Influenza, All You Need to Know

Influenza

It’s that time of the year again; the leaves are changing colour and our noses are runnier. We can’t do much about the leaves, but we can protect ourselves and others from Seasonal Influenza.

What Is Influenza?

Influenza refers to illnesses and symptoms, ranging from mild to severe, caused by a number of different influenza viruses. Typical symptoms are fever, coughing, sore throat, runny or stuffy nose, headaches, body aches, chills and fatigue. Annual outbreaks usually occur during the late fall through early spring.

How to Protect Yourself and Others?

The best prevention for influenza is getting vaccinated. An influenza vaccine not only provides protection for an individual, it also helps protect vulnerable populations that are at a higher risk of complications.

These “high risk” groups include:

  • Pregnant women
  • Children 5 years of age and younger
  • Adults 65 years of age and older
  • People with chronic illnesses, such as asthma, heart disease and diabetes

Receiving an influenza vaccine is particularly important if you work in a high-risk environment such as a hospital. As you can be infectious with the influenza virus for up to 24 hours before displaying symptoms, you could inadvertently spread influenza before you become sick with symptoms. The seasonal influenza vaccine is extremely safe for everyone, including pregnant women and children. Learn more about vaccination here. Other ways to help protect yourself and others from getting influenza include:

  • Staying home from work if you have influenza-like symptoms
  • Regularly washing your hands with soap and water or hand sanitizer
  • Coughing and sneezing into your sleeve or a tissue

What if I Get Sick?  

If you have influenza-like symptoms you should:

  • Stay home, drink clear fluids
  • Get plenty of rest
  • Avoid close contact with others

If you have significant influenza symptoms or are in one of the high risk groups (see above), you should see your health care provider, preferably within the first 48 hours, to see if you are eligible for antiviral medications. If you are taking care of someone at home who has influenza remember to protect yourself and others in the household.

What Is Pandemic Influenza Again?

Pandemic influenza refers to a novel influenza A virus for which there is little or no immunity in the human population. Because it is a novel virus, it takes approximately 6 months to develop an effective vaccine. A pandemic influenza virus can cause serious illness and spreads easily from person-to-person worldwide. The most recent example of a pandemic influenza was in 2009, caused by the novel H1N1 (swine) virus.

Google Flu Trends Outlook for British Columbia: Moderate

 

Google Flu TrendsGoogle Flu Trends is a very powerful tool that can predict the severity of the upcoming flu season with frightening accuracy. Using Flu Trends we can monitor flu activity in real-time, often ahead of reporting agencies. At this time Google Flu trends is reporting a flu activity to range from low to moderate throughout Canada. Explore Google Flu Trends

Further Information on the flu may be found here. 

 

Weekly H7N9 Virus Update

H7N9

Flu Update
Weekly Avian Influenza A (H7N9) virus update: May 8, 2013

Introduction
Health officials in China have reported several additional A(H7N9) infections since last week; the outbreak’s total laboratory-confirmed infection count is 130 of which 31 people have died from the virus.  On May 5th, China’s Ministry of Agriculture reported that five more poultry samples tested positive for A(H7N9); there is still no strong evidence of human-to-human transmission of the virus. The World Health Organization is not recommending any travel or trade restrictions.

Key Alerts

  • May 7 – The WHO released an A(H7N9) update yesterday – available here.
  • May 6 – The Public Health Agency of Canada updated Canadians on their current risk management plans with respect to the virus – available here.
  • May 6 – China reports two new A(H7N9) cases – available here.
  • May 1 – Scientists are concerned the virus is killing a fifth of those infected – a Guardian news story is available here.

Summary, Risks, and Recommendations
Of primary concern to most doctors and scientists is the potential for human-to-human transmission of the A(H7N9) virus.  Although new infections are emerging on a weekly basis, most leading centres for disease control are indicating that there is no serious threat for human-to-human transmission.  In particular, the United States Centre for Disease Control has issued a press release noting that this particular strain, at the moment, poses no real threat of launching a pandemic.  Dr. Thomas Frieden, of the US CDC, noted that roughly 2000 people have been exposed to the disease; however, very few of these people became infected with the virus.  Although the current risk assessment of the potential for human-to-human transmission is low, experts are still cautioning that a mutation of the virus could easily enable person-to-person transfer.

Statistics
Total confirmed cases: 130
Total fatalities: 31
Countries with infection – China, Taiwan

Additional Information
Thank you for checking our weekly Avian Influenza summary, please check back next week for Iridia Medical’s update on the A(H7N9) virus.  For more information, please visit http://www.bccdc.ca/default.htm

What Will the 2013 Flu Season Bring?

Before we get into this season’s flu trends, it’s worth learning a little bit about influenza.

What Is Influenza?

