We are not ready for the influenza pandemic

[lordsummerisle]

Interesting op-ed piece by Ann McFeatters

https://www.seattletimes.com/opinion/we-are-not-ready-for-the-influenza-pandemic/

[quartz007]

1. I had the flu-shot in early November,

and still got the flu in middle of December.

Same thing happened last year. The flu-shot was useless.

Problem is the flu vaccine is based on best guess which strain of flu will appear. Obviously they guessed wrong again.

Next year, I will just skip the flu-shot and spend the money on 2 dinners in restaurants.

[Fiendish Thingy]

2. How much are you paying for a flu shot?

Most pharmacies charge about $15. That's barely enough for two fast food meals.

I've had the flu 4 times in my 60 years, and would gladly pay $50 for even a 1% reduction in the chance of getting sick...

A lot of people mistake a bad cold or norovirus/"stomach flu" for influenza as well, and blame the flu shot for not working.

The only way to make a 100% effective flu shot, is to wait until flu season hits, develop the vaccine, by which time flu season is over. They have to make an educated guess each year, some years are better than others.

Btw, it takes 2-3 weeks after getting the shot to develop immunity.

[quartz007]

4. I guess you are right

I get a price break because of my insurance, but my wife has to pay around $40 for flu shots. So she avoids them, and does not catch flu often. In my case, even a 10% reduction in chance of getting the flu, I should get it every year.

Another thing is my flu was mild, which may have been from the flu-shot?

[Hekate]

19. You and your wife have separate insurance and don't share the cost of meds in your household?

Oh, okay.

[quartz007]

21. Correct, I have HMO, she has PPO

We are in different age groups, and both policies are via employers.

[lunamagica]

34. Are you sure it was the flu?

[quartz007]

78. I based it on symptoms..

began with a sore throat, then had chills, some muscle ache, and then morphed into coughing. But had no significant fever.

[Orangepeel]

70. Huh. I thought that post ACA, insurance was required to cover flu shots

[quartz007]

75. I thought so as well

but she refuses to get a flu shot, and has not had one for many years. And does not get the flu---ever. But I swear I just (last month) saw a sign in a drug store saying flu-shots for $40. So some people must have to pay for them.

[jpak]

6. Mine was free - with Obamacare

n/t

[Anon-C]

30. Even at $15 per shot, for a family of five thats $75 ...

...for a vaccine that's 30-60% effective. For some thats a lot of money, sadly.

[Hortensis]

71. It usually reduces the severity somewhat. Our

grandson got the flu last year in spite of the shot, but he missed only 2 days of school and a great deal of misery, played video games most of the time he was resting.

Flu shot is $8 at local Walmarts. Most aware parents consider protecting their children is worth that, or twice as much. And neither the ACA or CHIPS are canceled yet

Yes, sadly $75 out of pocket would be prohibitive for some, but they are a small minority, and this discussion is really about whether people should get flu shots.

Scientists wonder when a great pandemic will occur, not if. And when could still be this year.

[Squinch]

76. I thought they were saying 10% effective.

[arthritisR_US]

52. My Mother got the flu shot every year and in January 2013 she died from

the flu, it was really fecking affective.

[quartz007]

77. My condolences

for loss of your mother. There is no love superior to a mother's love. But I guess we all have to go one way or another.

As for the flu shots, they are formulated early in each season, and it is based on best guess as to which strain of flu will be coming along later. So it is not 100% effective.

Also, other factors come into play. Such as age, health status etc.

[Skittles]

3. supposedly getting the shot will reduce sympoms if you get the flu

I will take all precautions to try to avoid the flu

[left-of-center2012]

7. I agree

I'll use everything available to avoid the flu or ease it's pain.

[quartz007]

8. Yes, I can vouch for that

If I catch the flu it is usually very mild.

[Skittles]

10. I had the flu once and it slammed me so hard

and I was YOUNG......I have been getting the shot ever since

[The Velveteen Ocelot]

26. Me, too - got Hong Kong flu in the 1968 epidemic (H3N2).

and I haven't been that sick before or since. I always get the flu shot; whatever chance it gives me of not getting that sick again, I'll take it.

[JustAnotherGen]

55. It did for me this year

My immune system is already compromised by A.S.

Got the shot at work the 3rd week of October.

1st week of November only left my bed on day two for Tamiflu.

This has lead to steroids, four rounds of antibiotics, hospital for systemic sinus infection (shock), lung infection etc etc.

Rheumy checked me last week and said the flu shot probably saved me.

I say - at least "try". Give yourself a chance with a shot.

[left-of-center2012]

5. Insurance pays for the flu shot

Do you not have health insurance?

