Your Health

Get the shot, not the flu

Just a few minutes could help reduce your chance of contracting the flu - or giving it to someone else

Dr. Michael Routledge

Find out where you can get your free flu shot

Winnipeg Health Region
Wave, September / October 2011

Dr. Michael Routledge is a Medical Officer of Health for the Winnipeg Health Region. Each year, Routledge works with a small army of health-care providers to organize influenza vaccination clinics throughout the city. He recently took time to explain how these clinics help contain the spread of the flu virus and why members of the public should consider getting a flu vaccination shot this year.

It seems like every year about this time there is a lot of attention paid to influenza, also known as "the flu." Why?

Well, simply put, influenza poses a serious health threat to the community. It's estimated that the flu affects five to 15 per cent of Canadians each year, with many being sick for as long as a week. Moreover, it is estimated that about 20,000 hospitalizations and 2,000 to 8,000 deaths can be attributed to the flu every year in this country. The risk of complications is greater for seniors, young children, pregnant women, and people who have a variety of chronic health conditions. So the human cost is quite significant.

But there is also the impact on the economy to think about. The cost from lost productivity due to people taking sick days runs into the millions of dollars by some estimates. And then there is the cost to the health-care system. Every flu season, emergency departments and doctors' offices are clogged with people who have influenza, which strains resources in the system.

What's the difference between the flu and the common cold?

Typically, a person with a cold will have a runny nose and sneeze a lot, while a person with influenza will have a sore throat, fever, muscle aches and coughing. There is a big difference in how people feel - most people with a cold feel OK, while people with influenza typically feel lousy. Most importantly, cold viruses do not cause significant health complications, while influenza can. Complications can include bacterial pneumonia, ear and sinus infections, dehydration, and worsening of chronic medical conditions.

How is the flu spread?

Influenza viruses are spread mainly by droplets made when people cough, sneeze or talk. These droplets can land in the mouths or noses, or be inhaled into the lungs, of people who are nearby. Less often, a person might also get infected by touching a surface or object that has virus on it and then touching their own mouth or nose. Most healthy adults may be able to infect others beginning one day before symptoms develop and up to five to seven days after becoming sick. Some people can be infected but have no symptoms, while still being able to spread the virus to others. Various studies suggest that as many as one in five people may have an influenza virus and not show any signs of illness. This means that you may be able to pass on the virus to someone else either before you are sick or without knowing you are infected.

Given that the flu is actually quite a serious infection, what can people do to protect themselves?

One of the best ways to protect yourself from the flu is to get vaccinated in the fall before the flu season, which is usually between November and March. Not only does a vaccination reduce your risk of getting sick, it limits the possibility that you will spread the virus to someone else.

Who should get a flu shot?

Almost everyone. Canada's National Advisory Committee on Immunization encourages everyone over the age of six months to get a flu shot, but especially if you are:

• Over the age of 65, or between six months and four years of age
• Living with a chronic health condition such as a cardiac or pulmonary disorder (including COPD, cystic fibrosis and asthma), diabetes, cancer or immunodeficiency (due to underlying disease and/or therapy)
• Of Aboriginal ancestry
• Pregnant
• Morbidly obese
• Living in a personal care home or longterm care facility
• A health-care provider, a caregiver, or in close contact to anyone in the above groups

The primary exception is people who have had an anaphylactic reaction to a previous dose of an influenza vaccine, or the components of the vaccine including eggs. Anaphylaxis is a severe form of allergic reaction that can include hives, swelling in the mouth or throat, and shock. People with other milder forms of allergy should talk with their doctor about whether they should receive a flu shot.

But if older people with chronic conditions are more vulnerable, doesn't that mean younger, healthy people can do without the shot?

No. Just because some people are more vulnerable does not mean that others are not vulnerable at all. Influenza is unpredictable, and how severe it is and which groups are most affected can vary widely from one season to the next. Also, less vulnerable people can pass infection on to other people who are less able to resist infection. For example, let's say you have the flu and take the bus to work. Maybe you pass on the virus to someone on that bus, and then maybe they pass it on to someone else, who then visits someone in a senior's residence or comes into contact with someone who has a chronic condition. And the thing of it is you may not even realize you are infected even as you are passing on the virus. Plus, getting the shot saves you from feeling lousy and being stuck in bed.

You mean I could inadvertently pass on the virus without even knowing it, just because I didn't get a flu shot?

That's right. It's one reason why we here at the Winnipeg Health Region are working to raise awareness. Previously, the seasonal vaccine was free only to people deemed to be most at risk of becoming infected with influenza and their care providers. But starting last year, anyone attending our flu shot clinics can get vaccinated at no charge. The clinics will be held between Oct. 18 and 22.

Click here to find flu shot clinic near you

I've heard it said that a person can get the flu from the flu vaccine. Is that true?

No. The influenza vaccine is made using a dead virus. It mimics an infection, causing the body to produce antibodies to fight the actual flu virus, but it cannot cause infection.

Why do people need to keep getting the flu shot year after year?

That's because the virus keeps mutating. There are three types of viruses that cause outbreaks each year: Two Influenza A types and one B type. Each year, the World Health Organization determines which three strains of influenza virus are likely to have the greatest impact on people. Influenza vaccines are made based on this information. Individuals need to be vaccinated annually to ensure your body can form the antibodies required to guard against the most common strains of viruses circulating in a given year. Protection from the flu shot only lasts about one year, so even if the vaccine components haven't changed from the previous year, which is the case this year, you still need an annual shot.

So what should I do if I think I have the flu?

The message is wash your hands, cough into your sleeve and stay home as much as possible. Whether you have the flu or some other type of illness, it's best not to go to work, school or other public places. If you do, you run the risk of infecting those you come into contact with.

	About Wave Wave is published six times a year by the Winnipeg Health Region in cooperation with the Winnipeg Free Press. It is available at newsstands, hospitals and clinics throughout Winnipeg, as well as McNally Robinson Books. Read the Sept. / Oct. 2011 issue of Wave