They’re Heeeeeere
Posted by WhiteCoat on January 5, 2008
The little influenza bugs, that is.
We saw 7 influenza patients yesterday. According to the CDC’s surveillance map, there is sporadic activity in almost every state. Some states like Texas and Arizona have regional outbreaks. A few states haven’t been hit … yet.
According to the limited available data, there seems to be a good prediction of the strains of influenza likely to hit this year (although the CDC says it is to early to predict exactly how well the vaccine and circulating strains will correlate). A short article on how the strains are picked for the vaccine each year is here. The WHO has to decide which strains to use six months in advance because it takes that long to “grow the viruses in chicken eggs and formulate them into trivalent (three-strain) vaccines.”
There are unfortunately a lot of unsubtyped cases of influenza being reported thus far. I am not sure about the following statement, but believe that there is less immunity afforded from the immunization with the unsubtyped influenza A infections. Two of our seven cases of influenza yesterday had received their influenza shots this year. To the immunologists out there - am I correct on this one?
For a weekly update on influenza activity in your state, go to this site:
http://www.cdc.gov/flu/weekly/fluactivity.htm
Some things to keep in mind about the flu:
- You’re contagious before you even have symptoms.
- If you have the flu, antibiotics (such as amoxicillin and Zithromax) WILL NOT HELP YOU.
- Tamiflu may improve your symptoms and may shorten the course of your disease, but will set you back a good $100 … AND you have to take it within the first 48 hours or it generally doesn’t work.
- Some anti-influenza drugs such as amantadine and rimantadine have been deemed useless against influenza due to the high rate of resistance. Don’t waste your money on them.
- If you are coughing, do so into your arm or elbow. Coughing into your hand and then touching things is a quick way to spread the virus. If you do cough into your hands, cough into a tissue and wash your hands afterwards.
- The best way to keep from getting the flu is to stay away from people who are sick - especially those who are coughing! My usual recommendation to patients is to hold your arms straight out in front of you and have someone else do the same. A perimeter of that distance between you and someone else (3 to 6 feet) is usually good.
- Wash your hands and keep your hands away from your nose and mouth! This is how the virus gets from one person to another.
Some guidelines for infection control from the CDC are here.
Actually, the CDC has an entire web site dedicated to influenza. It is well laid out and very informative.
Of course, the spike in influenza is correlating nicely with all the state election primaries. I feel a little bad for all those political candidates out there shaking hands. Who’s going to catch the flu first?
January 5, 2008 at 7:28 pm
What kind of an idiot goes to the doctor/er/hospital/clinic for the freakin’ flu?
Wait, nevermind. Never underestimate the stupid.
January 5, 2008 at 7:46 pm
ER/hospital, no. Doctor/clinic, yes. How else do you get a script for your Tamiflu? 100 bucks and worth every single penny.
January 6, 2008 at 12:16 am
I feel a little bad for all those political candidates out there shaking hands. Who’s going to catch the flu first?
It would probably be a good idea for people who meet the candidates to wash their hands after shaking hands with them. Politicians can be vectors for disease as well.
January 6, 2008 at 12:53 am
I never got the flu, even after being around people and working in fast food since age 17 4 years ago who may have had it and were too ignorant to stay home. Chalk it up to one damn good immune system. Have to get it this year though.
January 6, 2008 at 3:28 am
Thanks for the post-most informative.
I forgot to ask my doc about the flu shot when I went in with the URI in December.
January 6, 2008 at 6:48 am
We’re getting smothered with flu cases around here.
January 6, 2008 at 10:17 am
Commenter #1, it sounds like you’ve never had the flu. I think a lot of people say they have the flu when they just have a cold. I’ve only had it once, but it knocked me on my ass. The fever, headache, chills, and aches in my legs kept me in bed for days (and I’m tough). Finally I dragged myself to the doctor for antibiotics, and I didn’t feel right for nearly a month. I infected my poor grandmother and she nearly died. The flu is serious.
January 6, 2008 at 12:40 pm
Lisamm…you are so right! I had it 3 times in my life and oddly with the last one even the “skin” on my back hurt. My husband said the same thing.
Then one day while still under the weather but better than I had been,I decided to call someone but called a wrong number. It turns out he was a delightful guy.
I don’t remember what got us talking but it turns out he trained mixed breed dogs that he adopted out of pet shelters to perform in some kind of show and was telling me the places they had been and that they were televised as well. Also that mixed breed dogs are very intelligent. But I digress.
We were discussing the flu and he said he had just gotten over it and then with out any prompting from me said, “Even the skin on my back hurt.” I thought that was interesting and wondered if that was just a particular strain of flu that caused that?
January 6, 2008 at 2:19 pm
In CA, we haven’t had much flu yet, but we have had bumper crop of RSV this year.
January 6, 2008 at 2:32 pm
I’m in CA, and I don’t know what RSV is.. should I be afraid? (Rushing off to lock my doors and windows!)
January 7, 2008 at 12:22 pm
Any tips on how to keep four year olds from sharing germs! I swear my four year old brings home everything under the sun and I end up catching it. I wash my hands any time I touch things. I hate going to grocery stores or outside period because I know some little kid has wiped their nose then touched something. Or put their mouth on the grocery cart! My son’s preschool tells us to keep him home even if he just has a runny nose! Do you know how many parents still send their kids to school? Almost all of them!
January 7, 2008 at 1:01 pm
We did something with my daughter’s Brownie troop when she was in 1st grade that you might want to try with your 4 yr old. We explained what germs were, and how they can make you sick. We then gave each girl a wet babywipe to wipe off their hands (and to get them a little damp). Then we shook glitter onto their hands, explaining that these were like germs. We had them try to wipe them off (they couldn’t). We had them shake hands with us, so they could see how the glitter “germs” would pass to someone else. They then had to go to the sink and really scrub up their hands to get the glitter “germs” off. It was a good lesson and my daughter still remembers it 4 years later.
January 7, 2008 at 8:01 pm
What a great visual Lisamm! I think I will use that.
January 8, 2008 at 2:49 am
[...] some areas of the country that are clearly being affected by the nasty influenza bug. Also blogger White Coat Rants is an ER physician that reports on higher than usual flu activity - click here to read about the [...]
January 8, 2008 at 1:59 pm
Sometimes I almost wonder if abx’s need to just be in the cold and flu aisle at the store, seeing how patient’s will doctor shop or beg til they get them for their viral ailment anyways.