Optimal Health Newsletter November 26, 2006
The ‘Flu’- 2006
Introduction
This issue of OHN (Optimal Health Newsletter) will deal with influenza, or, ‘the flu’. This is a topic of great interest, lots of publicity, and oftentimes a lot of ‘hype’. As those of you who are reading this know, my main interest in medicine at this point in my career is primarily in preventive and nutritional features. Therefore the focus of much of this newsletter is on these aspects.
At this time of year (Fall and early winter) there is a great deal of discussion about influenza, particularly in regard to whether or not to obtain a vaccination against the illness. For most people, most of the time, a bout of influenza is an inconvenience and uncomfortable but is not a major health situation. Although this is the case in most healthy individuals, there are situations where this is not the case. Particularly, when making decisions about whether or not to obtain a ‘flu shot’, it is important to consider many factors. These are discussed below. Further individualized questions, beyond the scope of this newsletter, should be addressed to Dr. Young or your health care provider.
Flu shots are available at our office at the present time. I would recommend that you read through this newsletter, consider your individual situation, and make a decision. Dr. Young and staff are available to discuss any questions you may have related to influenza and the vaccine.
Influenza - What is it?
Influenza is a viral infection that is transmitted from one person to another, most commonly during the winter months between December and February (the ‘flu season’). The main modalities of spread are probably hand to hand and airborne. The most effective proven method of prevention is adequate hand washing.
Typical symptoms, present in virtually every case, are body aches, weakness, and fever. Cough and sore throat very commonly accompany the illness. Since other respiratory infections, such as ‘colds’, are also more common during the winter months it is sometimes confusing to people whether or not they have ‘flu’ or a ‘cold’. Because of treatment options, this is an important distinction (it will be discussed further in paragraphs which follow). In almost every case, if fever and body aches are not present, the illness is not influenza. With influenza, it is not unusual to be ill enough to interfere with activities such as work for several days. Typical symptoms last for about a week although the sensation of weakness can persist longer
It is important to realize that influenza can be a very significant and disabling condition. In some cases it can even be fatal, although these cases are generally in older individuals with poor underlying health. Oftentimes there will be ‘outbreaks’ in a community or region where many individuals will become ill during a period of a few weeks. When this happens medical facilities oftentimes become inundated with persons seeking acute care. Hospitals can become overcrowded with admissions of the more seriously ill. While these outbreaks are not unusual during ‘flu season’ the severity can fluctuate year to year depending on the virulence of the circulating influenza strain. Each year the genetic strains of the influenza virus vary to some degree. The variance is generally not great and many individuals who have previously had the flu will retain at least some partial degree of immunity to the newer strains. These individuals generally will either not become ill at all or will have symptoms of a lesser degree.
At much greater intervals, oftentimes decades apart, there will be major ‘shifts’ in the genetic composition of the influenza virus and virtually no-one will have any prior immunity to the new strain. When this occurs the infection can rapidly spread world-wide. These situations are referred to as ‘pandemics’ and have major health and associated economic significance. When a pandemic occurs there is a dramatic increase in both the numbers of people who become infected and the severity of the illness. Well known examples of historically significant pandemics are the Spanish Influenza of 1917-18 and Hong Kong flu in 1958. At the present time there is no indication from worldwide testing sites that there has been a major antigenic shift that would lead to a pandemic situation. The ‘Bird Flu’ situation that exists in Southeast Asia, although it has aspects that could (or could not) lead to a pandemic, to this point has not been shown to be transmissible between humans except in the rarest of circumstances.
In most healthy people influenza is a self-limited, non-life threatening illness Nevertheless, there are exceptions, and each individual must consider their own situation and factors.
Prevention of Influenza
Before beginning a discussion of the pros vs. cons of flu vaccines, anti-viral medications, or immune enhancing modalities such as supplementation, I want to mention that, irrespective of any other measures taken or not taken, frequent hand washing during the flu season has been shown to be the most important single factor to prevent acquisition or transmission of the influenza virus.
Flu Vaccine(s)
There are two types of influenza vaccine, injection (flu shot) and nasal spray. The injection form is a killed vaccine that resembles the circulating virus. The nasal spray is a live virus of a similar, but benign, structure. This discussion relates to the injection mode although much of the information is similar for both forms of the vaccine. Since influenza is a viral illness we do not have the same treatment options available that exist for a bacterial illness. Although there are a few anti-viral medications available (discussed below) they are generally not as effective as antibiotics can be for bacterial infections. Prevention, important in all health conditions, may be even more so in the case of influenza. Immunization via a ‘flu shot’ is a popular option for prevention.
Since generally, influenza outbreaks don’t begin until late December or January, the question at this time of year (fall and early winter) is really ‘who should get the flu vaccine?’ Many of us have gone for years without symptoms of flu, so why, we think, should we get a vaccine now? – maybe we are immune and don’t need it. As discussed above (and below), there is no absolute answer to this question and each person must make this decision according to personal factors.
I don’t think that anyone would question the fact that individuals who have significant underlying health conditions should receive the flu vaccine. Primary among this group would be individuals with emphysema (COPD) or other chronic pulmonary conditions. For these individuals, an episode of influenza could ‘tip the boat’ and cause significant and very serious health consequences. Other at-risk groups include older (what’s that anymore?) individuals where the reserve capacity of the lungs is diminished through the process of aging. In these situations influenza infections can have more serious consequences and recovery can be more difficult than in a younger person who has greater reserve lung capacity. It is up to each individual to decide how they fit into this picture. In general, however, persons in their 70s or 80’s+ generally fall into this group. Also, those who are routinely prone to flu or other respiratory infections may be more susceptible and should consider receiving the influenza vaccine. Health care workers should receive the vaccine so that they don’t accidentally transmit the infection from one patient to another. Individuals for whom missing work would be a significant issue should consider obtaining a flu shot since it statistically reduces the likelihood of infection (so does taking multivitamins, by the way).
