It’s flu season, and the bug has begun to circle.

Staff at Melissa Memorial Hospital said they haven’t seen any patients with major flu symptoms, but it is beginning to get on the minds of everyone.

Family Practice of Holyoke has held its annual flu clinics, and many people have taken the first step to safeguard themselves against the flu.

Claudia Powell, MMH director of nursing, said even though people receive a flu shot, there is always still a chance they could contract the flu­—it just won’t be as bad as if they had not received the shot.

This year’s flu shot is the same shot that was given last year. two years ago, the shot was completely different after the emergence of the H1N1 flu. The shot people are receiving this year covers H3N2, Influenza B and H1N1 viruses.

Kay Schmidt, LPN, gives a flu vaccination Thursday night, Oct. 27 at SunSet View Community Room. Family Practice of Holyoke held special flu clinics to offer flu shots at a discounted price.??—Enterprise photo

Powell and Pat Notter, RN, said shots are usually administered in October. this year, they said once the shots were received in September, they were told they could go ahead and begin to administer them.

“There’s no pandemic potential this year,” Powell noted.

Everyone, regardless of whether or not they received a shot, should safeguard themselves during flu season.

Centers for Disease Control and Prevention (CDC) offers its “Take 3” actions to fight the flu.

The first is to take time to get a flu vaccine. Secondly, take everyday preventive actions to stop the spread of germs. these include:

—cover nose and mouth with tissue when coughing or sneezing.

—wash hands often with soap and water. if soap and water are not available, use an alcohol-based hand rub.

—avoid touching eyes, nose and mouth.

—try to avoid close contact with sick people. if sick with flu-like illness, CDC recommends staying home for at least 24 hours after the fever is gone except to get medical care or for other necessities. (The fever should be gone without the use of a fever-reducing medicine.)

—while sick, limit contact with others as much as possible to keep from infecting them.

The third action is to take flu antiviral drugs if a doctor prescribes them.

Antiviral drugs are different from antibiotics. They are prescription medicines (pills, liquid or an inhaled powder) and are not available over the counter. The antiviral drugs help treat the symptoms of the illness.

Staying home is a big player in keeping others healthy. those who have been or still are sick, and return to work or school, can easily spread the illness.

“Our society just doesn’t know how to be sick anymore,” Notter said. “They just expect a quick answer and expect it to go away.”

With the holidays coming up, friends and families will gather in larger groups. With flu season in the midst, these times offer a greater chance for the spread of illness, according to Powell and Notter.

Staff at MMH reminds those who are sick or have symptoms, to not visit patients in the hospital. There are stands at entrances of the hospital with hand sanitizer, masks and gloves to help those visiting to stop the spread of illnesses.

Some patients will have signs on their door that state, “Please check with nurse before entering.” Powell said it would be a good idea to follow these instructions.

Signs and symptoms of the flu

Signs and symptoms of the flu include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, fatigue and sometimes diarrhea and vomiting.

Powell said not everyone with the flu will experience vomiting or diarrhea. these two symptoms may be signs of another illness.

People at high risk for developing flu-related complications include children younger than 5, adults 65 years of age and older and pregnant women. Anyone with asthma is also at high risk.

Emergency warning signs in children include fast breathing, not drinking enough fluids, not waking up or interacting, being so irritable that the child does not want to be held, unable to eat, trouble breathing, no tears when crying and significantly fewer wet diapers than normal.

In adults, difficulty breathing or shortness of breath or pain or pressure in the chest or abdomen are warning signs.

“People should never hesitate to call the clinic or hospital if they feel their symptoms are getting worse,” Powell said.

Test Your Flu I.Q.

