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We are now all enjoying the beginnings of the fall season.0414513001558352871.jpg

By Dr. Geneslaw, Coastal Healthcare Pediatrician

The days are cooler, leaves are beginning to change. Children are planning their Halloween costumes, mothers are contemplating their Thanksgiving menus and everyone is beginning to make their Holiday gift list. And we doctors are thinking of “the flu.” Influenza is an ancient disease caused by the virus influenza(it has nothing to do with the similarly named bacteria, hemophilus influenza); it was named during Renaissance times by Italian doctors as “influenza del aria fredda”–the influence of cold air. Flu season is classically from November through March(it can start as soon as October and last until May). It has an incubation period of approximately 1-4 days after contact, contagiousness begins a day before the patient is symptomatic and lasts from 3-7 days. Symptoms are well known–fever/chills, headache, abdominal pain and vomiting, progressing to sore throat, congestion and cough. Complications include bronchitis/pneumonia, dehydration, secondary bacterial infections. It is highly contagious–attack rates are 10-40%, community outbreaks can last 4-8 weeks or as long as 3 months for epidemics with multiple strains of the virus. 1% of infections result in hospitalization. That translates into 200,000 hospitalizations and 40,000 deaths annually, the 8th leading cause of death in the US (ahead of kidney, liver disease, hypertension). Influenza disrupts peoples’ lives–missed school and work days result in about $10 billion lost to the US economy annually.

The Center for Disease Control and all medical professional associations recommend that all citizens(with a few exceptions mentioned below) be immunized annually for the flu. There are now 3 different forms of the vaccine–the traditional “killed” vaccine injected intramuscularly (and even that one has a preservative free preparation for children under age 3), a newer form available for injection into the skin(available for 18-64 years of age), and one with a weakened, live(“attenuated”) virus in a nasal spray for people age 2-49(who have no respiratory problems like asthma and not household contacts of immunocompromised people). Children above age 6 months through senior citizens should receive vaccination as early in flu season as possible(before age 9 they need to get a booster dose one month after initial immunization). Particular emphasis should be made for people with chronic health problems like asthma, diabetes, and heart disease, households contacts of those individuals, as well as those employed in healthcare and public safety occupations, and senior citizens. One should not be immunized if one had a severe reaction to a previous flu shot, an allergy to any of the vaccine components, or a history of Guillain-Barre syndrome(a severe neurologic condition). One should not be immunized during a moderate to severe acute illness–wait until the symptoms have eased. Those with severe egg allergy MAY be eligible for flu vaccine–be sure to notify your doctor of egg allergy when discussing flu immunization.

Influenza vaccines are very safe and effective. Typical side effects are local irritation(arm pain, redness, swelling), mild fever, headache, fatigue, and occur in approximately 10-25% of vaccine recipients. They usually occur within 6-24 hours of immunization and last no more than 1-2 days. Life threatening reactions–severe allergic reactions within minutes of injections, Guillain-Barre syndrome–have been reported but are extremely rare. Efficacy rates vary among patient groups and seasonal flu strains but are generally between 67-95%, people are immune within 2 weeks of getting their shot. Those with”breakthrough” cases generally experience much milder disease.

Note that New Jersey law mandates that all children ages 6-59 months attending day care facilities (except for medical exemptions) MUST be immunized against influenza each year.

All of the physicians of Coastal Healthcare are well stocked with flu vaccines. We encourage all of our patients to call our offices and schedule you and all of your family members to receive this potentially life saving treatment. Protect yourself, your loved ones, and your community–call us now for your flu shot.

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