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Fading Out: Aging and Beyond RSS feed

The flu: what you need to know

assembled by Pat McNees, updated 4-23-24
A Guide to the Seasonal Flu for Seniors (National Council for the Aging)
Flu Shots (elsewhere on this website)
Influenza virus in China remains potential pandemic threat (Bara Vaida, Covering Health, AHCJ, 12-5-18) A strain of an influenza virus now circulating in China remains a potential pandemic threat while many gaps remain in preparing for such an event, a group of global health experts at the National Academy of Sciences (NAS) warned last month. The virus spreading in China, called H7N9 (flu virus names reflect their protein makeup) first emerged among poultry workers in 2013 and has sickened 1,567 people and killed 615.
A Century After the 1918 Flu Pandemic: Why Are We Still Concerned Today? (National Academy of Medicine event, 11-26-18) Webcast said to be available.
In the Flu Battle, Hydration and Elevation May Be Your Best Weapons (Kate Murphy, NY Times, 1-12-18). A good explanation of how the flu works and how to deal with it. Drink a cup or so of water or other liquid every hour, and avoid alcoholic and caffeinated beverages. Over-the-counter medications that suppress your cough and dry your sinuses may not be the best idea; you want to get rid of the infection. 'Although you want to rest, lying flat all the time can be problematic because it collapses your lungs so you can’t cough as efficiently, trapping bacteria in your respiratory tract. If the virus destroys enough cells in your bronchial tubes it creates openings for bacteria to get into your lungs, which can lead to pneumonia, a potentially life-threatening complication of the flu. When your lungs are vertical rather than horizontal, “you’re able to breathe deeply and freely and you’re able to cough out any inadvertent material, even microscopic bacteria, that get down into bronchial tubes,” Dr. Schaffner said.'
• ****Despite push for a universal flu vaccine, the ‘holy grail’ stays out of reach (Helen Branswell, STAT, 3-5-18) There is some momentum, but we're not even close. "[I]t isn’t clear if antibodies are enough to protect against flu. It could be that other parts of the immune arsenal — T cells, for instance — have to be harnessed if a vaccine is to be more broadly effective. There are also many questions about the impact of 'imprinting' on our ability to respond effectively to flu vaccines. That term refers to the shaping of each individual’s immune profile, created by the flu viruses each of us encountered, both through infection and vaccination — and the order in which they happened. It’s thought, for instance, that we will always generate the best response to the type of flu virus that triggered our first infection.)" "Monto thinks moving away from the need to vaccinate annually could improve the impact of next-generation vaccines. There are many complexities, such as the repeat vaccination question, that stand between us and those better flu vaccines." I recommend you read the full article.
• ****We're underfunding research on vaccines that may be able to prevent another terrible flu season (Henry I. Miller, LA Times, 1-19-18) "Since the 2004-05 season, the flu vaccines' effectiveness has varied from 10% to 60%. This year, the vaccine is an especially poor match, in part because what's going around is predominantly a virulent strain called H3N2. Although that strain is targeted by this season's flu shot, most of the vaccine is prepared from fertilized chicken eggs, a method known to reduce its effectiveness against certain strains, particularly H3N2....Regulators could encourage manufacturers to stop using chicken eggs and instead prepare vaccines in "cultured cells" — cells that are removed from animals and grown in controlled conditions."...The federal budget for flu vaccine research is meager compared with $1 billion spend to develop HIV vaccines and the many billions spent on vaccins for the Zika and Ebola viruses. (A vaccine specialist explains what needs to happen.)
Why People with Flu Should Stay Home from Work (Terry Graedon, The People's Pharmacy, 2-15-18)
Influenza (Flu) (Centers for Disease Control, CDC)
Despite push for a universal flu vaccine, the ‘holy grail’ stays out of reach (Helen Branswell, STAT, 3-5-18) And there are reasons.
