Flee, Fly, Flu, Flum

Hey!  It’s flu season.  Again!  I blogged about this three years ago and I think it’s worth an update.

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Disclaimer: I am not your doctor.  I am not trying to give you medical advice.  If you are experiencing a medical emergency, call 911 now.  Now!  Thank you.

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Tis the season.  Everyone has “The Flu.”  Unfortunately for health care providers everywhere, “The Flu” represents at least four different situations in our culture.

1) The Flue.  Let’s get this one out of the way as it’s the least confusing.  Anyone with a woodburning fireplace has A Flue.  The great news is, flues aren’t contagious!

2) Which brings us to the next The Flu, as in Influenza, as in THE REAL DEAL FLU!  This is the bad one.  It isn’t actually one at all but many.  Sorry.  There are a three types of the influenza virus that afflict humans.  Ya got yer influenza A and yer influenza B and yer influenza C.

But influenza A is further divided into subtypes: influenza A H(1-18)N(1-11).  In other words, there are 19 different possibilities of H protein and 11 different possibilities of N protein on the surface of the influenza A virus.  To put this in mathematical terms would require me to relive something involving factorials and I’m not going there.  Suffice it to say that nature can produce many H + N combinations for our respiratory pleasure.

The joy doesn’t stop.  There can be many strains of a certain subtype.  Remember H1N1 from 2009?  That was a new strain of influenza A H1N1.  Vaccine wizards try to predict which strains, subtypes, and types will be particularly important in upcoming flu seasons and tailor “The Flu Shot” to those strains.  Sometimes they get it right.  Other times not so much.  Don’t get too mad at them – remember that factorial situation.

How does The Flu Shot work?  Most of the shots contain dead flu viruses.  ”Inactivated” is the slightly more pleasant term.  So I get my shot and my immune system picks up the dead viruses and says, hm, we have an intruder.  (Technically, we have three ((trivalent vaccine – this year containing an A H1N1, an A H3N2, and a B)) or four ((quadrivalent vaccine – everything above plus another B)) intruders.)  Let’s make antibody weapons directed against this intruder!  It takes a couple weeks for me to really build up my antibody arsenal.  When someone with The Flu sneezes on my face and I get exposed to real live virus, my immune system recognizes the intruder and my antibody weapons are ready to be deployed.

To put this in perspective, our bodies are exposed to thousands of new “intruders” each day as we eat and breathe and live.  Most of us can easily handle a couple more.

FluMist, the nose spray flu vaccination, is made up of “live attenuated” virus.  Think of it like a scorpion with its stinger removed.  No don’t.  That’s creepy.  Think of it like a barberry bush with the thorns removed.  Never mind.  Don’t think of it at all because the CDC says DON’T GET IT THIS SEASON BECAUSE IT ISN’T EFFECTIVE ENOUGH!

Influenza A is currently running rampant according to my charming husband and this helpful yet alarming map.  If you lived in Guam or Washington DC during the month of December, good for you.  It’s January now though, and all bets are off.

This flu season ushered in a particularly nasty strain of Influenza A.  Over thirty children have already died in the United States.

The match between the strains in the vaccine and the strains we are seeing “in the wild” isn’t perfect.  However, the vaccine can still help your body identify and attack the intruder.  Think of it like a family resemblance.  The vaccine contains a specific strain of influenza A(H3N2).   [Ms. Richardson, the flesh-eating zombie who lives next door.]  You contract a slightly different influenza A (H3N2).  [Hey!  You look a lot like Ms. Richardson!  Really?  You’re her sister?  I thought I sorta recognized you…  Are you a zombie, too?  ACK!!!]

As we get older, our immune systems get older, too.  They don’t get as excited about the flesh-eating zombie next door.  Folks over the age of 65 can get a couple souped-up versions of the vaccine: 1) a high-dose vaccine [a whole den of zombies] 2) an adjuvanted vaccine – the vaccine inside a base of squalene oil [like a zombie with flames shooting out of its orifices – highly noticeable].

The Bottom Line is you should get a flu shot.  Now.  Posthaste.  And next year do it in October.  If you don’t want to do it for yourself, do it for the sake of the infants under six months who can’t get vaccinated.  Or the elders who don’t get bent out of shape about a couple zombies.

3) So how about The Flu, like The Stomach Flu, like I’m-Puking-And-Pooping-And-Miserable Flu.  Well, technically that isn’t flu at all.  Depending on your circumstances, it could be “food poisoning” (which isn’t really poisoning, but ingestion of food-borne microbes such as campylobacter and salmonella) or viral gastroenteritis caused by any one of a number of fecal-to-oral transmitted viruses.  Norovirus, the virus-formerly-known-as-Norwalk, is the big offender in this country.

Yup, you read that right.  Fecal, as in POOP, to oral, as in EAT POOP.  Ace and I both learned a scintillating saying in medical school: “If shit were red, the world would be pink.”  Just let that one sink in for a minute.  The moral to the story is: WASH YOUR HANDS.

4) Finally, we come to The Flu.  ”I have a touch of The Flu” is what your neighbor says when he has a runny nose and slight cough.  Folks, you cannot have a touch of the Actual Flu.  The Actual Flu doesn’t touch you, it bowls you over, leaving you prostrate and begging for mercy.  Your neighbor’s “touch of The Flu” is likely a viral upper respiratory infection, caused by one of a group of constantly mutating viruses.  Hence, no vaccine).  Common causes of The Common Cold include rhinovirus, parainfluenza virus, and respiratory syncytial virus (RSV).

People know that “a touch of The Flu” will excuse them from work, uncomfortable social obligations, and cooking duty.  ”A touch of The Flu” begs sympathy and chicken noodle soup.  ”I have a cold” and you can just join the club.  Buck up!

If you schedule an appointment with your Minnesota doctor for symptoms of a viral upper respiratory infection during the months of December or January, s/he is likely to be sicker than you are and more than a little peevish from a vexing combination of stress (it’s nearly impossible for doctors to just “call in sick”) and lack of sleep.

That is all.

 

Musical Moment

 

 

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