Flu (part1)
Flu (part1)
The 2009-2010 flu seasons was supposed to be "routine." Usually, patients take their seasonal flu shot. Those people who had flu symptoms normally go to the doctor's office for an exam and testing. It is usually easy to spot the flu patients. Among the usual nasal congestion and sore throats, there are certain people whose sickly appearance is really clear. These people usually appear to have just woken up, their hair is mussed, they are unshaven, and they are covered in sweaters or blankets but still shivering. In the doctor's office, they are brought back and examined for signs of the flu or other problems. If their throat is red, they are usually checked for strep throat.
The nasal flu swab, which is an antibody test for types A or B Flu, is available. Judging by the patient's clinical appearance and a positive test for Flu A or B, the doctor might prescribe the antiviral drugs Tamiflu or Relenza to lessen the severity and length of illness. However, 20% of the American population acquired the 2009 flu far. Billions of dollars in lost work productivity and hospital expenses come out of the country's pocket. At least 200,000 patients were hospitalized and there were 36,000 flu-related deaths. On top of that, something new now was added for 2009. The great scientists at the Centers for Disease Control (CDC) in Atlanta maintain careful observation over flu outbreaks all over the world. They test and name each flu. Using this data, scientists try to predict what seasonal flu will appear in the fall. They supervise pharmaceutical companies in the manufacture of the specific vaccine. When the flu scientists reach their prediction on the button, the vaccine is effective in 70 to 90% of recipients under age 65. It is less effective in recipients over 65, recipients who live in nursing homes, and those with chronic underlying illness. The vaccine is about 30% to 70% effective. The usual seasonal vaccine contains attenuated virus of the A (H1N1) and the A (H3N3) variety. There is now a new flu+ H1N1+H3N3 for people over 65 years over age.
A virus is not actually a separate live entity, so when we severely debilitate, we then say in the vaccine "attenuation." A virus is arguably the smallest semi-life form that exists in nature. It only can be seen with an electron microscope. It is called an obligate parasite. This means it must "live" within another living cell. It can only survive and replicate by taking over that cell's complex biochemical machinery to manufacture other viral units like itself. The influenza virus has its RNA taken up by a host cell to begin the manufacture process. Eventually the host cell dies by its viral infection. Influenza viruses were first identified and studied by scientists in the 1930's.
Type A viruses were the worst, and the ones typically producing epidemics and global pandemics. An epidemic is a local outbreak of the flu, usually annually, by viruses that already exist in the environment. It usually peaks in three weeks, and subsides after three weeks, sometimes affecting 50% of the population of that area.
The pandemic is a different phenomenon altogether. It is caused by a mutated virus (changed) to which humans do not have immunity. It can be spread worldwide. Scientists found that they could identify Type A viruses into subtypes by protein structures on their outer surfaces. These are called H (Hemagglutinin A) and N (Neuramidase B). There is no division of a Type B virus into a subtype because they cause milder symptoms and are more sporadic. Type C influenza viruses are not subtyped because they cause even milder symptoms and less evidence of outbreaks. The Type A viruses caused the pandemics of 1917, 1957, and 1967 when millions of lives were lost. The worst year for this was 1918.
Pandemics can be caused by a viral mutation (changed) or the re-emergence of a virus that has not been around for years. All in all, humans lack immunity to that specific virus and cannot fight them. Viruses do not stay in humans throughout the year as they are prevalent in primarily fall and winter. Where do they stay dormant and hide? Scientists discovered that certain coastal birds seem to be the reservoir for the viruses. There is fairly good evidence that the birds harbor these viruses without manifesting disease and have probably done so for millions of years. You may see a television show where scientists raise huge nets to catch migrating coastal birds to see what viruses they are carrying. Therefore, probably all "flu" is, to an extent, "avian" or "bird flu". It is theorized that wild ducks infect domestic ducks, which in turn, either spread it to chickens or swine. Therefore, most of the flu is "swine" flu. You are not going to catch the flu from a piece of pork in your refrigerator.
The current H1N1 seems to have started with a small swine population in a desolate area of Mexico. The American pork industry has been recently affected due to the public not buying as much pork. But this is not the problem. The problem seems to be this one batch of flu that arose in Mexico to which humans did not have immunity. With travel being what it is today, it did not take long for the virus to spread from person to person. It has recently even been announced that a group of swine were found to have the swine flu in Minnesota. It seems that both pigs and possibly chickens have the same viral receptors as humans and thus can be a vector for human transmission. Some people are not getting "Novel H1N1" (the newer name for the 2009 Swine Flu) because they perhaps gain some immunity from previous H1N1 immunization. Most people who saw the outbreak of swine flu in Mexico thought it was too far away to affect them. However, as we know, times have changed. Swine Flu ("Novel H1N1 Flu") is now widespread in most of the United States and elsewhere in the world. You will hear about it on almost every newscast and different government agencies hold numerous press conferences. The amount of daily information is enormous.
