HEALTH Flu-vaccine time for the vulnerable

ACT NOW?Healthcare workers, people who work with poultry and people with respiratory conditions are among those who should get annual flu shots.

Flu-vaccine time for the vulnerable


Health
Dr Ronan Clancy

What a summer it has been, with a more-than-welcome extension into October. In fact one of my patients, a Westport native all her life in her eighth decade, cannot recall a summer so fine. Despite the blue skies, the cyclical sore ears, throats and noses are running right on time. No pun intended!

Influenza
Influenza is a highly contagious airborne virus that causes infection of the airways. It develops in birds and mammals, and is passed from host to host via the inhalation or ingestion of tiny droplets through coughing, sneezing or mucus contact.
Over time, generations of viruses mutate, and the immune system fails to recognise them and so does not fight them. This slow process of mutatory change is called ‘Antigenic Drift’.
New infective flu strains can pass rapidly through much of a population in what is termed an epidemic. Epidemic flu can vary in severity, depending on whether the immune system partially recognises the new virus from its bank of known predecessors.
More serious problems
Occasionally two separate strains of flu virus (often from different species) will attack and insert their genes into the same cell for replication. When this happens a complete swap of entire sections of genetic material occurs, forming an entirely new strain of influenza to which no human or animal on the planet bears immunity. This potentially catastrophic event termed ‘Antigenic Shift’ results in global pandemics and millions of deaths.
There have been three great pandemics in the 20th century. The Spanish Pandemic (1918-1920) claimed 50-100 million lives worldwide, while the combined death toll of the Asian (1957) and Hong Kong (1968) pandemics was between 2 and 4 million.
The Swine Flu (H1N1) pandemic in 2009 contained influenza virus genes from human, pig and bird. Luckily, it was less severe than anticipated.

Symptoms
Fevers, chills, sore throat, headache, muscle aches and fatigue are the most common symptoms. They are similar to those of the common cold but are usually much more severe.
Influenza can cause viral pneumonia and secondary life-threatening bacterial pneumonia, especially in the risk groups as outlined below.

Protection
It’s easy to see how the vaccine manufacturers have their hands and pockets full keeping up with this clever virus! Every year, the World Health Organisation predicts the three most severe influenza strains that are likely to be circulating in the next year, and it calls on the vaccine manufacturers to produce vaccines.
The HSE has published list of persons at high risk of serious influenza infection. It is highly recommended that anyone to whom this list applies receives the annual influenza vaccine. On this list are persons aged 65 and over; anyone with a long-term medical condition, such as diabetes, heart or lung conditions, such as asthma and COPD/emphysema; people whose immune system is impaired due to disease or treatment; persons with a body mass index (BMI) over 40; pregnant women (the vaccination can be given at any stage of pregnancy); residents of nursing homes and other long-stay institutions; healthcare workers; carers; people with regular close contact with poultry, water fowl or pigs.
Your GP is best placed to provide the vaccine for a number of reasons. He or she knows the nature of your conditions and your vaccination status, and can notify you annually when your vaccine is due and deliver it on time. Also, should there be adverse or unexpected reactions to the vaccine, your family doctor is immediately at hand to deal with the situation competently.  Getting the vaccine is also an opportunity to link in with your doctor to discuss your general health or concerns.
The influenza vaccine contains inactivated (split) virus particles, which induce the immune system to produce protective antibodies against the relevant influenza strains within 2-3 weeks. Because the virus is split, you cannot develop flu from the vaccine. However, as the immune systems responds and does its job, mild symptoms such as low-grade fever, aches, tiredness or sweating may occur for a few limited days after vaccination.
People with egg allergy usually can receive the vaccination in consultation with their GP.

Treatment
People with flu should rest, drink plenty of liquids and avoid alcohol and tobacco.Paracetamol, anti-inflammatories and decongestants can provide much-needed symptom relief as advised by your doctor or pharmacist. Sometimes an antibiotic may be required.
Prevention involves good hand-cleaning measures, containing coughs and sneezes with handkerchiefs and avoiding crowds during outbreaks.

Dr Ronan Clancy is a GP at the newly opened Clancy Medical Practice, James street, Westport (www.westportgp.ie). He is in practice with Sarah Kavanagh, chartered physiotherapist.