Don’t Forget the Flu!
By Mahasin D. Shamsid-Deen

According to the Centers for Disease Control (CDC) the flu season is an annual increase of respiratory viral activity that begins in the fall and lasts through the winter.  What we call “the flu” is a shortened version of “Influenza” which is a viral infection that attacks the respiratory system — the nose, throat and lungs. It can cause mild to severe illness, and at times can lead to death, depending on the underlying health conditions of the person infected with the virus.

In the United States, although the flu season begins in fall and winter, influenza viruses actually spread year-round, but its spread and incidence typically begins in October and then peaks between December and February. However, depending on the virus activity, it can last as late as May.

The influenza virus in the US has been prevalent and ever present since the 1918 influenza pandemic. This pandemic was the most severe pandemic in recent history besides the Covid-19 pandemic. Scientists observed that the 1918 flu was a mutation of an H1N1 virus which potentially originated with avian (bird) genes, thus making it zoonotic. A zoonotic disease in general is an infectious disease caused by a bacterium, virus, parasite or even  prion  that has  jumped  from an animal (usually a  vertebrate ) to a  human . Typically, the first infected human transmits the infectious agent to at least one other human, who, in turn, infects other people.

The 1918 Influenza pandemic was worldwide but its exact origins have not been agreed upon by the consensus of scientists and virologists. However, according to the CDC, its impact was severe, with estimates of one-third of the world’s population becoming infected with the virus which translated to about 500 million people worldwide with 50 million deaths. 

In response to this devastating pandemic, scientists worked on a vaccine. Since the viruses that make up the influenza pathogen were not eradicated, they continue to mutate and change, even today. Thus, more than 100 years since this devastating pandemic, scientists have only been able to develop a vaccine that lessens the severity of the disease, rather than cure it.

Over time, many Americans have learned to just “live” with the flu and the importance and potential severity of disease may not be something people pay attention to. However, the flu is not to be taken lightly. Although most people who get infected with the flu virus will likely recover in a few days, for some people, pre-existing medical problems are exacerbated, or they may develop severe complications which can be life-threatening and result in death. For instance, an infected person could develop pneumonia, have a severe asthma attack, inflammation of the heart, brain or muscles, experience organ failure, or even experience an extreme inflammatory response in the body which can lead to sepsis.

Currently, the Covid-19 pandemic is prevalent, which is pushing Influenza into a subordinate position in the minds of people. This is exacerbated by reports from the CDC that in the 2020 flu season which coincided with the Covid-19 pandemic, the incidence of flu transmission was the lowest it had been in 100 years. Most agree that this was a probable result of less human-to-human contact and heightened hygienic conduct through frequent handwashing, masking, social distancing and some isolation.  A viral infection cannot be spread if humans are not in physical contact or even approximate distance with each other. But the worldwide restrictions during Covid have largely been lifted and the incidence of human interaction has increased exponentially.

Therefore, everyone needs to go back to taking precautions to prevent getting and spreading the influenza virus. A cold is much less severe because colds typically do not include fever, chills or headaches. Plus, colds come on gradually, whereas flu symptoms are abrupt. Flu presents itself with the following symptoms:  

• fever or feeling feverish/chills
• cough
• sore throat
• runny or stuffy nose
• muscle or body aches
• headaches
• fatigue (tiredness)
• Some people may have vomiting and diarrhea, though this is more common in children than adults.

Severe flu disease, however, has slightly different symptoms that require immediate attention.  These include:

In children Fast breathing or trouble breathing Bluish lips or face Ribs pulling in with each breath Chest pain Severe muscle pain (child refuses to walk) Dehydration (no urine for 8 hours, dry mouth, no tears when crying) Not alert or interacting when awake Seizures Fever above 104°F In children less than 12 weeks, any fever Fever or cough that improve but then return or worsen Worsening of chronic medical conditions

In adults Difficulty breathing or shortness of breath Persistent pain or pressure in the chest or abdomen Persistent dizziness, confusion, inability to arouse Seizures Not urinating Severe muscle pain Severe weakness or unsteadiness Fever or cough that improve but then return or worsen Worsening of chronic medical conditions

Influenza does not have a cure. The best defense is the annual flu shot. However, if flu is present , it can be treated by over-the-counter medications to reduce symptoms of fever, cough, and sore throat. Those with the flu need to rest and stay well hydrated. Also, taking antiviral drugs prescribed by a doctor can lessen severity.

Ultimately, preventing the flu is the best defense. The CDC recommends 

• Avoid close contact with anyone who is sick. 
• Stay home if experiencing flu symptoms so as not to spread to others. 
• Cover the mouth and nose. 
• Wash hands often with antibacterial soap.
• Avoid touching eyes, nose, or mouth so as not to infect yourself. 

The Influenza virus has been a public health concern for more than 100 years. It has not gone away, and we all need to remember that.

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