Its that time of year again….
John Howard Bryant once wrote “Autumn, the year’s last loveliest smile”. What he neglected to mention was that that smile sat in front of a swollen set of tonsils, beneath a green discharging nose and stuffed, high pressured sinuses. Yes Influenza season is approaching as surely as the leaves turn brown and the AFL kicks off.
“The Flu” is caused by the influenza virus. This virus mutates constantly making it difficult for your body to recognise from year to year. Consequently, someone can experience the flu year after year as they do not carry over immunity from the previous season. Influenza outbreaks occur mainly in the colder months. Queensland sees the influenza season extend from May to October, but really patients can be affected at any time of year. The government collects statistics (Available here)) on how many positive influenza notifications are made each year and this allows them to trace how many people are affected and also to determine which different strains are most prevalent in the state at any one time.
In 2018 there were 15,685 patients identified with Influenza in Queensland
In 2018 there were 15,685 patients identified with Influenza in Queensland; of this 12,670 patients had Influenza A. Last year there were two peaks in prevalence, one in September and one in December. A staggering 1,715 patients required hospital admission due to the severity of their illness and 200 of these patients ending up in intensive care units due to the level of care that they required. If we look closer into these statistics the Gold Coast identified 2,092 cases and a whopping 14.6% (306 cases) of these patients were admitted to hospital. As a comparison there were 3506 notifications for Salmonella and 9551 notifications for Chicken Pox in Queensland. It’s important to remember too that notifications only occur when a patient sees their GP and receives a positive test for the Influenza virus.
Influenza- what is it?
Influenza is an acute infection which effects the respiratory tract causing symptoms such as runny nose, cough and sore throat. There are also systemic symptoms including headache, muscle aches and pains, and fevers. Whilst the patient is affected profoundly in the short term in most otherwise healthy adults the disease is usually self limiting, meaning they are like grassfires and will burn themselves out.
So saying, influenza can vary in its severity and affects certain people more severely. These patient groups include the very young, the elderly and patients with underlying medical conditions or those with any means of immunocompromise. Aboriginal and Torres Strait Islander people, pregnant women, overweight people, and smokers all who are more at risk than the general population.
Transmission modes include sneezing and coughing directly around another person or through contacting a surface that has been sneezed/coughed on
Influenza is spread from person to person by droplet infection. Transmission modes include sneezing and coughing directly around another person or through contacting a surface that has been sneezed/coughed on. Influenza has a 1-4 day incubation period between contracting the virus and when the patient will begin to notice symptoms.
Unfortunately, the virus is reproduces and spreads for 1-2 days before symptoms and than 6-10 days after onset of symptoms meaning that people will continue spreading the virus to others before they even realise they are contagious. Flu spreads very easily through common areas, for example through families, childcare centres, schools and workplaces. Patients usually suffer with weakness, malaise and fatigue, muscle aches, sore throat, fevers, and dizziness. Kids may have gastrointestinal signs as well such as vomiting.
Influenza infection can result in more serious conditions. Complications from influenza include pneumonia, inflammation of skeletal muscles, inflammation of heart muscle, inflammation of the nervous system and death. There is also a link between influenza infection and the risk of heart attack.
Looks like I have Influenza-what now?
If you get the flu first line treatment is supportive management . Stay home! Wash your hands. Use tissues or the inside of your arm when coughing, not your hand. Bin tissues immediately and wash your hands. If you have symptoms stay away from others a minimum distance of 1 metre to try to decrease spread of the virus. Clean frequently touched surfaces ie mobile phones, keyboards, gym equipment etc. regularly to decrease risk of inadvertent transmission. Make sure you get lots of rest, take lots of fluids and use of some over the counter medications such as paracetamol to help manage symptoms such as pain and fever. If you are concerned about your symptoms or those people in the high risk groups (as previously described) should see their GP if they have flu. Here is a leaflet from Queensland Health regarding these recommendations.
How do I avoid getting Influenza?
prevention is better than cure
The most important thing to know is that prevention is better than cure!! Vaccination is the best way to stop the flu. Vaccines protect against getting infected and will reduce the severity of the disease if infection does occur. As discussed earlier the virus mutates constantly in order to try to evade the bodies immune system. Luckily world health organisations can track the different strains of flu around the world and predict, to a certain extent, which strains will be “coming to Australia” each year. Typically vaccinations are produced for the three or four most prevalent strains each year and, provided you get your immunisation, you can avoid the virus!!
Many people who have the vaccination don’t experience any side effects and simply enjoy a flu free flu season
Yes needles hurt, but they hurt less than flu and certainly less than an ICU admission! The common side effects of vaccination include mild pain, swelling at the injection site, low grade fevers, muscle aches and mild fatigue. These symptoms may last for 1-2 days and are self limiting. Many people who have the vaccination don’t experience any side effects and simply enjoy a flu free flu season. As with any medical treatments in very rare cases there are severe side effects. Your doctor should talk to you about these before your immunisation as part of the consent process. In exceptional cases vaccination can cause hypersensitivity reactions including hives, swelling of tissues or a condition called anaphylaxis. An anaphylactic reaction occurs in about 1 in a million cases so it is exceptionally rare however it is also the reason why all vaccination needs to be carried out in a medical clinic as a the doctors and nurses in a clinic are equipped and ready to treat this complication immediately should it arise.
it is important to recognise that the more people who get immunised the less flu is floating around each year
As a final note on immunisations it is important to recognise that the more people who get immunised the less flu is floating around each year. This provides group protection to those in our community who can not, for various reasons, get their own immunisations. These people might include babies, those with known sensitivity reactions and those with severe immune compromise. So you will save yourself the week of work and you’ll help add to the herd immunity of the community and decrease the overall severity of the season.
So like all of Australia, Queenslanders are susceptible to Influenza epidemics and as occurred last year they may happen later in the year than typically expected. For many patient groups the government subsidises the flu shot so see your GP as you may be entitled to a free one. It is very important to vaccinate against this virus, particularly if you fall into a high risk group, in order to have a happy and healthy Winter 2019 while we wait for the lovely smiles of Spring to return.
GPearls on the GC
- Influenza is a serious virus that affects a large part of the population each year
- Flu can end up with the patient in Intensive Care.
- Feline Flu is not caused by an Influenza Virus but by a Herpes virus!