[quartz007]

9. Yes I have health insurance

through Humana.

[Neurotica]

36. Not always

My husband and I got our flu shots recently. Our insurance (a good corporate plan) would not pay because we got our flu shots at our local pharmacy rather than making an appointment at a physician's office. We paid out of pocket.

Completely ridiculous.

[GP6971]

79. With our company insurace the flu shot

is free, but it's a $15.00 copay for the Dr. visit I got mine 2 years ago at the local pharmacy and it cost me $28. Last year I got mine at the VA and it was free...and it was literally a drive through. Never got out of the car.

[womanofthehills]

48. Flu shot only 10% effective this year for the main strain

supposedly it mutates.

[NCTraveler]

64. I was paid five dollars to take my flu shot.

Why did you pay the equivalent of two eat-out meals?

[Historic NY]

11. Kiryas Joel fighting flu outbreak 1370 people down with it

at least one death believe to be flu related.......densely populated village of 20k. Most are large multi-generational families.


[link:http://www.recordonline.com/news/20180112/kiryas-joel-fighting-flu-outbreak|]

[roamer65]

12. Its a nasty little strain that came from Australia...H3N2.

The flu shot doesn’t protect against it.

[stevenleser]

24. The Flu shot gives about 33% protection against H3N2

https://www.vox.com/2018/1/12/16882622/flu-season-epidemic-prevention-vaccine

By that 33%, it apparently means that 33% will not need to go to the doctor if they are exposed to it, i.e. it hits you less hard.

[lapfog_1]

40. Current flu shot is only 10% effective against the H3N2

[Irish_Dem]

13. 20 to 50 million died in the 1918 flu pandemic. Do we know why it was so deadly?

I cannot find out much of anything online.
Researchers don't seem to know.

[dixiegrrrrl]

14. From what I have read, it went into pneumonia quickly

and the spread was partly due to overcrowding in places like the military, tenements schools , hospitals.

Here in Ala, which has been hit hard, the Gov. has declared state of emergency, a lot of schools are closing because of too many sick pupils.
2 21 year olds, a man and a mother, died in just a couple days of getting it. The mother got it from her kids, the kids recovered, she did not.

[Irish_Dem]

15. Without antibiotics, pneumonia is serious. Yes about 8 years ago we had flu deaths in my area too.

Last edited Mon Jan 15, 2018, 10:41 AM - Edit history (1)

The swine flu hit the area hard and three teenagers died.
One at my daughter's school. My daughter, a young teen at the time,
asthmatic, was diagnosed with the swine flu at the same time other kids were dying.
I spend some very anxious days.

I hate to hear that Ala is going through this.
The Gov is doing the right thing to close the schools, there is nothing worse
than children dying. And the illness will just spread more if the schools are kept open.

And the mother with children, that is so sad. And the young adults, just so sad.

Do you know the timing of the deaths?
Here, the teens had the swine flu, they seemed to be better,
starting to eat, take showers, etc and then suddenly died.
One teen died after eating soup and taking a shower, he was feeling much
better and then just collapsed in the shower. The others who died were
the same pattern.

When my daughter was recovering, I kept a close eye on her when
she started to feel better. She also got the Tamilflu shot.

I hope you stay safe, wash your hands, and stay out of crowded areas.

[dixiegrrrrl]

20. We got a few weeks ago, got better fro a couple of days, then it came back,

Luckily, the return was only for a couple more days, and not as bad.

Mr. dixie went shopping on a Thursday, got sick 2 days later. I have not left the house for weeks ( my preferred winter pattern here) and got it from him.
Usually one of the benefits of both of us living like hermits is we have avoided a lot of bugs.


the 2 deaths I mentioned were in the news, not Ala. people, but the death of the mother was reported to have hit quickly.

Latest report I got yesterday said 200 dead, across the country, but when you look at the current flu maps, it is the South that is getting it the hardest.

[Irish_Dem]

58. Maybe that is what happened here, the flu came back.

The people were getting better, and then they got hit with a second round.

I got a mild to moderate case of the flu this year after going to
the grocery store too. I had not been anywhere else around that time.
I try to use the disinfectant wipes to wipe down the card handles
that are available when you get a cart in the entrance of the store.
But I didn't that time, the wipe canister was empty.

Oh, well a physicianl friend of mine says it is good to get the flu every now
and then, it boosts the immune system. And I read that getting the swine
flu supercharges the immune system. But I am a bit germ phobic and
don't want to get sick.

Glad you and Mr. D are well now...
And hope that the flu season ends soon.

