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

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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

This Year’s Flu Season Has Begun

Flu season has already begun, with three cases being reported in Western Massachusetts, and this year may be different from those past as the CDC has made multiple new recommendations and different options made available for the public.  Let’s answer your questions.

 

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.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

 

Posted in flu, Health, news

Should We Keep our Mouths Shut When it Comes to Guessing Flu Shot Efficacy?

Low flu shot efficacy predictions may be turning people off from getting the life-saving vaccine.

A 3-year-old girl from Indiana who died days after being diagnosed with the flu was never vaccinated against the virus since the family was dissuaded by efficacy reports.

Alivia Viellieux of Muncie, Indiana was diagnosed with Influenza A when she presented to medical providers with a fever of 106 degrees.

child-flu-death-alivia-ho-ps-180213_10x9_992.jpg

She was hospitalized and when she improved she was sent home. Unfortunately she began feeling worse again at home and died in her sleep the next day to what the family believes was pneumonia.

The number one cause of flu-related death is pneumonia.  Most children are vaccinated against pneumococcal pneumonia with Prevnar as infants, as are those over 65 who receive the Pneumovax.

Alivia’s grandmother, Tameka Stettler, stated they didn’t give the toddler the flu shot this year due to its purported low efficacy rate.  She states, “Alivia did not have it because they had told us once the flu is going around it’s not going to matter if you got it or not.” She continued, as reported by Fox News, “We just decided not to put those chemicals in the girl’s body if it’s not gonna help.”

The flu vaccine this year has been reported to be approximately 30% effective against this year’s flu strains, including H3N2, H1N1 and an Influenza B strain.  Strong efficacy would range in the 60-65% range. Why not 100%? Virus strains mutate easily as weeks go by and vaccine manufacturers need to rely on data from the Southern Hemisphere who combats the flu season before us.

A November study published in the New England Journal Of Medicine stated that Australia had dealt with the majority of strains this season to be H3N2 and their flu shot was found to only be 10% effective.

US media outlets reported these findings and the public panicked.  However, the medical community still urged everyone over 6 months of age to get the flu shot as any vaccine efficacy can still be life saving.  However, that might have fallen on deaf ears.

Which brings me to ask….Should we be reporting flu shot efficacy before we know the facts?

We don’t really know how effective the flu shot is until late until the season.  Moreover in those of us who received the flu shot and did not get the flu this season, was it due to the shot or our good health, or luck?  And who reports to the CDC that they were “all clear” this flu season?  If data on flu shot efficacy is not able to accurately collected on those who did not get the flu, how are we getting a true estimate of vaccine effectiveness?

I understand that media outlets want to warn us of a deadly flu season without an ideal vaccine but the panic may work against us with many NOT taking precautionary measures.

I suggest at the start of next flu season, the media reminds viewers, listeners, readers that flu shots are never 100% effective but can provide protection without giving a “guestimate” percentage. Reporting what happened in the Southern Hemisphere the season before is fine with a caveat that we may not know our vaccine’s true effectiveness till later in the season.  Emphasizing good hand washing, avoiding others who are sick, good nutrition, being well rested and getting vaccinated will do more good than grabbing people’s attention with a scary headline that may not be entirely accurate.

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

Posted in Health, news

Is the “Man Flu” Real? Science says so.

For decades women have been accusing men of being “weaker” when it comes to the common cold and flu.  But a new study finds men to be more susceptible to viral respiratory illnesses and to be more at risk of hospitalization due to the flu.

Dr. Kyle Sue, assistant professor at Memorial University of Newfoundland, presented his findings in the British Medical Journal.  He suggested men may have a weaker immune response when it comes to common winter colds/infections and may not be as responsive to the flu shot as the female gender.  He states, “I do think that the research does point towards men having a weaker immune response when it comes to common viral respiratory infections and the flu,” and continued with, “this is shown in the fact that they [have] worse symptoms, they last longer, they are more likely to be hospitalized and more likely to die from it.”

Why? Are women more likely to multitask and “suck it up”, appearing less sick?  Are women more likely to seek treatment sooner than men?

Another theory to be considered is men’s diets.  Many women will gladly eat a salad for dinner as her main entrée, yet the average male would choose a meat dish (I’m with them on that one).  Do men consume less vegetables, hence less cold-fighting vitamins?

One study suggested the hormone testosterone may dampen the immune system where as female hormones enhance it.

The flu season this year may be a vicious one as our 2017-18 flu shot has been predicted to be 10% effective.  Although this will still save thousands of lives, fewer individuals may receive the protection they need.  If “man flu” is real, start loading up on your veggies now.

 

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

Posted in Employment, food, Health

Employers: How to Help Improve Your Employees’ Health

Image above from MedicalDaily.com

 

While the future of employer based health insurance remains uncertain, one certainty that remains is employers need healthy employees.

Your staff is the backbone of the organization, hence nurturing and facilitating good health practices not only ensures their stability and health but also that of your company/business.

