by Dr. Rajiv Narula
The year 2000 will be remembered as the “Year of Waiting….” waiting for elections to end,…waiting for the stock market to stop spiraling down to the bottom,….waiting at busy airports …..and yes, waiting for the flu vaccine. In case you had not noticed there was a delay in the distribution of this year’s vaccine to distribution sites : hospitals, clinics and Doctor’s offices. This has unfortunately left vast amounts of people unprotected. To get a flu vaccine in my experience, is a confusing decision for some people. Usual reasons given include: the misconception that one will get the flu from the vaccine, knowing other people who believe that they got the flu after a vaccine. Recently I had a patient who asked me if an episode of abdominal pain almost 2 weeks after getting the vaccine was due to the vaccine!
Influenza or the ‘flu’ as it is commonly called has been around since the time of Hypocrites. According to the World Health Organization there have been 31 pandemics – these are worldwide epidemics. Three of these have been in the last century in 1918, 1957 and 1968. In 1918 atleast 20 million people died from the disease !
Influenza is an acute respiratory disease caused by influenza viruses A and B. Usually it is a mild viral infection transmitted through hand contact via sneezing and coughing – think about that next time you shake hands with someone !! Symptoms usually include fever, cough, sore throat, runny nose, headache, muscle aches and fatigue. Most people recover within 1 –2 weeks. However it can lead to pneumonia in children and vulnerable people like the elderly and people with chronic diseases. Treatment has usually involved taking a few days off, resting, tylenol and other symptom specific medications. A new medication called Relenza, is showing good promise, it works by reducing viral multiplication. However it needs to be taken within 48 hours of becoming symptomatic. Most patients self treat for a few days prior to seeking medical care Unfortunately flu-like symptoms may also be present in other illness that may be caused by bacteria – such as Strep., this would cause a delay in getting proper treatment.
The composition of the influenza vaccine has to be determined every year due to the fact that this virus has the capability to change over time. This chameleon like quality and the fact that there are different strains that circulate, makes it necessary to produces a different vaccine every year. The responsibility of coming up with the composition of the vaccine rests with the World Health Organization. Using a dragnet of 110 National Influenza Centers in 83 countries, this network continuously monitors influenza activity in all regions of the world. Usually in September the WHO makes recommendations on what will be the composition of the next years flu vaccine. A recent WHO press release published the composition of the 2001 fu vaccine. For those of you may go on to the “Who will be a Millionaire” show the three components are : A/Moscow, A/ New Caledonia, A/ B / Sichuan.
For travelers the flu vaccine makes a great deal of sense. In the US the flu season is in the winter time, in the tropics flu season is all year round . Sitting and waiting in congested airports with people hacking etc. is also a possible way to pick up this virus. So next time before you shake hands with someone .. think about it !!!