Posted in flu, Health

Clark County Sees First Flu Death of the Season

A Clark County resident has died of flu-related illness, according to the Southern Nevada Health District (SNHD).

According to their website, the SNHD reports there have been 64 hospitalizations with one death in a person over 65 years-old.  The report is here.

Although the official cause of death is not reported, most flu-related deaths are caused by pneumonia.

Per the SNHD, Influenza B has appeared to be the predominant strain, however, H3N2 (A strain) is predicted to be most prevalent this upcoming flu season.

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-swine-flu-virus
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.

sneezing

 

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!!

 

ultimate book cover final

Great Gift!!!

The Ultimate Medical Student HandBook

 

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

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-swine-flu-virus
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.

sneezing

 

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!!

 

ultimate book cover final

Great Gift!!!

The Ultimate Medical Student HandBook

 

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

Posted in flu, Health, news

CDC Reports More Severe Wave of Flu to Come

This season’s primary strain of H1N1 is becoming overshadowed by new H3N2 cases according to health officials.

The H3N2 strain is more deadly and was responsible for last year’s epidemic that claimed 80,000 lives.

For the week ending Feb. 16, 2019, the CDC reports the following:

The percentage of respiratory specimens testing positive for influenza viruses in clinical laboratories increased. While influenza A(H1N1)pdm09 viruses predominated in most areas of the country, influenza A(H3) viruses have predominated in HHS Region 4 and accounted for 47% of subtyped influenza A viruses detected nationally during week 7. During the most recent three weeks, influenza A(H3) viruses were reported more frequently than influenza A(H1N1)pdm09 viruses in HHS Regions 6 and 7 and influenza A(H1N1)pdm09 and influenza A(H3) viruses were reported in approximately equal numbers in HHS Region 2.

WebMd reports:

“It looks like we are moving from an H1 wave to an H3 wave,” said Lynnette Brammer, lead of CDC’s domestic influenza surveillance team. “There’s still a lot of flu to come.”

Fortunately the strains show susceptibility to antiviral medications such as oseltamivir and peramivir.

WHOPHL07_small.gif

It’s not uncommon for various strains of flu to case illness during a single flu season.

Last week, the CDC reported a mid-season efficacy rate of 47% for this year’s flu shot, up from 36% estimated efficacy last year. However this may change in light of these new reports.

In a good year flu shot efficacy may be 65%.  It’s difficult to reach higher numbers as viral flu strains mutate easily and immune systems of the general public are so varied.  Per the CDC the flu shot during the 2010-2011 flu season was one of the most effective.

 

vaccine-effectiveness_v3

This year the predominant flu strain was H1N1, in contrast to the more wily H3N2 which evaded being a sharp match for last year’s flu vaccine. However, now that H3N2 is making the rounds, we could see a drop in our flu vaccine efficacy.

They report the following:

Interim estimates of vaccine effectiveness based on data collected during November 23, 2018–February 2, 2019, indicate that, overall, the influenza vaccine has been 47% (95% confidence interval = 34%–57%) effective in preventing medically attended acute respiratory virus infection across all age groups and specifically was 46% (30%–58%) effective in preventing medical visits associated with influenza A(H1N1)pdm09 (6).

It is not too late to get the flu shot and medical providers are still recommending vaccination.

According to the CDC “preliminary cumulative in-season prevalence estimates indicate that influenza has caused 155,000–186,000 hospitalizations and 9,600–15,900 deaths.”

To date, 28 children have died this year from flu related illness.

Flu season peak is still occuring as winter appears to more severe this year, hence numbers can rise.

 

The Flu – Your Questions Answered

__________________________________________________________

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 multiple flu related deaths 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-swine-flu-virus
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/Michigan/45/2015 (H1N1)pdm09–like virus
  • A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus
  • B/Colorado/06/2017–like virus (Victoria lineage)

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.

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.

sneezing

 

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.

 

IMG_1781

The Baby Boomer’s Guide to Online Dating

 

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

Posted in flu, Health, news

This Year’s Flu Shot Efficacy Improved Over Last Year

The CDC reports a mid-season efficacy rate of 47% for this year’s flu shot, up from 36% estimated efficacy last year.

In a good year flu shot efficacy may be 65%.  It’s difficult to reach higher numbers as viral flu strains mutate easily and immune systems of the general public are so varied.  Per the CDC the flu shot during the 2010-2011 flu season was one of the most effective.

 

vaccine-effectiveness_v3

This year the predominant flu strain is H1N1, in contrast to the more wily H3N2 which evaded being a sharp match for last year’s flu vaccine.

They report the following:

Interim estimates of vaccine effectiveness based on data collected during November 23, 2018–February 2, 2019, indicate that, overall, the influenza vaccine has been 47% (95% confidence interval = 34%–57%) effective in preventing medically attended acute respiratory virus infection across all age groups and specifically was 46% (30%–58%) effective in preventing medical visits associated with influenza A(H1N1)pdm09 (6).

It is not too late to get the flu shot and medical providers are still recommending vaccination.

According to the CDC “preliminary cumulative in-season prevalence estimates indicate that influenza has caused 155,000–186,000 hospitalizations and 9,600–15,900 deaths.”

To date, 28 children have died this year from flu related illness.

Flu season peak is still occuring as winter appears to more severe this year, hence numbers can rise.

 

The Flu – Your Questions Answered

__________________________________________________________

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 multiple flu related deaths 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-swine-flu-virus
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/Michigan/45/2015 (H1N1)pdm09–like virus
  • A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus
  • B/Colorado/06/2017–like virus (Victoria lineage)

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.

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.

sneezing

 

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.

