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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50 Responses to “The Bird and Swine flus are back”

  1. Whitewitch says:

    I think we agree – generally. I think the vaccine this year is NOT a good match. I have not seen our office “taken down” like this in a good long time, as most people here get the vaccine for free through our office on all the same day (kind of like a party). Normally, our office does not suffer the effects of the flu has it has this year.

    I believe that is the point I was trying to make, albeit not well.

    I agree that us “older than dirt” people are less likely to things…as we exposed to the “real” thing and have built up good and strong immunity. Me – I have not had the flu – to my knowledge save once back in the day…but I have had everything you can imagine when younger. So we shall see if 20 years from now we are hearing the same about vaccines that we are hearing about other things which have turned out to not benefit a human (such as sitting at a desk working on a computer 8-10 hours a day without sunlight or exercise; antibacterial soap; eating of refined processed foods, etc. etc.)

  2. Ninong says:

    Actually, not that wasn’t my point. I was just pointing out that the flu vaccine, even when perfectly matched, prevents only about 75% of the vaccinated persons from getting the flu. That’s still a good number. When it is not perfectly matched, it still prevents about half of the vaccinated people from getting the flu. I mentioned that because I think that some people are under the impression that if you get the flu vaccine, then you won’t get the flu.

    Another way of saying it is that if you have 1,000 unvaccinated people, perhaps 40 of them will come down with the flu but if you have 1,000 vaccinated people — in the same area — then only 10 of them would get the flu if the vaccine is a good match, or only 20 of them if the vaccine is not a perfect match. Either way it’s a better result than 40 catching it in the unvaccinated population. Obviously if the flu strain that year is especially virulent, maybe 100 or even 200 people out of 1,000 in the unvaccinated population might come down with it. Then the number in the vaccinated population would be either 25-50 or 50-100 depending on how good the match is.

    This year we’re being hit with another H1N1 season but the vaccine this year is a good match. Hopefully this season won’t be as bad as the 2009 H1N1 pandemic, which was truly horrible, just not as horrible as 1918-1920.
    Some people agree with your position and resist getting vaccines. Most medical professionals are of the opinion that everyone over the age of 6 months should get a flu shot every year. One more point, you shouldn’t compare flu vaccinations with antibacterial soaps. Influenza isn’t a bacterium, it’s a virus. I have no idea if it builds up resistance based on exposure to vaccines. Maybe it does, but I will leave it to the medical experts to tell me whether I should get a shot or not. I know that all of my doctors agree that antibacterial soaps are not a good idea except in special circumstances. I don’t use an antibacterial bath soap anymore. I stopped that about 15 years ago.

    I think I read somewhere that older people are not as susceptible to this year’s strain of H1N1 because they have been exposed to previous H1N1 seasons more than younger people. That would seem to indicate that our bodies have built up antibodies over the years. I know that when I was young, we were exposed to everything as soon as we went to school and we all came down with just about everything because there were very few vaccines in the 1940’s. Even penicillin didn’t come into general use until after the war.

  3. Whitewitch says:

    I have no idea what you just said…so sorry. I think you are using statistics to support getting the vaccine each year and I just have a hard time with that. To me, either the Flu Vaccine is to vaccinate against the flu or there is no sense in taking it. Particularly when there is a chance that the vaccine will make you ill. In my way of thinking we are over protecting people, with anti-bacterial washes, soaps and cleaners and with the over use of antibiotics – it is stopping us from making our own immunity to things…and forcing the body to make antibodies each year for a new strain…putting us in a constant state of immunity fighting.

    I see so many people with autoimmune diseases now – where their body is just fighting itself and I think there must be something to this and us humans (thinking we are superior to nature) forcing our bodies to continually be in a state of “aggressive immunity building”.

    I totally support creating a vaccine for this years flu and giving it to people because it is a tough one and yet the shot my co-workers got is not stopping the flu this year at all. I read a great book about how they determine which flu strains to put in the vaccine each year, based on the early flu break-out…very interest – I will dig it up and share if I can find it in my vast library (it might be being the Gary Taubes books).

