Naval Hospital Bremerton Providing for Feverish Flu Season

By Douglas H. Stutz, Naval Hospital Bremerton Public Affairs

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This particular flu season has already made headlines. So far there have been 16 laboratory confirmed fatalities attributed to influenza reported in the state of Washington.

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All age groups should be protected by receiving the influenza vaccinations, whether young and healthy or older with chronic illness.

According to Tom Shirk, NHB Infection Control coordinator, “Most of the deaths have been in middle to older aged people who have had medical conditions that made them more likely to develop pneumonia. While the current influenza vaccine may not provide full protection against the drifted virus it will help reduce severity of illness and symptoms. It is really very important to emphasize that all age groups should be protected by receiving the influenza vaccinations, whether young and healthy or older with chronic illness. This influenza season is somewhat unique due to an unexpected genetic drift in one of the primary circulating flu viruses.”

Capt. Mark Malakooti, NHB Preventive Medicine physician genetic says drift in a flu strain is due to natural changes in the circulating virus the last few months.

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The vaccine does provide protection against H1N1 and B strains of influenza virus, further reducing someone’s chances of getting a flu infection and illness.

“If someone has been vaccinated with the current 2014/15 flu vaccine, there is no need to get another one for this season, not until next fall when next year’s vaccine becomes available. It is true that one of the three current vaccine components, the H3N2 one, does not exactly match the H3N2 strain that is making most people sick this flu season, but the vaccine will still provide some protection against H3N2, and some studies show that vaccination may reduce the severity of illness if someone gets infected with the influenza despite having been vaccinated.  The vaccine does provide protection against H1N1 and B strains of influenza virus, further reducing someone’s chances of getting a flu infection and illness.

He also said, “It’s important to keep in mind that past experience shows that H3N2 dominated flu seasons like this one are more severe, have higher rates of hospitalization and more deaths. Experts agree that vaccination is still the best protection.”

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Pregnant women are also at higher risk of severe influenza if they get infected, as are adults 65 and older and people who have medical conditions.

NHB’s seasonal influenza vaccine immunization program was held this past fall with a week-long Influenza vaccination clinic, specifically designed for Sailors and Marines, mission-essential healthcare personnel, and eligible beneficiaries. More than 4,500 took advantage of the clinic, a 10 percent increase from the previous year.

For those who missed that opportunity, they can visit NHB’s Immunization Clinic at the main hospital and Branch Health Clinics that offer injectable and, for healthy patients between 2 years and 49 years of age, intranasal flu vaccine (while supplies last).

“We are still providing the flu vaccine to our beneficiaries. They do not need an appointment to go to the Immunization Clinic in Family Care Center between 8 a.m. and 4 p.m., Monday through Friday. While no vaccine is 100 percent effective, the current flu vaccine will greatly decrease the chances of influenza infection, and if someone does still become infected, they are less likely to have severe symptoms,” stated Malakooti.

Malakooti cites U.S. Centers for Disease Control and Prevention recommendation that everyone, even those as young as six months, get the influenza vaccine each year.  It is especially important for those at greater risk of severe infections.

“Anyone can become infected with the flu virus, but those in certain categories are more likely to become severely ill with influenza or even die from the infection. Children less than six months who are too young for flu vaccine and with not yet fully developed immune systems, are at high risk. Therefore, it’s very important for anyone who has contact with those children to be vaccinated, to reduce the risk of exposing the child to infection. Pregnant women are also at higher risk of severe influenza if they get infected, as are adults 65 and older and people who have medical conditions such as asthma and other lung diseases, heart disease, diabetes, weakened immune systems due to disease or medication and other chronic conditions. It is important for all these people to get their flu vaccine ever year.”

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Alcohol hand sanitizers are very effective against flu virus.

Dr. Dan Frederick, NHB Population Health and Forecasting expert, points out that the value of vaccinating the pregnant population is multiplied because of the cocooning protection to the newborn when mom (and other close household contacts) are vaccinated. Just as it is important for military personnel who live and work in close quarters to receive the vaccine, it is also highly recommended for school-aged children, as they come into close contact with each other and can easily spread the influenza virus.

