Sunday, September 21, 2014

NPM14: Giving Preparedness A Shot In The Arm


Photo Credit PHIL


Note: September is National Preparedness Month, and this is one of a series of new or updated preparedness articles I will be running for the occasion.


# 9098


While it is hard to quantify the absolute risks from any of them, in the nearly 9 years that I’ve been doing this blog, I don’t ever recall seeing as many infectious disease threats on the horizon as I do this fall and winter. 


In addition to the standard onslaught of seasonal flu (which can vary greatly in intensity each year) and our usual host of winter respiratory viruses (RSV, Adenoviruses, Rhinoviruses), we’ve got a rogue enterovirus sweeping across the nation called EV-D68, affecting mostly (but not solely) kids (see CDC EV-D68 Update & FAQ).




Another cause of `flu like’ symptoms, but less common than the winter respiratory viruses, are infection via one the vector borne diseases like West Nile Virus, Dengue and Chikungunya. 

What all of these have in common is that they can initially present as do most viral infections  – like a mild cold or the flu; Fever, malaise, body aches . . . sometimes accompanied by a cough or other respiratory symptoms.

All of which not only makes getting a firm diagnosis from your doctor (other than you’ve picked up `a virus’ ) problematic, it increases your chances of picking up `something’. 


Much, much further down the list of things to be worried about (at least in North America) are imported exotics like H7N9, H5N1, and MERS-CoV. 


Still, they cannot be ruled out completely, as 2 of the 3 have already happened this year (see CDC Statement On 1st H5N1 Case In North America & CDC : 2nd Imported MERS Case Confirmed In Florida), and public health officials continue to watch for additional cases.


With heightened scrutiny over these imported threats (not to mention Ebola), traveling while symptomatic (fever, cough, vomiting) may prove exceedingly difficult this fall.  Many international airports are screening passengers for fever, and showing up at the terminal with `flu-like symptoms’  just might get you bumped from your flight . . . or worse.


Making this year – perhaps more than ever before – a good year to go ahead and get that flu shot early.  


No, the shot won’t protect against any of these exotics.. The vaccine only offers protection against 3 or 4 pre-selected stains of seasonal influenza. Sill, flu is a relatively common severe winter respiratory virus – and claims tens of thousands of lives every year – making it well worth avoiding if at all possible.  


As we’ve discussed before, flu vaccines – while considered very safe – most years only offer a moderate level of protection against influenza. Their VE (vaccine effectiveness) can vary widely between flu shot recipients, and is often substantially reduced among those older than 65 or with immune problems.


In 2011, NFID - the National Foundation for Infectious Diseases - convened a group of experts to address the issues of influenza and the elderly. From that panel a 5-page brief has emerged, called: Understanding the Challenges and Opportunities in Protecting Older Adults from Influenza.


While the elderly generally see less protection from the flu vaccine, they state that older individuals may still mount a robust immune response. Even if the vaccine doesn’t always prevent infection in the elderly, studies suggest that the vaccine may blunt the seriousness of the illness in those over 65.


You might not have thought about it, but getting your seasonal flu shot each year should be part of your overall preparedness plan. During a disaster or prolonged emergency you are likely to be tired, stressed, and your immune systems could be weakened.


The last thing you need during a crisis is to be sick with the flu on top of it.


Which is why I’ve already paid a visit to my local CVS pharmacy and got my yearly seasonal flu shot.  The process (and the shot – nice job, Carol) were painless.


According to the CDC, more than 50 million doses of this year’s flu vaccine have already been distributed, so finding a shot should be no trouble.



September might seem a little early to be getting the flu shot, but we are already seeing scattered reports of influenza around the country, and it takes a couple of weeks after getting the shot for immunity to kick in. 


While the vaccine can’t promise 100% protection, it – along with practicing good flu hygiene (washing hands, covering coughs, & staying home if sick) – remains your best strategy for avoiding the flu (and other viruses) this winter. urges all Americans to follow these 3 steps to better preparedness:





Sage advice. But if you want to be truly prepared, I would add an important 4th step.

Get a shot