Winter is fast approaching and the time has come once again for many of us to get the flu vaccine. In fact, it may be all the more important this season as predictions suggest we may be facing one of the most significant flu outbreaks in decades.
In Australia, rather strikingly there has been a more than a doubling of new cases of influenza in the past two months (over their winter period) when compared to last year. This has also been matched by a doubling of cases requiring hospitalisation and also reports of deaths in younger people including an eight-year-old girl and a 30-year-old man.
The virulent strain (H3N2) appears to be responsible for most of the severe cases and has put considerable pressure on Australia’s health service, raising concerns that a similar trend may follow suit in Ireland.
So who should get the flu vaccine? In the US, annual vaccination is recommended for everyone aged six months or older. In Ireland, UK and other countries a more targeted approach is taken focusing on high risk groups.
The HSE recommends vaccination for everyone aged over 65 and in those with chronic heart or lung conditions such as heart failure, bronchitis or asthma. In addition, you should also get the flu jab if you have diabetes, are pregnant, have chronic liver or kidney disease or a weakened immune system.
It’s also crucially important that healthcare workers and those in regular contact with older adults who are more vulnerable to complications get vaccinated.
The vaccine should ideally be administered by the end of October before the flu season begins and takes about two weeks to provide immune protection.
This year’s vaccine is estimated to be about 60% effective in preventing the flu and is based (as predicted by the WHO) on the three virus strains most likely to cause infection. Importantly, even when infecting viruses are not exactly matched with the vaccine, some degree of ‘cross protection’ may be provided which may make the illness milder and help prevent flu related complications. As the vaccine contains inactivated or killed virus particles, it can’t actually cause the flu. However, about 1-2% can develop a fever and mild soreness or swelling at injection site may occur.
Influenza is highly contagious and is spread by dispersion of virus particles from coughing and sneezing. Indeed, the virus can be shed from as early as two days prior to developing symptoms and for up to five days after. Simple strategies like avoiding people who are ill (where possible) and washing your hands regularly will reduce your chance of contracting infection. Covering your mouth or nose when coughing or sneezing (with your elbow) will also help to prevent its spread.
While the common cold is a milder illness resulting in a sore throat and blocked nose as the main symptoms, the flu is much more debilitating giving rise to a high fever, chills, muscle pains, lethargy and headaches.
The virus significantly increases the risk of secondary bacterial infections such as pneumonia, which in at risk groups is the main complication. It can also rarely cause infections elsewhere such as meningitis.
If you are unfortunate enough to get the flu this winter make sure to keep warm and adequately hydrated.
Taking regular paracetamol and ibuprofen as needed will help with fever and pain. The anti-viral ‘tamiflu’ can be considered within the first 48 hours particularly if you have severe illness, as it may reduce the risk of complications
‘At risk’ groups
So make sure to get your flu vaccine if you are in any of the mentioned ‘at risk’ groups. For those aged over 65 and at risk, the vaccine is provided free of charge by the HSE to both GP practises and pharmacies where you can also get vaccinated. Do bear in mind, however that an administration charge may apply if you don’t have a medical or GP visit card.
Finally, if you are over 65, it’s also important to make sure you’ve got the pneumonia vaccine at some point. This provides immunity against one of the most virulent causes of pneumonia due to the pneumococcal bacteria and in most people only needs to be given once in your lifetime. Booster doses in some may be required after five years so you should check with your GP.
Dr Kevin McCarroll is a Consultant Physician in Geriatric Medicine, St James’s Hospital, Dublin.