Tue | Jul 23, 2019

Michael Abrahams | Understanding influenza

Published:Monday | April 15, 2019 | 7:45 AM

Last week I received a message from a patient of mine, informing me that she was diagnosed with Swine flu and was resting at home. She also wanted to know if was okay for her to eat pork. I smiled to myself before realizing that it was serious question. I reassured her that it was quite okay for her to do so. A few days later, I saw a news item about a young woman who was infected with influenza. She was pregnant at the time, and as her condition deteriorated, the baby was delivered, prematurely, in an effort to save its life. Unfortunately, the infant died shortly after birth, and the woman succumbed to her illness. Her grieving mother was interviewed, and lamented that before her daughter fell ill she knew nothing about the viral disease.
We are now in our “flu season” (from October to May), and Jamaica is seeing an increasing incidence of influenza, including infections caused by the H1N1 strain. Unfortunately, despite efforts by the Ministry of Health to inform and educate the populace, many remain ignorant.
Influenza, or the flu, is caused by a virus. There are, however, different types of the influenza virus: A, B, C and D. Type D, discovered in 2016, does not infect humans, but the others do. In addition, unlike types B, C. and D, influenza A has over ten different variants, or serotypes, and each serotype can cause different outbreaks. For example, H1N1, a strain of Influenza A caused the Spanish flu pandemic in 1918, and the Swine flu pandemic in 2009, which infected and killed millions of people.
The infection is often transmitted when afflicted persons cough or sneeze, and the viral particles are inhaled, or come in contact with the eyes, nose or mouth of someone who is not infected. When an infected person coughs or sneezes, hundreds of millions of viral particles are released. These particles can be transmitted directly to others, or can remain airborne after being expelled, and be inhaled by unsuspecting victims. Infection can also be transmitted by direct contact with an infected person, such as via a handshake, or by touching contaminated surfaces such a banknotes, doorknobs, light switches or computer keypads.
When one thinks of the ease of transmission, it is a bit scary. For example, picture this scenario. A man with the flu sneezes and wipes his nose with his bare hands. He walks up to an elevator and presses a button indicating the direction in which he intends to go. The elevator arrives, the door opens, and he enters the cabin, which is filled to capacity. Once inside, he presses another button to indicate his desired destination. As the door closes, he sneezes, but does not cover his mouth, and moves to the back where he grasps a rail. This man has the potential to infect not only those in the elevator with him, but also those who enter the cabin after he has left. Yes, it is that easy.
The symptoms of influenza are multiple and include fever with or without chills, cough, nasal congestion, nasal discharge (runny nose), sneezing, sore throat, hoarseness, earache, muscle pain, fatigue, headache, and irritated, watery or reddened eyes. Some persons may develop a rash, and infected children may experience gastrointestinal symptoms such as vomiting, diarrhoea and abdominal pain. Once infected, adults can remain infectious for up to nine days, and children up to two weeks. The symptoms of influenza, especially in its early stages, may be similar to those of other viral illnesses, such as the common cold, and it is best not to self-diagnose, but to see a doctor.

Unfortunately, there is no cure for influenza, and treatment is centered on alleviating the respiratory and other symptoms such as pain and fever. A few antiviral drugs are available that may lessen the severity or shorten the course of the illness. Antibiotics kill bacteria, not viruses, and will not treat influenza. However, if someone with the flu develops a secondary bacterial infection, such as pneumonia or a sinus infection, the drugs may be useful.
The influenza vaccine (flu shot) may prevent infection, and is recommended for high-risk groups, such as children, the elderly, health care workers, and people who have chronic illnesses or are immuno-compromised.
Perhaps even more importantly, in order to minimize the spread of the disease, it is of utmost importance to practice good hygiene, such as frequent and proper hand washing, and not touching your eyes, nose or mouth, in addition to staying away from those who are afflicted. When you cough or sneeze, cover your mouth and nose with tissue, dispose of it and wash your hands. If you do not have tissue, cough or sneeze into your upper sleeve, not your hands.
We cannot cure influenza, but we can decrease its transmission and protect ourselves and those around us.