  4. Mike_in_the_Tundra says:

    I got my shot back in October, and came down with the flu last Thursday. It was more annoying than bad. I broke a tooth and went to the dentist Thursday morning. I dozed off twice while in the dentist chair. I was parked about a block away, and I had to rest in the car for about fifteen minutes before driving home. I had a headache, achy joints, runny nose, and chills, but compared to the time I had the full fledged flu about twenty years ago, it was a walk in the park.

  5. benb says:

    Costco…I think the vaccine is $15.00.

  6. Ninong says:

    You’re right. I know that Kaiser Permanente recommends that everyone six months and over should get a flu vaccination every year. And they don’t charge their insureds anything.

    I’m in a Medicare Advantage Plan right now and they let you get it at one of their free clinics or at any one of several participating pharmacies (e.g., Wahlgreens). Even people with no insurance coverage can usually get it for $25 or less at many local pharmacies.

    Medicare also covers the pneumonia vaccine with no co-pay and they recently reduced the co-pay on the otherwise rather expensive shingles vaccine (recommended for people who had chicken pox in their youth).

  7. emjayay says:

    One year I got the flu twice, about two weeks apart. So did one or two other people I knew, so I wasn’t imagining things. That was rather convincing and I’ve gotten a shot every year since, and no flu.

  8. emjayay says:

    Well, this is one stupid Shutterstock photo I didn’t complain about. Lovely art direction also.

  9. emjayay says:

    I think probably all insurance now covers the shots. If not, local health centers often have them for free.

  10. KC Jenner says:

    Thanks for the link Ninong.. I remember seeing that date of 1918. Some people have asked if I am related to Sir Edward Jenner that came up to the Cow Pox Vaccine that then lead to the Small Pox Vaccine. I think that was the beginning of vaccines. However I am not related.

  11. Ninong says:

    Influenza is an Italian word. We borrowed it from them a long time ago.

  12. karmanot says:

    It gave me a fever John

  13. KC Jenner says:

    I remember using Google Earth to track the different flu types going on around the world and that is what the vaccine contains as an expected type for the season as it is about to hit the USA.
    I remember many years ago there was a conspiracy about Poland getting the Vaccine and many of the people died.
    It has been also said the being clean is very important.
    My father had gotten a flu shot and his doctor was very good to test him for GBS Garre-Barre Syndrome (excuse my probably incorrect spelling a that French Name. He had to have a blood tranfusion in his (1 each month for 6 months). He had become paralyzed and the CDC (and his doctor confirmed the diagnosis. He is an ex-phamacy from Thritfy’s Drug Store that is now Called Rite Aid.
    He is now 83 years old. I think he got the GBS in 2006.

  14. Ninong says:

    John Barry was describing the particular strain of H1N1 commonly called the Spanish Flu. It caused a cytokine storm (overreaction of the immune system) and that’s why young, healthy adults in the prime of their lives were more vulnerable than the usual over-65 population that is more vulnerable to regular seasonal flu.

    Fortunately we have not yet had a repeat of that exact strain of H1N1 but the 2009 H1N1 pandemic was particularly nasty.

  15. Ninong says:

    If the vaccine matches the strain correctly, it’s about 75% effective, but even if it’s not a perfect match, it’s still about 50% effective. In other words, the number of cases among vaccinated persons will be 75% fewer than among the unvaccinated population if they guess correctly on which strain will be prevalent the next flu season, or 50% fewer if they predict the wrong strain.

  16. KC Jenner says:

    I thought it came from the word ‘influenza’ (that may be Italian). I am not a language expert. I just googled the word.

  17. Ninong says:

    I’m familiar with it how it came to be called Spanish Flu but since that’s how it is commonly called, I used that name so that people would know what I’m talking about. Maybe it started in Kansas and was brought over to France by American troops?

    Bacterial pneumonia was a secondary infection resulting from the weakened immune system, but many victims died sooner from hypercytokinemia before the pneumonia could kick in. Remember that Army reports at the time referred to “fulminating pneumonia, with wet hemorrhagic lungs.” Studies done in the past decade on tissue samples exhumed from victims indicates what is now called ARDS (acute respiratory distress sysdrome).

