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In the News

The Upcoming Flu Season and a Few Words about the Avian Flu

By Ed Nguyen, M.D., Attending Physician at 75th St. & 126th St. Medical, Ocean Pines Medical & Doctors Weight Control & Wellness centers, Ocean City, MD.

Now that summer is over and autumn has settled in, the annual flu season has likewise begun. Each year, starting in late September through the remainder of autumn and much of the winter season, the flu vaccine is provided to millions of Americans.

Recently, due to the growing concern over the avian flu and the possibility of an inevitable worldwide pandemic sometime in the near future, more and more people have been anxiously obtaining their annual flu shots. The current flu vaccine, however, provides protection only against the New York, New Caledonia, and Jiangsu strains, not a mutated avian flu.

Interestingly, all influenza viruses originally arose in birds. While the vast majority of these avian influenza viruses do not affect humans, occasionally, one will change in such a manner that it can indeed cause illness in humans. Mutations or reassortments of viral genetic material have contributed to the biggest outbreaks of influenza over the past century, including the last pandemic in 1968.

Health officials have been speculating whether the current H5N1 strain of the avian flu in Asia may represent the next strain to cross over into humans and cause the next influenza pandemic. The H5N1 virus is named for proteins on its surface coat. Thus far, there has been no laboratory evidence that the H5N1 virus has mutated beyond its avian hosts. Nevertheless, since 2003, the H5N1 avian flu outbreak has claimed 60 human lives, mostly in people who regularly handle fowl and similar birds. Outbreaks of the H5N1 strain in birds have been mostly limited to Southeast Asia (particularly Vietnam) and are perhaps linked to spread from wild birds, which serve as reservoirs, into domestic stock.

The last true influenza pandemic was in Hong Kong in 1968, although the deadliest one remains the 1918 pandemic. Over half a million Americans died from the 1918 pandemic, with an estimate of up to one hundred million casualties worldwide from influenza. Clearly, a pandemic of equal potency is of great health concern.

Current studies are underway to create an effective human vaccine against a possible H5N1 flu outbreak. Early signs for this new vaccine are promising, although let us hope that there will never be a need for it. Among currently available medication therapies, only the antiviral medications oseltamivir and zanamivir are believed to provide a limited degree of protection, especially if administered within forty-eight hours of the onset of symptoms.

All flu viruses (and not just avian strains) are normally spread by aerosol contact. The usual measures we take to prevent spread of the "common cold" are also sufficient in this case, too, and include covering our mouths when coughing, washing hands regularly, and avoiding large gatherings (malls, sport events, etc.) if possible. Those people who feel sick (i.e., cold-like symptoms, cough, fever, shortness of breath) should generally stay at home or contact their primary care physician for further management. Remember, general precaution remains the best course of action for prevention until which time a true vaccine is perfected and made widely available.

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