Flu, Pneumonia or Cold

(2/25/08)- Looking for regular updates as to where influenza is circulating? Check www.cdc.gov/flu/weekly

(3/29/08)- The following information was extracted from the CDC Web site:

Synopsis

During week 12 (March 16 - 22, 2008), influenza activity continued to decrease in the United States.

• Nine hundred eighty-six (21.3%) specimens tested by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories were positive for influenza.
• The proportion of deaths attributed to pneumonia and influenza was above the epidemic threshold for the eleventh consecutive week.
• The proportion of outpatient visits for influenza-like illness (ILI) was above national baseline levels, while the proportion of outpatient visits for acute respiratory illness (ARI) was below national baseline levels. ILI was below the region specific baselines in the West South Central and Pacific regions, but remained above region-specific baselines in the remaining seven regions. The proportion of outpatient visits reported for ARI was below all region-specific baselines.
• Seventeen states reported widespread influenza activity; 30 states reported regional influenza activity; two states and the District of Columbia reported local influenza activity; and one state and Puerto Rico reported sporadic influenza activity.

National and Regional Summary of Select Surveillance Components

* Elevated means the % of visits for ILI or ARI is at or above the national or region-specific baseline
† National data is for current week; regional data is for the most recent 3 weeks.
‡ Includes all 50 states and the District of Columbia

Laboratory Surveillance

During week 12, WHO and NREVSS laboratories reported 4,625 specimens tested for influenza viruses, 986 (21.3%) of which were positive, including 27 influenza A (H1) viruses, 156 influenza A (H3) viruses, 363 influenza A viruses that were not subtyped, and 440 influenza B viruses.

Since September 30, 2007, WHO and NREVSS laboratories have tested a total of 171,992 specimens for influenza viruses and 31,722 (18.4%) were positive. Among the 31,722 influenza viruses, 24,159 (76.2%) were influenza A viruses and 7,563 (23.8%) were influenza B viruses. Seven thousand ninety-eight (29.4%) of the 24,159 influenza A viruses have been subtyped: 1,999 (28.2%) were influenza A (H1) viruses and 5,099 (71.8%) were influenza A (H3) viruses.

Although influenza A (H1) viruses predominated through mid-January, influenza A (H3) viruses have been reported more frequently than influenza A (H1) viruses since week 4 (January 20-26), and during week 4 influenza A (H3) became the predominant virus for the season overall. This season influenza A (H3) viruses have been reported more frequently than A (H1) viruses nationally, as well as in seven of the nine surveillance regions (East North Central, East South Central, Mid-Atlantic, New England, South Atlantic, West North Central, and West South Central). Influenza A (H1) viruses have predominated circulation this season in the remaining two regions (Mountain and Pacific).

(1/25/00)- Recently, this editor suffered with a bout with the flu, which compromised my respiratory system. Through this experience I became acutely aware of the differences between flu, pneumonia and the common cold. It seemed important that we inform our readers of the differences.

Pneumonia is an infection of the lungs caused by bacteria, viruses, fungi, parasites and other germs infecting the air sacs of the lung. It is usually secondary to flu but can occur independent of the flu. It involves a number of types including viral pneumonia and bacterial pneumonia.

Viral pneumonia symptoms include fever, tiredness and a dry cough, while bacterial pneumonia symptoms involve a sudden high fever, shaking chills and stomach problems. Bacterial pneumonia is usually treated with antibiotics.

A vaccine is available that appears to protect against 23 types of bacteria that cause pneumonia, which are thought to cause 88% of the cases of bacterial pneumonia. Indications are that it is effective in 60% of the cases of bacterial pneumonia. Please see our article "Pneumococcal Disease Vaccination and the Elderly". The Center for Disease Control (CDC) does not recommend this vaccine for those who are asthmatic.

The following table will help readers distinguish between a common cold and the flu. However, this is no substitute for checking with your own physician when you are feeling ill.

Influenza virus (Flu) involves virus particles latching onto a cell in your nose or throat, tricking this cell into producing new viruses. Your immune system begins to fight these virus and produces flu symptoms.

This process takes about two days but could take as long as 6 days to manifest itself. A person is contagious for about six days. The flu vaccine is about 90% effective in the general population and about 70% effective for seniors

. If you are allergic to eggs, you should not get the flu vaccine. Also people with chronic lung diseases, heart disease and immune disease should not take this vaccine unless advised by their physician.

There are medications approved by the Food and Drug Administration that can prove helpful once you get the symptoms of flu. Most of these drugs need to be taken with 24 to 48 hours of the first sign of symptoms of flu. The FDA has recently approved two new drugs. One is an inhaler called Relenza and the other is a pill called Tamiflu. Both drugs have side effects: Relenza can cause sinus problems and diarrhea while Tamiflu causes nausea. These drugs need to be taken for five days.

We hope this information will prove helpful to our readers.

FOR AN INFORMATIVE AND PERSONAL ARTICLE ON PRACTICAL SUGGESTIONS WHEN SELECTING A NURSING HOME SEE OUR ARTICLE " How to Select a Nursing Home"

By Harold Rubin, MS, ABD, CRC, Guest Lecturer
updated March 29, 2008

e-mail: hrubin12@nyc.rr.com or rubin@brainlink.com

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