With the annual flu season looming, GPs are anticipating a frenzy of vaccinations, perhaps more so than ever this year. As so many ‘flu and respiratory viruses circulate every year, and as the ‘flu vaccine is for one strain of influenza only, is the vaccine worth getting, and what are the risks associated with vaccinating vs. not vaccinating?
In this week’s episode, we discuss the high vaccine uptake in New Zealand, and the role that social distancing for COVID-19 may have played in their low numbers of seasonal flu. We also talk about whether or not the message we give to patients about the benefits and risks of vaccination is transparent enough, and how we might communicate better with them to allow them to make an informed decision. We feel pressure to increase vaccination rates, because we believe we are protecting people, but does the evidence support that?
Our guests: Nikki Turner is the director of the Immunisation Advisory Centre (IMAC) at the university of Auckland. She is an academic general practitioner, and a professor at the university. Jeff Kwong is a professor at the University of Toronto, and the interim director of the Centre for Vaccine Preventable Diseases at the university’s Dalla Lana School of Public Health. Newest Oldest Longest Shortest Random
CENTERS FOR DISEASE CONTROL & PREVENTION (August 25, 2020) – A CDC study published today that looked at more than 80,000 U.S. adults hospitalized with flu over eight flu seasons (2010-11 through 2017-18) found that sudden, serious heart complications were common and occurred in one out of every eight patients (~12% of patients).
The study looked at a range of sudden heart complications called “acute cardiac events” that resulted in the following:
- damage to the heart muscle,
- inflammation of the heart muscle,
- fluid or inflammation of the sac surrounding the heart, or
- weakening of the pumping function of the heart.
The most common acute cardiac events reported in the study were acute heart failure and acute ischemic heart disease. Acute heart failure is the sudden inability of the heart to pump enough blood to meet the body’s demands, while acute ischemic heart disease is a term that describes heart problems caused by narrowed or blocked heart arteries.
Scientists and doctors have observed for thousands of years that some diseases, like polio and influenza, rise and fall with the seasons. But why? Ongoing research in animals and humans suggests a variety of causes, including changes in the environment (like pH, temperature, and humidity) and even seasonal and daily changes to our own immune systems. Figuring out those answers could one day make all the difference in minimizing the impact of infectious disease outbreaks—such as COVID-19.
From an MIT Technology Review article (March 11, 2020):
Here are six differences between coronavirus and the flu:
- Coronavirus appears to spread more slowly than the flu. This is probably the biggest difference between the two. The flu has a shorter incubation period (the time it takes for an infected person to show symptoms) and a shorter serial interval (or the time between successive cases). Coronavirus’s serial interval is around five to six days, while flu’s gap between cases is more like three days, the WHO says. So flu still spreads more quickly.
- Shedding: Viral shedding is what happens when a virus has infected a host, has reproduced, and is now being released into the environment. It is what makes a patient infectious. Some people start shedding the coronavirus within two days of contracting it, and before they show symptoms, although this probably isn’t the main way it is spreading, the WHO says.
- Secondary infections. As if contracting coronavirus wasn’t bad enough, it leads to about two more secondary infections on average. The flu can sometimes cause a secondary infection, usually pneumonia, but it’s rare for a flu patient to get two infections after the flu. The WHO warned that context is key (someone who contracts coronavirus might already have been fighting another condition, for example).
- Don’t blame snotty kids—adults are passing coronavirus around. While kids are the primary culprits for flu transmission, this coronavirus seems to be passed between adults. That also means adults are getting hit hardest—especially those who are older and have underlying medical conditions. Experts are baffled as to why kids seem protected from the worst effects of the coronavirus, according to the Washington Post. Some say they might already have some immunity from other versions of the coronavirus that appear in the common cold; another theory is that kids’ immune systems are always on high alert and might simply be faster than adults’ in battling Covid-19.
- Coronavirus is far deadlier than the flu. Thus far, the mortality rate for coronavirus (the number of reported cases divided by the number of deaths) is around 3% to 4%, although it’s likely to be lower because many cases have not yet been reported. The flu’s rate is 0.1%.
- There is no cure or vaccine for the coronavirus. Not yet, anyway, although work is under way. There is, however, a flu vaccine—and everyone should get it, not least because being vaccinated could help lessen the load on overstretched medical services in the coming weeks.
The pandemic of H1N1 virus in 1918 infected about one-third of the world’s population, causing at least 50 million deaths, including more than a half-million in the United States. Martha Teichner reports.
Although coronavirus disease 2019 (COVID-19) dominates the news in early 2020, it affects few people in the US. In contrast, at the same time the US is experiencing a severe influenza epidemic, which has caused an estimated 250 000 hospitalizations and 14 000 deaths.
Timothy Uyeki, MD, lead for the CDC’s 2019 novel coronavirus response team and Chief Medical Officer of CDC’s influenza division, discusses influenza in the US, how it compares to coronavirus, and what both patients and clinicians should know about this year’s flu season.