    That particular strain of H1N1 attacked the body’s immune system, causing an overreaction. Victims with a healthy immune system were more likely to suffer more than victims with younger or older, weaker immune systems. The victims literally drowned to death within two or three days after the cytokine storm (overreaction of the immune system) began.

    I have followed the various articles on this pandemic for the past 60 years or so, since it directly affected my family in a very significant way.

  18. KC Jenner says:

    I appreciate the that photo that you picked for the Doctor’s article.

  19. cole3244 says:

    got the shot in oct and since i am retired now i don’t come in contact with as many people which is a safety net all by itself.
    try to avoid shaking hands if you can that’s a good way of spreading germs.

  20. Mike_in_the_Tundra says:

    It was noticed and appreciated.

  21. Naja pallida says:

    Sorry, I make a point to avoid sick people. No matter how cute they may be. :)

  22. GarySFBCN says:

    Also, it was called the ‘Spanish flu’ because the Spanish press was somewhat liberated in those days and reported the pandemic, while other countries tried to hide information about the flu because of shame or something. It may have been a strategy for the war – which, by the way, spread the flu faster than had ever been seen before via the deployment and movement of soldiers around the world,

  23. Ninong says:

    Once you qualify for Medicare, it won’t cost you a cent. Medicare Part B covers 100% of the cost of a flu shot once a year in the fall or winter.

  24. GarySFBCN says:

    I got a flu shot in late October or early November. I got the flu 9 days ago. I am still feeling it and it knocked my on my ass for 3 days. I missed a full week of work because I didn’t want to infect anyone.

    But 7 people in my 22 person unit all got sick. While my case seemed intense, I had the most ‘mild’ case compared to what I’ve heard from the others – a few had ER visits, etc. One friend, a 40-something woman, is still in bed after 11 days.

    Sometimes the vaccine doesn’t prevent the flu, but it minimized the ‘case.’

  25. GarySFBCN says:

    Technically, most deaths in the 1918-19 influenza pandemic were caused by bacteria pneumonia – their bodies were weakened by the flu and the bacteria too hold.

    My flu voodoo kit includes guasfenisen to prevent colonization in my lungs and antibiotics, just in case.

  26. Ninong says:

    The last time I got it — about 20 years ago — I ran a fever of 101-102 for three days and had terrible aches in my rib cage. Followed by the fever breaking but then persistent coughing taking over for the next couple of weeks. After than I have gotten the flu vaccine every year and so far I have been lucky and haven’t gotten it again.

    Feel better soon!

  27. Ninong says:

    John, even if the vaccine is perfectly matched to the circulating strain, effectiveness is only about 75% after that first two-week period to allow anti-bodies to build up, but it’s still about 50% effective even when it does not exactly match the prevalent strain.

    The trick is for the CDC to predict next season’s prevalent strain because it takes so long to make the stuff that you can’t wait for flu season to decide which strain is causing the problem. That would be too late.

  28. Ninong says:

    Hope you feel better soon. Flu vaccine, even when perfectly matched to the circulaging strain, is only about 75% effective. When the vaccine doesn’t match the strain, it’s still about 50% effective. However, even in cases where a vaccinated person comes down with the flu, it won’t be as severe as it would have been without the vaccination.

  29. Ninong says:

    Okay, he is nice looking but don’t you think that outfit is a little over the top?

  30. StraightGrandmother says:

    Got the flu shot at Walgreens it was only $35
    Well worth the peace of mind AND there must be better/sharper needles nowadays because I swear I didn’t even feel it at all.

    I had the flu about 20 years ago and I spent 2 weeks off work and actually about 6 weeks recovering.
    I’ll never forget that flu. Make sure all your elderly friends and family are protected as well.

  31. BeccaM says:

    It’s both actually. If the strain is an exact match for the vaccine, you probably will not catch it, provided the vaccination actually did produce the necessary antibodies (it does not always work). If the strain to which someone is exposed is close or a near mutation of the vaccine stock strains, you might get sick, but it probably won’t be as bad.

    Personally, I think what’s happening in many areas right now is there’s a strain (or more than one?) which doesn’t match up very closely with the shot being given out this year. They don’t always get the formulation right.

  32. BeccaM says:

    He’s cute, but not my type. I’ve always felt that if a guy is going to grow facial hair, he should commit to an actual beard and/or mustache.