#1: A flu vaccine can’t give you the flu. answer: True#2: The “stomach flu” and influenza are the same thing. answer: False#3: getting a flu vaccine in December or later is not too late. answer: True#4: Flu viruses change constantly which requires a new flu vaccine to be produced each year. answer: True#5: Washing your hands is the best thing you can do to protect against the flu. answer: False#6: The flu vaccine protects against three strains of flu. answer: True#7: The flu is typically spread through coughs and/or sneezes. answer: True#8: The flu is not a serious illness. answer: False#9: The flu vaccine is available as a shot or a nasal spray. answer: True#10: you can spread the flu to others before you have symptoms. answer: True

Holyoke Enterprise November 3, 2011

When it comes to viral diseases (and many other things), the old adage, “an ounce of prevention is worth a pound of cure” applies to almost every situation. There are few medicines that are effective against viruses. And they seldom, if ever, really provide a cure, but rather slow down the virus so the victim’s natural immune system can beat back the virus. the good news is that vaccines have been developed to stop people from catching and spreading many dangerous viruses. the bad news is that the vaccines are expensive to develop and produce. they are not without side effects, even though those side effects are generally mild and short-lived. I am sure you have heard of tetanus (lockjaw) shots, “flu shots” and “baby shots” and have likely experienced these vaccines since they are required by the government before attending school. however, there are other vaccines that are recommended but not yet required for school entrance. the target population of two of these vaccines has recently been expanded by the U.S. Food and Drug Administration. the vaccine to prevent herpes zoster, also known as shingles, has been available to adults 60 years old and older since 2006. however, it has not been given as widely as it should have been because of the excessive expense and inconvenience involved in receiving this vaccine. This past March, the indication for the shingles vaccine (Zostavax) was expanded to include adults age 50 to 59 years. This is a live attenuated virus vaccine, which means that you are injected with a weakened virus that can be fought off by your immune system. It will leave behind the capability for your immune system to keep the virus under control and prevent future outbreaks of the chickenpox virus, which is the virus that causes shingles. In a study of approximately 22,000 adults between 50 to 59 years of age who were followed for at least one year for the development of shingles, the vaccine reduced the risk of developing the disorder by approximately 70 percent. As with most vaccines, the most common side effects observed with Zostavax are redness, pain and swelling at the site of injection and headache. the FDA has also recently expanded the indication to boys ages 9 through 26 years for the vaccine Gardasil to prevent genital warts. This is a new use for a product already approved to prevent cervical cancer and genital warts in girls and women. Gardasil was already is approved in women to block four strains of the humanpapilloma virus (HPV) that cause the majority of cervical cancers and genital warts. about 50 million doses of Gardasil have been sold worldwide since its approval in 2006. Genital warts caused by HPV usually clear up by themselves, and the cancers caused by the virus are extremely rare in men. however, the spread of the HPV virus is generally through sexual contact. therefore, prevention in both genders is recommended. HPV infects about six million people in the U.S. each year. It usually causes no symptoms although rare cases can develop into warts and cancer in both men and women. Although Gardasil appears to be effective, there are some questions about the longevity of the vaccine’s effect and concern over its price tag of nearly $400. HPV immunity has only been tracked out to five years in women and three years in boys and men. This fact has caused some public health advocates to argue that more evidence should have been required to show evidence of Gardasil’s long-term effectiveness. however, others believe that the only way to really find this information is through widespread use of the vaccine in the hope that the spread of the virus and the cancer it causes can be decreased in the meantime. the concept of these vaccine indication expansions brings to mind another old adage, “a stitch in time saves nine.” I wonder if anyone besides me thinks in terms of old adages. if you are interested in obtaining Zostavax or Gardasil or other vaccines, contact your health care provider, pharmacist or public health department. if they do not provide the vaccines, they will know how you can get them.

I got a flu shot for the 1st time about 10 days ago and since then I've been feeling sort of achy, with a little pain while swallowing. Nothing major, I still go to work each day, but I wondered if anyone else had these symptoms.

This is fairly common

it can happen. keep in mind that they are injecting a small amount of the virus into your system, although it is either dead (flu shot) or somehow paralyzed (flu nasal spray). and, as you said, symptoms are usually milder than the full-blown flu. don't worry, it is a common occurrence

no they can't actually cos it's a killed vaccine.

