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CommentaryPreventive MedicinePrimary Care

Flu Is Here

By December 10, 2014February 21st, 2020No Comments

Influenza aerosol Influenza A cases are now being reported in New England. We have not yet ourselves seen one, but they will be coming soon.  Three issues to understand and act on:

Get Your Flu Vaccine

We still have 25% of our members who may be at risk, because we did not give you the vaccine ourselves and you have not yet let us know that you had it elsewhere. You probably read that the influenza A strains chosen for this year’s vaccine are not optimal against the actual prevalent strain, so even the flu vaccine most of you have received may not be fully effective. The current vaccine will, however, be effective against many influenza A strains and as well against the influenza B strains more prevalent in the springtime. So, I still strongly think it helpful and important to get the vaccine, following the Rumsfeld principle: You go to battle (influenza) with the vaccine (army) you have. You can come to the office most any time. Please call and come.

The quadrivalent vaccine we administered to most of you is the best available. To those over 65, we gave the high-dose version, which has four times the potency of the two influenza A strains, but just one influenza B. There is no better vaccine available for this year for anyone.

Call Early for Any Flu-like Illness

Please contact us and come in promptly for any upper respiratory illness that might be influenza, characterized by high fever (over 101F), severe cough, muscle pains and weakness. We will examine you and do a rapid antigen test to see if you have influenza A (or B), and then would initiate treatment with Tamiflu that day. Tamiflu (generic oseltamivir) is an antiviral that has modest but worthwhile efficacy to reduce the severity and duration of influenza by perhaps a day, providing it is initiated within the first two days of infection. Side effects are mainly mild central nervous system symptoms such as dizziness or nausea. We would prefer to get the required nasal swab test and not prescribe without a brief exam, since influenza can be highly serious and be followed by bacterial pneumonia.

Personal Precautions

Influenza is spread by aerosol (droplets) through cough and sneezing and through contact with secretions on hands and mouths. Please take obvious precautions of covering your mouth with your arm (preferable) or hands when you cough or sneeze, keeping away from others if you are substantially sick, using careful handwashing, and avoiding handshakes (use elbow bumps) when sick. Personal surgical masks are available and reasonable to protect others if you are out and about and sick, and can be considered to protect yourself if you are well in a sea of coughers. The Japanese do this all the time. They may be on to something.


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