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All I Want for Christmas is Flu...Vaccination

By Rhoda Frost

Photo credit: Pixabay

Well, it’s that time of year again. Joy to the world, Santa Claus, a baby in a manger… and the flu season. Every year, like clockwork, we hear of new strains of this virus, nationwide vaccination campaigns start up, and everyone gets slightly panicky. But flu is just a bad cold, right? Should we be worried? Allow me to fill you in.

What is the influenza virus?

‘Flu’ is just the abbreviation of ‘influenza’, which is what we call the virus that causes the disease. A virus is a really small particle, and it’s not even really alive. The flu virus is basically round, and is surrounded by an ‘envelope’, which is made up of bits of the cell it infected last. [1] In this envelope are little proteins, some of which allow the virus to bind to your cells (called haemagglutinins, or H for short) and others which allow it to bud away to spread to other cells (called neuraminidases, or N). [1] This is where we get the names of flu strains you might’ve heard of, like H1N1 – swine flu. It is changes in these little proteins that can cause the big flu epidemics we see every few years.

Isn’t it just a bad cold?

There can be quite a lot of overlap between the symptoms that you see in flu and the common cold, but there are a few differences that can help to distinguish them. The common cold tends to be caused by things called rhinoviruses and coronaviruses, rather than the influenza virus, so the two diseases are actually caused by different agents. [2] Most adults will have at least two colds per year, in which they will have a short bout of mild illness, with headaches, a sore throat, chills and sneezing towards the beginning, and coughing, a runny or blocked nose and general discomfort towards the end of the illness, lasting around a week in total.[2] The common cold rarely causes fever. On the other hand, flu victims will suffer fever, headache, sore throat, muscle aches, weakness and more, [2] all of which will start very suddenly, and which may have lasting effects for weeks after the main part of the illness has subsided. [3] I would say that if you’re able to be at work, you probably have a cold, not the flu.

Photo credit: Pixabay

In individuals whose immune system is weaker than normal (for example children, the elderly, and people with certain diseases), flu can be very serious, even life-threatening. It is therefore important to try to stop the virus from spreading, and to protect those who are more vulnerable to its effects.

Treatment

Can I quash one rumour, please? If you do become ill with the flu, antibiotics cannot help you. The flu is caused by a virus, and antibiotics only work on bacteria, which are completely different. Visiting your GP with the flu to try to get antibiotics will only result in a possibility of spreading the disease to other people visiting their doctors, and your GP will not be able to prescribe you a miracle cure, certainly not in the form of antibiotics. For normally healthy people, the medical advice would be bed rest, hydration and paracetamol and/or ibuprofen to control any pain or fever. For the more vulnerable groups of individuals, a GP can provide anti-viral medication, but that would be up to their discretion, and visiting the surgery in person is still not a good idea.

How does it spread?

‘Coughs and sneezes spread diseases’ – possibly slightly cliché, but still true. The influenza virus is thought to be mostly spread via the ‘droplet’ and ‘contact’ routes. [4] The ‘droplet’ route is where the infected person coughs, sneezes, or talks, and produces large droplets from areas like the throat, the nose and the mouth. These droplets may contain many, many copies of the virus, and they can be propelled up to 1 m through the air. These droplets could then be inhaled by a nearby person, or may come to rest on skin or surfaces, which could then be taken up to cause infection in someone else. The ‘contact’ route involves either physical contact between an infected person and a non-infected person, or by indirect contact through contaminated skin or surfaces, as in the ‘droplet’ route. [4] Either way, the virus makes its way into the new susceptible victim, causing disease in that person so that they are also contagious and can spread the disease.

Flu victims can become infectious even 1-2 days before they start to show symptoms of the disease, and infectiousness has actually been seen up to 6 days before a person becomes obviously ill. [5] This time of contagiousness could last even longer in children. The most important thing then is prevention, stopping the spread of the disease at every level, as we may not even know who is carrying it.

