by Peggy Spencer
Daily Lobo columnist
Dear Dr. Peg,
I saw that the Student Health Center has flu shots, but I already had the flu last week. I puked my guts up for two days. But my roommate didn't get sick. Is that because he got the flu shot last year?
Dear Puker,
You didn't have the flu. You probably had a viral infection in your intestines. You might have called it "stomach flu," but that is a misnomer. We all throw the word flu around, using it as a shortcut for viral infection. The word flu is short for influenza, a disease caused by a specific group of viruses that attack the respiratory system.
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Influenza is a nasty illness. You burn with fever, shake and ache with chills, hack and cough, take to your bed. If you have ever had it, you know how miserable it is. Most young healthy people get over it in a week or so, but it can be much more dangerous to children, the elderly and those with weakened immune systems or chronic illnesses. Influenza kills about 36,000 Americans every year and puts 200,000 more into the hospital with pneumonia, encephalitis or other complications. It's no small player. You have probably heard about the famous flu pandemic of 1918, which killed 40 million people worldwide - including 200,000 New York City residents in one fall swoop.
You catch the flu from inhaling virus particles carried in infected droplets. That's a nice way of saying you'll get sick if someone with the flu coughs or sneezes on you - or near you, or onto an object that you then touch, followed by you touching your eyes, nose or mouth.
The best way to avoid getting the flu is to get a flu shot. And, no, your roommate's shot from last year is not good enough for this year. This is because of the shape-shifting nature of the flu virus, as I will explain.
Influenza comes in three types - A, B and C. Type C causes a mild respiratory illness, not dangerous enough to include in the vaccine. Type B only affects humans and is severe enough to include in the vaccine. Type A, however, is the real bad character. Influenza A viruses are found in humans and many animals, including birds, pigs, horses and even whales. Type A can be further subdivided based on proteins on the surface of the virus. The proteins, or antigens, are called H for hemagglutinin and N for neuraminidase. H and N can be even further subdivided into types such as H1N1, for example. These subtypes of Influenza A are what vaccine makers put into the flu shot, along with type B antigens. The antigens stimulate our bodies to make antibodies to fight the flu.
The tricky part is that the subtypes can change over time, and the CDC spends a lot of time chasing after these quick-change artists to identify the alterations, so that the best vaccine can be made for us for the year. Alterations in H and N can be small - which is called "antigenic drift" - or large, which is "antigenic shift." Drift happens all the time - small changes that don't pose a huge danger, but do require a new, updated flu vaccine every year. Shift happens about every 30 years or so. When it happens, the result is a pandemic.
Back to basics. Flu season in this hemisphere is November through March with a peak in February. To avoid the flu, steer clear of people with the flu and wash your hands often. Attend to your basic health needs such as sleeping and eating well. Stay out of crowds and airplanes during flu season. If you want a flu vaccine, you can get it at the Student Health Center for $13 if you're a student and $20 if you're not. If you have Student Health Insurance Plan A or Grad Plan, the flu shot is free. The flu shot does not cause the flu (there are no live viruses in the shot), but it can result in a sore arm and a couple days of minor aches and low-grade fever. There is also a nasal spray form of influenza vaccine, but so far no medical facilities or pharmacies in New Mexico carry it.
If you choose not to get vaccinated, and you get the flu, stay home, get plenty of rest and liquids and take acetaminophen for your fever and aches. If you are over 50, under 2, pregnant or have a chronic illness, you might benefit from early antiviral medication in the first 48 hours of illness.
By the way, the much reported "bird flu" is a type of influenza A - type A (H5N1), to be precise. This type is not included in the yearly flu vaccine, because so far, it hasn't been shown to spread easily from person to person. However, many scientists believe that the 1918 pandemic was caused by a new virus that formed from a mixture of bird and human flu strains, so they're watching this one closely, and a vaccine is already in the works.
Peggy Spencer has been a UNM student health physician for 16 years. E-mail your questions to her at Pspencer@unm.edu. All questions will be considered and all questioners will remain anonymous. This column has general health information only and cannot replace a visit to a health care provider.