The influenza vaccine is scientifically formulated about nine or ten months in advance of the winter flu season. The composition of the vaccine will differ year to year based on the strains of influenza that are circulating or expected at that time. If an unexpected strain of influenza appears after the vaccine has been made and distributed it will not provide protection against these newer strains. In these situations a person may still become infected with the flu even though they have received the vaccine.
About 10% of the people who receive the vaccine have a mild ‘flu-like’ illness following the shot. These side effects can begin several hours after immunization and may last for 2 days or so. If you have experience this previously, yet still feel you should receive the vaccine, it can be administered in half doses administered one month apart. Personally, I have never seen an individual have an adverse reaction to the flu vaccine when administered in this manner. Although the immunization may cause some ‘flu-like’ symptoms, the vaccine is a killed sterile organism and cannot cause influenza infection per se. Since it is manufactured on an egg medium, persons who are allergic to eggs should not receive the vaccine. The current flu vaccine contains a trace amount of the mercury containing substance, Thimerosol. At the present time there is no available vaccine that is free of these trace amounts of mercury.
There is an internet site that monitors the level of influenza in the United States. You can sign up to receive their ‘alerts’ for your area by going to their website: https://www.flufacts.com/know/emailalerts.aspx
Anti-viral medications
Anti-viral medication can be used to both prevent and treat influenza infection - For individuals where prevention is necessary, but who cannot receive the flu vaccine due to adverse reactions, it is possible to take an anti-viral medication on a daily basis such as (Amantadine / Symmetryl). This is an effective method of preventing infection with Type A strains of influenza. The dosage must be adjusted to age and body size since it is possible to experience some confusion side effects with this medications.
Influenza can be treated using anti-viral medications.l. Treatment is limited somewhat by the need to start early, within two days of the onset of symptoms. Oftentimes persons do not realize that they have the flu until several days have passed since the onset of symptoms. Nevertheless, if the illness is severe, anti-viral medication can be of value. There is often a temptation to take antibiotics when a person has the flu but these will not have an effect against a viral infection. Oftentimes, even though the primary infection is viral, a secondary bacterial infection can develop due to congestion and increased respiratory secretions. In these situations antibiotics can be useful. This is a decision that is best made in conjunction with a health care professional.
Supplements and prevention of influenza
As far as preventing the development of illness, much can be said for specific supplements which enhance the immune functions of the body. As stated in previous OHN editions, a basic good quality vitamin-mineral supplement should be a part of everyone’s daily regimen. Many of these substances profoundly enhance our immune defense systems. The antioxidant vitamins, especially Vitamins E and C, are particularly important. Trace minerals play significant roles in enzymes related to immune function. In addition, the following natural supplements can enhance the ability of our innate immune capability against viral and other infections:
Beta Carotene; a precursor to Vitamin A which is crucial to the defense of the respiratory epithelium. Vitamin A has been used for many years as a natural defense against viral and other respiratory infections. If taken in the Beta Carotene form there are no side effects or contraindications to large doses (up to 100,000 units/day)
Vitamin C – necessary in large amounts during times that the body is fighting (or defending itself) against infection. A good basic preventive amount during the winter flu season would be about 2000 mgm (milligrams) daily, increasing to 5 to 10,000 mgm/day (5 to 10 grams) if signs of infection develop. This amount of vitamin C is best spread over the course of a day. If gastrointestinal symptoms develop (excess gas, diarrhea), reduce the amount to a level where these symptoms do not occur.. If you are fighting a viral infection it is unlikely that you will develop diarrhea or other problems with large doses of vitamin C. When the illness resolves you can cut back to 2-5,000 mgm/day as a health maintenance amount.
Herbal supplements such as Olive Leaf Extract, Echinacea, and Goldenseal can enhance the function of the immune system and help to fight off viral infections. My personal favorite is AIE10 (AG Immune). Call our office if you have any questions regarding any of these substances.
The most typical type of flu encountered in winter is the ‘Type A’ influenza virus.
As mentioned, this typically causes symptoms such as fever and severe generalized body aches. A person with Type A influenza can be quite ill, generally sick enough to not be able to go to work. At this point, vaccination is too late, but the infection can be treated with several prescription medications. If you develop these symptoms, and feel just terrible, don’t make the mistake that many do and think that ‘nothing can be done’. You do not have to ‘ride it out’. Prescription medication is available that can help significantly. Additionally, in our office we have other alternative modalities available that can be quite effective at terminating viral and bacterial infections.
Again, the best defense against infection is to maintain your optimal health. Take lots of vitamin C (5 – 10 grams/day) along with your regular vitamin/mineral supplements. Consider taking herbal immune enhancing products during the flu season (Olive Leaf extract, Echinacea, etc), drink 8 – 10 glasses of pure water a day and get to bed before 10PM on a regular basis (this is when a large part of our immune system regenerates itself).
As mentioned at the beginning of this newsletter, the flu vaccine is currently available at our office. If you decide that this immunization is appropriate for you it should be obtained in the fall or early winter.
Again, please feel free to contact our office if you have any questions related to the material discussed in this newsletter.
Best regards,