Doctor’s Notes: Flu

by Symptom Advice on February 8, 2011

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What is the difference between a cold and the flu?

? the flu and the common cold are both respiratory illnesses but they are caused by different viruses.

? it can be difficult to tell the difference between them based on symptoms alone.

? In general, the flu is worse than the common cold, and symptoms such as fever, body aches, extreme tiredness, and dry cough are more common and intense.

? Colds are usually milder than the flu.

? People with colds are more likely to have a runny or stuffy nose.

? Colds generally do not result in serious health problems, such as pneumonia, bacterial infections, or hospitalizations.

How can you tell the difference between a cold and flu?

? Colds and flu share many symptoms, so it can be difficult (or even impossible) to tell the difference between them based on symptoms alone.

? Special tests that usually must be done within the first few days of illness can be carried out, when needed to tell if a person has the flu.

What are symptoms of flu?

People who have the flu often feel some or all of these symptoms:

? fever* or feeling feverish/chills

? runny or stuffy nose

? muscle or body aches

? fatigue (very tired)

? some people may have vomiting and diarrhea, though this is more common in children than adults.

*It?s important to note that not everyone with flu will have a fever.

How does flu spread?

? Flu viruses spread mainly by droplets made when people with flu cough, sneeze or talk.

? these droplets can land in the mouths or noses of people who are nearby. less often, a person might also get flu by touching a surface or object that has flu virus on it and then touching their own mouth, eyes or nose.

What is period of contagiousness?

You may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick.

Most healthy adults may be able to infect others beginning 1 day before symptoms develop and up to 5-7 days after becoming sick.

Some people, especially children and people with weakened immune systems, might be able to infect others for an even longer time

What are complications of flu?

worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes.

How can we best prevent seasonal flu?

The single best way to prevent the flu is to get a flu vaccine each season. There are two types of flu vaccines:

The “flu shot” an inactivated vaccine (containing killed virus) that is given with a needle. the seasonal flu shot is approved for use in people 6 months of age and older, including healthy people, people with chronic medical conditions and pregnant women.

The nasal?spray flu vaccine ?a vaccine made with live, weakened flu viruses that do not cause the flu (sometimes called LAIV for “Live Attenuated Influenza Vaccine”). LAIV is approved for use in healthy* people 2-49 years of age who are not pregnant.

About two weeks after vaccination, antibodies develop that protect against influenza virus infection.

Flu vaccines will not protect against flu-like illnesses caused by non-influenza viruses.

The 2010-2011 seasonal flu vaccine protects against the three influenza viruses that research suggests will be most common.

When should I get vaccinated against seasonal flu?

Yearly flu vaccination should begin in September, or as soon as vaccine is available, and continue throughout the flu season which can last as late as may. This is because the timing and duration of flu seasons vary. While flu season can begin early as October, most of the time seasonal flu activity peaks in January or later.

Who should get vaccinated?

On February 24, 2010 vaccine experts voted that everyone 6 months and older should get a flu vaccine each year starting with the 2010-2011 influenza season.

CDC’s Advisory Committee on Immunization Practices (ACIP) voted for “universal” flu vaccination in the U.S. to expand protection against the flu to more people.

While everyone should get a flu vaccine each flu season, it?s especially important that certain people get vaccinated either because they are at high risk of having serious flu-related complications or because they live with or care for people at high risk for developing flu-related complications.

Who is at high risk for developing flu-related complications?

Children younger than 5, but especially children younger than 2 years old

Adults 65 years of age and older

Also, last flu season, American Indians and Alaskan Natives seemed to be at higher risk of flu complications

People who have medical conditions including:

Asthma (even if it’s controlled or mild)

Neurological and neurodevelopmental conditions [including disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy, epilepsy (seizure disorders), stroke, intellectual disability (mental retardation), moderate to severe developmental delay, muscular dystrophy, or spinal cord injury]

Chronic lung disease (such as chronic obstructive pulmonary disease [COPD] and cystic fibrosis)

Heart disease (such as congenital heart disease, congestive heart failure and coronary artery disease)

Blood disorders (such as sickle cell disease)

Endocrine disorders (such as diabetes mellitus)

Metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders)

Weakened immune system due to disease or medication (such as people with HIV or AIDS, or cancer, or those on chronic steroids)

People younger than 19 years of age who are receiving long-term aspirin therapy

People who are morbidly obese (Body Mass Index [BMI] of 40 or greater)

Who else should get vaccinated?

People who live in nursing homes and other long-term care facilities

People who live with or care for those at high risk for complications from flu, including:

Household contacts of persons at high risk for complications from the flu

Household contacts and caregivers of children younger than 5 years of age with particular emphasis on vaccinating contacts of children younger than 6 months of age (children younger than 6 months are at highest risk of flu-related complications but are too young to get vaccinated)

When should I use of the nasal spray seasonal flu vaccine?

Vaccination with the nasal-spray flu vaccine is an option for healthy people 2-49 years of age who are not pregnant.

Even people who live with or care for those in a high risk group (including health care workers) can get the nasal-spray flu vaccine as long as they are healthy themselves and are not pregnant. the one exception is health care workers who care for people with severely weakened immune systems who require a protected hospital environment; these people should get the inactivated flu vaccine (flu shot).

Who should not be vaccinated against seasonal flu?

Some people should not be vaccinated without first consulting a physician. They include:

People who have a severe allergy to chicken eggs.

People who have had a severe reaction to an influenza vaccination in the past.

People who developed Guillian-Barr? syndrome (GBS) within 6 weeks of getting an influenza vaccine previously.

Children younger than 6 months of age (influenza vaccine is not approved for use in this age group).

People who have a moderate or severe illness with a fever should wait to get vaccinated until their symptoms lessen.

What is Flu Surveillance?

The exact number of flu cases in Texas is unknown because most flu cases are not reportable, meaning that doctors, hospitals and others are not required to report them to public health authorities.

To track and assess flu activity, DSHS relies on reports from a sentinel surveillance network of doctors, hospitals and others who have agreed to report flu cases.

From those reports and other sources, DSHS prepares a Weekly Flu Surveillance Report. Part of that report classifies the flu activity level in Texas using classification criteria developed by CDC. the classifications range from no activity to sporadic, local, regional and widespread.

The weekly report also includes laboratory test results showing what types and subtypes of flu are circulating in Texas, the estimated level of flu-like illnesses occurring and the number of pediatric flu-associated deaths

Below are URL surveillance reports for last week. First is for Nation. second is for Texas ( I will abstract for News)

dshs.state.tx.us/idcu/disease/influenza/surveillance/2011/

What are the Influenza Activity Classifications?

No Activity: no laboratory-confirmed cases of influenza and no reported increase in the number of cases of influenza-like illness.

Sporadic: Small numbers of laboratory-confirmed influenza cases or a single laboratory-confirmed influenza outbreak has been reported, but there is no increase in cases of influenza-like illness.

Local: Outbreaks of influenza or increases in influenza-like illness cases and recent laboratory-confirmed influenza in a single region of the state.

Regional: Outbreaks of influenza or increases in influenza-like illness and recent laboratory confirmed influenza in at least two but less than half the regions of the state with recent laboratory evidence of influenza in those regions.

Widespread: Outbreaks of influenza or increases in influenza-like illness cases and recent laboratory-confirmed influenza in at least half the regions of the state with recent laboratory evidence of influenza in the state

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