Preventing spread

Photo credit: Pixabay

I’m sure we’re all familiar with some of the campaigns for hygiene for these types of illness, for example, ‘Catch it. Bin it. Kill it.’ Indeed, this is perhaps one of the most effective ways of preventing yourself from infecting others – catch your coughs and sneezes in a tissue, throw the tissue into the bin, and wash your hands. Flu prevention becomes even more important in areas like hospitals, where there are many vulnerable patients whose immune system is weakened in some way. The guidelines from the American Centre for Disease Control (CDC) [6] outline the ways in which healthcare settings should try to prevent the spread of flu and related diseases: using facemasks and perhaps isolating infected patients, enforcing hand washing by visitors, patients, and healthcare workers in particular, wearing gloves and gowns where necessary, reducing access by visitors, especially those that might be infected, and (the big one) vaccination.

Vaccination

Vaccination is so, so important. By being vaccinated you not only protect yourself, but also those around you, from disease. This is because if you have been vaccinated and become immune, then you cannot catch the disease and infect other people, even those who have not been vaccinated themselves. In fact, if rates of vaccination in the population as a whole are high enough, then it becomes impossible for the disease to spread, because too few people are vulnerable to it. This is called herd immunity, and it is the reason why diseases like measles, mumps and rubella are so rare in this country now, because children are routinely vaccinated against them at a certain age. Influenza is slightly different, because the virus mutates and changes what it looks like very quickly, so that the flu vaccine from last year will not protect you against the strain that is circulating this year. This is why it’s important to be vaccinated annually. The flu vaccine is offered free on the NHS to vulnerable people: those over 65, pregnant women, individuals with a BMI of over 40, and people with a long-term health condition or a reduced immune system. 2-4 year olds and children in school years 1 and 2 will also be offered the vaccine. [7] You can also pay a small amount to have a flu jab in certain places, although if you are healthy and do not fall into one of the categories above, then flu should not really cause you a serious illness.

Perhaps there has been some scare-mongering in the past about flu vaccinations, but I do not believe that it is justified against the weight of evidence that says how effective it is at preventing you from getting the disease. The flu vaccine is generally made by growing the virus inside chicken eggs (yes, really), after which the vaccine is inactivated so that it cannot cause flu. [8] The flu vaccine cannot give you flu. Some people may experience mild side effects for a few days – you may feel achy, and have a slightly raised temperature, but this is not the flu, and many people will have no side effects at all. Weighing up the slight possibility of mild side effects against the risk of serious disease in yourself (if you are high-risk), or in a friend or loved one (if they are high-risk), it would seem to me that having this vaccination is seriously worth it.

Conclusion

Perhaps a lot of this article is self-explanatory or obvious, and perhaps not. I just hope to get across how serious flu can be as an illness, and how it’s worse than just another cold. Antibiotics won’t help you, and most of the time you won’t need any treatment, but I’m sure we all know how much better prevention is than the cure. If you take one thing away from this – VACCINATION. If the NHS offer you a free vaccination, take it, and as soon as possible. In all other cases, keep everything hygienic; wash your hands, use a tissue and clean your surfaces. And have a wonderful, flu-free Christmas!


References

  1. R. A. Goldsby et al., “Immunology”, 5th ed, 2003, Ch 17, Houndmills
  2. R. Eccles, Lancet Infectious Diseases, 2005, 5, 718-725
  3. M. Aljohani, G. D. Horning and A. I. Cheh, “Ciottone’s Disaster Medicine”, 2nd ed, 2016, ch 148, pp 771-773, Elsevier
  4. G. Brankston et al., Lancet Infectious Diseases, 2007, 7, 257-265
  5. F. Carrat et al., Am. J. Epidemiol., 2008, 167, 775-785
  6. CDC: Prevention Strategies for Seasonal Influenza in Healthcare Settings, available from http://www.cdc.gov/flu/professionals/infectioncontrol/healthcaresettings.htm [accessed 24/11/15]
  7. NHS: Flu – Prevention, available from http://www.nhs.uk/Conditions/Flu/Pages/Prevention.aspx [accessed 24/11/15]
  8. J. K. Aronson, “Meyler’s Side Effects of Drugs – The International Encyclopedia of Adverse Drug Reactions and Interactions”, 16th ed, 2016, pp 98-106, Elsevier Science


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