What you've probably done is caught a cold virus in the waiting room

Oh yes, but it is more mild. Nothing is lovely about the flu any which way you can say it but the flu shot helps not to get it in the worst way. We get the flu shots every year and sometimes it feels achy or ishy feeling but that's about it and it'll go away soon.

Not usually.

Mild flu like symptoms are really the side effects of your body's virus fighting strategies, so itis possible.

yea just like tylenol gives u headaches

No. you probably picked up another strain of flu, or a cold virus while you in the waiting room or Drs office. This is very common.

Three strains of influenza may be the reason why local drug stores are constantly stocking cold, cough and other over-the-counter medications for flu symptoms. And why Sierra View District Hospital saw a 21-percent spike in visits to the emergency department by patients with flu symptoms.

“We’ve seen an influx of patients with influenza-type symptoms asking for medicines that will help them with their symptoms,” said Scott Tuttle, pharmacist, Rite Aid Pharmacy Store on Morton Avenue. “It’s been hard trying to keep all the medicines stocked.”

Tuttle also said he had no official data but that it appeared that less people opted for flu shots, taking their chances and suffering the consequences. Medications appeared to fly off shelves at various pharmacies across town, pharmacists reported.

“it seems like in the last couple of weeks, or a month actually, we have had quite a bit of an increase in sales of cough and cold symptom over-the-counter medications as well as prescribed medications that come as a result of those symptoms,” said pharmacist Sepehr Mansuri, pharmacist at the CVS Pharmacy on East Olive Avenue.

This year, the peak of the flu season came late, said Dr. Karen Haught, Tulare County Public Health Officer.

“It’s just now peaking,” Haught said. “And there’s three strains of influenza circulating, including the 2009 H1N1 (Swine Flu) strain.”

It may have hit at a different time frame but the symptoms of the flu remain the same.“There’s a lot of flu out there but there are no real numbers to look at because it is not a condition that has to be reported,” Haught said.

Locally, clinics, hospitals and physician offices have been seeing an obvious increase in the number of patients with influenza symptoms.

At Sierra View District Hospital, the emergency department has seen a couple of spikes during the last week of February, reported Donna Davis, director of emergency services.

On Feb. 23, the number of influenza cases in the emergency department went up 9-percent. The next day, Feb. 24., the number spiked to 21-percent. The number of cases moved up and down for the next three days before rising again to 21-percent on Feb. 28.

But since then, the number of cases have been below 6-percent consistently, hospital officials said.

Kaweah Delta Lindsay Health Clinic also reported an increase of patients with flu symptoms.“We’ve seen an increase in the past three weeks,” said David Rodriguez, M.a., Kaweah Delta Lindsay Health Clinic. “I would say at least 30-percent increase in flu cases, mainly children — 30-to 50-percent of them — have been in with flu symptoms.

Most people, if they are healthy tend to get over the flu in three to four days — simply by drinking fluids and resting, Haught said.

“but people with chronic conditions, the elderly, those who are pregnant and young children are especially vulnerable. that is why it is important for them to see their physician as soon as possible,” Haught said. “There is medicine to help shorten the illness but it must be started early in the illness in order for it to work.”

And because the H1N1 virus is still here, it is crucial for younger children and pregnant women to protect themselves with flu shots, she said.

This year CDPH is recommending flu vaccine for everyone six months of age and older. Vaccine is plentiful and available throughout the state.

Free flu shots will be offered from 2 to 4 p.m. Tuesday at Lindsay Healthy Start, 475 E. Honolulu. No appoint is needed but they do not accept healthy Families Insurance or private insurance. they will accept non-insured, Medi-Cal or insurance that does not cover immunizations. a parent must be present with the child and past immunization records should be taken.

