By Dr Carmen
1. What exactly is Swine Flu and how do you contract it and treat it?
It’s probably better for me to explain the Influenza virus in a little more detail first.
The flu is caused by the Influenza virus.
There are four types of Influenza virus; A, B, C and D: Types A and B cause the seasonal epidemics each year. Influenza A is the most common flu virus and it infects both animals and humans. Influenza B only infects humans and usually does not make you as sick as Type A. Type C also causes the flu but it’s very mild and type D is not known to cause illness in humans.
Influenza A is divided into subtypes depending on two proteins; H and N. There are a number of different H and N proteins and a wide number of possible combinations. Current subtypes of Influenza A than most commonly infect humans are H1N1 and H3N2.
Just to confuse us a little more, Influenza A can further be broken down into strains. The genes responsible for making the H and N proteins continuously mutate and therefore there can be many strains of the same subtype. These are most commonly only small changes in the DNA but it is for this reason the flu vaccine changes each year.
In 2009 a completely new strain of the Influenza A (subtype H1N1) virus was born. This originated in pigs and hence the name Swine flu. The changes in DNA were so great that the H1 and N1 proteins that emerged from the pigs were very different to the original human H1N1 seasonal strain. Since this strain was completely new, humans did not have any immunity towards it and it caused a pandemic. This new strain of H1N1 has now replaced the old one. It is important to realise that this virus is not necessarily more aggressive and deadly than other strains.
The Influenza virus is very contagious and spreads easily from person to person. This can happen from inhaling infected droplets that temporarily float in the air after someone who is infected coughs or sneezes. Infection can also happen by touching surfaces and hands where these droplets have landed and then touching your own eyes, mouth and/or nose. The Influenza virus can survive for up to 48 hours on a surface!
There is no cure for Influenza. They are best treated symptomatically. This means treating the fever, aches and blocked nose. Tamiflu is an antiviral that can be prescribed. It is effective against both Influenza A and B. It basically stops the virus from spreading in the body but it does not kill the virus. The body needs to use its own defenses to do this. So what antivirals do, is give our bodies a better chance by reducing the number of viral cells it has to fight against. This can therefore shorten the duration of the illness and reduce the risk of complications.
2. Many rumours have been made that Tamiflu (for swine flu) is only effective if taken within 48 hours of symptoms. Is this true?
The clinical benefit of Tamiflu is greatest when it is started early, when the number of viral cells in the body is lowest, especially within 48 hours of the onset of symptoms. It can however be started at any point and still be beneficial, especially in individuals at high risk of serious complications.
It is not routine practice to prescribe Tamiflu for an Influenza infection. If this were done it could lead to drug-resistant strains. Tamiflu is recommended in people at risk of severe infection and complications such as pregnant women, people with chronic medical conditions, infants and the elderly.
3. What is the difference between Antibiotics and Tamiflu?
Antibiotics are only effective against bacteria. Antibiotics will not work against the flu because the flu is caused by a virus. Tamiflu is an antiviral that can be used for the flu.
4. Do you recommend flu vaccinations, and what is your view on having this vaccination when pregnancy or giving it to your baby/small kids?
I am pro-vaccine and strongly recommend the seasonal flu vaccine. It has been proven to be effective in clinical trials all around the world. I recommend that anyone over 6 months of age gets the flu vaccine, with some rare exceptions.
Since the flu vaccine is an inactive vaccine it is also safe in pregnancy and all pregnant women should get it regardless of their trimester. A mother’s antibodies will pass to the baby and protect the baby in the first 6 months of life when they are not able to get the vaccine.
By getting the vaccine not only are you protecting yourself but you are also protecting others. The more people that get vaccinated, the more difficult it becomes for the disease to spread. Therefore fewer people will become ill and vulnerable people at high risk of complications will have a lower chance of contracting the virus.
If you really don’t want to get the flu vaccine then I suggest that all children six months to five years, pregnant women, adults over 65 years and all individuals with chronic diseases regardless of age, receive the flu vaccine.
5. How soon should you have the flu vaccination before Winter?
It takes up to two weeks to develop antibodies to a vaccine. So it is better to get the vaccine two weeks before the winter season starts. This can be difficult to determine since the flu season seems to be starting earlier and earlier each year. I recommend getting the seasonal flu vaccine as soon as it becomes available. It can however be given at any time throughout the winter. Its always better to be vaccinated than not!
6. Can you get the flu vaccine after already having had the flu?
Yes you should! Since there are multiple strains of Influenza floating around at one time you can definitely get the flu again (just not with the same strain as you previously had). This is why the flu vaccine protects you against not only one strain, but either 3 or 4 depending on which vaccine you get. There are also other viruses that cause flu-like illnesses that spread during the winter season. So just because you had ‘flu’ does not mean it was caused by the Influenza virus.
Can you get the flu vaccine whilst you are sick?
If you are feeling really sick it’s probably better to wait to get the vaccine until you feel better. Your immune system is trying to fight off an illness so it is already really busy. By giving it more work to do, it may not be able to develop antibodies to the vaccine as effectively as it should.
7. Can the flu vaccination give you the flu?
This is a very common myth. You cannot get the flu from the flu vaccine! This is because the flu vaccine is an inactivated one and therefore does not contain any live virus. Yes, you may feel a little down and out after the vaccine for a few days but this is a very normal and healthy immune response. Coughing, sneezing, fever, inflammation and the resulting body aches are actually all caused by the immune system and not the pathogen. These symptoms indicate that the immune system is working and although these are not pleasant symptoms they are what we want. We want the immune system to be making antibodies to protect us against future exposure to a live virus.
On the odd occasion you may develop the flu after a flu vaccine because you have contracted a strain of Influenza that was not in the vaccine or you were going to get the flu anyways because you contracted the virus 1-4 days before getting the vaccine.
Dr Carmen is a medical doctor with years of experience in Accident and Emergency Room trauma in South Africa and abroad. She also has her Masters in Public Health and is incredibly passionate about prevention of disease and injury through knowledge. She is the founder of OneAid, and through this incredible brand - she hopes she can empower parents and caregivers alike through sharing her own journey as a Mom-Doc and offering useful information, tips and products relating to children’s health and safety.
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