Are You Ready for Flu Season?

Rarely, I take time out on this blog to discuss regular health issues I find important. I am a proponent of vaccines. I’ve seen non-immunized children suffer the effects of illnesses that they could have been protected against.

While doing an on-line education program for my nursing job, I came across some very valuable statistics that I wanted to share with you. I don’t have an author of the CEU but the company is called CHEX and the module is called Influenza Introduction (v.6.14). The information in this post comes directly from that program to give credit where it’s due.

Did you know that pediatric influenza deaths numbered 830 between the years of 2004 and 2012? Does that surprise you? It surprised me and I work in the healthcare field. When flu season hits, we test for Flu A and Flu B. What’s the difference? Flu A is capable of infecting animals like wild birds. Flu A is also responsible for the majority of deaths in the pediatric category (78%). Flu B is only found in humans and is less likely to cause pandemics. There is also Flu C but infection is usually mild and well tolerated. It is not thought to cause pandemics either.

Of the pediatric deaths mentioned above the mean age was seven. Thirty-five percent died before hospital admission and 43% had no high risk complication (something like asthma.) The majority of deaths were among children who had not been immunized.

The flu vaccine is not perfect. It’s effective in about 60% of cases or has a moderate rate of effectiveness.

The benefits of getting a flu vaccine are decreased illness, decreased unnecessary use of antibiotics, decreased incidence of hospitalizations and decreased deaths.

The age old question is why some people still get the flu despite being immunized. Chances are they were exposed shortly before the vaccine or in the two weeks before they had immunity from the vaccine. They could have gotten a virus that wasn’t covered by the vaccine or they didn’t get an adequate immune response after the shot. I have a personal friend who doesn’t mount an immune response when she gets normal immunizations.

No vaccine is perfect but, personally, I don’t like the risks of not immunizing my children every year for the flu.

What about you? Will you be getting your flu shot this year?

What is Influenza?

Since we’re getting into “respiratory season” I thought I’d do some public service/illness education. Of course, you can always inflict your characters with these illnesses.
Just make sure you pick the right time of year. 
Most often when patients sign in with a complaint of “flu” they are really having vomiting and/or diarrhea. Flu has become a commonplace term for just not feeling well.
If this is the concern you have in bringing your child to the ER they likely have gastroenteritis which is generally caused by a viral infection of the intestinal tract. Your child should be seen in the emergency department for concern for dehydration, if any blood is noted or if they are vomiting bright yellow or green– and this was not caused from them eating a pile of yellow or green crayons.
How do we know you don’t have the flu? Like RSV, flu is a seasonal illness. It comes out to play in late fall and early winter. This is why flu shots are given around September, October and November.
Fine. But it is that time of year. The second reason we know it’s gastroenteritis is that flu is a respiratory illness . . . not an intestinal one.
Influenza is transmitted through droplets by coughing and sneezing. Typical associated symptoms are high fever (generally 102 and up), generalized muscle aches and cough.
In children, what can happen is what we term post-tussive emesis. This is when the child coughs so hard that they trigger their gag reflex and vomit. It’s more a mechanical issue than a viral one.
Do I need to go to the ER? Not necessarily. Fever can be managed with appropriate dosing of acetaminophen and ibuprofen. Remember that ibuprofen should not be given to children less than six months and no aspirin for children under 21 unless specifically prescribed by your doctor. Lots of fluids. Don’t worry too much if they’re not eating but they must drink. They should be hydrated if they are peeing at least every six hours. Don’t just give water. If you have an H2O lover at home at least alternate it with something that has some sugar and electrolytes. This can be Pedialyte or equivalent for children under 2 years and sports drinks for kids over 2. Juices are good but if you are concerned about the amount of sugar you can cut it in half with plain flavored Pedialyte.
Are you getting your flu shot this year?

Primer on Pathogens: Part 2/3

I remember a few years back when H1N1 (the swine flu) hit. Our ED volumes were through the roof. H1N1 affected middle and high school aged kids more than older populations. It was one time that perhaps the elderly were not as affected (perhaps because of years and years of flu shots and being exposed to other viruses.)

I was working with a PICU intensivist who was moonlighting in the ER. These are doctors who work in the Pediatric ICU. He was wicked smart, managed ED volumes well, had an awesome bedside personality and was great with the nursing staff. If you work in healthcare you’d realize these things ALL together in one physician are rare.

H1N1 Influenza Virus

There was becoming a concern about resources. If H1N1 hit as bad as was thought– this is what he said, “There won’t be enough ventilators to take care of everyone.”

That’s not funny.

Have you heard of coronavirus or the one that’s in the news a lot lately: MERS-CoV that’s affecting people near and around Saudi Arabia.

So far there has been 81 confirmed cases and 45 deaths— that’s about a 56% death rate.

That’s high. In medical terms, this would be considered a highly virulent bug. Imagine you’re told you have this virus and you have more than a 50% chance of dying.

MERS-CoV is a member of the coronavirus family. If you remember SARS from a few years back that affected South China and Hong Kong — this is a member of the same family. Consider it a cousin. Death rate from SARS was around 10%.

See what I mean?

Transmission of MERS is from close contact. This generally means you have to be within six feet of someone for prolonged periods of time to contract the bug– like living in the same household or being a medical person caring for a patient.

People present with symptoms of a URI (upper respiratory infection) which would be fever, cough and shortness of breath.

Thus far– there have been no cases in the US.

However, coronaviruses are common but usually not fatal. In fact, the CDC website says most people will be infected at some point in their life.  They were first identified in the 1960s.

Interestingly, the SARS virus mentioned above hasn’t been seen since 2004. Where is it hiding? Will it come back?

The coronavirus family is a good example of the gamut viruses can run that are related. From mild infection to death.

Have you heard of the Saudi Arabian MERS virus? Did you know it had such a high death rate?

To read more about MERS: check out this post.

Here is Part I of the series.

Medical Question: Flu and Pregnancy

Bonnie asks:

My question has to do with one of my characters who gets a deadly form of influenza (swine and avian flu combined) early in her pregnancy. She winds up in the ICU. She survives but then discovers she’s pregnant. She worried about the baby.

What are the possible dangers to the baby?
Heidi says:
The flu is actually more dangerous to the pregnant woman herself than to the fetus. Most women and healthcare providers delay preventative and treatment of the flu because they fear possible effects on the baby. More women in their third trimester of pregnancy die of the flu, than anything else including accidents and domestic violence.
Untreated flu symptoms that can and usually do send pregnant woman to the ICU include such things as high fevers, dehydration, and viral infections. The effects on the fetus include an increase in still births, brain damage, premature birth, and spontaneous abortion. Woman early in pregnancy are at greatest risk for spontaneous abortion. This would be the case for your patient. Treatment of the flu (antiviral’s), is the best thing for this patient, the benefits greatly outweigh the risks.
I encourage all pregnant patients to get the flu shot and to call their health care provider immediately for flu like symptoms. Tamiflu and Relenza work best when given within the first 48 hours of flu symptoms. Always your best defense is a good offense, get your flu shot.
Adelheideh Creston lives in New York. She is former military and married military as well. Her grandmother was a WAVE and inspired her to become a nurse. Heidi spent some time as a certified nursing assistant, then an LPN, working in geriatrics, med surge, psych, telemetry and orthopedics. She’s been an RN several years with a specialty in labor and delivery and neonatology. Her experience has primarily been with military medicine, but she has also worked in the civilian sector.

Heidi is an avid reader. She loves Christian fiction mysteries and suspense. Though, don’t recommend the gory graphic stuff to her… please. She enjoys writing her own stories and is yet unpublished.