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Something’s in the Air

SPECIAL TO THE TIMES

Settled in her second-floor office in the Health Services Administration Building in downtown Los Angeles, Dr. Shirley Fannin was happy to share her expertise about the bugs of winter.

As director of disease control programs for the Los Angeles County Department of Health Services, she’s seen good years, bad years and everything in between. But first, she needs to vent a bit about that word “flu,” often used as a catchall phrase to describe a host of ailments.

True influenza is defined as the highly contagious respiratory tract disease caused by various strains of viruses and marked by fever, chills, headache, cough, sore throat and muscle aches.

“People talk about stomach flu,” groans Fannin. “There is no such thing.” What they call stomach flu might be gastroenteritis (stomach and intestinal inflammation) or other ailments.

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That misconception cleared up, it’s on to the nuts and bolts part of the interview--to find out how to dodge winter’s germs and what to do if you don’t.

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Question: Who should consider getting vaccinated against influenza?

Answer: The ones most prone to illness or death are the elderly and the chronically ill, so they have to be first priority. But any person who would like to decrease the risk of getting influenza should get a shot. It’s just one of the mechanisms to reduce your risk of getting the disease. Anybody who doesn’t want to get the circulating virus can get the influenza shot and possibly be protected.

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Q: Possibly?

A: The effectiveness of the vaccine is probably 85% for the young and healthy and lower than that for the elderly--probably 65%.

Q: Who shouldn’t get an influenza vaccine?

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A: People allergic to any part of the shot, people allergic to eggs [the vaccine is made in embryonic egg culture, according to the federal Centers for Disease Control and Prevention], people who have ever had a severe reaction to a prior influenza shot should not get it. And by “severe reaction” I don’t mean something like feeling bad or getting a mild fever and achy muscles. I mean [for example] a neurological problem . . . diagnosed by a physician.

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Q: How late is too late to get an influenza shot?

A: Once influenza is cycling in the community, you are a little late. . . . But until you get your first symptoms, it’s probably worth a try. If you have no experience with this [influenza] virus, it takes two to three weeks to get antibody . . . effects. If you have ever had experience [with the circulating virus], you get a booster effect within two to three days.

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Q: What about those folks who have sworn off influenza shots forever, claiming that they got a shot one year and caught influenza from it?

A: This is a killed vaccine, so you really don’t get influenza from the vaccine. You may be [already] incubating the virus when you get the shot. And some people get side effects from the influenza vaccine, and they interpret this [mistakenly] as influenza.

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Q: What’s the best approach for those who get influenza?

A: They should stay home and nurse their illness, eat lightly, drink lots of fluids and stay away from other people.

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Q: For how long?

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A: In general, you are most contagious during the period of the fever, usually three to five days. If you are feeling really good by the third day, you are probably not contagious.

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Q: How contagious is influenza?

A: Influenza viruses are easily spread by sneezing, coughing, anything that will get your respiratory secretions spread into the air. If you are standing in an ordinary room in front of 35 people and you sneeze or cough, you can put out enough [virus] to infect half the room. These are such tiny particles that they hang suspended in the air for several hours.

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Q: What’s the typical course for a case of influenza?

A: You feel pretty bad for three to five days and then may have two weeks of post-influenza--where people don’t snap back. This is when people say, “I can’t seem to shake this.”

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Q: Which is easier to dodge, colds or influenza?

A: Influenza may be a little more contagious--because unless you have a cough with a cold, you don’t have as much of a mechanism for propelling it out into the air.

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Q: What about the practice of wearing facial masks, seen sometimes in other cultures? Does it stop the spread of colds and influenza?

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A: It’s the world’s worst idea. You have to change it every half hour because as soon as it gets wet, it provides a highway for the entrance of disease organisms. When people keep them on hour after hour, they become a hazard.


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