Influenza: How to combat it

By: Dr. Samayug Bhowmik, Bureau Chief, ICN West Bengal

KOLKATA: Commonly known as  flu, Influenza is mild to moderate in nature but may turn violent and even cause death.In the recent past, when deadly virulent strain appeared in India, it was known as Swine Flu and Bird flu. It has now become a matter of great health concern as it  may transform and develop into deadly lethal influenza strain.

History has shown that the worst incident of influenza was first recorded during 1889-90, named as “Asiatic flu” when it became pandemic and killed about 1 million people worldwide. Again in 1918 an altered Influenza virus attacked 500 million people and killed 50 million which is known as “Spanish flu.

In 2009-10 India witnessed the worst outbreak of the Swine flu, which was renamed as Influenza A (H1N1) by the World Health Organisation (WHO) where nearly 50,000 people were affected and more than 2,700 died. Again up to May 7, 2017 In India had 8,648 of cases of swine flu where 345 patients died as per data from the ministry of health and family welfare of India.

Types of Influenza

Although Influenza is common in our country and comes in every season, the most highlighted and dangerous variants are Swine Flu and Bird Flu in recent past.

It is a contagious respiratory infection and has been prevailing in our country for  more than four decades. The common types of influenza viruses are A, B, C and D. Human influenza A and B viruses causes seasonal disease in general but the emergence of a new, different influenza A virus strain may infect people and can cause an influenza pandemic.

Regarding the type and power of the respective strain, Types A and B are nearly similar. Influenza C infections generally cause a mild respiratory illness and do not cause epidemics. Influenza D viruses primarily afflict cattle and are not known to infect human beings.

The bout of the flu typically lasts for one to two weeks, with severity of symptoms usually subsiding in two to three days. However, weakness, extreme fatigue, dry cough, and a reduced ability to move may persist for a few weeks.

Those highly susceptible:

There are four categories of people who are considered to be at higher risk, hence they are strongly advised to be immunised with Flu/Influenza vaccine. They are:

  1. Children below the age of 5 years.
  2. Pregnant women
  3. Elderly people
  4. People suffering from:

A.Asthma

B.Diabetes

C.Ischemic heart disease

D.Cancer

Common symptoms:

Fever, Cough and cold,Shortness of breath or difficulty in breathing,Abdominal pain or Diarrhea.

What it may lead to and what to do then:

1-Acute breathing distress:  Consult your doctor or hospitalize the patient.

2-Infections in ear, nose, throat and sinuses : Consult an ENT specialist

3-Dehydration: Consult  your doctor and encourages the patient to drink more liquid and ORS drink.

4-Low Blood Pressure : Intake of ORS and fluids.

What you need to know  about :

Swine Flu :-

It is scientifically categorized as H1N1 influenza virus which was first detected in 2009, it was called “swine flu” because the virus was similar to those found in pigs. It is currently found in humans.

Bird Flu :-

It is scientifically categorized as H5N1 Avian Flu (Bird Flu) is a highly powerful influenza virus that has caused serious outbreaks in different parts in our country. This type of influenza is most often contracted by contact with sick or dead chickens mainly from domestic poultry. There are reports of spread from person to another person. The disease has high mortality in humans. About 60% of the total infected people died during the course of illness. Except the above strain, all other Avian influenza viruses rarely infect human beings.

Some FAQs and their answers are given herein:

1- How is Influenza detected?

It is detected by laboratory testing of  swab from throat and/or swab from nasal discharge. by. “Rapid influenza diagnostic test.” although in few cases the result may be false negative results in patients who are suffering with Influenza  and may also give false positive results in cases who are not suffering with Influenza.

The test will provide results within approximately 15-30 minutes.Rapid influenza diagnostic test may able to detect 50-70% of influenza cases.

If the above test result is negative in case of a suspected Influenza victim then  confirmation is needed by the culture of the influenza virus from the sample or a more sensitive molecular test named as Real Time Reverse Transcription Polymerase Chain Reaction (RT-PCR) which is able to detect viral genetic material (RNA) from the swab samples. It is more sensitive and specific test for the influenza. This test detects 60%-100% of cases. Again please note that if a new strain of influenza becomes prevalent in the locality and in the sample the above tests cannot reliably detect the same.

Thus a negative result does not rule out the possibility of Influenza.

2-Then what other tests might my doctor suggest to diagnose my flu-like symptoms?

Doctor may advise a complete blood count (CBC) ,CRP,Throat swab test for streptococcal throat infection, RSV test to check for respiratory syncytial virus,a sputum culture to look for bacterial and/or fungal causes of a respiratory infection. Also other tests may be individualized as per the pre-existing disease profile of the patient.

3-Is there any protection to prevent influenza?

Yes, by vaccination, which is  to be renewed every year.

4-Should everybody get the Influenza vaccination? :

“The Centers for Disease Control and Prevention (CDC)”  recommends that everyone from 6 months old and older get a flu vaccine every year specially the people who are at high risk of complications e.g. young children, the elderly, workers-doctors-sisters of  a nursing home/hospital, pregnant women, and people with pre-existing diseases such as asthma, COPD, heart disease, and liver or kidney disorders, Diabetes Mellitus, and suffering with cancer.

5-Can I still get influenza, if I’ve had the vaccine?

Yes, it is possible to get the flu after being vaccinated as no vaccine in this world will give 100% protection in any individual in any disease. However, if you get the flu after being vaccinated, it is usually of milder variety which leads to quicker recovery. Again please note that a person after vaccination to develop inbuilt protection vaccine takes few weeks (usually 6-12 wks.) to develop specific antibodies. Therefore it may be possible that you may get the attack of Influenza after vaccination within the above latent period .Moreover, if a new strain circulates in your locality which is not in the vaccine already you have, you will not be protected against that new strain of the virus.

6-Why is the vaccine to be taken each year?

Each year, the available flu vaccine is targeted to protect against the expected strains, based on the observations and experience of doctors and scientists. They systematically track the influenza virus circulating worldwide and try to anticipate the future strains that may eventually appear in the future seasons.

As influenza viruses travel internationally in all continents and in all communities side by side with us because now-a-days due our need and urgency we are travelling from one continent to another. It may undergo spontaneous changes in their character and behavior and thus even a previously vaccinated individual may suffer by this new strain and may result in more severe illness.

7-As I may suffer with Influenza again if vaccinated previously then why should I take vaccine?

Actually the vaccine we took previously will protect you over the virus strains which were incorporated on that vaccine and by which your body defence will protect you if you come across with those viral strains but if a new strain develops and if you get contracted with that, you may suffer again.

Therefore if you are a non-vaccinated individual you may suffer with a mixture of old and new strain but if you are vaccinated you will only suffer with new strain

8-Is there any tablet/capsule to prevent Influenza?

Till date no oral tablet or capsule is available to prevent Influenza however if you contracted SWINE OR BIRD FLU and it is confirmed by your doctor with specific laboratory testing within 48-72 hrs of the starting of illness, then some oral antiviral medicines may help .

Finally, my dear readers, I hope, now after reading the above, you are well informed, what to do if you or anyone of your family member  is supposed to have an attack with Influenza.

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