The best scientists of our time are saying, "Get your Flu shot when it is available." (Actually they are saying," Get your seasonal Flu shot now and the Swine or Novel H1N1 vaccination as soon as it is available.") On the other side are the "nay-sayers" who say, "The Flu is not as bad as they said. Don't give it to your children: it will give them autism. It has mercury or thimerosal in it. For my part, I'm siding with the CDC: Everybody should have the seasonal vaccination and the H1N1 vaccination. One thing to remember is that it takes time for the immune system to respond to the vaccine for the flu. A conservative estimate is that it takes 6-8 weeks to achieve its desired effect. That is why the vaccine is better if you take it sooner than later. There are two kinds of flu vaccine; more will become available as they are released. Flu-Mist is an attenuated virus that is squirted into your nose. Because it is attenuated, it will not give you the flu and are not infectious. This is approved for use on patients aged 2 to 49.
The other is the Flu Shot, usually administered in the upper arm. The shot can cause some mild symptoms like pain at the injection site, low-grade fever, and slight sluggishness. These side effects respond to Tylenol or Motrin. Neither of the vaccines will give you the Flu, though the guy sitting in the next desk swears up and down that the Flu vaccine always gives him the Flu. Both treatments are grown in eggs, so if you have an egg allergy you must discuss this with your doctor to plan a strategy or avoid the injection.
We know that people with impaired immune systems get worse illness. In pregnancy, the immune system is not up to par. Of the 100 or so patients who have required Intensive Care Unit treatment, 28 pregnant women have died. That is why the Flu vaccination (both kinds) is so important for all pregnant females. There have been no adverse effects of Flu vaccination in any pregnant female. Others with impaired immunity have worse Flu illness: Diabetics, people with liver or kidney disease, AIDS, chronic neurological impairment, cancer, and/or chronic inflammatory diseases like arthritis and colitis. And the list goes on and on with chronic medical disease. These are the ones that push the numbers into the thousands for Flu-related deaths and prolonged hospitalizations.
John Drew Laurusonis M.D.
Doctors Medical Center
The 2009-2010 flu seasons was supposed to be "routine." Usually, patients take their seasonal flu shot. Those people who had flu symptoms normally go to the doctor's office for an exam and testing. It is usually easy to spot the flu patients. Among the usual nasal congestion and sore throats, there are certain people whose sickly appearance is really clear. These people usually appear to have just woken up, their hair is mussed, they are unshaven, and they are covered in sweaters or blankets but still shivering. In the doctor's office, they are brought back and examined for signs of the flu or other problems. If their throat is red, they are usually checked for strep throat.
The nasal flu swab, which is an antibody test for types A or B Flu, is available. Judging by the patient's clinical appearance and a positive test for Flu A or B, the doctor might prescribe the antiviral drugs Tamiflu or Relenza to lessen the severity and length of illness. However, 20% of the American population acquired the 2009 flu far. Billions of dollars in lost work productivity and hospital expenses come out of the country's pocket. At least 200,000 patients were hospitalized and there were 36,000 flu-related deaths. On top of that, something new now was added for 2009. The great scientists at the Centers for Disease Control (CDC) in Atlanta maintain careful observation over flu outbreaks all over the world. They test and name each flu. Using this data, scientists try to predict what seasonal flu will appear in the fall. They supervise pharmaceutical companies in the manufacture of the specific vaccine. When the flu scientists reach their prediction on the button, the vaccine is effective in 70 to 90% of recipients under age 65. It is less effective in recipients over 65, recipients who live in nursing homes, and those with chronic underlying illness. The vaccine is about 30% to 70% effective. The usual seasonal vaccine contains attenuated virus of the A (H1N1) and the A (H3N3) variety. There is now a new flu+ H1N1+H3N3 for people over 65 years over age.
A virus is not actually a separate live entity, so when we severely debilitate, we then say in the vaccine "attenuation." A virus is arguably the smallest semi-life form that exists in nature. It only can be seen with an electron microscope. It is called an obligate parasite. This means it must "live" within another living cell. It can only survive and replicate by taking over that cell's complex biochemical machinery to manufacture other viral units like itself. The influenza virus has its RNA taken up by a host cell to begin the manufacture process. Eventually the host cell dies by its viral infection. Influenza viruses were first identified and studied by scientists in the 1930's.
