The Daily Dose 2/26/09

If you have a medical problem, or something is bothering you or a member of your family, The Jackson County Times now has a local physician, Dr. John Spence, of the Panhandle Family Care Associates available to respond to your questions via e-mail.

Dear Dr. Spence,
Please tell me about the flu. I am a health care worker and am concerned about contracting the disease.
Signed,
Hacker

Dear Hacker,
The flu, or influenza, is a virus that is responsible for a substantial number of infections every year in the United States. In fact, is it estimated that 5 to 20% of the U.S. population is affected by the flu on a yearly basis and more than 200,000 people are hospitalized each year for complications related to the flu. More than 36,000 people die annually. It is highly contagious and, therefore, steps at prevention are globally recommended (i.e. flu vaccines).
The flu causes a host of symptoms. I should know as I had it last week! Most prominently, flu is characterized by high fever, often not relieved substantially by ibuprofen or acetaminophen (Tylenol). Other symptoms include sore throat, headache, severe muscle aches, runny or stuffy nose, and fatigue which is often quite dramatic. In my office, the typical scenario is a patient who presents with rapid onset of high fever, malaise, and the feeling that they were "hit by a truck". Complications may include bacterial pneumonia, dehydration or worsening of other disease such as asthma or congestive heart failure.
As it is spread from direct contact with an infected individual or through respiratory droplets, universal precautions such as hand washing are mandatory! A person may pass on the disease to others one day prior to having symptoms and up to five days afterward. Treatment may inhibit viral replication and prevent spread to others and is therefore generally recommended.
More importantly, prevention via vaccination is a must. We typically recommend the vaccines to nearly all patients, though there are certain subsets of the population who are certainly at greater risk. All children age 6 months to 19 should get the vaccine, as should patients over the age of 50 or anyone with specific medical conditions. All healthcare workers, pregnant women and nursing home patients should get the vaccine as well (note to self!). The vaccine consists of an inactivated or killed virus that is given by injection. The Center for Disease Control attempts to predict the particular flu strains for the upcoming year and the vaccine reflects these predictions. Unfortunately, it is never foolproof. Many patients refuse to get a flu shot claiming they "got the flu" after administration. I try to assure them that one does not get the actual flu given that it is a killed virus. It is possible to feel bad and get a "flu-like" illness, but there is a big difference.
For those who are completely needle-phobic, a nasal influenza vaccine does exist. It is a weakened live virus, again incapable of causing flu. It is recommended for healthy non-pregnant patients between the ages of 2-49.

Do you have any medical questions or concerns that you would like addressed? You can contact Dr. Spence by email at panhandledailydose@hotmail.com or by mailing your question to Daily Dose, P.O. Box 6107, Marianna, FL 32446.