditions are urged to get vaccinated against the flu.  Moreover those who qualify should get the pneumonia vaccine as well.


h1n1 virus


What does this year’s flu vaccine cover?

According to the CDC, the trivalent vaccine covers for these three strains of flu virus:

  •  A/Brisbane/02/2018 (H1N1)pdm09-like virus
  • A/Kansas/14/2017 (H3N2)-like virus
  • B/Colorado/06/2017-like (Victoria lineage) virus

Quadrivalent influenza vaccines will contain these three viruses and an additional influenza B vaccine virus, a B/Phuket/3073/2013–like virus (Yamagata lineage).

These vaccines are aimed at providing protection against the Swine flu, and some influenza A and B strains.

What about older individuals?

This year, those over 65 will have three options for their flu vaccine.

Fluzone High-Dose – a higher dose flu vaccine that will hopefully allow their immunity to protect against the flu longer

FLUAD – the trivalent flu vaccine with an adjuvant to stimulate more of an immune response.

Flublock Quadrivalent – provides protection against 4 strains.

What about the nasal spray vaccine?

This year, the CDC allows use of the nasal spray vaccine as it has shown to have improved efficacy from  prior years. However it is only recommended for  those who are between the ages of 2 and 49 and cannot be given to those who are pregnancy or who have compromising medical conditions as outlined by the CDC.

Who should get the flu shot?

All individuals 6 months old and older unless specified by their medical provider.

How long does it take the flu shot to “kick in”?

The average immune system takes a couple weeks of to prime, so we suggest getting the flu shot before the season starts…or peaks.  However, experts recommend to still get the flu vaccine to anyone who missed early vaccination.

What if I’m allergic to eggs?

Most individuals allergic to eggs can still get the flu vaccine, but if the allergy to eggs is severe (anaphylaxis, angioedema, difficulty breathing), the CDC recommends notifying your medical provider and being in a facility to monitor you if you do get the flu vaccine.

Will I get the flu from the flu shot?

No.  The flu vaccine has a “killed” version of the virus meaning it’s not an active virus (as opposed to a live attenuated vaccine, a weakened down version of it).   A “killed” or “inactivated” vaccine merely has the pathogen particles to induce an immune response.  Additionally, when one states they got the flu despite the flu shot it could be that the flu shot only protects against 3 – 4 strains and they were infected with a more rare strain not covered by the vaccine.

How effective is the flu vaccine?

The average effectiveness each year hovers around 60%.  Last year’s efficacy was much lower and this year’s has not been predicted as of yet. Australia is still reporting active cases on their Department of Health website.

I feel sick after the flu shot, why?

For some, the immune response that ensues can make one feel mildly ill, but should not resemble the flu. Those who state they got the flu “immediately” after receiving the shot, might have already been exposed and had not had a chance to produce immunity prior to their exposure.



What are symptoms of the flu? How is it different from a cold?

A cold comes on slower and less severe.  Flu symptoms are more abrupt and can include:

  • Fever
  • Body Aches
  • Cough
  • Sneezing
  • Sore Throat
  • Shortness of Breath
  • Fatigue
  • Headache
  • Nausea
  • Vomiting

Are there medications to treat the flu? Will antibiotics work?

There are antiviral medications available, such as Tamiflu, to treat the flu.  Antibiotics, however, will not work since the flu is not caused by a bacteria but rather a virus. However if a secondary bacterial infection takes over, antibiotics may be used.

How can I prevent getting the flu?

Besides vaccination, avoid being around those who are sick, thorough hand washing, and take good care of yourself.  A balanced diet, exercise and sleep regimen can help boost your immune system.

Wishing you health this season!!


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Great Gift!!!

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

Posted in disease, Health, news

West Nile Virus Cases in Humans Reported in Multiple States including Nevada


Multiple cases of West Nile virus has been confirmed in Clark County, Nevada. The Southern Nevada Health District has declared an “outbreak of mosquito-borne diseases” following new cases of the virus being reported earlier this month.

This summer has been a wetter season in the Southwest, most likely causing an uptick in mosquito activity.

States throughout the country have been reporting cases of West Nile virus as well, with the highest occurring in Arizona (42 cases as of 7/23/19 per CDC).




West Nile Virus Disease Cases* and Presumptive Viremic Blood Donors by State – United States, 2019 (as of July 23, 2019)

West Nile Virus Disease Cases and Presumptive Viremic Blood Donors by State – United States, 2018 (as of November 27, 2018)
State Neuroinvasive
Disease Cases†
Disease Cases
Deaths Presumptive viremic
blood donors‡
Arizona 42 15 57 1 16
Arkansas 1 0 1 1 0
California 2 0 2 1 1
Colorado 0 1 1 0 0
Iowa 0 2 2 0 0
Kentucky 1 0 1 0 0
Maryland 0 1 1 0 0
Missouri 1 0 1 0 0
Nebraska 1 0 1 1 0
Nevada 1 0 1 0 0
New Jersey 1 0 1 0 0
North Dakota 1 0 1 0 0
Oklahoma 1 2 3 0 0
South Dakota 0 1 1 0 0
Virginia 0 1 1 0 0
Wyoming 1 0 1 0 0
Totals 53 23 76 4 17
*Includes confirmed and probable cases.
†Includes cases reported as meningitis, encephalitis, or acute flaccid paralysis.
‡Presumptive viremic blood donors (PVDs) are people who had no symptoms at the time of donating blood through a blood collection agency, but whose blood tested positive when screened for the presence of West Nile virus. Some PVDs develop symptoms after donation.
Please refer to state health department web sites for further details regarding state case totals.

What is West Nile virus?

West Nile virus was originally discovered in the 1930’s in the West Nile district of Uganda.  It is believed to have reached the United States in the late 1990’s.

It’s in the family of Flaviviridae in which the disease is vector transmitted, such as by ticks, or mosquitoes, and can infect mammals as hosts. West Nile is in the same family as Zika, Yellow Fever, Dengue Fever, and Japanese Encephalitis.

Culex genus/species of mosquitoes are the usual culprit.  They feed from evening to morning, hence are more active during those times.

How is West Nile transmitted?

A mosquito contracts the disease while feeding on an infected bird and then can transmit it to humans.


What are the symptoms of West Nile virus infections?

80% of those infected do not exhibit symptoms.  Some however, may elicit the following if they have mild illness:

  • Fever
  • Body aches
  • Fatigue
  • Nausea
  • Vomiting
  • Joint  pains
  • Weakness
  • Rash


Image from Reserachgate

Rarely (1 in 150 people) may become seriously ill with neuroinvasive symptoms.  These include:

  • Headache
  • Neck pain/Stiff neck
  • High fever
  • Sensitivity to the light (photophobia)
  • Tremors
  • Weakness
  • Paralysis
  • Confusion
  • Disorientation
  • Seizures
  • Coma
  • Death

Since mosquitoes are the primary vector, avoiding them is paramount to limiting infection.  We recommend the following:

Clean up areas of standing water around the house such as kiddie pools, puddles, buckets as they provide a breeding ground for mosquitoes.

Wear light long sleeve clothing, pants tucked into socks/shoes when outside.

Use DEET or insect repellent that can also be sprayed onto clothes when planning to be outdoors.

Be aware that many mosquitoes are active from dusk till dawn.

If bit by a mosquito, contact your local medical provider if you have any of the aforementioned symptoms.


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Great Gift!!!

The Ultimate Medical Student HandBook


Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.