Bumps To Babies | The Flu and You
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The Flu and You

By: Stefanie Castro, RN, BSN

Lately, as I take my kids to school I joke to myself that I’d love to walk into their classrooms and spray Lysol in every direction.  I’m not a huge fan of the winter months because the flu rears its ugly head.  When we have little kids, we are at a higher risk of being exposed to the virus.  This year the flu has been particularly dangerous.  Throughout the nation, incidences of the flu are steadily increasing, mimicking the flu season from 3 years ago, when hospitalizations and deaths were at all-time highs.  Unfortunately, we remain in the thick of this flu season and the end isn’t as near as we want.  As somber as that sounds, I write this blog in hopes to educate you further on the flu virus and the vaccine available.  This is a scary flu season for all of us, but there is an opportunity to become more knowledgeable on what it is, why it’s so deadly this year, and how you can help protect yourself.

When my kids started school, I came to realize how many parents are unaware of the multitude of viruses that surround us.  People tend to get half the information and, unfortunately, come to their own conclusions.  The first way to begin this topic is to answer the basic question: what is the flu?  The flu is a virus, also known as influenza.  As most people may know, colds are characterized by sore throats, coughing, runny noses, headaches and chest discomfort (WebMD.com, 2018).  The flu exhibits those symptoms, but also includes an extremely high fever, is highly contagious, and causes intense body aches (WebMD.com, 2018).  In order to know whether you actually have the flu, you must have a positive swab test result for the virus.  Although the inconveniences of a cold are quite irritating, the flu can sometimes stop you from simply getting out of bed (WebMD.com, 2018).  I should also stress that influenza is not the stomach flu.  While also contagious, the stomach flu is a gastrointestinal virus that will cause extreme vomiting but is unrelated to influenza.  Therefore, the flu shot doesn’t prevent you from getting the stomach flu.

Unfortunately, I think we can all agree that we have encountered at least one person who has been hit hard by the flu this season.  The incidences of hospitalizations and deaths associated with the flu are climbing significantly (CDC, 2018).  In the 2014-2015 flu season hospitalizations were at an all-time high (CDC, 2018).  This year the numbers are on track to be as bad, possibly even worse than 2014-2015 once this flu season passes (CDC, 2018).  The CDC started documenting flu cases in the 2008-2009 flu season and this year has already shown a rise in cases of documented deaths relating to the flu compared to previous years (CDC, 2018).  To date, fifty-three children have died of the flu this season (Cohen, 2018).  Sadly, from the information gathered, “…only 20% of those children had received the [flu] vaccine” (Matoba & Patel, 2018).   I think with this information it is important to understand more about the flu and the strains that exist.

There are multiple strains of the flu virus each season, with any particular strain falling into one of the two groups: Type A or Type B (Cohen, 2018).  This season, there have been high incidences of H3N2 and H1N1, which are subtypes of Type A  (Cohen, 2018).  Of those listed, H3N2 is this year’s most dominant virus (CDC, 2018).  It is not a new virus, originally dating back approximately 50 years (McNeil, Jr., 2018).  At this point, the current vaccine has shown 17% effectiveness (CDC, 2018).  Even with these preliminary numbers, the CDC is still asking that people get vaccinated because it can decrease the severity of the virus if you come down with the flu (Cohen, 2018).  The percentage of people the flu vaccine protects varies, however, this year the number is lower than some previous years.

I think it’s important to understand why the flu vaccine may not work in all strains of the virus.  Many locations offering the flu vaccine have a quadravalent form of the injection.  In other words, the vaccine contains 4 different subtypes of the virus (Cohen, 2018).  With this being said, the vaccine is not as effective with the H3N2 strain of the virus, only protecting a smaller percentage of the people who receive the vaccination if they come in contact with this strain of the flu (Cohen, 2018).  This decreased effectiveness arises because “…the vaccine is manufactured by growing human flu viruses in chicken eggs, and when H3N2 from humans adapts to chicken cells, it mutates.”  In the process of the mutation, the effectiveness is weakened (Cohen, 2018).  Again, this is of particular issue since there are high occurrences of H3N2 this year.  This information brings clarity as to why the vaccine works more effectively some seasons than others.  This year, unfortunately, H3N2 is registering as the most severe of the cases.

Even with scientific information available, many families still fear vaccines in general.  For a long time, I thought those fears were primarily centered on the Measles, Mumps and Rubella (MMR) vaccine.  It turns out, the fear goes far beyond this specific vaccine, and includes the annual flu vaccine.  In past seasons, the CDC “…estimates that…80 to 85 percent of children counted as pediatric flu deaths had not received the vaccine (Cohen, 2018).”  People would rather cling on to the so-called myths related to the flu vaccine than educate themselves.  Some of the myths floating around parenting circles include, but are not limited to, the vaccine itself will cause an illness and healthy people do not need to bother receiving the vaccine (Matoba & Patel, 2018).  To briefly argue each point: the vaccine is actually produced using inactivated viruses, so the flu can’t be contracted from the vaccine itself and some of the deaths documented have occurred in individuals who are seemingly healthy (Matoba & Patel, 2018).  The problem is, the more we hold on to these myths, the more deaths we will see.