Here are a few ways to accomplish this:

Offer the Flu Shot

According to the CDC, 20% of Americans get the flu each year, costing businesses $87 billion dollars a year.  The cost of supplying the flu shot pales in comparison to 1/5 of your workforce calling out sick during your busy season.  Supplying a one day flu shot clinic is not only economical but life saving as the flu can be deadly.

flu-vaccine

 

Provide Adequate Sick Leave

Sick leave varies per company and critics of extended sick leave are concerned with abuse of the paid days given.  Some employees may use up their sick leave for personal time and then when cough and cold season comes around, they are forced to go to work sick or face unpaid leave.  This exposes other workers to illness leaving more posts vacant when those employees need to take leave.  Understandably, it’s a controversial subject as a small employer would have to staff double to ensure adequate coverage of a position if one calls out sick. The more sick leave, the potentially higher the cost.

However a few modifications may help both employer and employee.

a.  Begin the Sick-Leave Cycle during Flu Season.  Rather than Leave Periods renewing every July 1, start the new Leave Cycle November 1.  This helps increase the chance that the employee would have their sick days untouched during a very common time of year when it needs to be used.

b.  Make sure adequate hours are offered for both sick leave and personal leave.  A cold, respiratory infection, stomach ailment, etc. can easily burn through 5 sick days.  An employee taking off one or two days could still be contagious days 3-5 or more.  Adequate sick leave prevents one from returning to work too soon.

c.  Offer a means to earn extra days of leave.  If an employee wants to re-earn sick leave/personal hours for later in the year, offer incentives or work projects that allow employees to gain extra days.

d.  Institute an “hours bank”.  If an employee has used all of his/her personal, vacation and sick leave, they can borrow from an “hours bank”.  The “hours bank” could include hours donated by other employees, hours won during office contests, or simply a bank that exists that will award an employee additional time with the understanding that they will have to replenish the hours in the bank at a later date.  This will allow an immediate need for sick time to be gratified but prevent abuse as it is understood to be a “loan” of hours.

Promote Prevention/Offer Screening Services

Encouraging employees to get preventative screens may help prevent serious illness. These screens can be done at their primary care provider’s office or the employer can bring the screening in-house.

 

Encourage Getting Up and Moving Around

Before the end of each hour, a “stand up and move around” alarm should go off and allow 5-10 minutes of physical activity. Not only is this beneficial for health but helps prevent burnout in the work place.

Offer Healthy Snacks

Swap the sugary carbs in the snack machine with healthy juices, snacks, and bottled water.  Encourage potlucks or contests where employees bring in their most creative healthy snacks.

Healthy_Vending_Machine_Option.jpg

Image above from HealthyFamily

 

Have Plenty of Sinks and Hand Sanitizing Stations

An individual’s workplace can get very dirty as studies have shown computer keyboards to hold more pathogens than a toilet seat.  Offering cleansing wipes, wall sinks and sanitizing stations will improve employee hygiene.

sanitizer.jpg

Offer Workstation Modifications

Many employees may suffer from low back pain, arthritis, hemorrhoids, and a variety of conditions that may worsen when one sits all day at a computer.  Offering chair modifications, for example, could decrease their need to call out and help improve their comfort and therefore efficiency.

Awesome-Exercise-Ball-Office-Chair-94-On-Small-Home-Decor-Inspiration-with-Exercise-Ball-Office-Chair.jpg

 

A well implemented program for workplace and employee health is a necessity for all organizations, and as you will come to see, cost saving in the long run.

 

 

                                                                                                         

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

Posted in Health, news

Flu vaccine this year is fairly effective

The effectiveness of the flu vaccine varies each year.  Being 60% effective is considered great.  Yet in some years its been lower, such as the 2014-2015 season, when the efficacy was 19%.

This year the CDC reports our trivalent flu vaccine that protects against three viruses (the Influenza A H1N1, H3N2, and Influenza B) is averaging 48% effectiveness. They found against the H3N2 virus, which is the predominant strain this year, the flu vaccine has been 43% effective.  And the less common Influenza B virus has been kept at bay 73% of the time.  According to the CDC this averages to overall protection of 48%.

Last year the vaccine efficacy was 47% but what’s interesting is the year before last, in which the flu shot was only 19% effective, the flu was dominated by the H3N2 strain. This is the same strain that is predominant this year.  Dr. Brendan Flannery, lead investigator for the US Flu Vaccine Effectiveness Network, said, “The prediction for the H3N2 virus was right on in terms of that particular virus continuing to be a dominant virus.”

Vaccines will rarely, when it comes to influenza, reach 90%+ accuracy in that it’s cocktail needs to be determined based on previous seasons’ data and information received from over 100 countries who conduct surveillance of their own.

We usually don’t find out how effective our vaccine is until we peak in the flu season. For the United States the peak is now.   Therefore the CDC is urging those who haven’t received the flu vaccine do so now.

 

For more information on the flu please visit:  https://doctordaliah.wordpress.com/2016/10/23/this-years-flu-season-and-flu-vaccine-your-questions-answered/

 

                                                                                                         LearnHealthSpanish.com

                                                                                                         Medical Spanish made easy

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