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February 19, 2012 at 8:08 PMComments: 2 Faves: 0

"The Flu" vs. Influenza

By Jeffrey VanWingen M.D. More Blogs by This Author

For the past several months I have offered my patients the yearly vaccination against the influenza virus and many times I have heard, “No thanks. I have already had the flu.” But what IS “the flu?” Is it influenza or some catch-all for the innumerable viral bugs out there? And, what is the place of “the flu shot” in all of this? This blog will explore what influenza is and is not, exploring myth vs. fact.

What "The Flu" ACTUALLY Is

Influenza is a virus that is spread from person to person via respiratory droplets (coughing or sneezing). Influenza is a seasonal illness, usually peaking in the winter. The peaks CAN arrive as early as October and as late as the spring, however.

Symptoms of influenza include:

  • Severe Muscle Aches
  • Headache
  • Fever
  • Coughing
  • Sore Throat
  • Fatigue 

Duration and Side Effects. While most who get the flu will recover in about two weeks, complications can develop such as pneumonia which may lead to hospitalization. Influenza can even be lethal. Children, the elderly and people with chronic disease (especially respiratory illnesses like asthma or emphysema) are a greater risk for more severe outcomes. 

Types of The Flu. Of the influenza virus, there are several subtypes and strains.  We have seen some examples of this recently with the “avian” and “swine” flu epidemics.  To further complicate matters, the genetics of the influenza change from year to year.  This is the reason that a new flu vaccine is needed each year — to cover the expected virus that will arrive on the scene. Scientists are quite good at predicting what strains will emerge year to year. This year’s flu vaccine covers three strains, one being the H1N1 “swine” flu. Considering that in 1918 a strain similar to the recent “swine” flu killed an estimated 50 million people worldwide, we have come a long way, namely due to the vaccine and preventative practices.

Treatment.There are anti-viral medications that can be used once infection occurs, but these serve only to lessen the severity of the illness at best.  As a preventative measure, the medication is not much better.

What "The Flu" is Not

It's NOT the common cold! The flu is not just any illness that makes you feel sick.  Most illness that causes congestion and/or sore throat, fever, headache, rash, etc. are a variation on the common cold.  While these illnesses are as contagious as influenza, they are not as serious.  Our bodies rid themselves of such viral illnesses after about a week regardless of what we do. 

It's NOT the stomach flu! Further, the “stomach flu” is not influenza.  These illnesses, also quite contagious and viral in nature, only affect the stomach and intestinal tracts. The infection most often causes vomiting and then diarrhea before resolving. 

Can the flu vaccine make you sick?

I often hear people implicate the flu vaccine for an illness that occurred after the shot. While it is true that the nasal spray version of the vaccine contains the living flu virus, it has been rendered unable to cause illness.The injectable version contains killed, inactivated virus.

Vaccines are Like Tigers. I tell my patients that vaccines are like tigers. Some vaccines are like a piece of tiger fur. Others are like a living tiger with no claws or teeth. Both give us the ability to recognize the tiger. In our bodies, vaccines allow our immune systems to recognize the illness and mount the ability to fight it off immediately if it ever attempts to invade the body. 

A Matter of Coincidence. The misfortune with the flu vaccine is that it is given right at the time when so many viral illnesses become prevalent, like the common cold—guilt by association. 

Problems the Vaccine CAN Actually Cause. It is true, though, that the body’s immune system has some work to do once the vaccine is given.  This can at times cause fatigue or a mild fever.  The most common side effects of the vaccine are a rash or soreness at the injection site or a runny nose with the nasal version.

Will you judge me if I DON'T get the flu shot?

Fundamentally I believe that people have the right to choose their health course, provided that they are properly informed.

Many situations come my way with patients where the risks and consequences are questionable—a sports clearance for the contact sport of football for instance.  My job with such a situation as with any vaccine, however, is the same. 

Vaccines do differ, though, the fact that if a person declines the vaccine and contracts the illness they can spread it to others does not. For this reason, many healthcare settings make influenza vaccine a requirement for employment. Once considered a controversial move, it is now common practice. In general, however, people are free to make this choice.

In sum, influenza is a small portion of what is commonly referred to as “the flu.”  Influenza can be lethal, especially in certain vulnerable populations.  The flu vaccine only works for influenza.  It is my hope that this information allows you to make an informed decision on the flu vaccination. 

Here’s to a healthy and better informed flu season!

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  • Dr. VanWingen: My grandmother on my dad's side was 3 years old in 1918 when the epidemic hit. Sadly, she lost siblings to it, and she had it herself but survived. She passed away a few years ago, but I remember as a kid hearing my dad and her talking and mention that she can't get vaccinated because of it. Any chance you can explain why that might have been the case, and if that can still happen with others today? Thanks, and excellent blog as usual. :)

  • Great question, Dave. Actually, the reason that someone should not get vaccinated if they lived during a recurrent strain is that they are likely immune or would have a much more minor infection. We saw this with the recent H1N1 outbreak. Some thought that it was cruel to offer the vaccine to younger members of the population before the elderly as rationing took place. In reality, though, older people were likely exposed decades ago when it had a prior go-around. So, in such a case it is not that prior exposure prevents the ability to vaccinate but rather that it not as necessary.

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