Influenza (FLU)

WARNING:

My colleague admitted a 9 year old boy with flu and secondary bacterial pneumonia on Sunday and despite life support he passed away in the early hours of Tuesday morning.

It was a shock to all, but also a wake up call for us to realize how dangerous and severe flu(Influenza) can be.
First thing on Tuesday morning I had myself vaccinated in the Pediatric ward of our hospital .
We are experiencing a very bad outbreak of flu currently in our area.
We see many cases of flu each day at the moment.
All ages are affected, from infancy to old aged people.
The very young, old and pregnant people are at most risk, including those with chronic illness such as heart and/or lung disease.

Symptoms:
Appears 1-4 days after being infected and resolves usually within one week.
•Headache
•Fever
•Runny nose
•Sore throat and cough that can persist for 2 weeks
•Muscle aches and pains
•Occasionally a measles like skin rash

Complications:
•Acute otitis media or middle ear infection
•Bronchiolitis
•Croup
•Sinusitis
•Viral meningitis
•Pneumonia viral and sometimes secondary bacterial infection caused by Staphylococcus Aureus

Cause:
Three types of influenza viruses affect people, called Type A, Type B and Type C.
How does one contract flu?
Usually, the virus is spread through the air from coughs or sneezes.  This is believed to occur mostly over relatively short distances. It can also be spread by touching surfaces contaminated by the virus and then touching the mouth or eyes.
A person may be infectious to others, both before and during the time they are showing symptoms.

Diagnosis:
The infection may be confirmed by doing a throat or nose swab for the virus or testing the sputum.
A number of rapid tests are available, however, people may still have the infection if the results are negative. A type of (PCR test) polymerase chain reaction test that detects the virus’ RNA is more accurate.

Prevention:
Frequent hand washing reduces the risk of infection because the virus is inactivated by soap.
Wearing a surgical mask is also useful.
Yearly vaccinations against influenza are recommended by the World Health Organization for those at high risk. The vaccine is usually effective against three or four types of influenza. It is usually well tolerated. A vaccine made for one year may not be useful in the following year, since the virus evolves rapidly.

Treatment:
Antiviral drugs, such as the Neuraminidase Inhibitor Oseltamivir (Tamiflu), among others, have been used to treat influenza.
Antibiotics for secondary bacterial infections.
Symptomatic treatment for the pains and fever with antipyretics and analgesics.

Burden of disease:
Influenza spreads around the world in a yearly outbreak, resulting in about three to five million cases of severe illness and about 250,000 to 500,000 deaths. In the Northern and Southern parts of the world, outbreaks occur mainly in winter while in areas around the equator outbreaks may occur at any time of the year.
Death occurs mostly in the young, the old and those with other health problems. Larger outbreaks, known as pandemics, are less frequent. In the 20th century, three influenza pandemics occurred: Spanish influenza in 1918 (~50 million deaths), Asian influenza in 1957 (two million deaths), and Hong Kong influenza in 1968 (one million deaths).  The World Health Organization declared an outbreak of a new type of influenza A/H1N1 (Swine flu) to be a pandemic in June 2009.  Influenza may also affect other animals, including pigs, horses and birds.

TAKE HOME MESSAGE:
•Be aware of the current outbreak and danger.
•Be vigilant and be on the look out for serious complications .
•Protect against infection
•Vaccinate everybody over 6 months of age, especially those at high risk.
•Seek medical advice as soon as complications are suspected.

Dr Willem Smit

Paediatrician

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