Flu FAQs From the Mayo Clinic: Answers for You
December 18, 2003
By Mayo Clinic staff
For most healthy adults, coming down with influenza (flu) this season will be annoying but not life-threatening. For those at high risk of complications, influenza poses a bigger threat. With vaccine supplies low or depleted, you want to know how you can protect yourself and your family from this illness.
Gregory Poland, M.D., director of the Vaccine Research Group at Mayo Clinic, Rochester, Minn., and president of the International Society for Vaccines, answers some common questions regarding the influenza outbreaks, vaccine alternatives and self-care tips if you do get the flu.
As new questions surface regarding this season's flu, check back here for answers from specialists at Mayo Clinic.
Had any of the people who have been hospitalized for or died of influenza been vaccinated?
Yes. In fact, an elderly woman with emphysema who had the flu shot has died. However, I think it's more likely that the people who haven't gotten the vaccine are the ones who are being hospitalized and who are more at risk of dying. Although there's a mismatch between the vaccine and the predominant influenza strain circulating, the vaccine that we have does offer some cross-protection against the Fujian strain of influenza.
In light of the shortage, is the flu vaccine being rationed?
Until recently, that answer was no. However, on Dec. 11, 2003, the Centers for Disease Control and Prevention recommended that people now be prioritized for vaccination in light of the changing situation.
The first priority for vaccination includes:
Children age 6 months to 23 months
People over the age of 65
Anybody with a chronic medical condition
Women in the second or third trimester of pregnancy
Those with the next highest priority for vaccination are:
Anybody who shares a home with an immunocompromised person
Health care workers
If my doctor or pediatrician doesn't have the flu shot available, how can my child or I get vaccinated?
Be persistent. Efforts to redistribute the vaccine are happening right now. Just because your doctor says he or she doesn't have the vaccine today doesn't mean it won't be available tomorrow.
Consider an alternative to the flu shot. Right now, about 4 million doses of the intranasal spray vaccine (FluMist) are available. Keep in mind, though, that FluMist isn't licensed for use in anyone younger than age 5 or older than age 49.
Beyond the flu shot or nasal spray, the only option is to use antiviral medications (Flumadine, Tamiflu, others) if you develop flu symptoms.
What can you tell me about the nasal spray vaccine?
FluMist is a flu vaccine administered through a nasal spray rather than an injection. The nasal spray is available for healthy people between ages 5 and 49. Because the spray contains a live virus, it's not recommended if you have a chronic medical condition or take anti-rejection medications.
The nasal vaccine stimulates your immune system to build up antibodies to fight off the infection. Your body stores these antibodies, which spring into action if you get the flu.
Possible side effects of the nasal spray include:
Children may also experience fever as a side effect of the nasal spray.
Why do children need two doses of the vaccine? Should I be worried if my child received the first dose but can't get the second dose?
Children age 8 or younger require two doses of the vaccine if it's the first time they've ever been vaccinated for influenza. That's because children don't develop a high enough antibody level the first time they get the vaccine. Antibodies help fight the virus if it enters your child's system.
After being vaccinated for the flu one season, children only need to get one dose a year thereafter. If your child only got one dose of the influenza vaccine this year, he or she will still have some level of protection. However, it's not optimal.
If I haven't been vaccinated, what should I do if I'm exposed to the influenza virus?
If you're exposed to the virus and you fit into a high-risk group — children age 6 months to 23 months, people over age 65, anyone with a chronic medical condition or women in the second or third trimester of pregnancy — consider taking preventive (prophylaxis) antiviral medication (Flumadine, Tamiflu, others). You'll have to take one tablet a day through the remainder of the influenza season.
If you're not in a high-risk group, it's a matter of waiting to see if you develop signs and symptoms of influenza, such as:
Severe muscle and joint aches
As opposed to other respiratory illnesses, you could be treated with antiviral medication, but this has to be started within 24 to 48 hours of developing symptoms to be effective.
If I've been vaccinated, how concerned should I be about contracting the Fujian strain of the flu?
It's still possible that you might get the Fujian strain of the flu. However, the vaccine and the antibodies that it produces are likely to moderate the effects of the illness. So you may have some symptoms, but you likely won't be sick enough to be hospitalized or die of it. Unless you're elderly, frail, have a chronic medical condition or are immunocompromised, you don't have to be overly concerned.
Have other strains besides the Fujian strain started showing up in the United States?
Not all of the cases of influenza are from the Fujian strain. About 70 percent to 80 percent of the strains currently circulating in the United States are Fujian. The other 20 percent to 30 percent are flu strains that are well-matched by what's in the current vaccine. These include a different A strain and a B strain of influenza.
How do this season's death rates from influenza compare with recent years and pandemic years?
It's really hard to say at this point. We've seen influenza peak in a couple of southwestern states, but we're nowhere near the peak in the Midwest or on the East Coast. My guess is we're in for a worse year than most based on what kind of flu strain this is, the season starting earlier than it has in the past 30 years and what we've seen early on in some of the southwestern states. I estimate 50,000 to 70,000 Americans may die as a result of this flu season.
In comparison to pandemic years, it's interesting. Pandemics don't necessarily mean death — they just mean widespread disease. Unfortunately, death is usually a part of the disease. About 34,000 people died in the 1968 Hong Kong pandemic in the United States. Nearly 70,000 people in the United States died in the 1957 Asian flu pandemic. And over 20 million people worldwide died in the 1918 pandemic.
I hear that people with the flu are catching other diseases, such as staph infection. What can I do to prevent that from happening to me or my family?
One of the complications from influenza is developing post-influenza pneumonia from bacteria called Staphylococcus aureus. Such an infection is better known as a staph infection. This is one of the contributing factors making this such a tragic year.
Unfortunately, many of these bacteria are highly resistant to the usual antibiotics used to treat them. If you develop post-influenza pneumonia, in all likelihood you'll have to be hospitalized to receive intravenous antibiotics.
Seek medical treatment if you:
Don't begin to recover after five to seven days of influenza
Start coughing up sputum
Have a fever that isn't diminishing
Are generally getting sicker rather than better
It might mean that you're developing a complication from influenza.
What can I do to lessen my symptoms if I do get the flu?
First of all, don't go to work or to school. That's the worst thing you can do — you don't want to spread a contagious disease to someone else.
Other things you can do to relieve your symptoms include:
Drink plenty of fluids
Take antiviral medication if prescribed by your doctor
Monitor yourself, too. If you start feeling worse, see your doctor to be evaluated.
And next season, when a flu shot is available to you, get vaccinated. Part of the problem with the vaccine shortage this season is the flu vaccine manufacturers didn't want to make too much of the vaccine and have it go to waste because the public didn't use it all. Consider getting a flu shot every year from now on to prevent epidemics like this.
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