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Shoot the flu

Annual vaccination best way to prevent influenza

Annual vaccination best way to prevent influenza
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Influenza information and resources for individuals and families

BY AUDRA KOLESAR
Winnipeg Health Region
Wave, September / October 2012

What is influenza?

The flu is an infection caused by a virus. It can spread easily from one person to another through coughing, sneezing or sharing food or drinks. You can also get the flu by touching objects contaminated with flu virus and then touching your mouth, eyes or nose.

The flu season in Manitoba usually begins in the late fall and lasts into the spring.

What are the symptoms?

Flu symptoms usually appear suddenly and can include cough and a fever, sore throat, muscle aches, joint pain and exhaustion.

Children may also feel sick to their stomach, vomit or have diarrhea. Elderly people, young children and people with lowered immunity may not have a fever.

Not everyone who gets the flu develops symptoms but they still may be able to spread it to others, especially if they cough or sneeze. It's important for all people to practise proper cough and sneeze etiquette, whether or not they feel ill.

What can I do to prevent influenza?

The most important thing you can do to protect yourself from the flu or prevent it from spreading is to get a flu shot.

Other preventive measures include:

  • Wash your hands frequently.
  • Keep your hands away from your face.
  • Cough and sneeze into your arm, not your hand.
  • Keep common surface areas clean and disinfected.
  • If you get sick, stay home.

It's not too late to get your flu shot!  Influenza vaccine is available from primary health care providers, such as family doctors and nurse practitioners, QuickCare Clinics or through public health offices by calling 204-956-SHOT.

Who should get the flu vaccine?

The annual seasonal flu shot is available to all Manitobans at no charge and is available from health-care providers. It will offer protection against three seasonal flu strains.

An annual flu shot is especially important for those at increased risk of serious illness from the flu, their caregivers and close contacts.

This includes:

  • Seniors age 65 or older.
  • Residents of personal care homes or long-term care facilities.
  • Children age six months to 59 months.
  • Those with health issues or chronic illness such as:

    • Children and adolescents with conditions treated for long periods with aspirin (acetylsalicylic acid).
    • An immune system weakened by disease or medical treatment.
    • A condition that makes it difficult to breathe.
    • Other chronic medical conditions (e.g, diabetes, mental disabilities).
  • Pregnant women.
  • Health-care workers and first responders.
  • Individuals of Aboriginal ancestry.
  • People who are severely overweight or obese.

Healthy persons aged five to 64 years are also encouraged to receive influenza vaccine even if they are not in one of the priority groups. Children under nine years of age who have never had a seasonal flu shot before will need two doses, given four weeks apart.

Who should not get the influenza vaccination?

  • Anyone with an egg allergy who had a reaction to a previous dose will need an assessment prior to getting a flu shot. Please contact your primary care provider to arrange your immunization if you have an egg allergy. If you have an egg allergy, and have received a previous flu shot without a reaction, you may receive another flu shot, and need to be observed for at least 30 minutes post-immunization.
  • Children under the age of six months.
  • Anyone who developed Guillain-Barré Syndrome within eight weeks of a previous flu shot.
  • Anyone who has a fever on the day ofhe flu shot is to be given. But you can still get the flu shot if you have a mild illness like a cold.

Are there side-effects associated with a flu shot?

Vaccines are known to be very safe. It is much safer to get the vaccine than to get the flu.

But it is common to have soreness, redness and swelling where the vaccine was given. Some people may have fever, chills or fatigue. These are mild reactions and usually last one to two days. Acetaminophen (Tylenol or Tempra) can be given for fever or soreness.

ASA (Aspirin) should never be given to children because it can cause a severe liver and brain disease called Reye's Syndrome.

It is important to stay in the clinic for 15 minutes after getting any vaccine because there is a rare possibility of a severe allergic reaction. This can include hives, difficulty breathing, or swelling of the throat, tongue or lips. If this happens after you leave the clinic, call 911 or go to the nearest Emergency Department for immediate treatment.

Other rare conditions

In past flu seasons, some people experienced one or more of the following symptoms associated with Oculorespiratory Syndrome (ORS): red eyes, shortness of breath, chest tightness, cough, sore throat, or swelling of the face. These symptoms usually appeared within 24 hours of getting the flu shot and were gone within two days.

Seasonal flu shots have been associated with Guillain Barré Syndrome (GBS), which is a form of paralysis that is usually temporary. It is a very rare reaction that occurs with approximately one out of every million flu vaccinations.

What about women who are breastfeeding?

Influenza immunization does not adversely affect the health of breastfeeding mothers or their infants. Breastfeeding is not a contraindication for influenza immunization.

What basic precautions should people with the flu take?

If you have flu symptoms:

  • Stay home from daycare, school or work and limit contact with others while you are sick.
  • Cough or sneeze into your elbow or sleeve, or use a tissue to cover your nose and mouth. Place the tissue in the garbage immediately.
  • Wash your hands often with soap and water, especially after you cough or sneeze. When soap and water are not available and your hands aren't visibly soiled, hand sanitizers may be an acceptable alternative. Children may need help washing their hands.
  • Limit touching your eyes, nose and mouth.

