Every year we hear about the coming of the flu like we're anticipating the next bubonic plague and might need to consider walling off the city from infected outsiders. Recently, a big newspaper seller has been fearful headlines about the avian flu epidemic and how it's coming to get us like the bogeyman hiding in our closet or under our bed. As a result of "flu fear," many people get the flu shot every year as part of the annual sacrifice of the arm for the rest of the body. But despite our best efforts, it seems that every year, a few vaccinated victims fall prey to the body aches, runny noses, fevers and general feelings of blah. Usually this unfortunate group of people is rather small and something to be expected, since vaccination is never 100-percent perfect for all people. But this year is different.
This year, almost all 50 states are reporting widespread flu, including illness in people who were vaccinated. Most people assume the vaccine will protect them from getting the flu, but the vaccine is just the best estimate as to which strains will be circulating in a given year based on strains isolated in previous years. A strain is a certain variation of the flu's genetic code, and each year, the flu acquires mutations that make it different from previous strains. There usually exists some cross-protection between the old strains included in the vaccine and the new strains, since the new ones are still quite similar to the old ones. Sometimes, however, the differences are enough to cause even vaccinated people to come down with the flu. Unfortunately, there is no flu crystal ball to predict future mutations, and vaccines can only be based on previous strains, so there will always be people coming down with the flu despite their best efforts. Just because the vaccine isn't perfect, however, doesn't mean it isn't worth receiving since it still protects people from the most likely strains. It only takes getting the flu once to sell anyone on the virtues of the vaccine!
For people who come down with the flu, there are certain medications to treat it. Traditionally, people think viruses can only be prevented, not treated once they are acquired, but there are a wide variety of anti-viral drugs that prevent viruses from making more copies within the human body. The most common treatment is oseltamivir, better known as Tamiflu. It can be taken after exposure to someone suffering from the flu to prevent infection or it can be used as a treatment within 2 days of symptom-onset to prevent spread within the body and to hasten recovery. This is a very powerful drug that has been quite effective in flu treatment, but like bacteria, resistance is developing. Resistant strains come about through the same mutations that give rise to other strains, except they have developed methods to avoid being affected by drug therapy. Normally, less than 1 percent of flu strains in a given year demonstrate any resistance, but this year at least 4.6 percent of flu samples are exhibiting at least some resistance.
Not to be doomsday about it, but resistant flu strains have consequences for the future. It will be increasingly difficult to treat people who come down with the flu, which can be especially problematic in children, the elderly and those with compromised immune systems. Resistance might increase the likelihood of pandemic flu sooner, rather than later, because resistant strains would have increased ability to infect and spread to more people and because they avoid our means of treating them. This might be especially true if the dreaded avian flu jumps from birds to humans faster than we think possible. It is normal for birds to harbor flu, serving as the source for new strains, but the actual avian flu that is so widely publicized is scary because it has an unusually high mortality rate in otherwise healthy people. Recognize, though, that all cases so far have been in people who work and live very closely with birds.
With all this flu floating around, especially in the close environments of dorms and parties, it's difficult to avoid everyone infected with the flu. But there are ways to stay healthy until it's all over come April. First and foremost, frequent hand-washing is key. Wash with soap and water for at least 20 seconds -- sing the alphabet while you're doing it. Also, avoid super-close contact with people you know are infected; encourage them to go home and rest instead of spreading germs. It's also important to cover your mouth and nose when you sneeze or cough -- just like mom taught you -- to avoid spreading the flu to other people. And, as always, get rest and drink plenty of fluids. If you start feeling like you're getting the flu, get yourself to Student Health ASAP!
Katie is a University Medical student. She can be reached at kmcbeth@cavalierdaily.com.
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