Flu? What Me Worry?
by Dr. Ann L. Engelland
(October 26, 2004) As always, a New Yorker cartoon in
my mail today captures it best. Roz Chast’s drawing
shows three middle-aged folks standing under the caption: “Survivors
of Near-Flu Experiences.” The surprised woman
says: “I thought I was getting a chill, but,
as it turns out, I was just cold!”
When our babysitter went home sick today, wondering
if she had the flu, one of my middle-schoolers wondered
aloud: ”Why is everyone so worried about the flu?” I
would grant that the children of pediatricians are
rather smug about mundane illnesses, but it struck
me that she
had indeed been influenced by the hype surrounding us.
So what is the deal? Do we need to panic that we can’t
all get vaccinated, even those of us who fall into
Some questions and answers:
Is the flu supposed to be worse this year than in years
There is no evidence at all to support that. The virus
itself is no more potent, dangerous or lethal, and
there is no reason to believe so far that there will be
cases than in the recent past. In fact last year’s “flu
season” was relatively early and mild. Generally,
the flu peaks in January although sporadic (and well
publicized) cases are reported to have begun appearing
Why were so many people led to believe they should get
vaccinated this year when they never got it before?
It’s an ironic and unfortunate coincidence that
this year the government, Centers for Disease Control,
and the American Academy of Pediatrics all urged
clinicians to vaccinate nearly everyone. The thinking was
had a safe, at least partially effective, and relatively
inexpensive vaccine that if given in huge numbers
to most of the population would help prevent a widespread
epidemic of the flu. That was fine until the supply
Why do some people feel they must get the shot?
The vaccine is now (and hopefully temporarily) a scarce
commodity. It has a new value that few thought of before.
For some it seems to be a badge of “depends whom
you know” kind of thing. I would say anyone flaunting
the “ability” to obtain or luck into procuring
a vaccine should keep his or her mouth shut. There will
be millions of folks who should have the shot who won’t.
But they say there really is enough vaccine for those
who need it.
Experts say that the absolute numbers show enough vaccine
in circulation for all at highest risk and those who
until recently would have been the only ones for whom
it was recommended.
But, hold on. It’s not that simple. Much of the
supply has already been delivered. The distribution
to those most in need depends at this point on the good
will of those providers who have it and their willingness
to pass it on. It also depends on the privileged
with resources or connections to forego vaccination
so, it is hoped, their doses can be recycled into the distribution
stream. This is not difficult to do. When I found
with fifty extra vaccines, one quick phone call to
a busy internist was all it took to rid myself of this
moral hot potato.
What about those who rationalize that the flu would
wipe them out for ten days and they have important jobs
This is a rare time in our lives when something has
to be rationed. We are not used to any sort of altruistic
sacrifice. Those who are eligible for the vaccine in
this time of scarcity could truly die of the flu. It
is much more than an inconvenience for them. Picture
the child with severe asthma or cystic fibrosis. Picture
the elderly man on an oxygen tank with emphysema. Picture
the woman whose immune system is suppressed and is recovering
from breast cancer. They could require hospitalization
or artificial ventilation just to survive the flu.
Is there anything we can do to prevent the flu?
First of all, we all need to practice good nutrition,
exercise and hygiene habits in order to minimize our
exposure to virus and maximize our immune response. Good
hand washing before eating is a simple and effective
way to prevent all viruses transmitted in the same manner
as the flu, including the common cold. It sounds basic,
but we often neglect this important habit and need to
remind our kids to wash when they come home, before eating
and after using the bathroom. Simple.
What are the symptoms of the flu? How do I know if I
really have it?
The flu typically begins with fever, upper respiratory
symptoms, runny nose, cough, aches all over, and general
malaise. People generally want to go to bed, be pampered,
and rest. Most often the symptoms worsen over 2 to 3
days then begin to abate. If the symptoms worsen after
4 to 5 days, a secondary infection like pneumonia or
sinusitis may have set in and may require an antibiotic.
Although it is possible to make a definitive diagnosis,
it does not serve any useful purpose in most patients,
other than for epidemiological tracking.
What remedies are recommended?
Unless you are a person who is at risk of severe lung
disease, wheezing, or pneumonia from the flu, chances
are that time-tested remedies like rest, fluids,
painkillers and Ibuprofen (Advil family) or Acetaminophen
family) will help most. When it still feels unbearable,
most doctors recommend Jewish Penicillin—chicken
Dr. Engelland has a practice in Mamaroneck devoted
to Adolescent Primary Care. She can be reached at
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