The Startlingly High Cost of the ‘Free’ Flu Shot (Phil Galewitz, KHN, 11-19-19) The Affordable Care Act requires health insurers to cover all federally recommended vaccines at no charge to patients, including flu immunizations. Although people with insurance pay nothing when they get their shot, many don’t realize that their insurers foot the bill — and that those companies will recoup their costs eventually. Typically, health insurers’ reimbursements to private health providers are closely guarded secrets. The insurers argue secrecy is needed for competitive business reasons.But there’s one place those dollar figures appear for anyone to see: the “explanation of benefit” forms that insurers send to members after paying a claim.Cigna paid $32 to CVS for a flu shot in downtown Washington and $40 to CVS less than 10 miles away in Rockville, Md. In Southern California, Cigna paid $47.53 for a flu shot from a primary care doctor with MemorialCare in Long Beach. But it paid $85 for a shot given at a Sacramento doctors’ office affiliated with Sutter Health, one of the biggest hospital chains in the state. “We see the same pattern for more expensive services like MRIs or knee replacements,” she said. “That variation in prices is part of what’s driving insurance premiums higher in some parts of the country.” The wide discrepancy in costs for the same service highlights a major problem in the U.S. health care system.
Some flu vaccines may work better than others — but guidance to the public is scant (Healthier Environment Living Program) People in the know "sought specific products, the ones licensed for older adults that contain a performance-boosting compound called an adjuvant or more notably one of the two brands of vaccine not made — as most flu vaccines are — in eggs. "My colleagues who are over age 65, everybody wanted basically the Fluad or the Protein Sciences vaccine, Flublok,” said Dr. Michael Osterholm, director of the Center for Infectious Diseases Research and Policy at the University of Minnesota. (Fluad, made by Seqirus, contains an adjuvant; Flublok is produced in insect cells.)..."There are a host of different kinds of flu shots, and not all are created equal. In fact, in an incredibly crowded sector, four companies offered a total of 12 different influenza vaccines this past year, bringing to market roughly 152 million doses."
Antiviral Drug Supply (CDC)
10 Tips to Ease Flu Symptoms (WebMD)
Flu infection raises risk of heart attack in week after diagnosis (Helen Branswell, STAT, 1-24-18)
Stories about tragic flu deaths wrongly portray Tamiflu as a panacea (Mary Chris Jaklevic, HealthNewsReview, ) While the CDC maintains there’s a role for antivirals in stemming the symptoms and spread of flu if taken within two days of the onset of symptoms, there’s only modest evidence of a benefit. Tamiflu can help prevent hospitalizations from the flu but "this finding applies only to people who are at high risk of complications from the flu (for example due to an existing chronic illness); otherwise healthy people saw no reduction in the rate of hospitalizations."
Other flu websites (influenza in animals, bat flu, canine flu, avian flu, swine influenza, variant viruses)
America’s Infectious-Disease Barometer Is Off (Katherine J. Wu, The Atlantic, 4-24) Quoting: Somehow, the U.S. is both over- and under-reacting to bird flu and other pressing infectious threats. During this outbreak, experts have called for better testing and surveillance—first of avian and mammalian wildlife, now of livestock. But federal agencies have been slow to respond. The U.S. Department of Agriculture and other federal agencies could stand to shift from “almost this paternalistic view of, ‘We’ll tell you if you need to know,’” Osterholm said, to greater data transparency. Testing and other protections for people who work with cows have been lacking, too. The fumbles of COVID’s early days should have taught the government how valuable proactive testing, reporting, and data sharing are. What’s more, the pandemic could have taught us to prioritize high-risk groups... As long as infectious threats to humanity are growing, recalibrating our sense of infectious danger is imperative to keeping those perils in check.
A Key Lesson From The 1918 Flu Pandemic? 'Tell The Truth,' One Historian Says (Here and Now, NPR, 12-20-17) The death toll from the 1918 flu pandemic surpassed all the military deaths in the two world wars. Here & Now's Peter O'Dowd speaks with historian John M. Barry (@johnmbarry), who wrote about it in his book The Great Influenza: The Story of the Deadliest Pandemic in History.
This flu season has now reached pandemic levels (but it's not technically a pandemic) (Lena H. Sun and Lindsey Bever, WashPost, 2-9-18) "Pandemics occur when there is a new strain of virus for which people have no previous exposure. That's not the case here, because the seasonal strains that are circulating this year are not new. But the predominant one, H3N2, is a particularly nasty strain that is associated with more complications, hospitalizations and deaths, especially among children, those older than 65 and people with certain chronic conditions."'
This flu season's hospitalizations are highest in nearly a decade (Lena H. Sun, Wash Post, 2-2-18)

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