The limited supply of the flu vaccine has caused many Americans to experience a small taste of health care rationing for the first time in their lives.
Here in the United States, we are accustomed to being able to get whatever we want in terms of medication and health care services. Sure, we occasionally have to fight with HMOs and insurance companies, but it is rarely the case where there physically is not enough to go around.
The vaccine shortage threw many people into a panic as patients frantically called around or waited in long lines. Patients often felt compelled to play the game “Who has a worse disease?” with the winner getting a flu shot. Fueled by dire predictions in the media, the public perception became one of trying to get the last lifeboat off the Titanic.
There are more than 100 new cold and upper respiratory viruses each year in the class of Rhino and Reo viruses. These infections produce varying degrees of fever, aches, nasal congestion, sore throat, increased cough and mucous production. Most healthy individuals will get one or two such infections per year. There is no specific treatment, nor prevention for these viral infections.
In contrast, the flu is a disease caused by two unique viruses, Influenza type A and B, with type A being responsible for nearly all cases. The symptoms from infection with Influenza type A/B usually include high fevers, generalized body aches, fatigue, nausea, diarrhea and respiratory symptoms, such as a severe cough. In truth, Influenza A/B infection is relatively benign for the majority of people. The exceptions are the very young and the very old, those with underlying diseases or those who are immunocompromised.
Even if you were not able to get the flu vaccine this year, there are several steps you can take.
Avoidance
Obviously it is helpful to avoid people who are already ill. Good hygiene, especially hand washing, can help reduce contact with the flu. In addition, eating properly and getting adequate rest are always recommended.
Nasal vaccine
FluMist is a vaccine that is administered through a nasal spray. Because it is a live virus vaccine, it is not recommended for those under 5 years old or who are older than 50.
In addition, it cannot be given to immunocompromised individuals, nor individuals with respiratory illnesses. It is therefore not helpful for the people who are most at risk for the flu. It is also costly, about $50. Health insurances generally do not cover its cost.
Symptom relief
If you begin to get symptoms of the flu, there are many over-the-counter remedies to help deal with the symptoms. Acetaminophen and ibuprofen can be used to reduce fevers and aches, decongestants and cough suppressants for respiratory symptoms, and bismuth and loperamide for diarrhea. It also is sensible to stay home from work or school if you are sick so as not to spread the virus to more people and to get rest in order to avoid more serious complications.
Preventing secondary complications
The flu can lead to more serious illnesses such as pneumonia. If you are over 50 and/or have underlying respiratory diseases, it is recommended that you receive a pneumonia vaccine every 10 years.
Diagnosing the flu
Many physician offices have a rapid test to determine if you have the flu. The test uses a nasal swab and can be read in about 10 minutes.
It is important to remember that of all the patients who contract an upper respiratory infection-cold, coughs, fevers, aches, congestion-very few of them actually have the flu. Garden-variety upper respiratory infections are much more common.
If you have the flu
There are several anti-viral medications that can be given by a physician that will reduce the severity of the flu. However, in order to be effective, they must be given within the first 48 hours of the onset of symptoms. Again, these medications do not cure the flu, but they can reduce the severity and length of the infection.
This is an area where a little common sense goes a long way and hopefully this year’s flu vaccine shortage will not result in a major epidemic. Although some people recommend vitamins, such as vitamin C, there is very little data to prove its efficacy. However, like a good bowl of chicken soup, “it couldn’t hurt.”
Dr. Gary Green is a Clinical Professor at UCLA and internist and sport medicine specialist who is a resident of Malibu and practices in Pacific Palisades at the Pacific Palisades Medical Group.