Deadly virus diseases have dominated the news this month. A deadly Ebola virus outbreak originating in Africa arrived in the United States this month via Thomas Eric Duncan. Mr. Duncan brought the disease here while not having any symptoms of illness. Viruses are scary in general because they cause rapidly deteriorating diseases, and there aren’t many options for treatment. (Antibiotics don’t work on viruses, hence there is no cure for the common cold either.)
There have been over 8,000 cases of Ebola in western Africa and over 4,000 deaths. There has now been one death from Ebola in the United States and 2 non-fatal cases in nurses who cared for Mr. Duncan. Hundreds of other potential exposures are being tracked. Science says that Ebola can be contained with proper isolation procedures like were used when treating Dr. Kent Brantly and missionary Nancy Writebol in hospitals with special containment units.
However, human behavior is much more difficult to predict and control. Note the nurse that flew on a commercial airline after caring for Mr. Duncan. Although she didn’t meet the CDC-set criteria for being infectious, her travel has sparked increased fears that she may have exposed hundreds of people. The infected nurses are currently stable, and as of this writing no new cases have appeared here. Hopefully the current procedures of our advanced healthcare system will contain current infections and prevent a widespread epidemic in this country.
Enterovirus D68 is another virus that has been in the news. Enteroviruses and rhinoviruses cause millions of “cold-like” illnesses among children each year. D68 is one of about 100 “non-polio” enteroviruses that has been causing an outbreak of serious respiratory illness in children this fall season. 825 people in 46 states have been affected, and several children have died of the disease as well as several adults. Those with asthma and other underlying respiratory problems are at highest risk. Fortunately there is evidence that this disease is starting to decline across the country.
Finally, as we struggle to avoid and contain Ebola and Enterovirus D68, a proven killer lurks! This year it is predicted that 30,000 people will die of influenza virus — the flu! Overheard this week on a national talk program when the moderator was told about this prediction — “Yeah, but that’s just the flu”. Just the flu? What about 30,000 people predicted to die causes one to make a cavalier comment like that? As difficult as it is to understand, it is true that Americans take “the flu” lightly. They’re “used to it.” Many people each year suffer a “flu-like” respiratory illness and think they’ve survived influenza. However, these are likely “colds” (rhinoviruses) or “influenza-like” illnesses caused by other, milder, seasonal respiratory viruses. Although influenza A and B can cause mild disease in some, they often cause moderate disease requiring hospitalization and fatal disease is not uncommon. Those at the extremes of life (very young or very old) are at high risk, and other high risk groups include pregnant women and those with chronic health conditions, including asthma, diabetes, chronic lung disease (COPD), kidney or liver disease, blood disorders (sickle cell), those immunosuppressed by HIV/AIDS or cancer, and those who are morbidly obese with a BMI over 40. Unless there are other special conditions, most of these do not prevent people from getting the flu shot. In fact, these high risk group should make a special effort to be immunized to prevent severe illness.
Although influenza is mostly preventable by immunization, each year many people won’t even consider a flu shot or the nasal vaccine because they think they will give them the flu. In fact, most of these fears are ungrounded. The flu shot is made from parts of dead viruses, and the nasal product is severely attenuated. This year’s flu vaccines contain two influenza A strains (including H1N1) and one or two influenza B strains, depending on the product. Flu vaccines are available now — this year’s season has just begun.
Although Ebola and Enterovirus D68 have hijacked the news media this year, seasonal influenza is poised to claim a much bigger toll on work and school days missed, healthcare costs, and life itself. Please talk to your healthcare provider today about a flu shot or nasal vaccine, and stay healthy this winter!
Dr. Fleming is the Medical Director of The Jane Pauley Community Health Center (closely affiliated with Community Health Network). Ideas for this column can be e-mailed to Dr. Fleming at AskDrFleming@gmail.com. Or you can write your medical questions to Dr, Fleming at AskDrFleming, 8931 E. 30th Street, Indianapolis, IN 46218. On written correspondence, please include your name and city (names will not be published).