The flu is coming back. The 2018/2019 influenza season is arriving soon.
Seasonal influenza is a preventable infectious disease, mostly with respiratory symptoms, caused by the influenza virus and is easily transmitted by direct or indirect spread from respiratory secretions.
Severe illness and complications due to influenza are most commonly seen in infants, young children, pregnant women, people with underlying medical conditions and people over 65 years of age. However, anyone can develop severe influenza.
There is still the general belief that the flu is a benign disease, that it does not need prevention and the only ones that can die are fragile old people. Very wrong!
Flu is rarely a cause of death by itself, but infection by the influenza virus diminishes the defences at the level of the respiratory system, favouring secondary bacterial infections such as pneumonia and the exacerbation/decompensation of chronic diseases like heart failure, chronic obstructive pulmonary disease and diabetes. These are the main causes of death.
Recent studies have shown that the flu activity in the community doubles, or more, the risk of death due to acute heart attack.
The flu vaccination also indirectly protects against heart attacks, in 15% to 45% of cases.
According to the European Centre for Disease Prevention and Control (ECDC), increasing the vaccination within the risk groups, using a trivalent vaccine, could prevent up to two million cases of illness, the loss of 850,000 days of work, 916,000 family doctor visits, 65,000 hospitalisations and 37,000 annual deaths.
Due to the constantly evolving nature of influenza viruses, the compositions of viruses in influenza vaccines need to be revised periodically.
The European Medicines Agency (EMA) has issued the European Union (EU) recommendations for the influenza virus strains that vaccine manufacturers should include in vaccines, for the prevention of seasonal influenza from autumn 2018.
Vaccination, the most effective measure to prevent severe disease caused by influenza
Influenza vaccines are safe and the principal measure for preventing influenza and reducing the impact of epidemics. WHO recommends that health-care workers and people who are most at risk of developing serious complications from influenza infection – the elderly, people with chronic conditions, pregnant women and young children – be vaccinated every year before the season begins.
When should people get vaccinated?
Before the flu begins spreading in the community. It takes about two weeks after vaccination for antibodies that protect against flu to develop in the body, so make plans to get vaccinated early in autumn, before the flu season begins. It is recommended that people get a flu vaccine by the end of October. Getting vaccinated later, however, can still be beneficial and vaccination should continue to be offered throughout the flu season, even into January or later.
Children who need two doses of vaccine to be protected should start the vaccination process sooner, because the two doses must be given at least four weeks apart.
Can I get a flu vaccine if I am allergic to eggs?
The recommendations for people with egg allergies are the same as last season.
■ People who have experienced only hives after exposure to egg can get any licensed flu vaccine that is otherwise appropriate for their age and health.
■ People who have stronger symptoms, such as angioedema, or who have needed epinephrine or another emergency medical intervention, can also get any licensed flu vaccine that is otherwise appropriate for their age and health, but the vaccine should be given in a medical setting and be supervised by a healthcare provider who is able to recognise and manage severe allergic conditions (settings include hospitals, clinics, health departments, and physician offices).
What sort of flu season is expected this year?
It is not possible to predict what this flu season will be like. While flu spreads every year, the timing, severity and length varies from one season to another.
Flu viruses are constantly changing so it is not unusual for new flu viruses to appear each year.
The timing of flu is unpredictable and can vary in different parts of the country and from season to season. Seasonal flu viruses can be detected year-round, however, seasonal flu activity often begins as early as October and November and can continue to occur as late as May.
Yearly flu vaccine
For everyone six months of age and older, it is the first and most important step in protecting against this serious disease.
In addition to getting a seasonal flu vaccine, you can take every day preventative actions, like staying away from sick people and washing your hands to reduce the spread of germs. If you are sick with flu, stay home from work or school to prevent spreading flu to others. In addition, there are prescription medications called antiviral drugs that can be used to treat influenza illness. These drugs work best if given within 48 hours of when symptoms start.
Encourage all your family members and friends to get vaccinated!
Getting vaccinated each year provides the best protection against flu throughout the flu season. It’s important to get a flu vaccine every season, even if you got vaccinated the season before and the viruses in the flu vaccine have not changed for the current season.
Can a person get vaccinated and still get the flu?
Yes. It is possible to get sick with flu even if you have been vaccinated (although you won’t know for sure unless you get a flu test). This is possible for the following reasons:
■ You may be exposed to a flu virus shortly before getting vaccinated or during the period that it takes the body to gain protection after getting vaccinated. This exposure may result in you becoming ill with flu before the vaccine begins to protect you (antibodies that provide protection develop in the body about 2 weeks after vaccination).
■ You may be exposed to a flu virus that is not included in the seasonal flu vaccine. There are many different flu viruses that circulate every year. A flu vaccine is made to protect against the three or four flu viruses that research suggests will be most common.
■ Unfortunately, some people can become infected with a flu virus a flu vaccine is designed to protect against, despite getting vaccinated. Protection provided by flu vaccination can vary widely, based in part on health and age factors of the person getting vaccinated. In general, a flu vaccine works best among healthy younger adults and older children. Some older people and people with certain chronic illnesses may develop less immunity after vaccination.
Flu vaccination is not a perfect tool, but it is the best way to protect against flu infection.
Even during seasons when there is a less than ideal match, antibodies made in response to vaccination with one flu virus can sometimes provide protection against different, but related, flu viruses. A less than ideal match may result in reduced vaccine effectiveness against the flu virus that is different from what is in the flu vaccine, but it might still provide some protection against flu illness.
Get all the possible weapons ready to fight, for when the nasty virus comes back to town.
Best health wishes,
Dr. Maria Alice
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Dr Maria Alice is a consultant in General and Family Medicine. General Manager/Medical Director – Luzdoc International Medical Service / Medilagos. Medical Director – Grupo Hospital Particular do Algarve