1 June 2019

Procrastinating over a needle

Will I? Won’t I? Will I? Won’t I? At the start of each flu season many people toss up whether to get the flu jab. Excuses include a dislike of needles and it’s a waste of time and money because “my immune system will cope”.

But while the very young and the elderly are at most risk, influenza can strike anyone and at any age. Two years ago, Australia experienced one of its worst ever flu seasons. And this summer past, more Australians came down with influenza than in any recent summer. In NSW, flu cases spiked with three times as many cases recorded compared to the summer of 2017/18 while Victoria had double the number.

Many people still regard the flu as just a heavy cold or somewhat of a nuisance. They are wrong. Flu, or influenza, is a common viral respiratory illness that can be life-threatening, especially in the frail and elderly.

There have been many well-documented influenza epidemics throughout history. The most severe outbreak of ‘modern’ times was the 1918 epidemic which claimed between 40 and 70 million lives. Swine flu or H1N1 caused issues around the globe earlier this century but was not as dramatic as the Spanish flu. It was serious enough, however, for the World Health Organisation to declare the flu a global pandemic.

Fresh outbreaks occur because the flu virus can slightly change its structure which removes any immunity that people may have built up previously. An international surveillance system is in place to detect these changes in the virus and each year a new vaccine is produced to cover the types of influenza that are most likely to be encountered.

Melbourne GP Dr Andrew Pattison says the symptoms of flu are quite dramatic. “The patient usually develops a high fever and severe aches and pains. Headaches, sore throat and a cough frequently occur, and the person is often barely able to get out of bed. In the absence of any complications a full recovery will follow after several days,” he says.

“There is no doubt that immunising high-risk individuals with the flu-vaccine is the best way to ward off influenza.”

Those particularly at risk are:

  • People over 65 years of age.
  • All residents of nursing homes and other chronic care facilities.
  • Adults and children with chronic diseases like heart, lung and kidney problems.
  • People whose immune system is suppressed or those on treatments like chemotherapy.

Dr Pattison recommends that people in these categories should be immunised each year, in early autumn, if possible. “Unfortunately, fewer than half high-risk Australians have been receiving the flu vaccine, even though it is at least 70 per cent effective,” he says.

“People working in health services and some public utilities should also consider being immunised. However, there is no real reason why healthy children and younger adults should be given the vaccine.”

Some people mistakenly believe that they might catch the flu from a flu vaccine, says Dr Pattison. “This is impossible because it is an inactive vaccine that does not contain any live virus. However, in children or those previously never exposed to the flu, a slight fever may occur for a day or two after the immunisation. Because the flu vaccine is prepared from eggs, people who are highly allergic to eggs should not be given the vaccine.”

Treatment consists of rest, fluids and paracetamol for relief of symptoms. No antibiotics are required unless there is definite evidence of a secondary bacterial infection. The development of viral pneumonia or a secondary chest infection can be a major concern and further treatment in hospital may be required.

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