The Bird and Swine flus are back

The Centers for Disease Control is reporting growing numbers of flu cases, including a lot of Swine Flu (H1N1) cases, and even a (rare) case of the Bird Flu (H5N1).

The incidence of flu has been rising, and has not peaked yet. The number of states reporting significant increases in flu cases has gone from 25 states to 35 states currently.

Along with the uptick in numbers of people affected, the number of people hospitalized has increased proportionately. Many of those hospitalized are people who failed to get a flu shot during the current flu season. And the number of deaths reported related to having flu has also increased.

Man with cold via Shutterstock

Man with cold via Shutterstock

Interestingly, some states (Nevada and California, for example) are reporting that more younger people seem to be getting the flu in those states than usual. A physician from Nevada says that more young and otherwise healthy adults are falling victim to the flu this year.

If you haven’t been vaccinated, it’s not too late. Flu may continue to spread for some time still.  Having said that, in some areas of the country, as cases of the flu are rising, the unvaccinated are now trying to get vaccinated, while stocks of flu vaccine in those areas may be depleted.  But it’s worth asking your doctor about still getting vaccinated.

Flu can make those with chronic medical conditions (like cardiac disease, chronic obstructive pulmonary disease and others) much more ill, and may require them to be hospitalized. Sometimes, the added burden of flu on top of a preexisting condition, can be fatal.

Is it the flu or a cold?

Sometimes people get confused as to whether they’re suffering from the flu or simply a cold.

The symptoms of the flu may be very similar to those of a cold, so something it actually is hard to tell the difference between the two. But if it’s the flu, often the symptoms are more severe. The flu victim feels tired and lethargic and just wants to stay in bed, rest and deal with the other symptoms (fever, chills, etc.).

Another difference is that the flu seems to hit quickly – no gradual increase in symptoms. Often with a cold the symptoms start gradually and escalate. And with flu, the fever may be higher (>101.9 degrees) than that seen with a cold. There’s also a medical acronym that helps to list the key features of the flu: It’s FACTS (Fever, Aches, Chills, Tiredness, Sudden onset.)

Bird Flu is back

In a related note, a Canadian woman has died from a strain of “bird flu” (also called H5N1, as opposed to H1N1 which is (or was) commonly referred to as the swine flu).

The woman had recently returned from China. She started experiencing symptoms en route back from Beijing. She developed a meningoencephalitis (infection of brain and adjacent tissue) and died about 6 days after she developed symptoms. he majority of cases seem to involve close contact with birds.

In this case, the woman did not leave Beijing, visit farms or markets where she could come in contact with birds. She is the first recorded death from this strain of avian flu in North America. There have been deaths from bird flu in China this year, as well. Avian flu cannot be transmitted from person-to-person, so there is no risk that she could have infected others.

The Swine Flu is back too

Finally, Swine Flu, otherwise known as H1N1, has also been in the news of late, with several cases being reported around the US.  There have been nine cases confirmed in the San Francisco Bay area. A man reportedly died in north Texas, and cases have been reported in Missouri, Oregon, the southeast and beyond.

The CDC reports that H1N1 is in fact the predominant flu this season, and that it’s hitting young adults particularly hard, as I noted at the top of this story:

“The predominant virus this year so far is H1N1,” said epidemiologist Dr. Michael Jhung with the Centers for Disease Control and Prevention’s Flu Division….

“It’s affecting a different age group this year — more young adults rather than elderly this year,” Dr. Jhung said.

For those who think flu shots don’t work…

There are several strains of flu circulating per given year.  They pick the three or four strains that they think will most probably be prevalent for that season, and make that year’s vaccine using those.

Is it possible that you get the vaccine and still get sick? Sure.

First, you can get the shot shot and still get one of the other flus circulating that year.

You also can get a flu that the vaccination was intended to prevent, simply because you didn’t develop sufficient antibodies to prevent the flu.

It’s also possible to get the flu before you have enough antibody built up from the shot (e.g., you get the shot, then one week later you get the flu because it takes about 2-3 weeks after the vaccination to develop enough antibodies).

The CDC has much more on vaccine effectiveness.  On average, the NYT reports that the flu vaccine is 56 percent effective.  But that varies by year.  Last year, 2013, they say the vaccine was 62 percent effective.

You can’t get the flu from the flu shot

And one final point: You can’t get the flu from the flu vaccine.  Here’s the CDC on that:

Can the flu vaccine give me the flu?

No, a flu vaccine cannot cause flu illness. Flu vaccines that are administered with a needle are currently made in two ways: the vaccine is made either with a) flu vaccine viruses that have been ‘inactivated’ and are therefore not infectious, or b) with no flu vaccine viruses at all (which is the case for recombinant influenza vaccine). The nasal spray flu vaccine does contain live viruses. However, the viruses are attenuated (weakened), and therefore cannot cause flu illness. The weakened viruses are cold-adapted, which means they are designed to only cause infection at the cooler temperatures found within the nose. The viruses cannot infect the lungs or other areas where warmer temperatures exist.

Again, there’s still time to get vaccinated. Make sure to ask your doctor about it.

Mark Thoma, MD, is a physician who did his residency in internal medicine. Mark has a long history of social activism, and was an early technogeek, and science junkie, after evolving through his nerd phase. Favorite quote: “The most exciting phrase to hear in science... is not 'Eureka!' (I found it!) but 'That's funny.'” - Isaac Asimov

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