With the knowledge of what the flu is and how dangerous it is this year, the next question may be how can I prevent it from entering my home?  Specifically talking about the flu, there are preventative measures you can take.  Some include: (1) get your flu vaccine—although some locations are out-of-stock at the moment, there is a link at the bottom of this blog to find locations in your area where the vaccine can still be found; (2) wash your hands thoroughly—remind kids to wash their hands while singing a song like “ABCs” or “Happy Birthday” twice in order to ensure the proper amount of time is being used; (3) cover your mouth with your elbow when you sneeze or cough, also known as the vampire cough, in order to decrease the spread of the germs; (4) clean surfaces, using antibacterial wipes—the flu virus can survive up to 72 hours on some surfaces  (Clorox.com, 2018); (5) hydrate—keeping your body well hydrated can flush out toxins from the system; (6) if you suspect you or your child are sick, please stay home.  I can’t stress this last point enough—countless times I’ve seen children walk into school miserable only to later be sent home, after infecting their entire class.  I understand you may have work or other commitments, but the quicker your child can recover, the sooner they will return to school.  Please be mindful of the rules in place at your child’s school.   Please don’t send your children to school with a fever!  They are extremely contagious when febrile (i.e. feverish) and by keeping them home, you are preventing another child and their family from getting this horrible virus.

Understandably, the reported deaths are cause for concern.  Many people only get part of the facts regarding why these deaths occurred.  Please be mindful that there is a lot of story in-between the person contracting the flu and passing away.  It has been stressed by the CDC that individuals may start feeling better from their flu symptoms, and then shortly thereafter begin to develop another high fever (CDC, 2018).  This suggests that a secondary infection may have resulted as a complication of the flu, called bacterial pneumonia (CDC, 2018).  These secondary infections are extremely serious, but oftentimes families think it is simply part of the course of the flu (CDC, 2018).  If you or someone you care for had flu symptoms, began treatment for the flu with antivirals, started to improve and all-of-a-sudden felt ill again (with a high fever and difficulty breathing), please call your physician (CDC, 2018).  I always lean on the side of caution and I feel it’s the most beneficial way to care for my children.

I think it should be emphasized that you must pay close attention to your family members when they become ill this season. My son recently went to the ER for an asthma attack.  Instead of properly diagnosing him, the physician quickly escalated his care by prescribing nearly an entire pharmacy based on fear, because he was potentially exposed to the flu.  Her reasoning was, “Most parents want us to give them everything for treatment!”  Luckily, I am skilled at making my own assessment.  He arrived home with 3 prescriptions, 1 of which was Tamiflu, the antiviral drug prescribed to people diagnosed with or directly exposed to the flu.  I knew I could hold off on giving the Tamiflu for 48 hours from the onset of his fever and I got him swabbed at his pediatrician’s office the next day.  He tested negative and it solidified that waiting for a firm diagnosis was best.  I tell this story not to deter you from seeking medical attention or trusting in medical staff, but to empower you to be the advocates for your children.  Sometimes we have to listen to that inner voice telling us something does or does not make sense.  I was confident he didn’t have the flu due to his symptoms, but I can’t help but think about the parents who aren’t as educated about the signs and symptoms associated with this nasty virus.

This flu season brought upon more fear than I’d care to relive, but I will say, the more educated I become each season to the reasons why influenza may be stronger, the more I can try to protect my family from this mutating virus.  I understand that many parents are scared, either to vaccinate or of the severity this year, but I think the more informed you choose to be, the more empowered you’ll feel to face it head on.  I think it’s important we don’t hide behind our fears and instead try to learn more, because by educating others, we can save a life.

References

Clorox (2018, February 13).  Flu prevention tips.  Retrieved from

https://www.clorox.com/cleaning-and-laundry-tips/healthier-home/cold-and-flu/flu-prevention-tips/?gclid=EAIaIQobChMI28nKjqOk2QIVBpF-Ch0HfAxkEAAYASAAEgJhBPD_BwE.

Cohen, J. (2018, February 2).  Nasty U.S. flu season continues to intensify.  Retrieved

from http://www.sciencemag.org/news/2018/02/nasty-us-flu-season-continues-intensify.

Matoba, N., Patel, A.  (2018, February 9).  Don’t believe flu myths: getting everyone

vaccinated can weaken the severity of the virus and decrease its spread.  Retrieved from https://www.usnews.com/opinion/policy-dose/articles/2018-02-09/dont-believe-flu-vaccine-myths

McNeil Jr., D.G. (2018, January 26).  This flu season is the worst in nearly a decade. 

Retrieved from https://www.nytimes.com/2018/01/26/health/flu-rates-deaths.html.

Transcript for CDC Update on Flu Activity (2018, February 5).  Retrieved from

https://www.cdc.gov/media/releases/2018/t0202-flu-update-activity.html.

WebMD.com (2018, February 13).  What is the flu?  Retrieved from

https://www.webmd.com/cold-and-flu/what-is-flu#1.

If you are interested in getting a flu vaccine and need to know where to find them in your area, please visit: vaccinefinder.org.  (please note this will be a hyperlink in the blog)

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