Influenza refers to illnesses and symptoms, ranging from mild to severe, caused by a number of different influenza viruses. Typical symptoms are fever, coughing, sore throat, runny or stuffy nose, headaches, body aches, chills and fatigue. Annual outbreaks of seasonal influenza usually occur during the late fall through early spring.

Have a look at our post: Seasonal Influenza, A Helpful Reminder to learn how to protect yourself influenza and what to do if you become sick.

2013 Flu Trends

2013 Flu Season

2013 flu season (dark blue) compared to the past six years.

By looking at data gathered by Google so far this year, we can see that 2013 is beginning to look like one of the worst flu seasons in recent years. Compared to the previous 6 years, this season is only overshadowed by the 2009 H1N1 outbreak. Unfortunately, it is still to early to determine if flu cases will continue to rise.

By using millions of data points, Google Flu Trends is able to determine (with a high-level of accuracy) how big of an impact the flu is having on a seasonal basis.

This data is important because it can show flu queries in real-time, often weeks ahead of reporting agencies.

Flu season

Comparing flu search results throughout Canada.

How does Google Flu Trends Work? (excerpt from Google)

Each week, millions of users around the world search for health information online. As you might expect, there are more flu-related searches during flu season, more allergy-related searches during allergy season, and more sunburn-related searches during the summer.

Flu trends

Google Flu Trends compared to Public Health Agency of Canada records.

We have found a close relationship between how many people search for flu-related topics and how many people actually have flu symptoms. Of course, not every person who searches for “flu” is actually sick, but a pattern emerges when all the flu-related search queries are added together. We compared our query counts with traditional flu surveillance systems and found that many search queries tend to be popular exactly when flu season is happening. By counting how often we see these search queries, we can estimate how much flu is circulating in different countries and regions around the world. 

 —

As you can see, Google Flu Trends is a very powerful tool that can predict the severity of the upcoming flu season with frightening accuracy. Given the intensity of the flu in 2013, it is as important as ever to get vaccinated. Learn more about vaccination here: http://www.phac-aspc.gc.ca/im/vs-sv/vs-faq17-eng.php

Go explore Google Flu Trends yourself!

 
 
 

Update – BC Influenza Control Policy

Earlier in the year, health authorities throughout BC (on the advice of Dr. Perry Kendall, BC’s Provincial Health Officer) agreed to ramp up efforts to protect patients and seniors from influenza exposure this flu season (read the full story). Now, after a much heated debate, the government has temporarily backed away from the controversial plan to force thousands of provincial health workers to get a flu shot before they can work with patients. 

Original Influenza Policy:

Effective December 1, 2012, all staff, physicians, students, volunteers, contractors and vendors must either be immunized against the flu or wear a procedure mask while in patient care areas.

BC Influenza Policy

Updated BC Influenza Policy (Dec 5th):

The Ministry of Health decided that during the first year of flu policy implementation the focus will not be on enforcement. Health authorities will not be disciplining employees, but will focus on education and awareness to promote compliance with the new policy.

Unimmunized staff must still wear masks in patient care areas, and immunized staff must display the flu shot sticker on ID badges during flu season.

From our Medical Director Dr. Allan Holmes:

“The following Influenza Control Policy for the Health Authorities remains in effect. The only change is that the enforcement within the Health Authorities will not be a focus in the first year. I remain support of the policy as it is designed to maximize protection for our patients.”

Learn more about influenza:
http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/diseases-maladies/flu-grippe-eng.php

Waging War Against Influenza in BC

Before the end of the year, residents of British Columbia can look forward to better protection  measures against the common ailment – influenza.

Influenza in BC

Health authorities throughout BC (on the advice of Dr. Perry Kendall, BC’s Provincial Health Officer) have agreed to ramp up efforts to protect patients and seniors from influenza exposure for the coming flu season.

The implementation plan calls for any health care workers who come into contact with patients at publicly-funded health care facilities to get the influenza vaccine, or wear a mask during the flu season.

“Influenza causes more deaths annually than all other vaccine-preventable diseases combined, and hospitalized patients are more vulnerable to complications from influenza than the general population,” said Dr. Kendall.

“This policy will protect patients. Putting in place consistent policies to prevent influenza from spreading is the right thing to do from a patient safety perspective.”

Influenza Measures

Kendall said health authorities in B.C. have been trying to get immunization numbers to go up “for years,” but said despite the encouragement, levels have decreased since 2010.

Even with a recent push towards vaccinations, healthcare workers had a dismal 40% vaccination rate last year.

“This decision has been made by all health authorities, acting upon the advice of the Provincial Health Officer, and ensures we are reducing the risk to our patients to the best of our ability,” said Dr. Nigel Murray, president and CEO, Fraser Health.