Tulare County Department of Public Health officials said they will continue to vaccinate until they no longer have a supply or until the end of the month of June, whichever comes first.Flu shots are also available at many of the pharmacies for a nominal fee.Flu-prevention tips from CDPH:

To stop the spread of flu and other respiratory illnesses, Californians should:- Stay home when sick. Limiting contact limits the spread of disease.

• Cover your cough or sneeze. By using your elbow or a tissue and properly disposing of the used tissue, a person reduces the spread of disease.

• Wash hands thoroughly. Using soap and warm water or an alcohol-based hand sanitizer, and avoiding contact with your eyes, nose and mouth, limits disease.

• Stay healthy. Everyone benefits from eating a balanced diet, drinking plenty of water, not smoking, and getting adequate rest and exercise.

so i dont think ive ever had influenza virus (only the stomach bug and colds) so i was wondering what the symptoms are, how long do they last and do you VOMIT with it?

Im talking about influenza, not the stomach flu which technically isnt a flu.

i don't know i had never had a really bad case of it i just felt a little sick i don't know why i am taking flu shots i never got the flu that bad anyways

You cant really tell the difference from flu and stomach virus. they are pretty much the same. There is no cure for any virus and you may or may not throw up. You will have a fever most likely and you should drink plenty of water and juice. and get rest, lots of it. It can last a few days or weeks depending on your age. Eldery people and children can die from a Flu because their bodies cant handle the virus. Normal adults just need a few days to rest and drink fluids. if you are throwing up nonstop and cant keep any foods down then go to a hospital because you may need to be hooked up to an IV so you dont die.

MONTREAL – when Jennifer Madar’s twin girls were born premature at 29 weeks, she dropped her usual wariness about flu shots and got one right away.

So did her husband, her father and anyone else she thought would come into close contact with her girls.

“My babies had spent almost three months in the neonatal intensive care unit,” Madar recalled. “So when they came home, it was very important that they not get sick. We didn’t want to take the chance of one of us getting the flu and passing it on to them.”

Three years later, Madar’s girls – Jessica and Romy – are the picture of health with their rosy cheeks and blond curls, romping around their living room in St. Laurent and often testing the limits of their mother’s patience.

The family is also expanding as the 35-year-old Madar is pregnant again and expects to give birth to a boy in December. At 29 weeks, she’s in her third trimester – and is therefore considered by public-health authorities to be on the priority list to get the influenza A (H1N1) vaccine.

So are her children, but this time Madar isn’t so sure about rolling up her sleeve for a flu shot.

“I’m going to have to get a little bit more informed about it,” she said. “But I have to tell you the truth. For me, it’s a new vaccine and I’m kind of reluctant, because you never know about possible side effects. I’m just worried about the things that they might discover down the line.”

Madar isn’t alone in her misgivings about the H1N1 vaccine. A U.S. public opinion survey released this week found that only 40 per cent of parents said they will get their children vaccinated against the H1N1 virus (while 54 per cent indicated they would give their kids the regular seasonal flu shot.)

Even some health professionals have expressed doubts. in a poll of more than 2,000 Hong Kong health workers, researchers discovered that during the height of the global swine flu panic in may, less than half were willing to get inoculated.

(This week, a pregnant nurse at the Lakeshore General Hospital emailed the Gazette, saying she was having qualms about the H1N1 vaccine. This, despite the fact that two pregnant women in Quebec died over the summer from H1N1 complications.)

To vaccinate or not to vaccinate – that is rapidly becoming the question of 2009.

Acknowledging the public skepticism about the upcoming H1N1 vaccination campaign, Canada’s obstetricians and gynecologists are mounting an information blitz aimed at pregnant women. Posters and fact sheets are being sent to hospitals, clinics and doctor’s offices. Physicians are being told to provide advance prescriptions to pregnant women for the antiviral drug Tamiflu that could be filled at the first sign of H1N1 symptoms.

