Flu part 2

Flu (Part 2)
There is one other very important Flu group: Kids. Their immune systems just have matured and acquired the antibody response that healthy adults have. In shear numbers, children get the Flu 2 to 3 more times than adults. That is why we are hearing tragic stories about otherwise healthy 7 or 10 year olds who have died with the Flu (there were 11 pediatric deaths in this country during week 38 of the current epidemic). This is the reason that as the CDC is releasing vaccine, they are targeting children for vaccination among the first to receive it. In Novel H1N1 Flu, 77 people autopsied, fully one third had Streptococcus pneumoniae, or as it is called, pneumococcal pneumonia. True, it's variably treatable with antibiotics.
But there is a proven vaccine available for this bacterium. It protects against 23 encapsulated pneumonia bacteria which are the most common and greatest percentage of pneumococcal in human. It's available for all ages with increased risk for immune deficiency. We know now that only one-third of those who should receive it actually get it. It can be given along with the flu vaccine. Ask the doctor about it: "Pneumovax 23".The H1N1 Flu is spread by respiratory droplets. This is why students in classrooms and military recruits in barracks are so susceptible. All it takes is one cough or sneeze, and the virus is out there ready to be picked up by the next person. It can persist on surfaces like grocery cart handles for 2 to 6 hours touch those hands to your eyes, nose or mouth, and you're exposed. The incubation is 1 to 4 days after you've breathed in the virus-laden droplets. It's ironic that you, in turn, are at most risk of spreading it to others the day before you first show signs of illness. No wonder it spreads!
Children can be infected for more than 10 days. Severe immune deficiency can cause a person to shed the virus for weeks or months. These people should kindly wear their masks when they are around the rest of us. The symptoms of the Flu are pretty universally recognized: Malaise (Just feeling tired and sick), chills, fever, headache, bodyache, nasal congestion, sore throat, and sweats to name the most common. There are danger signs, though: A pregnant woman with the Flu, productive cough (say, with discolored sputum), chest pain, altered level of consciousness, (maybe disoriented or hard to arouse), appearing gray or with bluish lips like someone who is not getting enough oxygen, severe vomiting or signs of dehydration. When these are present, it's time to get to the doctor or the ER. These are signs that you have some potentially serious complication of the Flu.
Most people will not have the serious symptoms, but we all need to be alert for them. Likewise most people with the Flu get better within a week or two. If the symptoms come roaring back after an initial clearing (relapse), this is a danger signal. In these circumstances, one might have pain with each breath, cough up nasty-looking sputum, or have hard shaking chills. Don't fool around: Get to the doctor. Once again, children can have more serious symptoms and complications: Convulsions due to high fever, middle ear infections, and pneumonia. Let's now talk about treatment. First of all don't give aspirin to a child with fever. It is associated with Reye's Syndrome: A serious multi-organ failure with potentially catastrophic brain injury. You can give Tylenol (acetaminophen) every 4 hours according to body weight for chills, fever, malaise and headache. Motrin (ibuprofen) every 6 hours seems to be a safe alternative. The person should take in a lot of fluids--- Water, Gatorade, light soups, and eat lightly as the stomach allows. Bed rest with lots of naps is recommended to shorten the length of illness.
The person should stay home from work or school until there has been at least one full day without Tylenol or Motrin, and no fever. But what about the pregnant woman, the patient with chronic medical conditions, the person with decreased immune function, and very symptomatic children? These are the cases in which the doctor must see and decide whether to prescribe antiviral medication. It can be used prophylactically for persons closely exposed to the Flu patient to lessen or prevent the Flu. The 2 antivirals that we use are oseltamivir (Tamiflu) and zanamivir (Relenza). Tamiflu comes as a caplet for adults or a liquid for children. Relenza comes in a metered dose inhaler. Both are used every day for 10 days. They work best when given within the first two days of symptoms. They decrease the severity of the symptoms and shorten the course of the Flu. Relenza is not a good choice for patients with asthma or chronic lung disease.
The CDC and the Biopharmaceutical companies have worked exhaustively to prepare a safe vaccine to keep people from getting the severe ramifications of the flu. There is a lot of magical, wishful thinking in the population on how to "beat the flu," but science is not on their side. There is no vitamin, raw vegetable, or special drops to prevent the flu. It is time to realize that the CDC is a collection of the best minds in science and medicine, dedicated to the protection of health for the U.S. citizens and person around the world in the event of a pandemic. It is doctors and scientists trying to keep the public well, period. It's time to stop blowing the conspiracy horn and take your shots. In doing so, you protect yourself, your family, your co-workers, and your fellow citizens in general.
I was watching a press conference by Dr. Ann Schuchat, the CDC Immunization Director. She had a very well-constructed report addressing the plans for mass immunization in a tiered way so that the ones at most risk would receive their vaccinations first. She was very candid about flu deaths to the present, and the intricacies of combating the epidemic, or more correctly, the pandemic of novel H1N1 (Swine Flu, as it is often known.) What impressed me a lot was the presence of major news reporting organizations: AP, UPI. Atlanta Journal, Washington Post, ABC, and USA Today.
Here is the discussion of the flu in a nutshell:
1.) Get your seasonal flu vaccination, either shot or nasal spray;
2.) Get your Novel H1N1 (Swine Flu) vaccination when it is available;
3.) If you are pregnant or have chronic illness be sure to get both;
4.) Be sure kids are vaccinated;
5.) If you have severe flu or a relapse--see your doctor;
6.) If you have the warning signs of severe illness-- see your doctor;
7.) Wear a mask if you are sick or severely immune deficient;
8.) It takes about a week to get over the flu. Do not return to work or school until you have been fever-free for at least 48 hours; drink plenty of fluids, take Tylenol or Motrin for fever, and bedrest as much as possible. Do not give other over-the-counter medicines to young children without consulting a doctor; do not give aspirin for fever as it may lead to Reye's Syndrome;
9.) Learn as much as you can about the Flu from reliable sources;
10) There are no magical Flu preventatives or treatments out there--Rely on science and a physician to get through this time.

John Drew Laurusonis M.D.
Doctors Medical Center