  33. Monoceros Forth says:

    Besides, “flues” is a different word altogether!

  34. annetteboardman says:

    Except I got the shot in October and came down with the flu the 1st of January (or the 31st of December). But whatever happened to cause it, I vow to be very sympathetic with my students who get the flu in the spring!

  35. And I go through all the trouble to find a stock photo of a really hot sick guy to accompany this post, and nobody even notices ;)

  36. That sucks. It still is possible, as Mark mentions, that you were already infected, or got infected, before the 2 to 3 weeks period it takes to build up the antibodies.

  37. I googled it before publishing :)

  38. I’m pretty sure posting 20 hammer and sickles isn’t going to help with the fundraising LOL

  39. DRoseDARs says:

    Wut? Someone call 911, I think this spambot just had a stroke…

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  41. Whitewitch says:

    Oh nooo it was/is the flu…they look like death warmed over, have the fever (and some vomitting – ick). And they are being told by their doctor(s) it is the flu…so I am going to stick with that.

    I did not realize it was to keep you from being killed by the flu – I though it Prevented the Flu.

    Thanks for the book suggestion – I will have to get it.

  42. Outspoken1 says:

    The goal of the flu vaccination is to develop enough antibodies to keep the flu from killing you. So if you get the real flu, it at least won’t kill you. Are you sure your co-workers have the flu and not variants of a cold?

    Flu is more deadly in the younger because their robust immune systems over-react and they suffocate. Great read – The Great Influenza by John M. Barry. Really explains how the flu killed people as well as inept politicians and a under-developed medical system.

  43. Whitewitch says:

    Hope you are feeling better Annetteboardman….the flu has hit hard here as well…thankfully I have missed out – and intent to keep it that way. Stay well.

  44. Whitewitch says:

    I note that you say Many of those hospitalized are people who failed to get a flu shot during the current flu season.. You say “many”, rather than all failed to get a shot. At my work, we get the shot every year (this year in October) and many of those who got the shot are still getting the flu. It is a harsh flu this year too…the group here is pretty stoic and there have been people out of work for 7 to 10 days. So the flu shot does not seem to be helping them, perhaps it didn’t have the correct strain this year?

  45. Naja pallida says:

    Flu is a diminutive form of a loanword from Italian. The only logical application of the plural would be to go with the standard rules for most nouns, thus throwing an s on the end.

  46. pseverinc says:

    FLUS rhymes with PLUS. Does flu really have a plural?

    Remember it takes some time after a shot to build up the antibodies…a week, maybe two…not 100 percent effective but that shouldn’t be a reason not to get a shot

  47. karmanot says:

    8 deaths so far in this county north of SF.

  48. BeccaM says:

    New Mexico confirmed its first H1N1 death, a 76 year old woman in Santa Fe county.

    Truly, it’s a good idea to get the shot each year, unless advised not to by one’s doctor. For folks on Medicare, they’re free. For those with health insurance, they’re heavily discounted — I think I had to pay $15 for mine this year, and that was with my semi-crappy PPACA high-risk pool insurance. And for those without insurance, many of the pharmacies and supermarkets have flu vaccination drives where the cost isn’t that much.

    A lot of folks, especially younger and healthier ones, think it’s not that big a deal — but they forget that while they have the flu, they’re spreading it around, and could very easily give it to someone else who isn’t so healthy to begin with.

    I think the usual interpretation with respect to younger folks getting hit especially hard by a particular flu strain is there was probably another strain relatively close to it that us oldsters and semi-oldsters picked up and developed immunity to when we were younger.

    Anyway, ever since my great grandmother (age 86) died of the flu back in the late 1970s, I take it very seriously. Quite honestly, if I caught the flu and gave it to my wife and she died from it, I don’t think I could live with myself after that — so we get those shots each year, without fail.

  49. annetteboardman says:

    I had a flu shot and was down for a week, and am still hacking up a lung another week later. I have asthma and would not consider going without the flu shot, but I really could have used another year avoiding getting a different strain. I was so achy, slept 15-20 hours a day, and had a fever of 101 degrees, when I normally never get a fever. Ick.

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