The influenza vaccine is extremely safe, and is the most effective way to prevent illness from the influenza virus, helping to prevent infection in healthy adults by up to 80 per cent.

Influenza in BC

  • Influenza causes the most deaths among vaccine-preventable diseases
  • In addition to being a quality and safety issue, improved influenza vaccination coverage helps to reduce rates of employee illness
  • Flu shots are traditionally available around Thanksgiving each year.
  • Flu season typically runs from late November/early December through to the end of March. 
  • Studies have demonstrated that health care workers who are ill with influenza frequently continue to work. 
  • B.C. will be the first jurisdiction in Canada to implement this province-wide policy. 
  • People who may be at increased risk include: seniors, people with chronic health conditions (especially heart or lung conditions), aboriginal people, or those with compromised immune systems

Every fall, we set up immunizations for the entire staff at Iridia. We recommend immunizations for all low-risk groups, as is it the most effective ways to protect against influenza.

Learn more:
http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/diseases-maladies/flu-grippe-eng.php

Stay Home and Have an Influenza Day

Who doesn’t enjoy a break from school on a snow day? For many they are blessing; a free day to have some fun, where otherwise, you would be counting sheep waiting while minutes to tick by. The good news, you may get the break you’re looking for. The bad news, there will have to be a flu pandemic first.

 Influenza Day

Have an Influenza Day!

A recent study in Alberta has shown that by closing schools, we could potentially slow the spread of a flu pandemic. The study in the Annals of Internal Medicine analyzed data on H1N1 infections in the province during the 2009 pandemic.

View the study summary:
http://www.annals.org/content/156/3/I-28.full.pdf

How does shutting down the school reduce the spread of a flu pandemic? Well, it turns out children play an important role. “School-age children were fundamentally important drivers of [pandemic H1N1] transmission in 2009,” the study’s lead author, Prof. David Earn of McMaster University in Hamilton.

“We suggest that school closures [either local or regional] should be seriously considered if a pandemic occurs during the school year.”

Researchers used the data they collected to plot lab-confirmed H1N1 cases on a graph. A correlation between school closed for the summer and a drop in incidence began to emerge.

“Using state-of-the-art modelling, we then demonstrated that transmission was reduced by at least 50 percent,” Earn said.

50 percent by school closures alone! That’s quite the change, but not the only factor. The model also showed that a large drop in temperature seemed to influence a spike in H1N1 cases throughout the province, but the weather changes were less important than closing school for the summer.

By chance, schools in Alberta happened to be closed for during the first wave of H1N1 infections in summer 2009, but the observations suggest that closing all schools could affect the course of future epidemics, the researchers said.

On an interesting note, during the pandemic, public health authorities recommended against school closures. While other provinces tightened criteria to test for respiratory viruses when the first wave of the pandemic grew in intensity, Alberta did not; this gave the researchers higher-quality data to model.

The study highlights the important issue of how to prevent the spread of influenza. However, the verdict is still out on the long-term benefits of this course of action. Perhaps future studies will shed some light.

 

 

H1N1 Paves the Way for Possible Universal Flu Vaccine

A study published by researchers in the Journal of Experimental Medicine suggests that scientist are nearing an understanding of influenza viruses that could lead to a universal flu vaccine.

Universal Flu Vaccine

Before a vaccine was available in 2009, the team analyzed antibodies found in nine patients whom had been infected during the first pandemic wave of H1N1. They found five antibodies that proved cross-protective against a number of influenza variants including the 1918 pandemic strain and the avian flu, H5N1.

Universal Flu Vaccine

Sample structure of a flu virus. The hemagglutinin proteins are labelled “HA”

Flu viruses possess a lollipop-shaped protein structure called hemagglutinin. The protein at the “head” of the lollipop allows the virus to latch onto and infect other cells. Since all viruses require this structure to reproduce, flu drugs and vaccines focus on identifying this protein to the immune system so that it can fight infection. The genius of the flu virus is that this protein readily mutates so that the virus appears to the immune system to be completely different from one flu season to the next.

Two years ago, researchers found that the stalk of the protein –the lollipop’s “stick”– does not mutate and is generally the same for all flu viruses. Because the H1N1 strain was so different from other flu viruses, it’s likely that the immune systems of those infected made antibodies for the only part of the virus that it recognized: the hemagglutinin stalk. “Previously, this type of broadly protective, stalk-reactive antibody was thought to be very rare,” said Jens Wrammert, a member of the research team. But in the H1N1 patients, they were “surprisingly abundant.”

According to Patrick Wilson, who also worked on the project from the University of Chicago, these antibodies could demonstrate “how to make a single vaccine that could potentially provide permanent immunity to all influenza.”

The US National Institutes of Health is now running human tests on a two-step vaccine process that uses stalk-reactive antibodies to prime the immune system before a regular flu shot. Reuters