January 16, 2013 - Eminent Dangers

It has been years since we’ve had an Influenza epidemic in this country, and I have been receiving many questions from concerned patients and friends. For that reason I wanted to go over some key points.

First, a flu season is not necessarily a flu epidemic.  Flu seasons are expected—epidemics are not. In fact, they are dreaded. And as of last Friday, the United States is under an epidemic—an epidemic of a dangerous Influenza. In the midst of it, there are some important facts to consider this year.

For an epidemic to occur, one or more things must happen.

  • The host population (us) becomes more susceptible to the virus. There is an argument to make for this theory this year, in that the weather, which has caused drastic and rapid changes in our environment in recent weeks, has triggered sinus infections and lowered immunities, making it much easier for the influenza to gain a foothold.
    • Although there is some indication that this is occurring, it doesn’t quite fit the mold. For example, when increased susceptibility occurs, it is usually a regional problem that may or may not spread to other areas. But that is not the case. Instead, we are seeing a widespread outbreak of the flu nationwide.


  • The anti-viral medications no longer work.
    • There is no resistance to the current medications, Tamiflu and Relenza. That’s good news, even though those meds don’t guarantee recovery, they do cut the viral period short. Coupled with a flu shot earlier in the season, this combination makes it much less dangerous to get through a bout of Influenza.


  • The Virus mutates, and becomes more invasive.
    • It does appear that the Influenza virus that is causing the most severe illness right now is a mutated, or variant form of influenza A. That does not mean that it is resistant to the anti viral medication, but it is more difficult to diagnose, and much more durable. For example, if you have had a flu shot, it does not necessarily prevent you from getting the flu. It does give you a 60% greater chance of not getting the flu compared to those who don’t get immunized, and it still makes the flu battle shorter and less severe.


There are also some unfortunate misunderstandings about the flu that I would like to address.

  • The flu shot can give you the flu.
    • This is not true, however our body’s response to the shot and the building of antibodies against the flu virus can make us feel icky for several days, but it’s not the flu. They symptoms are so mild, they rarely interrupt an individuals normal daily activities.


  • The medication doesn’t really help.
    • Not true. The medications can shorten the course and lessen the severity of the illness, but only if started early in the process. Ideally we should be starting the anti viral meds within 24-48 hours of the beginning the flu, otherwise it may not help at all. I realize that visiting the doctor’s office is unpopular, especially when there is an outbreak like we have now, but it’s critical.


  • Once my fever breaks, I’m home free!
    • Unfortunately, also not true. If the fever breaks, symptoms improve, and the illness seems to recur in a few days, this is an ominous warning sign. If it happens, a secondary bacterial infection requiring antibiotics may be the culprit. Even in youngsters, it is important to follow-up immediately if the symptoms or fever returns, since this can be life threatening.

This flu epidemic is a challenge, and it’s important to be smart about it. This is a deadly virus and should be respected. Some otherwise very healthy folks have already died. Don’t play with it this year.

Questions for me? Please ask them below. I will do my best to answer.