Flu season is an event that occurs annually, particularly in the cold months in each hemisphere. For 2018-19, we did not see the severity of illness, but it did set a record for the longest flu season in a decade, according to the Centers for Disease Control (CDC). It lasted 21 weeks (from November to April) with a severity rating of “moderate.” This is thought to be due to a high level of early flu season vaccination rates and a particularly effective vaccine. Still there were over 42 million people infected; almost 650,000 hospitalized and just over 61,000 who died during the 2018-19 flu season. There were 116 pediatric flu-related deaths in 2018-19 compared with 183 the year prior.
What is the flu?
Flu is a respiratory illness. Symptoms include a runny nose, sore throat, sneezing, and coughing. Fever is a prevalent symptom and it can rapidly rise to unsafe levels (over 102 degrees F) especially in children and the elderly. Congestion can lead to worsening cough, wheezing and runny nose. Headache and body and muscle aches can cause extreme discomfort. Vomiting and diarrhea can be associated with the flu especially in young children often due to continuous coughing and as a reaction to cough/cold medications. However, the flu is not a digestive system disease. There is no such thing as “the stomach flu.” This would likely be gastroenteritis caused by a virus such as norovirus or novovirus which are not related to the Influenza viruses.
Why take the flu shot?
The flu vaccine can prove to be very effective in preventing the spread of flu virus and decreasing the risk for hospitalization and death. The vaccine causes the body to produce antibodies within about two weeks after vaccination that will help the body to fight off the flu viruses. It is important to get the flu shot as early as possible before flu season takes hold. Vaccines are usually available by mid to late September, and the CDC recommends everyone should be vaccinated by the end of October to ensure effectiveness.
Every flu season is different, and researchers can only attempt to predict with some degree of accuracy what strain(s) of virus will be prevalent that year and then develop a vaccine to help prevent the outbreak. Flu is a serious illness that poses the largest threat to those over 65 and to children. In the US, most flu vaccines are trivalent or quadrivalent meaning they protect against 3-4 strains of flu virus. These can include the more virulent strains of virus such as Influenza A (H1N1and H3N2) and the less severe Influenza B strains. The stronger trivalent with the adjuvant vaccine is recommended for those over 65 to provide a stronger immune response. The adjuvant is an ingredient that increases the immune response. The vaccines are made with either inactivated influenza vaccine (IIV), recombinant influenza vaccine (RIV) or live attenuated influenza vaccine (LAIV) and are licensed for specific age groups and those with limiting parameters such as pregnancy, chronic and acute illnesses or conditions. The CDC recommendation is for anyone 6 months or older be vaccinated with age-appropriate vaccines annually with rare exception. In children, a nasal spray may be available instead of injection.
Can the flu shot cause the flu?
In a word, NO! Even the live attenuated virus vaccine will NOT cause the flu. The immune response in which antibodies are building up in the body to fight off the Influenza viruses can cause symptoms such as headache, low grade fever muscle aches, fatigue and perhaps nausea. There may also be redness, soreness, and possible swelling at the injection site. With the nasal spray, additional symptoms may include wheezing or runny nose. Indeed, the symptoms may be severe, but with the use of OTC meds such as Tylenol or Ibuprofen, they can be eased and last only 1-3 days. The actual flu symptoms continue to worsen and last in the range of 7-14 days.
It takes about 14 days for the full immune response to develop. Those who actually end up with the flu after being vaccinated were either exposed to the virus before or during the 14 days to build the immunities or have a strain of virus the vaccine wasn’t meant to fight. It can also be a similar illness such as rhinovirus and not the flu at all. This can happen when especially when the viruses mutate and flourish in a direction that scientists did not anticipate.
Understanding the process of immunization, the immune response from the body and treating symptoms will help all individuals to make decisions to help stop the spread of flu. Nurses can take advantage of their continuing education courses to learn more about immunizations and in turn help to educate patients, families and caregivers.
What else helps to stop the spread of the flu?
Handwashing is the most effective means of preventing the spread of illness or germs. Florence Nightingale lectured some of the first nurses on this during the Crimean War. Educating patients, families and caregivers to wash their hand s effectively is one of the most important teaching tools nurses can use. Covering coughs and sneezes is essential. Coughing or sneezing into a bent elbow can stop the airborne pattern of droplets of virus. Cleaning surfaces such as doorknobs, handrails, countertops, tables, toilets and proper disposal of used tissues can all help stop the spread.
Of the utmost importance is staying away from crowds and if you are having symptoms, stay home! Stay in bed, drink fluids and rest. Don’t go to work and don’t infect others. Anti-flu medications can be given if flu is diagnosed by test within the first 48 hours. These meds are meant to reduce severity and length of illness and are most highly recommended for children and the elderly.
Complications from the flu make anyone who is high-risk much more vulnerable and priorities for vaccination. Complications can include pneumonia, and for anyone with chronic illness, exacerbation of the symptoms of their disease is a strong possibility. With severe flu symptoms, becoming bedridden can be a complicating factor for dehydration, weight loss and worsening symptoms which can result in pneumonia. Complications of the flu cause hospitalizations and can lead to untimely deaths.
Resources:
The immune response to influenza vaccines
Flu Shot
Flu
Key Facts About Seasonal Flu Vaccine
