On January 9, 2019

Flu season is underway


It’s no fun to be sick, especially with the flu! But the season is upon us. Protect yourself!

The year 2018 marked the 100th anniversary of the 1918 influenza pandemic, known more infamously as the “Spanish flu.” That pandemic killed 675,000 Americans and more than 50 million people globally. Since then, efforts to improve flu preparedness have changed significantly. Yet, flu still affects more than 3 million people in the US every year and it is still deadly.

Last flu season, more than 80,000 people died, according to the Centers for Disease Control and Prevention. Last year’s flu season was the most severe in decades, according to federal health officials.

Benjamin Lee, MD, is a pediatric infectious diseases physician at the UVM Children’s Hospital. He is also a researcher at the Vaccine Testing Center at the University of Vermont.

Q&A with Dr. Lee

What does influenza do to the body and why is it deadly?

Dr. Lee: Influenza is a respiratory virus and a significant cause of acute respiratory illness. In temperate climates, the flu season occurs in the winter months. High fever, cough, headache, sore throat and severe body aches are the most typical symptoms.

It’s deadly for a number of different reasons. First, there are a number of severe complications that can result from an influenza infection, the most feared of which is pneumonia, which is infection and inflammation within the lungs. The virus itself can cause pneumonia, but it’s also now well-recognized that people who have the flu are at much higher risk for getting a secondary bacterial pneumonia.

Finally, a number of underlying medical conditions may predispose someone to a more severe illness and difficulty fighting off the infection.

What’s the difference between a cold and the flu?

Dr. Lee: The most common difference is that the flu tends to be much more severe and tends to have a much more rapid onset. Fever is usually present and the symptoms come on very suddenly. The classic description of feeling like you’ve been hit by a truck is very fitting for influenza.

The common cold tends to be a bit more gradual. You may feel a little under the weather and then the next day a little bit worse, but the onset usually is not as rapid and the severity of the symptoms are usually not as intense. Fevers are less common with a cold, at least in adults. The symptoms generally tend to be upper respiratory symptoms, so nasal congestion, runny nose, sneezing, a bit of cough, et cetera. The most severe symptoms we generally tend to see with the flu.

Now, certainly there can be a little bit of overlap, but if you feel like you’ve been hit by a truck and you have a high fever and cough during the winter time, most likely that’s the flu.

How quickly does the flu spread?

Dr. Lee: It can spread very rapidly, especially in areas where there are a lot of close contacts, such as in schools or other crowded settings.

Flu generally spreads person-to-person via respiratory droplets. Coughing and sneezing expel respiratory secretions and direct contact with these secretions is how the next person gets infected. Simple precautions make a big difference:  like sneezing or coughing into your elbow or shoulder and washing hands frequently.

Why is the flu shot important?

Dr. Lee: The flu shot is vital to our efforts to combat influenza because it remains the single most effective way to prevent flu infection.

Now there are a lot of misconceptions about the flu vaccine. We recognize that the current versions of the flu vaccines are not perfect; however, they do work and they are effective at both preventing influenza and importantly, even if somebody catches influenza after vaccination, we know that it helps prevent some of the more severe complications. So, it both prevents the flu and, in individuals who have the flu, it may prevent or decrease the severity of the illness.

What are some misconceptions about the flu shot?

Dr. Lee: One of the most common is that you can catch the flu itself from getting the flu vaccine. This is inaccurate and it’s simply not true. The reason I feel so confident in saying that is that all flu shots only contain either a completely inactivated or killed virus, or only specific influenza proteins. What that means is that the contents of the vaccine cannot cause an infection.

Sometimes what can happen is somebody can experience side effects that could be common to getting any type of shot, such as a sore arm, a low grade fever, a little bit of achiness, that sort of thing, and that gets mistaken for the flu.

Anybody who’s had a true rip-roaring case of flu would recognize the difference between how sick they felt with the flu versus a little bit of discomfort they may have had for several days after getting the shot.

What do you say to healthy adults who do not get the flu shot?

Dr. Lee: The first thing that I would say is that if you did not get the flu shot and didn’t catch the flu, then that means you got lucky. I don’t think relying on good luck is necessarily the safest health strategy.

Anybody can get infected and anybody is at risk for severe complications. A classic example is secondary bacterial pneumonia due to a bacteria called Staphylococcus aureus, or Staph aureus. For whatever reason, these specific types of pneumonia tend to affect younger and healthier patients when they have the flu. They can be devastating and deadly illnesses.

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