Type A viruses were the worst, and the ones typically producing epidemics and global pandemics. An epidemic is a local outbreak of the flu, usually annually, by viruses that already exist in the environment. It usually peaks in three weeks, and subsides after three weeks, sometimes affecting 50% of the population of that area.
The pandemic is a different phenomenon altogether. It is caused by a mutated virus (changed) to which humans do not have immunity. It can be spread worldwide. Scientists found that they could identify Type A viruses into subtypes by protein structures on their outer surfaces. These are called H (Hemagglutinin A) and N (Neuramidase B). There is no division of a Type B virus into a subtype because they cause milder symptoms and are more sporadic. Type C influenza viruses are not subtyped because they cause even milder symptoms and less evidence of outbreaks. The Type A viruses caused the pandemics of 1917, 1957, and 1967 when millions of lives were lost. The worst year for this was 1918.
Pandemics can be caused by a viral mutation (changed) or the re-emergence of a virus that has not been around for years. All in all, humans lack immunity to that specific virus and cannot fight them. Viruses do not stay in humans throughout the year as they are prevalent in primarily fall and winter. Where do they stay dormant and hide? Scientists discovered that certain coastal birds seem to be the reservoir for the viruses. There is fairly good evidence that the birds harbor these viruses without manifesting disease and have probably done so for millions of years. You may see a television show where scientists raise huge nets to catch migrating coastal birds to see what viruses they are carrying. Therefore, probably all "flu" is, to an extent, "avian" or "bird flu". It is theorized that wild ducks infect domestic ducks, which in turn, either spread it to chickens or swine. Therefore, most of the flu is "swine" flu. You are not going to catch the flu from a piece of pork in your refrigerator.
The current H1N1 seems to have started with a small swine population in a desolate area of Mexico. The American pork industry has been recently affected due to the public not buying as much pork. But this is not the problem. The problem seems to be this one batch of flu that arose in Mexico to which humans did not have immunity. With travel being what it is today, it did not take long for the virus to spread from person to person. It has recently even been announced that a group of swine were found to have the swine flu in Minnesota. It seems that both pigs and possibly chickens have the same viral receptors as humans and thus can be a vector for human transmission. Some people are not getting "Novel H1N1" (the newer name for the 2009 Swine Flu) because they perhaps gain some immunity from previous H1N1 immunization. Most people who saw the outbreak of swine flu in Mexico thought it was too far away to affect them. However, as we know, times have changed. Swine Flu ("Novel H1N1 Flu") is now widespread in most of the United States and elsewhere in the world. You will hear about it on almost every newscast and different government agencies hold numerous press conferences. The amount of daily information is enormous.
The best scientists of our time are saying, "Get your Flu shot when it is available." (Actually they are saying," Get your seasonal Flu shot now and the Swine or Novel H1N1 vaccination as soon as it is available.") On the other side are the "nay-sayers" who say, "The Flu is not as bad as they said. Don't give it to your children: it will give them autism. It has mercury or thimerosal in it. For my part, I'm siding with the CDC: Everybody should have the seasonal vaccination and the H1N1 vaccination. One thing to remember is that it takes time for the immune system to respond to the vaccine for the flu. A conservative estimate is that it takes 6-8 weeks to achieve its desired effect. That is why the vaccine is better if you take it sooner than later. There are two kinds of flu vaccine; more will become available as they are released. Flu-Mist is an attenuated virus that is squirted into your nose. Because it is attenuated, it will not give you the flu and are not infectious. This is approved for use on patients aged 2 to 49.
The other is the Flu Shot, usually administered in the upper arm. The shot can cause some mild symptoms like pain at the injection site, low-grade fever, and slight sluggishness. These side effects respond to Tylenol or Motrin. Neither of the vaccines will give you the Flu, though the guy sitting in the next desk swears up and down that the Flu vaccine always gives him the Flu. Both treatments are grown in eggs, so if you have an egg allergy you must discuss this with your doctor to plan a strategy or avoid the injection.
We know that people with impaired immune systems get worse illness. In pregnancy, the immune system is not up to par. Of the 100 or so patients who have required Intensive Care Unit treatment, 28 pregnant women have died. That is why the Flu vaccination (both kinds) is so important for all pregnant females. There have been no adverse effects of Flu vaccination in any pregnant female. Others with impaired immunity have worse Flu illness: Diabetics, people with liver or kidney disease, AIDS, chronic neurological impairment, cancer, and/or chronic inflammatory diseases like arthritis and colitis. And the list goes on and on with chronic medical disease. These are the ones that push the numbers into the thousands for Flu-related deaths and prolonged hospitalizations.
John Drew Laurusonis M.D.
Doctors Medical Center
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