How can I treat flu symptoms?

  • Get plenty of rest.
  • Gargle with warm salt water if you have a sore throat.
  • Use a cool mist humidifier to help with a stuffy nose.
  • Dress in lightweight clothing and keep the room temperature around 20ºC (68ºF).
  • Drink plenty of fluids.
  • Have small, nutritious meals.
  • Take acetaminophen (e.g., Tylenol, Tempra). Use the dose and schedule recommended on the package or by your doctor or pharmacist. Ibuprofen (e.g., Advil, Motrin) may be used for children older than six months and for adults.
  • Do not give acetylsalicylic acid, also known as ASA, (e.g., Aspirin) to anyone under 18 years of age because it can lead to brain and liver damage (Reye's Syndrome).

How long will the effects last?

Although most people recover from the flu within a week to 10 days, for some people, the complications from the flu can be severe, or even deadly. These complications can include bronchitis, pneumonia, kidney failure or heart failure. One of the most common complications related to influenza is a bacterial infection of the upper and/or lower respiratory tract. Symptoms of a bacterial infection include lack of improvement in a person's condition after three to five days, and bloody mucous coming up when the person coughs.

Adults and children who suffer from cardiac or pulmonary disorders (e.g., asthma, cystic fibrosis) may see their chronic condition worsen.

Young children are particularly susceptible to complications from the flu. Some symptoms of complications in children include difficulty breathing, sudden paleness, fever or low temperature, inability to drink or breast-feed, vomiting more than two to three times in 24 hours, a stiff neck, lethargy or confusion, and convulsions or seizures.

Pregnant women who contract influenza may develop pneumonia and may require hospitalization.

Elderly people (65 years and older) have the highest rate of hospitalization and death from the flu. Common complications of the flu for seniors include bacterial infection and pneumonia.

When should I seek medical care?

The decision to seek medical care will be affected by factors such as age, existing health problems, and the symptoms you are experiencing at the time. People with symptoms of influenza should contact their health-care provider if they:

  • Have heart or lung disease.
  • Have a chronic condition that requires regular medical attention.
  • Are frail.
  • Have an illness or are on treatments that suppress (weaken) the immune system.

People who are normally healthy and have symptoms of influenza should seek medical attention as soon as possible, if they experience any of the following:

  • Breathing that is difficult or painful.
  • Coughing up of bloody sputum (phlegm or saliva).
  • Wheezing.
  • Presence of fever for three to four days, along with not getting better or getting worse.
  • Sudden return of high fever and other symptoms after initial improvement.
  • Extreme ear pain.
  • Extreme sleepiness, difficulty waking up, or becoming disoriented and confused.

People who need to seek medical care should contact their health-care provider to report illness by telephone (or other remote means) before seeking medical care.

People who have difficulty breathing or are believed to be severely ill should seek immediate medical attention by going to the nearest hospital emergency department or calling 911.

When should I seek medical care for a child?

Almost all children with influenza have a fever. The degree (or height) of a fever will not tell you how serious your child's illness is. How a child acts is usually a better sign.

A child with a mild infection can have a high fever, while a child with a severe infection might have no fever at all.

It is recommended that you contact your doctor if your child has signs of influenza and:

  • Has lung or heart disease.
  • Has an illness or is taking treatment that affects the immune system.
  • Takes acetylsalicylic acid (ASA or Aspirin) regularly for a medical condition or has a chronic illness requiring regular medical care.
  • Has a fever and is less than six months old but older than three months.
  • Has a fever for more than 72 hours.
  • Is excessively cranky, fussy or irritable.
  • Is not interested in playing with toys or is unusually sleepy, listless.
  • Has a fever and a rash or any other signs of illness that worry you, or is still not feeling better after five days.

Take your child immediately to a hospital emergency department or call 911 if your child:

  • Has a fever and is under three months of age.
  • Drinks very little fluid and has not peed at least once every eight hours for those under one year of age, and 12 hours for children over one when awake.
  • Has severe trouble breathing or blue lips.
  • Is limp or unable to move.
  • Is hard to wake up or does not respond.
  • Has a stiff neck.
  • Seems confused or is coughing a lot or coughing up bloody sputum (phlegm or saliva).
  • Has vomited for more than four hours or has severe diarrhea.
  • Has a seizure (convulsion/fit).
  • Was feeling better and suddenly develops a new fever.

Audra Kolesar is a registered nurse and manager with Health Links - Info Santé, the Winnipeg Health Region's telephone health information service.

The information for this column is provided by Health Links - Info Santé. It is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a health-care professional. You can access health information from a registered nurse 24 hours a day, seven days a week by calling Health Links - Info Santé. Call 788-8200 or toll-free 1-888-315-9257.

Wave: September / October 2012

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.

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