All of this is predicated on the fact that H1N1 is a relatively new strain and has killed a disproportionately higher number of young people than the seasonal flu. What’s more, the World Health Organization has declared an H1N1 pandemic emergency, and has warned that a second, perhaps deadlier, wave of infections is imminent this fall.

Alain Poirier, Quebec’s public health director, noted that pregnant women in their second and third trimesters are at an elevated risk of developing serious complications should they contract H1N1.

Although the death toll from H1N1 in Quebec is lower than initially feared – it stands at 27 – vaccination is still the best protection, he insisted.

“I’m sure that those people (who died) would have liked to have had the vaccine,” Poirier told reporters two weeks ago.

In Quebec, the government’s H1N1 response is akin to a war-time mobilization. It has purchased 53 million pairs of gloves, 23 million masks and 15 million syringes.

The government has ordered 11.5 million doses of the vaccine from GlaxoSmithKline’s Quebec City plant for the province’s 7.5 million residents. Starting in mid-November, about 100 clinics across the province will vaccinate 200,000 people a day, seven days a week.

In addition to pregnant women, children age six months to five years will be immunized first. they will likely be given a second booster shot, because their immune systems are not yet fully developed. As for those under six months, the vaccine has been shown not to work on them.

Health professionals, people from the ages of five to 18, police and firefighters, and those age 18 to 65 would follow. Paradoxically, the elderly who are usually highly susceptible to the regular flu appear to have some immunity to H1N1.

Yet the question persists – to vaccinate or not?

The doubts about the H1N1 vaccine arise from the perception that it’s being rushed into production and foisted on the public without being tested sufficiently, that it might not be effective, and that it might not even be necessary since the virus has so far proved to be less severe than anticipated.

Adding to the confusion is the fact that Canada has decided to use an adjuvant or immunity-boosting chemical in the vaccine, while the United States has opted for one composed wholly of dead fragments of the H1N1 virus.

And none of these concerns address the question about whether to go ahead with a separate vaccine to guard against the seasonal flu, which kills tens of thousands of people worldwide each year.

Experts readily concede that the H1N1 vaccine is being rolled out with great haste, but argue they have no other choice as they brace for a second wave of the pandemic. usually a new vaccine for a disease like hepatitis can take five years before it’s approved.

But it’s a different story with the seasonal flu vaccine. It’s produced from scratch every year because flu viruses mutate constantly. Typically, such vaccines contain fragments of three flu strains.

In contrast, the H1N1 vaccine is monovalent, containing fragments of only one virus.

“We’re fast-tracking the approval of this vaccine and for obvious reasons, because we are on the threshold of a pandemic, if we’re not already in it,” said Karl Weiss, a microbiologist at Maisonneuve-Rosemont Hospital.

“We have already accepted the vaccine not having the full results. I agree that it has to be fast-tracked. You have to put it in the global context. This is not what we usually do, and there are certain questions for which nobody has the answer.”

Two weeks ago, GlaxoSmithKline unveiled results of a preliminary study of its vaccine, noting that a single dose confers almost 100 per cent immunity from H1N1 three weeks after vaccination. the results were from a clinical trial involving 130 healthy volunteers, aged 18 to 60.

A study of this size is useful to spot any immediate danger signs with a new vaccine, but the world will only learn the full range of possible side effects once hundreds of thousands of people are inoculated.

“Nothing serious will happen out of nowhere,” Weiss said. “But there is the potential that after you’ve given it to 100,000 people, you might see three cases of liver issues, let’s say, which is more than you would expect for something like this. At that point, people would have to take a decision.”

Weiss, however, was certain about one thing: For those who have been confirmed to have been infected by H1N1, getting the vaccine would not be a good idea. That’s because their immune systems could overreact horribly.

Richard Schabas, the medical officer of health for Ontario’s Hastings and Prince Edward Counties and a long-time critic of the WHO, said people shouldn’t worry about the safety of the H1N1 vaccine.

