In­fluenza alert: From info to vac­ci­na­tion, how pre­pared are you?

Hindustan Times ST (Mumbai) - - HTNATION - SAN­CHITA SHARMA

We’ve all had sev­eral bouts of in­fluenza or the flu, which causes headaches, runny nose, cough and mus­cle pain.

This vi­ral in­fec­tion is self­lim­it­ing, with se­vere ill­ness last­ing for two to three days and most peo­ple re­cov­er­ing within a week af­ter us­ing non­pre­scrip­tion medicines for fever and pain.

It’s not con­sid­ered a se­ri­ous ill­ness be­cause it rarely causes hospi­tal­i­sa­tion in healthy peo­ple and kills caus­ing com­pli­ca­tions and co-in­fec­tions and ag­gra­vat­ing ex­ist­ing ill­nesses. The cause of death is rarely recorded as in­fluenza.

It kills up to 650,000 peo­ple ev­ery year, es­ti­mates the World Health Or­gan­i­sa­tion, with most deaths oc­cur­ring from pneu­mo­nia, heart or brain in­flam­ma­tion and cir­cu­la­tory shock from or­gans not get­ting enough blood or oxy­gen.

2018 marks the 100th an­niver­sary of 1918 in­fluenza pan­demic pop­u­larly known as “Span­ish flu”, which in­fected an es­ti­mated 500 mil­lion peo­ple world­wide — about one-third of the planet’s then pop­u­la­tion — and killed be­tween 20 mil­lion to 50 mil­lion peo­ple, in­clud­ing in In­dia.

The only decade in which In­dia’s pop­u­la­tion did not regis­ter a decadal growth is 19101920, ac­cord­ing to the Cen­sus of In­dia, with ex­perts at­tribut­ing the re­ver­sal in pop­u­la­tion growth to in­creased deaths from the flu.

HIGHLY CON­TA­GIOUS

The flu spreads eas­ily among peo­ple in close con­tact or in con­tained spa­ces, such as class­rooms, of­fices and pub­lic trans­port.

On Septem­ber 5, an Emi­rates Air­line flight from Dubai was quar­an­tined for hours at John F Kennedy In­ter­na­tional Air­port in New York af­ter 100 pas­sen­gers and crew mem­bers com­plained of cough and fever. Sus­pect­ing they could have a se­ri­ous res­pi­ra­tory ill­ness called Mid­dle East Res­pi­ra­tory Syn­drome (MERS), all the ill pas­sen­gers were tested for a range of dis­eases.

They were di­ag­nosed with in­fluenza, no one had MERS.

In 2018, In­dia has con­firmed 5,651 cases and 464 deaths from H1N1, the pre­dom­i­nant flu strain across states, till Oct7.

The in­fluenza virus has a quick­sil­ver abil­ity to mu­tate to evade the body’s im­mune sys­tems and in­fect more eas­ily.

If the mu­ta­tion cre­ates a brand new virus that can spread in­fec­tion from peo­ple to peo­ple and against which hu­mans have no im­mu­nity, pan­demics oc­cur, like H1N1 pan­demic in 2009-10 that spread across con­ti­nents within weeks. Un­like in the tem­per­ate zones where the flu virus cir­cu­lates and in­fects in the cold­est sea­son twice a year (once each in the win­ters of the north­ern and south­ern hemi­spheres), in­fec­tion con­tin­ues year-round in the trop­ics and sub­trop­ics af­ter peak­ing in the win­ter months.

VAC­CINE PRO­TEC­TION

Young chil­dren, older peo­ple, preg­nant women, or peo­ple with weak­ened im­mune sys­tems, should get vac­ci­nated against the flu at start of win­ter ev­ery year, rec­om­mends the WHO, which eval­u­ates and rec­om­mends vac­cines against the dom­i­nant in­fluenza viruses that are pro­jected to cause the most disease.

The rec­om­men­da­tions are made in Fe­bru­ary/march for the fol­low­ing in­fluenza sea­son in the north­ern hemi­sphere and in Septem­ber for the south­ern hemi­sphere be­cause six to eight months are needed to pro­duce and ap­prove vac­cines.

For the north­ern hemi­sphere, the rec­om­mended vac­cine for 2018-19 is a quadri­va­lent vac­cine con­tain­ing A/ Michi­gan (H1N1), A/ Sin­ga­pore (H3N2), B/ Colorado; and B/phuket viruses.

The vac­cine is safe as the viruses are in­ac­ti­vated, and though some peo­ple may feel fever­ish for a day or two af­ter vac­ci­na­tion, it does not cause in­fluenza.

Some peo­ple may get the flu even af­ter get­ting vac­ci­nated be­cause the vac­cine does not pro­tect against the dozens of flu viruses caus­ing in­fec­tions, but vac­ci­na­tion low­ers the sever­ity of disease and the risk of as­so­ci­ated com­pli­ca­tions.

The best time to get vac­ci­nated is in Oc­to­ber be­fore the start of the flu sea­son in In­dia, where it peaks in Fe­bru­ary and March.

It takes about two weeks af­ter vac­ci­na­tion for the an­ti­bod­ies to de­velop and pro­tect against in­fec­tion, and the ef­fect lasts for about a year.

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