For those with flu-like symptoms such as fever, sore throat, body aches and pain, Malakooti says they should stay home and rest to recover quicker and prevent spreading the infection. Drink plenty of non-alcoholic/non-caffeinated fluids, cover coughs/sneezes, wash hands frequently, and use an alcohol-based hand sanitizer.

“And get their immunizations! There are (also) prescription antiviral drugs that can be used to treat flu illness and prevent serious flu complications, especially for people in the high risk categories. If someone who is high-risk develops a fever during the flu season, even if they have been vaccinated, they should see their doctor/provider as soon as possible to discuss best treatment options. The sooner the oral antiviral is started, the more effective it can be,” said Malakooti.

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Influenza is not the common cold. Influenza can be a severe to life-threatening disease.

Shirk attests that alcohol hand sanitizers are very effective against flu virus, but notes that most people in an attempt to conserve their bottle of hand sanitizer, often use too little to be effective.

“As a guide, enough hand sanitizer product must be spread thoroughly covering all hand surface so that the hand feels wet for approximately 10 seconds. If your hands immediately feels dry, then too little product was dispensed. And for the sake of all of us, we encourage everyone to please cover their cough, but not with their hands! Contaminated hands are one of the primary ways in which influenza is spread to surfaces that everyone then touches,” Shirk said.

Influenza is not the common cold.  Influenza can be a severe to life-threatening disease and getting an annual influenza immunization (either the traditional shot in the arm or the newer nasal spray vaccine) protects many people from getting the disease or becoming severely ill.

Influenza is thought to spread mainly from people touching something with influenza viruses on it and then touching their mouth or nose.  One of the challenging aspects of flu is that someone who becomes infected can infect others one day before they have symptoms and up to five days after becoming sick.  Influenza usually causes mild to severe illness, and uncommonly can lead to death.  Symptoms of influenza include fever, headache, extreme tiredness, dry cough, sore throat, chills, runny or stuffy nose and muscle aches. Stomach symptoms such as nausea, vomiting, and diarrhea also can occur but are more common in children than adults. Traditionally, seasonal flu impacts the elderly and the young.

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Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick.

“I encourage parents to get a thermometer for home-use if they don’t have one already. If a family member is running a fever of 100.4 or greater has a cough and/or sore throat then it is very possible that they have influenza,” said Shirk. “If anyone is concerned that their symptoms are not consistent with a mild case of the flu, they should contact their medical provider and/or seek medical attention. For those with mild symptoms recovering at home with over the counter medications for symptom relief is usually all that is needed.”

Compiled statistics by CDC show that every year in the United States, more than 200,000 people are hospitalized from influenza complications and about 36,000 people die from influenza-related causes.

According to Malakooti, the precise timing of any flu season’s peak is hard to predict, and can also vary in different parts of the country and each season. Seasonal flu activity in the U.S. can begin as early as October and usually subsides by April, with peak flu rates somewhere between December and February.

“This season we saw the incidence increase rapidly in December with infections now widespread across the country,” said Malakooti.

“Our past experience with any type of flu strain reinforces the continual need to protect ourselves,” said Shirk, who also recommends for everyone to continue proper personal hygiene at all times. “It’s the little things that add up to the whole. We know it’s important and it’s up to us to not only set the example, but ensure our family and friends do the same.”

General information of seasonal influenza can be found at http://www.cdc.gov/flu/.

What can people do to protect themselves against the flu virus? 

Naval Hospital Bremerton follows CDC recommendations to:

  • Avoid close contact with people who are sick, when you are sick, keep your distance from others to protect them from also getting sick.
  • If possible, stay home from work, school and errands when you are sick.  You will help prevent others from catching your illness.
  • Cover your mouth and nose with a tissue when coughing or sneezing.  It may prevent those around you from getting sick.
  • Washing your hands often will help protect you from germs.
  • Avoid touching your eyes, nose or mouth.  Germs are often spread when a person touches something that is contaminated with germs and then touches his/her eyes, nose or mouth.