“I’m not particularly concerned about the risk profile of the vaccine,” he added. “We’ve been producing influenza vaccine for many years. It’s a very safe vaccine. And we’ve been putting adjuvants in vaccines for years. Their safety profile is excellent.”

What Schabas finds fault with is the recommendation by public-health authorities to vaccinate every man, woman and child in Canada against H1N1. He also takes issue with the decision to add the adjuvant, saying that has probably delayed the delivery of the vaccine by several weeks, raising the possibility that many people will get the shot only after a second wave hits.

The Canadian Medical Association Journal took a similar position about the adjuvant in an editorial last month. “Having enough vaccine for every Canadian would make more sense if the pandemic virus were highly virulent for large proportions of the population,” the editorial concluded. “But given current evidence, it seems a poorer choice than providing coverage to high-risk groups as early as possible.”

Schabas contends that it’s Canadians who suffer from pre-existing medical conditions like diabetes, morbid obesity as well as heart and lung disease who should get vaccinated.

“For the general population who don’t fall into these categories – healthy people are at a very low risk of H1N1,” he said. “I’m not saying that pregnant women shouldn’t be immunized, but to describe them all as a high-risk group I think misrepresents the data.”

Almost lost in the debate over the H1N1 vaccine is whether to proceed with the seasonal flu vaccine. in fact, the WHO has also recommended a trivalent vaccine for the northern hemisphere this year to protect against three viruses that are not part of the pandemic. One of those viruses, H3N2, has been shown to have sickened many people around the world.

Initially, the government suggested dropping the seasonal vaccine, but late yesterday it announced a compromise: It would put off the seasonal flu vaccinations until January. One of the reasons cited for staggering the two campaigns is that those who have been vaccinated in the past against the seasonal flu appeared to be more susceptible to H1N1. Therefore, it makes more sense to give the H1N1 shot first.

In practical terms, however, this means that adults will have to weigh the pros and cons of getting two different vaccines in one flu season for the first time in their lives. And parents will face the daunting prospect of getting four flu shots for children age six months to two years. That’s because children in this age group require booster shots.

Paul Saba, a family physician who runs a practice in Montreal West and a father of three young children, said he believes that both vaccines are necessary.

“They should have both, and if it means paying doctors and nurses more or opening the clinics for longer hours, then so be it,” he said. “You won’t want the elderly who usually get the regular flu to die. We shouldn’t let them suffer, either.”

To vaccinate or not to vaccinate – there are no clear answers. But for Weiss, that’s the whole nature of medicine, weighing risks against benefits.

“We live in an environment in which people would like to have a 100-per-cent guarantee that everything is safe and good,” he said. “But we can’t do that. there is some uncertainty.

“There is no guarantee that this vaccine will be 100-per-cent efficient. But chances are it’s going to work.”

© Copyright (c) the Montreal Gazette

ORLANDO, Fla. — Physicians at Centra Care reported a big increase in the number of cases of influenza in Central Florida.A total of 216 patients were diagnosed with influenza during the last week of December. Four weeks ago, just 28 cases were recorded.Duncan Dewahl said he hasn’t been feeling well.”It makes me worry. I haven’t had any flu shots, and I don’t ever take those, so I’ll check myself out early before it gets worse,” Dewahl said.Centra Care Dr. Tim Hendrix said a flu shot is the best protection against influenza.”Even though we’re starting to see a lot of cases of flu out there, and it’s really starting to get going,” Hendrix said. “Now is the time to get your flu shot.”It may take a week or two to build up the antibodies, but Hendrix said the protection will last for the rest of the season — and it will protect against seasonal flu and swine flu.”We’re recommending the shot for everybody. the high-risk groups that are really encouraged to get it (are those) over the age of 65, have a chronic medical condition like heart disease or asthma, congestive heart failure, anything that would put you at risk for complications from the flu,” Hendrix said.Young children, pregnant women and health care workers are also considered at risk.the symptoms of influenza include muscle aches, fever, headache, coughing and fatigue.