Disease fatigue
Here comes the flu: beware of 'disease fatigue'
By David G. Sidebottom, M.D.
It's been quite a year for infectious diseases.
In Massachusetts, Eastern Equine Encephalitis has resulted in three human cases, causing a young boy's death and prompting the first aerial spraying for mosquitoes in 16 years. State public health officials report Lyme Disease cases have increased sharply, soaring 44 percent in 2005 alone. Rabies, tuberculosis, and whooping cough are increasing. We've seen the return of measles, resulting in the quarantine of workers locally. West Nile Virus has spread to 47 states through September 15, with 37 states reporting human cases, including Massachusetts. And Avian Influenza, a reality in many parts of the world, still lurks in the background for the U.S.
Now comes the "seasonal" flu (influenza). For our personal and public health, we must remain alert and prepared. It's no time to get "disease fatigue."
The Centers for Disease Control (CDC) estimates that the flu annually hits 5 to 20 percent of the population, claims 36,000 lives, and puts some 200,000 people in the hospital. The flu can have serious complications for those with chronic medical conditions, such as asthma, diabetes, and congestive heart failure.
Three uncertainties the changing nature of the virus, how severely the flu might hit, and the supply and demand of vaccine keep providers on edge and patients confused every year. This unpredictability and the flu's impact in human and economic terms -- one study estimated the annual cost in lost productivity from illness at $48 billion -- are reasons enough to get prepared. So here is the physician's annual, shout-it-out reminder.
The best preparation is to get a flu shot. The supply should be ample, as CDC expects a record 100 million shots to be available this year - more than any other prior season. October or November is the best time to get vaccinated, although December or later is also advisable, as the flu season can last through May. It's also worth the peace of mind, especially for parents of young children and adults concerned about the elderly. Be aware that some people should not be vaccinated children under 6 months of age, people with egg allergies, and others so check with your doctor first.
The flu shot is approved for everyone 6 months or older, including healthy people and those with chronic medical conditions. The nasal spray vaccine is recommended for healthy individuals 5 years to 49 years old who are not pregnant.
CDC has issued new guidelines this year on who is most at risk and thus who should get a shot. One important change: all children 6 months to five years old, along with parents and caregivers of children, are considered high risk and eligible for the vaccine. Check the guidelines at www.cdc.gov and then talk to your doctor. Or call the State Department of Public Health toll free at 866-627-7968 for up-to-date information.
The best advice: Everyone who is eligible to get a shot should get vaccinated. The flu is, after all, both a personal and public health concern. For further safeguards, follow these common sense guidelines:
Practice good hygiene by washing your hands often or using an alcohol gel or hand rub, particularly if you've been out or around people with colds or flu. Avoid touching your eyes, nose, mouth; these are gateways for germs into your body.
Control coughing and sneezing by covering your mouth and never do either in the direction of someone else. These are primary ways that flu viruses spread.
Be cautious with young and old, as children and the elderly are among the most vulnerable to getting the flu. Parents should keep children home if they ill, and refrain from holding or kissing your children if you think you're getting sick.
Be cautious about sharing items that can spread germs and viruses, like straws, drinking cups, glasses or bottles.
The Massachusetts Medical Society offers educational materials on hand-washing - the best way to prevent the spread of infection at www.massmed.org/wash_hands. They're appropriate for all school ages and make good year-round reminders.
David G. Sidebottom, M.D. is Director of the Infectious Diseases Program at Saints Medical Center in Lowell, a member of the Mass. Medical Society's Committee on Quality of Medical Practice, and President of the Middlesex North District Medical Society. Physician Focus is a public service of the Massachusetts Medical Society. Readers should use their own judgment when seeking medical care and consult with their physician for treatment. Send comments to PhysicianFocus@mms.org
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