“But Dr. Domino, I don’t get sick that often, why do I need a flu shot?” This has been a common response to my offering the Influenza vaccine. I don’t tire of responding as I do in the title, and watch their expression.
“If you are healthy, and not pregnant, you will probably not die from Influenza this winter. The Influenza vaccine is recommended for everyone over the age of 6 months to keep most of us from passing the infection on to someone who will die from it.”
“Do many people DIE from the flu?” The death rate from illness rarely makes the evening news and is hard to tease out. The CDC states over 58,000 US citizens died from influenza and pneumonia in the US in 2009. A subset of those were people who developed pneumonia not secondary to influenza; most estimate the actual number of people who die in the US solely from an influenza infection to be around 15,000/year.
About 1 in 20,000 US citizens died in 2009 from the flu. Those that die are the very young and those with co-morbidities who die from secondary pneumonia. Small communities have less than 20,000 inhabitants; at least one of your neighbors died. And most deaths are preventable, but only if most everyone gets the vaccine.
These same skeptics will be calling us at 2 AM in mid January, because they are ill and asking for “Theraflu” (they really want oseltamivir, but watch too much TV.) Remind them influenza’s symptoms are not subtle: Temp usually > 101 F, chills, myalgias, rhinorrhea, non-productive cough. They are not typical URI/cold symptoms and low grade fever – the flu makes you feel really ill.
But, even if they have the proper symptom complex, many do not qualify for medications. Anti viral agents are only effective if started within 48 hours of symptom onset and should be reserved for patients most likely to develop a complication: those with asthma, blood disorders, COPD, cystic fibrosis, diabetes mellitus, heart disease, renal and liver diseases, obesity, neurological disorders or HIV. Populations at risk are: age < 2 and > 64, pregnancy, American Indians and Alaskan natives.
And, for the rest of us? Be aggressive with fever control (I use 1,000 mg acetaminophen + 800 mg ibuprofen every 8 hours – YES, they can be given together), fluids, maybe a decongestant, and chicken soup (it can’t hurt).
And, Elderberry Extract Lozenges (175 mg) QID x 2 days (again, if started within 48 hours of symptom onset). These lozenges are available at most pharmacies and health food stores. In 3 small trials, this extract was as effective at reducing symptoms as anti-virals [J Pharmacol Pharmacokin; 2009: 5:23]. It is safe, and may be helpful.
The wisest route is prevention. Get everyone immunized, and if you want to learn more, check out our chapter on Influenza.
- Frank J. Domino, MD
Filed under: In The News Tagged: | death, elderberry, flu, Influenza
Dr. Domino,
unfortunately, giving people an “out” (i.e. you aren’t likely to die from the flu) from the flu shot tends to defeat the point in your last paragraph. Fewer influenza cases around due to massive immunization means that the most vulnerable in the population are less likely to be exposed. The other fact about influenza is that it can pick its victims to kill fairly randomly, including completely healthy individuals who are neither very young or very old. I’ve seen it happen too often to be complacent about not encouraging all people to be immunized, not only to protect those around them, but to reduce their own chance of a life threatening viral illness.
The elderberry lozenges are an interesting tip for symptom control! Thank you!
Emily Gibson M.D.