 

spanish book

Learning Medical Spanish is Easy!!!

 

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

 

 

Posted in flu, Health, news

Buying “Used” Tissues is a Bad Idea

A company out of Los Angeles is selling used tissues to for people who want to get themselves sick, “choosing” when they get their illness.

Vaevtissue.com reports the following on their website:

We believe that when flu season comes around, you should be able to get sick on your terms. We’re not about chemicals or prescription drugs here at Væv. We believe using a tissue that carries a human sneeze is safer than needles or pills. This isn’t like any tissue you’ve used before, but we love using them, and you will too.

vaev+tissue+wide+

How much for this treasure??? $79.99

The logic behind the trend is people want to build up a natural immunity to diseases and not wait for the cold or flu but plan ahead of time when they can allow for sick leave and rest.

The problem?  You don’t know what you’re getting.  Used tissue could have a variety of contaminants that transmit in bodily fluids including Staph. bacteria, TB and Ebola.

Vaccines are the safest way to introduce a killed or attenuated version of an infectious agent.

 

spanish book

Learning Medical Spanish is Easy!!!

 

 

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

 

 

Posted in flu, Health, news

Flu Shot Found to be More Effective Than Nasal Mist Flu Vaccine

A new study published in Pediatrics reports the nasal FluMist vaccine to be less effective in treating the flu as compared to the traditional flu shot.

Study authors combined data from 5 US studies and found of the 17,173 children aged 2-17 reviewed, the flu shot was 67% effective where as the nasal spray (FluMist) was only 20% effective and protecting against the flu.

FluMist is a live attenuated vaccine that is not recommended in infants and pregnant women. It is indicated for those between the ages of 2-49 and introduces a live, weakened version of the flu virus to incite an immune response.  This differs from the injectable flu vaccine which uses killed versions of the flu strains to induce a flu response.

Children prefer the FluMist as the nasal spray offers a less painful option than an injection.

The US Centers for Disease Control and Prevention advisory committee voted last Fall to return the FluMist, nasal spray flu vaccine, to the recommended options for the 2018-2019 flu season.

In 2016 it was not recommended and discouraged as they found its effectiveness against seasonal flu to be approximately 46%, when 65% efficacy was touted by the injectable flu shot.  However during the 2017-2018 flu season, the current flu vaccine was found to be only 35% effective with one of the worst flu seasons in years taking the lives of healthy young adults and children.

Why was last season so severe? The H3N2 strain was the predominant one, notorious for bad flu seasons, and is crafty, able to mutate before the vaccine is finalized.  Hence our flu vaccine was not able to be as close a match as desired.

The panel voted 12-2 to include FluMist as an option for medical providers to recommend against the upcoming 2018-2019 flu season.

Why was FluMist removed?  Experts found it to be ineffective against one of the influenza A H1N1 strains. With its overall efficacy found to be lower than the flu shot it was deemed a less ideal option than the shot.

This year the H1N1 strain appears to be more prevalent.

The FluMist Quadrivalent nasal spray, manufactured by MedImmune of AstraZeneca PLC, offers protection against 4 strains of flu including H1N1, H3N2 and two influenza B strains.  According to FluMist’s prescribing information, the FluMist proved 90% effective against H3N2 as opposed to influenza B where it scored 44.3% effectiveness.   Another review found its efficacy against H3N2 to be 79%.

slide_25

Now that’s not to say the FluMist would have been immune to the vaccine issues experienced with last year’s flu shot as H3N2 is a highly virulent and mutable virus, and could have snowed the FluMist vaccine makers as well.

Yet we may need to consider that the FluMist may be more efficacious for some strains of the flu whereas the flu shot may better protect us against others.  More research needs to be done in this area. As of now choosing which flu shot to get for the next flu season may be a crap shoot.

For more on the study click here. 

 

dw sketch.jpg

 

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

 

Posted in flu, Health, news

Flu Now Widespread in Multiple States

The CDC has reported an increase in flu activity during our 52nd week of the year ending on 12/29/18.

The CDC reports outpatient visits for influenza-like illness (ILI) jumped to 4.1%, above the national baseline of 2.2%.

 

cdc map.gif

The CDC states the following:

New York City and 19 states experienced high ILI activity; nine states experienced moderate ILI activity; the District of Columbia and 10 states experienced low ILI activity; and Puerto Rico and 12 states experienced minimal ILI activity.

States experiencing high ILI activity include:

  • Alabama
  • Arizona
  • Colorado
  • Georgia
  • Illinois
  • Indiana
  • Kansas
  • Kentucky
  • Louisiana
  • Massachusetts
  • Mississippi
  • Nevada
  • New Jersey
  • New Mexico
  • Oklahoma
  • South Carolina
  • Texas
  • Utah
  • Virginia

 

States experiencing moderate ILI activity include:

  • Arkansas
  • California
  • Michigan
  • Missouri
  • New York
  • North Carolina
  • Pennsylvania
  • Rhode Island
  • Vermont

 

Low and minimal activity (noted in yellow and green) has been reported in the remaining states as well as Puerto Rico.

flu-survey-map (1)

Image from CDC

 

Currently it appears the majority of flu cases are caused by the H1N1 Influenza A strain. Even though the H1N1 caused an epidemic in 2009, this may forbode a less severe flu season from last year’s H3N2 epidemic.

The Flu – Your Questions Answered

__________________________________________________________

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 multiple flu related deaths 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-swine-flu-virus
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/Michigan/45/2015 (H1N1)pdm09–like virus
  • A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus
  • B/Colorado/06/2017–like virus (Victoria lineage)

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.

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.

sneezing

 

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!!

 

dw sketch.jpg

 

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