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‘Tis the Season

by Eileen Glanton Loftus

It’s that time of year, but you can start it off right by protecting yourself this flu season.

This time of year, a single sneeze can push a person’s panic button. Are you getting a cold? Did a dust bunny set off your sneeze as you pulled out your holiday decorations?

Or are you in for an achy, feverish, exhausting battle with the flu?

And then there’s another question: Did you get your flu shot this year?

Flu shots are an annual topic of debate. For starters, according to the Centers for Disease Control, they’re only about 62 percent effective. Plus, did you know we’re among the few countries in the world that even urge citizens to get them?

But for many medical professionals in the Delaware Valley, there’s really no room for argument: Most people should get the shot.

“I recommend that everybody 6 months and up should receive it,” says Dr. Joseph Gallagher, who practices family medicine with the Kennedy Health System. “The flu vaccine is the most important tool we have to prevent the flu.”

It’s too soon to tell how severe this year’s flu bug will be, local doctors say. Flu season generally begins in November, peaks in January, and limps along through March. This year, there’s been no forewarning of a super bug like the H1N1 virus that swept the country in 2009.

“The rates are still pretty low in the Northeast,” says Dr. Henry Fraimow, an infectious disease specialist with Cooper University Health Care. “We know it’s going to come, and we monitor it very carefully as it kicks in.”

In its least severe form, the flu can seem like a minor illness, with fever, muscle aches and coughing. But part of the reason doctors are so united in their quest to prevent it is that it can be quite severe, and can open the door to secondary infections that can even cause death. Elderly patients, young children, pregnant women and people with respiratory risk factors like asthma are the most susceptible to severe complications.

“Vaccines have done such a tremendous job at reducing our risks,” Gallagher stresses. “If we can prevent the flu, we absolutely should.”

Misconceptions about the shot
Perhaps the biggest misconception about the flu shot is that it doesn’t work. Doctors say they have all had patients who insist that the shot is ineffective, therefore, they don’t want to get it.

Effectiveness does vary each year, because the flu develops in different strains every time.

“The flu shot does not give you 100 percent protection,” Fraimow says. “But it should give you about a 70- to 80-percent decreased chance of getting it. And it’s likely to give you a less severe form of the disease.”

Doctors and public-health leaders also battle the perception that the flu shot gives people the flu. We’ve all heard anecdotal evidence, but scientifically, doctors say it is not true.

“The biggest thing is that people are afraid they’re going to get sick from the flu shot. It’s true that you can get a bit of fatigue, some muscle aches, maybe a low fever,” says Dr. Durr-E-Shahwaar Sayed, a family practitioner with Inspira Medical Group in Glassboro. “But those side effects are much milder than what you would experience from the actual flu.” She pointed out that at this time of year, colds and viruses are in heavy circulation, so people may be experiencing a different illness, and mistakenly believe it’s due to their flu shot.

Gallagher agrees. “Some people will get a bit of fever or achiness from the shot, and that’s OK. That is a sign that the body is recognizing the virus and marshalling its antibodies to fight back against the flu.”

New types of flu vaccines
No one likes a shot. For children in particular, the thought of receiving a flu shot can provoke some anxiety and tears.

About 10 years ago, FluMist was introduced, and it took away some of the fear factor. FluMist is a nasal spray made from a live virus and is recommended for patients between 2 and 49. Experts say it does not cause the flu, though its side effects can mimic a mild case of the flu.

“Just like the other flu vaccine, it won’t create the flu within you,” says Sayed. “But we are more careful with pregnant women or other people in high-risk categories who would be at risk for severe side effects if they did contract the flu.”

Fraimow says this year’s flu shot may actually be more effective than ever, as researchers are targeting more varieties of the flu.

“It used to be that the routine flu vaccine had three strains of flu. This year, some have four strains,” he says. Some doctors may also offer a higher-dose vaccine that’s believed to grant additional protection to older adults.

In previous years, patients with egg allergies would sometimes be encouraged to skip the vaccine. The typical flu vaccine is made with virus particles grown in chicken eggs, which could provoke allergic reaction.

This year, two new developments make flu shots a better bet for patients with egg allergies.

First, says Fraimow, there’s a new synthetic flu shot, called Flublok, that does not use any flu virus or chicken eggs in its manufacturing process. The Food & Drug Administration has approved it for use in patients ages 18 to 49.

Secondly, the U.S. Centers for Disease Control and Prevention recommended that most children, even those with egg allergies, get the flu vaccine. A child with a confirmed egg allergy should either be monitored in the pediatrician’s office for 30 minutes after receiving the shot, or should get the shot from an allergist.

“There is certainly more choice today for the health care providers in terms of which vaccine will work the best for each patient,” Fraimow says. “We are still sorting out those questions.”

Doctors say the flu shot does not necessarily have to be given in a patient’s own physician’s office; walk-in medical centers or public flu shot clinics are other sites that may administer the vaccine.

Fraimow also advises that patients should save the documentation of their flu shot. Increasingly, some workplaces require workers to receive flu shots, especially hospitals, health care systems and nursing homes.

If you get the flu
Some simple precautions can also reduce a person’s chances of getting the flu. “Hand-washing is obviously very important,” reminds Gallagher. “This is the time of year to use hand sanitizer as well as washing regularly.” He also recommends that people not touch their faces, as germs from an infected person can be easily transmitted into the nose or mouth.

Sometimes, despite all our best efforts, we just can’t outrun the flu. If you begin to feel sick, and it seems like something more than a cold, it’s best to stay home from work or school, rest, and take in as many fluids as possible.

Dr. Martin Topiel, infection control officer with Virtua, says the flu should run its course in three to six days. If symptoms improve within a week, most patients don’t need to see a doctor.

However, a few red flags can indicate the presence of a secondary infection. Topiel says patients experiencing shortness of breath, chest pain, persistent vomiting or symptoms that aren’t improving should see a doctor. In children, parents should watch for signs of dehydration, such as lethargic behavior or a lack of tears when a child cries.

Some patients may benefit from antiviral medication such as Tamiflu. When given early in the course of a flu bug, it has been shown to reduce the length and severity of symptoms.

Topiel says Tamiflu is sometimes used as a preventive measure, particularly in settings where the flu might be highly contagious.

“In a nursing home, for example, it may be given to try to keep it from spreading to other residents or health care workers,” he says. “But really, the vaccination is the best prevention.”


Cooper University Health Care
One Cooper Plaza
1 (800) 8-COOPER

Inspira Medical Group
1120 N. Delsea Drive
(856) 582-0500

Kennedy Family Health Services
445 Hurffville Cross Keys Road
Kennedy Professional Building, Suite A
(856) 218-2312

401 Route 73 N., Suite 401
1 (888) VIRTUA-3

Published (and copyrighted) in Suburban Family Magazine, Volume 4, Issue 10 (December, 2013).
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