[Irish_Dem]

18. I think that this is the fear with antibiotic resistance. We go back to 1918.

[tymorial]

33. Too many doctors placate patients by handing out antibiotics

Patients (especially older patients) are used to receiving antibiotics for sore throats and ear infections. For a very long time that was the standard course even though the cause could very well be vital. The doctors should have ordered cultures and then adjusted the medication accordingly upon result. Even better would be to not prescribe immediately unless the patient was high risk. Today some physicians still don't bother with the culture and just prescribe. It takes two days for cultures to return and there are of course cases where you definitely do not want to delay treatment (endocarditis, bacterial meningitis) so you prescribe. Coughs, sore throats though please... they are usually viral. People need to learn to hold off on calling the doctor and if you do go and are sent home with nothing that is because medication is more than likely not going to help you.

When I was a practicing nurse I saw so many patients cone to the ear with URIs looking for "penicillin".

[Irish_Dem]

60. I agree completely. This is one of the reasons a physician friend of mine quit Family Practice

and went into another specialty area. She said patients would come into the clinic demanding antibiotics for minor illnesses, and she would generally refuse. The patients would complain to management, and my friend would be reprimanded. Same situation with narcotics. So she now practices in an area where she doesn't have to deal with all of that.

Experts are saying there may come a time when antibiotics no longer work.
Then we are going to have some big problems in terms of public health.

[misanthrope]

50. The hospitals in Mobile are all full

A nurse I know told me two weeks ago the city's biggest hospital -- Mobile Infirmary -- was so packed they had patients who had been in ER for four days because there were no rooms for them. As of last week, they were turning away all admissions and some patients needing care were routed to Pensacola.

[Irish_Dem]

61. Wow, this is awful. People must be really sick to go to the ER.

So it is hitting your area hard.

[lordsummerisle]

16. There are a number of good books on this that a search will turn up n/t

[Irish_Dem]

17. Thanks, I did a quick search and couldn't find much, will keep looking.

The bottom line appears to be no agreement on exactly why so many died.
But the pneumonia and no antibiotics seems to be a factor.

[PoindexterOglethorpe]

31. The very best book about the 1918 flu

is The Great Influenza by John Barry. It's not only about that epidemic but about how doctors were educated in this country.

Several things to keep in mind about the 1918 epidemic.
1. It probably originated in this country.
2. Many of those who first contracted it were young soldiers who had literally never been off the farm they'd grown up on, and therefore had almost no immunity to anything.
3. Despite what doctors kept on telling Woodrow Wilson and the War Department, they insisted on continuing to send infected soldiers on crowded troop ships to Europe, absolutely guaranteeing the spread of the disease.
4. The best doctors had been drafted into the army. The ones left behind weren't very good for the most part. Some of them didn't understand the germ theory of disease.
5. Running water was a scarce commodity in many places. Regular hand-washing, the single biggest and best public health measure, wasn't very common. That means that most people weren't washing their hands regularly, didn't always understand how things like influenza were passed, and therefore couldn't take effective measures against its spread.
6. The main reason old people didn't die or even get the flu was that about 50 years earlier an epidemic of a similar flu type had occurred. The old people had either gotten it and recovered and were now immune, or were immune in the first place.
7. The sad and terrible reason young people died in such great numbers and died so swiftly was that their bodies mounted a fierce defense against the virus, and that very defense killed them.

Read the book. It's fascinating.

[MFM008]

47. Excellent book

Remember the line....
'But it was just the flu'..........

[Irish_Dem]

59. Thank you very much PointDexter. Fascinating.

I will get the book. The points you raise indicate a perfect storm of sorts.

It is so hard to imagine that 20-50 million people were killed in the 1918 epidemic.
More than were killed when the Bubonic plague hit.

I had no idea it originated here in the US and then spread world wide.
And that Wilson and the military refused to take action when the medical community
sounded the alarm about the spread of the illness. Good grief, the physicians not drafted
for the war, were not inclined to believe in the germ theory of illness.

You may recall a few years ago there was a serious outbreak of the flu in the Far East,
China, etc. Japan as I recall did not get one case of the flu.
Experts believe it is because of Japan's obsessive hand washing and cleanliness.

Yes, on the farms in the early 1900s there was a lack of basic sanitation.
Outhouses, no running water in the home, people drinking out of the same
cup attached to the well or water spigot outside the home.

My mother was a nurse during one of the polio outbreaks, and she said
that healthy young men seemed to be hit the hardest. They would be fine
and then suddenly fall to the ground, just total collapse, and end up in an iron lung,
but generally they did not live.

