Book menuINFLUENZA - Full extract 

Many people regard the flu as just a heavy cold, or a bit of a nuisance. Nothing could be further from the truth. Flu, or influenza, is a common viral respiratory illness that can be life-threatening...especially in the elderly and frail. 

Throughout history there have been many well-documented influenza epidemics. The most severe outbreak of modern times was the 1918 epidemic which claimed more than 20 million lives. There have been many epidemics since and in the USA alone there are up to 20,000 deaths per year from flu, mainly in the over 65 year age group. 

Fresh outbreaks occur because the flu virus can slightly change its structure; this removes any immunity that people may have acquired previously. Nowadays an international surveillance system is in place to detect these changes in the virus. A new vaccine is produced each year to cover the types of influenza that are most likely to be encountered. 

Around Australia there are several specialized viral laboratories and sentinel medical practices. When the first flu-like illnesses appear, swabs are taken and viral cultures performed to rapidly identify the virus or viruses responsible. Patients admitted to hospital with suspected flu are also tested. A pattern quickly develops and the flu is carefully charted Australia-wide over subsequent weeks. 

The symptoms of flu are quite dramatic. The patient usually develops a high fever and severe aches and pains. Headaches, sore throat and a cough frequently occur, and the person is often barely able to get out of bed. In the absence of any complications a full recovery will follow after several days. 

There is no doubt that immunizing high-risk individuals with the flu-vaccine is the best way to combat influenza. Those particularly at risk are:- 

  • People over 65 years of age. 
  • All residents of nursing homes and other chronic care facilities. 
  • Adults and children with chronic diseases like heart, lung and kidney problems.
  • People whose immune system is suppressed or those on treatments like chemotherapy. 

People in these categories should be immunized each year, in early Autumn if possible. Unfortunately, fewer than half high-risk Australians have been receiving the flu vaccine, even though it is at least 70% effective. People working in health services and some public utilities should also consider being immunized. However, there is no real reason why healthy children and younger adults should be given the vaccine. 

Some people mistakenly believe that they might catch the flu from a flu vaccine. This is impossible because it is an inactive vaccine that does not contain any live virus. However, in children or those previously never exposed to the flu, a slight fever may occur for a day or two after the immunization. Because the flu vaccine is prepared from eggs, people who are highly allergic to eggs should not be given the vaccine. 

Treatment consists of rest, fluids and paracetamol for relief of symptoms. No antibiotics are required unless there is definite evidence of a secondary bacterial infection. The development of viral pneumonia or a secondary chest infection can be a major concern and further treatment in hospital may be required. 

Of great international interest in recent years has been the development of the world's first specific anti-flu medication, called Relenza. This product of Australian research has been released as an inhaled medication -- taken twice a day for 5 days. A test-kit which allows doctors to make a rapid diagnosis of flu is also now available. For Relenza to be effective, it must be taken within 48 hours of the initial flu symptoms.

Health Tip:
* People in high risk groups should consider a flu vaccine every year...in early Autumn, well before the flu arrives.


Dr. Andrew Pattison: Common Consultations
North East Valley Division General Practice, Melbourne, Australia.   Disclaimer
  - Last modified: August 18, 2001