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New Bugs Not Likely To Bite This Flu Season

November 09, 1989|DENNIS MCLELLAN | TIMES STAFF WRITER

Winter ended in the Southern Hemisphere without a major influenza epidemic or the apparent development of any new strains of flu, and that's good news for those of us living up north.

"I don't know of any reason at this point to think that this year is going to be a particularly bad year (for flu)," says Orange County epidemiologist Dr. Tom Prendergast. "If this was going to be a really terrible year, we probably would have heard something by this time from the Southern Hemisphere.

"Right now nobody's identified an influenza virus, and we're not getting reports of widespread influenza types of illnesses in the community."

That doesn't let us entirely off the hook, however.

"This stands to be an ordinary flu year, which means there is bound to be a flu virus circulating," Prendergast said. "Also, there will be lots of people who become ill with illnesses that are like influenza but are not caused by influenza viruses but by other respiratory viruses that circulate more among people in the winter months."

Prendergast said there are two principal ways a serious outbreak of influenza occurs: Either a strain of flu reappears which hasn't been around in a long time, in which case young people are particularly at risk because they haven't developed antibodies to help fight it; or a completely new strain of the flu bug appears which is capable of putting the bite on anyone.

Regardless of the strain, you know it when you've got it: Symptoms, which typically last five to seven days, include a high temperature, that achy-all-over feeling, headache, cough, tiredness, and occasionally an upset stomach or runny nose.

"Flu is a very non-specific illness," said Dr. Adele Hofmann, medical director of ambulatory pediatrics at Childrens Hospital of Orange County. "The problem is, of course, as far as children are concerned, there are a number of other viruses that can cause similar pictures that are around all the time. The flu can look just like a really bad cold so we don't really always know."

And when exactly does the so-called flu season start? Jokes Prendergast: Whenever a newspaper editor feels flu-like symptoms and assigns a reporter to find out what's "going around."

Actually, he said, "flu season" can occur any time between October and April. "In general," he said, "the worst parts of the flu season are likely to last no more than a few weeks."

Individual cases of influenza are not reported to the county, Prendergast said, but recognizable epidemics are. In Orange County last February, there were 112 combined pneumonia and influenza deaths--representing 9% of all deaths in the county that month compared to the normal 4%.

That was the highest percentage of monthly deaths since the county began tracking combined pneumonia and influenza statistics in 1979.

"We were never able to pin down a specific epidemic strain. It may not have even been an influenza virus," said Prendergast, explaining that many pneumonia deaths are preceded by a bout of flu.

As long as this season's influenza strains are not different from those that appeared earlier in the year, Prendergast anticipates less of a problem because so many people already had the flu last winter.

But, he stressed, "I'm not telling anybody they won't get the flu this year or that it won't be a bad year.

"We have to basically wait and see."

Meantime, health officials recommend flu shots, particularly for people who are in danger of having severe effects with a bout of flu, such as those with chronic pulmonary disease or other significant underlying health problems. Health care workers also are advised to get a flu shot because of their higher risk of exposure to the flu virus.

Hofmann said a flu vaccine "has to be made each year depending upon what comes across the waters. Each year there seems to be a different variety or variation on the theme, if you will, on the type of flu bug that strikes. Usually it starts in Asia and gradually migrates eastward and God knows why. It isn't necessarily to do with the jet stream or jet travel."

Hofmann stresses that children should not be given aspirin or aspirin-related compounds when they have the flu because the combination may cause Reye's syndrome, a serious and sometimes fatal disease involving the liver and liver failure. They can, however, be given fever medicines that are "aspirin free."

Because there are no antibiotics for viruses, the only treatment for the flu is, as Hofmann puts it: "just plain old symptomatic treatment: Do whatever it takes to make the patient comfortable."

That means increased fluids ("Don't worry about the kid not eating") and keeping them home from school if they have a fever. If they're coughing, try to have them cover their mouths so they don't spread it around.

When it comes to children, Hofmann said, the flu is most common in school-age children because it is so contagious.

And, she advises, parents needn't rush their child, particularly the older ones, to the doctor the minute he blows his nose, because there isn't a lot a doctor can do for the flu.

There are, however, danger signs to watch out for: a persistent fever lasting more than two or three days and if the child just seems to be unusually droopy and unresponsive, particularly with a pronounced cough that doesn't seem to be clearing up after a couple of days.

With the primary exception of pneumonia, Hofmann said, there are relatively few complications associated with the flu.

"The average healthy child will go through the flu very successfully without any complications and will do just fine," she said.

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