What you should know about colds & flu this winter

After weeks of wondering if the cold weather was ever going to appear and chase us out of our sandals and T-shirts, winter is firmly here and has brought her evil companion “Flu” with her. It seems that this year’s Influenza has hit hard and fast, with doctors’ offices inundated and classrooms half empty.

What is Influenza and how can we best protect ourselves?

Firstly, it is important to realise that the term “flu” is often used very loosely for any infection involving the upper respiratory tract. Most of these “flus” are actually a common cold and are far less debilitating than true flu.

Flu is a contagious respiratory illness caused by Influenza viruses that infect the nose, throat, and sometimes the lungs. It can cause mild to severe illness, and at times can lead to death. Let’s not forget that during the 1918-1919 Spanish flu pandemic, the death toll reached a staggering 20 to 40 million worldwide.

“Flu viruses spread mainly by tiny droplets made when infected people cough, sneeze or talk. These droplets can land in the mouths or noses of nearby people.”

People who are sick with flu often feel some or all of these symptoms:

• Fever or chills
• Coughing
• Sore throat
• Runny or stuffy nose
• Body aches
• Headaches
• Fatigue

Flu viruses spread mainly by tiny droplets made when infected people cough, sneeze or talk. These droplets can land in the mouths or noses of nearby people. Less often, a person might get flu by touching a surface or object that has flu virus on it and then touching their own mouth, nose or possibly their eyes.

Flu timeline

• The time from when a person is exposed and infected with flu to when symptoms begin is somewhere between one to four days.
• It is possible to pass on flu to someone else before knowing you are sick.
• People with flu are most contagious in the first three to four days after their illness begins.
• Some otherwise healthy adults may be able to infect others beginning one day before symptoms develop and up to five or seven days after becoming sick. Some people, especially young children and people with weakened immune systems, might be able to infect others with flu viruses for an even longer time.

Prevention of flu

The best way to prevent flu is through vaccination. This needs to happen every year at least two weeks before the flu season starts in order to build immunity. The vaccine will differ from year to year based on the most prevalent strains seen, so having been vaccinated the year before does not guarantee any protection for the following season.

The current guidelines as to who requires a flu vaccine are as follows:

1. Pregnant women irrespective of stage of pregnancy and up to two weeks after delivery.
2. Persons at high risk for influenza and its complications (adults and children):

• Pulmonary diseases (e.g. asthma, COPD, TB)
• Cardiac diseases (e.g. congestive cardiac failure), except hypertension
• Metabolic disorders (e.g. diabetes)
• Renal disease (kidneys)
• Hepatic disease (liver)
• Certain neurologic and neurodevelopmental conditions, including disorders of the brain, spinal cord, peripheral nerve and muscle such as cerebral palsy, epilepsy (seizure disorders), stroke, mental retardation, moderate to severe developmental delay, muscular dystrophy and spinal cord injury
• Haemoglobinopathies (e.g. sickle cell disease)
• Immunosuppression (e.g. HIV, immunosuppressive medication, malignancy)

3. Healthcare workers
4. Residents of old-age homes and chronic care and rehabilitation institutions
5. Persons over the age of 65 years
6. Persons aged six months to 18 years on long-term aspirin therapy
7. Children six months to 59 months of age
8. Adults and children who are family contacts of high-risk patients
9. Any person wishing to minimise the risk of influenza, especially in industrial settings, where large-scale absenteeism could cause significant economic losses

Contraindications to the vaccine are a history of severe hypersensitivity to any component of the vaccine (including egg allergy), and infants under the age of 6 months.

Treatment of flu

If you become ill with influenza, the treatment is mostly supportive (bedrest, fluids and analgesia). Avoiding close contact with others is also imperative. Since influenza is a virus, antibiotics will not be of any value unless your doctor believes you have developed a secondary bacterial infection. There are antiviral agents available but they are only effective if given early in the course of the infection and may have unpleasant side effects. We tend to reserve those drugs for high-risk cases.

As far as possible, try to wash your hands often, stay away from crowded poorly ventilated spaces and avoid close contact with anyone who is obviously ill. And then, just maybe, you’ll remain healthy until we see those blossoms budding.

With thanks to CDC and Pathcare