What you may not know about the flu

The flu season in Maine last year (2017) started early and continued to generalize as spring approaches. At its official end, 1772 people were hospitalized and 82 adults died as a result of their illness.

As we enter the 2018 flu season, I wondered what lessons we learned from last year's experience. Dr. August Valenti, an infectious disease specialist, and the epidemiologist at the Maine Medical Center Hospital gave answers to my questions.

What has marked the flu season of last year?

August Valenti, MD
Courtesy Maine Medical Center

The first thing to do is that the number of people who have received a flu shot has gone down, which is very disconcerting. Another thing we learned is that it was a particularly bad flu season, largely due to the H3N2 virus, a particularly difficult strain. The vaccine match was not exactly where we would like it to be. The CDC reported that the vaccine was only 40% effective and in other places lower.

How is this year's influenza vaccine different?

They have beefed up the vaccine this year, so we hope it will be more effective. Even if they do not have the right mix, the flu vaccine provides some protection.

We also offer more varieties of vaccines this year. Last year, they did not approve the live attenuated vaccine, which is a nasal spray, and this year. They have made improvements to this vaccine so that it is more effective against H1N1.

Who should be vaccinated against the flu?

The CDC recommends that all persons older than six months be vaccinated by the end of October, as it is difficult to predict the start of the influenza season. Many people are waiting because sometimes the flu season here in Maine is a bit late, but we do not recommend it.

Young people who receive their first flu shot between the ages of six months and eight years need two doses. You want to start before the start of the influenza season, because you have to separate these two four-week injections. It is important.

Do you know why fewer people received a flu shot last year?

This was largely due to people who are currently using social media and traditional media who do not receive reliable information about vaccines. People are worried that some celebrities or key politicians are anti-vaccinators and are therefore afraid of getting vaccinated. There are many misconceptions. One study showed that a high percentage of parents with children under 18 still think that one can catch the flu through the vaccine. The other is that people worry about autism. Although there is no convincing link between autism and vaccination, it is still circulating on the Internet.

As a physician specializing in the prevention and treatment of infectious diseases, you must be frustrated when people refuse to be vaccinated against the flu.

It is very frustrating. I am that very, very carefully and when you see so many people, especially elderly people, dying from flu-related complications, it's embarrassing. The more members of a community or population that are vaccinated, the more the spread of the flu is slowed down. We call this the immunity of the flock. You want people to protect themselves and you do not want caregivers to spread the flu. You do not want the elderly or immunocompromised household members to get it, you do not want it to a pregnant woman. If you catch the flu in the second and third trimesters, it can harm your child and the mother. Vaccination has played an important role in the elimination of so many diseases. That's why I'm so engaged.

Can you catch the flu by getting vaccinated?

There are many reasons why people have this misconception. Sometimes they catch a cold and it's not really the flu or they get the flu before adequate antibodies are formed. You must wait at least two weeks before you start getting really protective antibodies. And then, sometimes, the vaccine may not be as effective for some people. I had the flu after receiving a flu shot maybe two years ago. And my boy, oh my boy, I was sick. I know that this is not due to the blow because apart from the live nasal spray, all other vaccines do not contain live virus. You do not get the flu from an influenza vaccine.

How can you tell if you have the flu?

I always tell people who say they have the flu, not you. Nobody touches the flu. It's very memorable in most adult situations. The guideline that I use, and this is not a strict guideline, is that I want patients to tell me that they suddenly had chills, fever, and very severe muscle and body pains. Some people do not have fever with flu and their illness may be lessened if they get vaccinated. Even so, most people really know that they have the flu and that it lasts. You are sick for a while, or even three weeks in some cases.

How is the flu confirmed?

They can do a quick test and rub your nasal pharynx [back of nose or throat] for antigens or do a more sophisticated test that looks for real segments of the virus. The tests for influenza are more sophisticated and many doctors want confirmation.

Do you need to contact your doctor at the first sign of flu symptoms?

The average athlete, young and healthy, may not have to do it, but if you are a person particularly vulnerable to the flu, yes. I will give you a few examples: if you are immunocompromised, for example, if you take a medicine that reduces your immune response to infections; if you are pregnant you are older; you have a respiratory illness, especially asthma or COPD; or if you have severe kidney disease. And if you live with a person who might be really affected by the flu, an elderly or vulnerable person and you catch the flu, you may want to get treatment.

How to treat the flu?

There are two antiviral drugs. the FDA just approved a new one last week called Baloxavir Marboxil. It's just a single dose, but you must take it within 48 hours. People say that it will reduce the symptoms by about a day or two, but of course, if you have the flu, another day of grace is a good day. The other is the old Tamiflu in standby. It's been a long time and sometimes, when people can not get the flu shot, we use it for prevention. We could use it in a nursing home outbreak in a confined space. If there is a lot of flu in the community during the flu season and you have symptoms, your doctor may decide to treat you without confirming you have the flu.

In addition to being vaccinated against the flu, can we do something else to protect ourselves and others?

There are two things I like to focus on throughout the year, but especially at this time of year. Good hand hygiene and respiratory etiquette. Cough or sneeze into your sleeve, do not store paper tissues. Throw them out and wash your hands. Be careful not to touch your face after touching surfaces because they may contain flu, other viruses and vermin. Nasty germs that can be deadly.

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