She also recalls the first time she saw penicillin used at the hospital where she worked.
A male with some sort of serious infection was treated. They put his arm in a splint to keep it
perfectly still, and then gave him the penicillin via IV. The medical staff could not believe
how he dramatically improved in a short period of time.

Thank you again for the information and book recommendation.
I will get it on amazon.

[ColoradoBlue]

23. Read a fascinating book

I read a fascinating book years ago about the 1918 flu. There were many things at play with the spread and why it was so deadly.

Because of WWI, it was able to travel quickly due to soldiers coming and going from Europe as well as the close quarters they lived in.

We didn't know what a virus was yet and therefore, had no idea what really caused the flu, how it was transmitted or how to stop it.

Unlike many flu strains which attack the very old or the very young, this strain was particularly hard on young, healthy adults. In effect, it turned their very robust immune system against them.

The book also really helps bring the devastating impact the flu had on families and cities. Really interesting and very scary.

If anyone is interested: https://www.amazon.com/Flu-Influenza-Pandemic-Search-Caused/dp/0743203984/ref=cm_cr_arp_d_product_top?ie=UTF8

[Irish_Dem]

62. Thanks for the book rec. Hard to believe how primitive health care was 100 yrs ago.

My mother was a nurse during one of the polio epidemics and she said healthy young men seemed to get hit the hardest in that outbreak. I always wondered why but
you and another poster are talking about the immune system activation as the reason.

[The Velveteen Ocelot]

27. There's tons of info on the Internet, even Wikipedia.

One reason it was so deadly is that it tended to cause cytokine storms, an overreaction of the immune system. Because young adults had strong immune systems, they got sicker and died in greater numbers than children and older adults. There's a very interesting book on the subject, https://www.amazon.com/Great-Influenza-Deadliest-Pandemic-History/dp/0143036491

[Irish_Dem]

63. Thank you for the book rec. VO.

I am not familiar with cytokine storms, will look up the book you recommend.

[Fiendish Thingy]

43. Cytokines storm- look it up

There's tons of info on the Spanish flu epidemic of 1918, my wife read a whole book on it. There was some recent story on the analysis of the virus done using today's medical technology.

It was so lethal because it's DNA was unique, and no one had antibodies- most strains are variants or mutations of others, and so many folks have at least partial immunity. When a unique strain, or one that most of the population doesn't have antibodies for, that's a pandemic strain.

A cytokines storm is an intense reaction by the immune system of healthy individual against the pandemic strain. That's why so many healthy young people, including soldiers, died in 1918.

[Irish_Dem]

65. Yes I will, had not heard of this before. Thank you.

So the 1918 flu was a new strain, no one had prior exposure.
And a young person's immune system would go into a cytosine storm reaction.

[Tanuki]

49. This is an excellent review:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4711683/

[Irish_Dem]

66. Thank you, very interesting.

So experts are exploring ways to not just reduce the viral infection but also
to counteract the hyper immune system response, but sounds experimental at this stage.
Interesting that the article mentions the use of Chinese herbs.

[d_r]

56. My grandmother

Was born in 1910. When she had the flu the doctor told my great grand parents there was nothing they could do, take her home to die. The fever was too high and they couldn't stop it.
So they did, she was in a coma a few says and woke back up. She couldn't remember anything from before and had to learn to walk and talk again.

[Irish_Dem]

68. She was near death but pulled through.

If she had been older her immune system may have killed her.

When I was younger, I wished I had paid more attention and asked more
questions regarding the history of my grandparents. So many remarkable
stories, like this one about your grandmother.

[Act_of_Reparation]

57. Cytokine storm.

Certain strains of influenza cause a positive feedback loop in healthy immune systems that can flood the lungs with fluids and immune cells. It's difficult to say (it's not like we have jars of 1918 flu just sitting around waiting to be tested) for certain, but given how other strains of influenza kill healthy adults, this is the most likely explanation.

[Irish_Dem]

69. Yes that is what everyone is saying here.

And the experts are working on ways to counteract the hyper immune system response.
And explains why a certain age group is more vulnerable.

[dixiegrrrrl]

72. Just in: CDC: Flu is now considered epidemic in U.S.

A severe influenza outbreak has spread to all the US states except Hawaii (and the District of Columbia), according to a report from the Centers for Disease Control and Prevention. Experts say that this year's flu season started much earlier than expected.
From Twitter news headlines

[Irish_Dem]

73. Spread to all US states. The flu spreads so easily.

And I guess the early occurrence is part of why we have an epidemic.

Thanks for posting Dixiegirl.

