Friday, April 1, 2016

2015/16 Flu season thus far...

No flu season is exactly the same. Some are much more challenging than others.

Most years we have an abundance of vaccine. Other years there is a shortage. Sometimes we end up with an adequate supply but it gets to us so late that we are challenged trying to get all of our patients immunized at the last minute. Every once in awhile the media focuses on Influenza fatalities and if there are vaccine supply issues that season it causes a bit of panic.

Sometimes the vaccine is a great match for the circulating strains. Other years it completely misses. The vaccine reaction varies as well. This makes sense because the formula usually changes every year as the experts try to predict which strains to include. Some years the patients seem uncomfortable and feverish for a day or so after flu shot; other years the reaction is very minimal.

The symptoms of the illness also change from year to year. I recall one season where every other patient was complaining of severe leg pain that lasted several days. Some years the high fever lasted for over a week. In those years, my antenna was way up for those first cases until we could see that this was a common trend.

The year that really stands out was 2009 when H1N1 was the big player. Because it was a strain that hadn’t been seen in most of our lifetimes, everyone was especially vulnerable. Many people, including young adults, were dying. It was terrifying. The H1N1 vaccine was quickly manufactured, but in small quantities. There was no way that the supply was going to take care of the demand. You can imagine that all the parents tried to do everything in their power to get a dose of the limited vaccine for their children. Our phones were insane.

One of the wise moms in our practice suggested that a blog would be the easiest way to communicate quickly with our patients. The blog that year was simply about the availability of the H1N1 vaccine and it morphed from that humble beginning into what it is now. That was how my first blog was born.

This 2015/16 season, the Influenza cases didn’t start showing up until fairly late, but then arrived with a blast. The illness swept through entire families. The brunt of it seemed to be late February through mid March. There are still a few cases showing up but at a trickle now. My heart went out to the poor sick moms and dads in the office who were trying to keep themselves upright while still trying to tend to their ailing kids. There were strains of both A and B circulating. The symptoms didn’t seem to differ all that much from strain to strain. The vaccine was somewhat protective. Reports claimed that it had over a 60% match. One of the most prevalent strains circulating was H1N1. The H1N1 has been included in the annual vaccine ever since it came back on the scene several years ago.
Most of our patients who tested positive this season  had not received the Influenza vaccine this year. We actually only had one official failure (someone with a positive test), but it was that patient's first flu shot season and they had only gotten their first one so far, so they were not fully protected.

One of the moms who got sick told me that she will never again skip getting the flu shot. That is wise, but even with the shot, some folks we talked to by phone, who certainly sounded like they had the flu, were in fact fully vaccinated. Were they quite as sick as the others? Perhaps not. They were still plenty miserable.

The reports also claimed that the rapid office tests had a significant number of false negatives this season. I believe that to be true. I didn't fully trust some of our negative results. Sending the swab along to the lab would give accurate report, but sometimes it isn’t worth the time and expense.

The symptoms that we saw with the flu this season were high fever (103-104), body aches, sore throat, headaches, cough and congestion. Appetites were diminished and energy was wiped out. Many folks also had stomach aches. Typically the course lasted 4-5 days of full fledged misery and then a few more days until the patients were getting back to feeling normal. We have not seen any serious secondary illnesses so far this year (knocking on wood as I type this.)

Some of our patients with an early diagnosis started on Tamiflu (an antiviral medication) and claimed that it helped quite a bit. I had one patient on it who got very agitated, so we opted to stop it. I am not sure if the Tamiflu was to blame or not, but the literature does say that it can happen.

We still have viable flu vaccine in the office, but at this point in the season I probably would no longer bother getting it unless this is your child’s first season and they have only gotten one so far. (The first year of getting flu shots for anyone under 9 is a 2 dose series. The doses need to be spaced at least 4 weeks apart.) In our office, there is no longer an option for flu mist this year; that ship has sailed.

As flu seasons go, there was nothing particularly notable this year. There were mild delays getting the flu mist, but since the flu didn’t show up until 2016, that was pretty irrelevant. With the Influenza, we just never know. Some seasons can really kick us in the butt.

And we get to start the process all over again in August when we get the new vaccine for the 2016/17 season!

1 comment:

  1. Your post was very interesting to me because I once caught the flu from someone who had received the flu shot before getting the flu. At the same time, I have noticed co-workers who get their flu shot never get the flu. I'm considering receiving a flu shot this year (my first time ever!) and will keep your post in mind.