[smirkymonkey]

22. I got the flu shot, but still ended up with it 2 days after Christmas. It has hit hard here in MA.

It's Jan 14 and I am still not over it. I think it would have been much worse if I hadn't had the shot, but this one has been hard to shake. Most of the flu symptoms are gone, but the cough persists. I have gone to the Dr. to get Tessalon Perles which have helped and something for post-nasal drip, which is what I think is causing the cough, but this has been a bad one.

[GulfCoast66]

25. Did not get the shot for the first time in years

Just lazy and not making time to do so.

Currently I am laying here with a 101 degree fever and my entire body actually hurts.

51 years of age and this is the first time I have had it. It is worse than I had been told.

Get the shot.

[Ilsa]

29. I hope you feel better soon without complications. nt

[GulfCoast66]

54. TY

[mucifer]

28. I work with palliative care and hospice kids. I get the shot. It's not fair to them

if I don't and I get sick because of it. Half of the peds nurses in my agency got the flu and they had their shots. I'm not sure why I haven't gotten the flu, too.

[PoindexterOglethorpe]

32. I don't get the shot, although perhaps in the future I will choose to do so.

I got the flu several times growing up, including (I'm pretty sure) the Asian flu in 1957. So I have a lot of confidence in my immune system.

As I said, I may change my mind in the future.

[The Velveteen Ocelot]

37. That was H2N2. You might not have any immunity for other strains

like H1N1 (swine flu, 2009) or H3N2 (Hong Kong flu, 1968), which is considered to be a particularly nasty strain. That's what's going around this year. I got it in 1968 and I can tell you that you really, really do not want to get it. Get the shot, it's not too late.

[PoindexterOglethorpe]

39. I got the flu several times growing up.

And haven't had it again in about 45 years, so I rather suspect I got enough different variants that I have a strong immunity.

I did not get the Hong Kong flu, which makes me think I already had immunity.

So if you got it in 1968 you are pretty much immune.

[Fiendish Thingy]

44. Ah, I had the flu in 1968- my first bout

It was nasty. Hopefully that has protected me somewhat, in addition to the shot.

[3catwoman3]

35. A 10 year old child died in the town...

...where my pediatric office is located. Our practice has had lots of kids testing positive, and some kids hospitalized.

There are days when I wish I could wear a hazmat suit to work. I've been around several very sick patients, and so far, my flu shot has been effective.

[Elwood P Dowd]

38. So what if you are allergic to the flu shot?

Haven't had one in years because of that.

[womanofthehills]

51. I don't get them because of allergies too

there are many different types of flu shots by different pharma companies. - one of the newest flu shots is is made from insect cells instead of eggs. This latest flu shot says it has no influenza virus, no eggs, no antibiotics, no formaldehyde, no thimerosal or other preservatives and no latex. So, that means that some of these ingredients are in some of the other flu shots -
so there are many different ingredients people can be allergic too.

Here is the list of the different flu shots available this season for age indication and which do and don't have mercury and latex.

https://www.cdc.gov/flu/protect/vaccine/vaccines.htm

[still_one]

53. If enough people you associate with are getting the vaccination, you are afforded afforded

protection from not getting influenza from those who have been vaccinated.

That is why most medical facilities require its employees to get the vaccination if they deal with patients, and are not allergic to the vaccination, to offer protection from the employees spreading it

[sarcasmo]

41. We're not ready for a missile strike.

[EllieBC]

42. My 7 year old has it I think.

She got the flu mist (they do the nasal most here for kids still) as did my 3 year old. Husband, 1 year old, and I got the shot.

Currently 7 year old has fever of 38.7 which keeps breaking after Tylenol and coming back, headache, sore throat, fatigue, and general feeling of awfulness. It all started this morning. I'm taking her to the walk in clinic tomorrow. Influenza scares the crap out of me.

[Hekate]

45. For those hunting for an excellent book: John M. Barry's "The Great Influenza"...

Subtitled "The Story of the Deadliest Pandemic in History." The copyright is 2004, and it's in paperback.

Highly recommended.

[Irish_Dem]

74. Yes, others here are recommending this book. nt

[MFM008]

46. My mom is in local hospital

Because of a fall. There were 48 admits this weekend for flu.
Another 1918 influenza is right around the corner.

[withoutapaddle]

67. a nearby school district was closed all last week

due to the flu and flu-like viruses. Hope your mom has a speedy recovery and doesn't get sick!

[Lifelong Protester]

80. I am re-reading "Influeza 1918" by Lynette Iezzoni

With a forward by David McCullough. It is subtitled "The Worst Epidemic in American History".
The book was what the American Experience was based upon. The biggest question in the book is why did America forget about it so quickly?