Influenza Season 2012-2013

[Katy Lied]

That's interesting. We've had this flu discussion in the Downton Abbey thread. When Lavinia dies of flu right before WWI, she seems to get better, and then gets rapidly worse. The writers of the show said that research showed that many more people died right after supposedly recovering from the flu. Does this happen all the time with flu or just certain strains?

[BigPiney]

That's interesting. We've had this flu discussion in the Downton Abbey thread. When Lavinia dies of flu right before WWI, she seems to get better, and then gets rapidly worse. The writers of the show said that research showed that many more people died right after supposedly recovering from the flu. Does this happen all the time with flu or just certain strains?

I certainly happened that way in 1919. [ame="http://www.amazon.com/The-Great-Influenza-Deadliest-Pandemic/dp/0143036491/ref=tmm_pap_title_0"]The Great Influenza: The Story of the Deadliest Pandemic in History: John M. Barry: 9780143036494: Amazon.com: Books@@AMEPARAM@@http://ecx.images-amazon.com/images/I/51xPuct29QL.@@AMEPARAM@@51xPuct29QL[/ame] This book was amazing and also scared me.

It happened a lot with young healthy people because they had too good or strong of an immune system. Their bodies just kept fighting and fighting, filling their lungs up with fluid till they drowned. Often within 1/2 a day.

[Jeff Lebowski]

I certainly happened that way in 1919. The Great Influenza: The Story of the Deadliest Pandemic in History: John M. Barry: 9780143036494: Amazon.com: Books This book was amazing and also scared me.

It happened a lot with young healthy people because they had too good or strong of an immune system. Their bodies just kept fighting and fighting, filling their lungs up with fluid till they drowned. Often within 1/2 a day.

I read that too. Scary indeed.

[kccougar]

I've never had the flu. I don't plan on getting a shot.

I guess you never say never, right? I think I may have had the flu on Saturday, but since I felt fine on Sunday I guess I don't value a doctor's opinion enough to go in so that he can tell me whether or not I really had it.

I last ate Friday night around 6:00, and my stomach started feeling queasy around 10 Sat morning so I assume it was too late for it to be food poisoning. Anyway, after one episode of vomiting, I hung out in bed the rest of the day because I felt chilled, and when I got up and moved around it again made me feel a little nauseated. By Sunday morning I was fine.

[doctorcoug]

Was the influenza diagnosis formally confirmed with a nasal swab?

If it was then you wouldn't benefit from a flu shot at this point.

If it's possible you just had a bad viral illness that was not influenza then sure you should still get a flu shot. No reason to wait.

I disagree with multiple parts of this statement.

1. Nobody should be doing flu swabs at this point in time unless you are on a ventilator in the ICU. Physicians are notoriously bad at interpreting lab results from rapid tests and a prime example is the rapid influenza test. I'd bet money that over 90% of physicians would not interpret the results of a rapid test accurately even 50% of the time during the flu season.
2. The influenza vaccine is a trivalent vaccine. The predominant strain this year has been H3N2, which is covered in the vaccine. There are still other strains that could infect a patient. The flu season has come very early this year and it is possible that we could see another surge of cases again with a different strain.

So, I would recommend immunization after a documented case of influenza. I don't know if there is data out there to support this, but it makes sense scientifically, although the probability of getting a second strain of influenza in one year seems low.

[doctorcoug]

That's interesting. We've had this flu discussion in the Downton Abbey thread. When Lavinia dies of flu right before WWI, she seems to get better, and then gets rapidly worse. The writers of the show said that research showed that many more people died right after supposedly recovering from the flu. Does this happen all the time with flu or just certain strains?

Post-influenza pneumonia is most commonly caused by MRSA. That was not likely the case in the early 20th century, obviously. Today, almost every post-influenza pneumonia case I have seen has resulted in an ICU admission and multiple deaths. I have reviewed cases of patients dying of post-influenza pneumonia in young healthy patients because the doctors give the standard pneumonia treatment of levaquin or azithromycin and rocephin and fail to give vancomycin. By the time we figure it out, the patient is tanking and it dawns on us that this is post-influenza pneumonia and we are grabbing the "oh shit" bar.

[calicoug]

Here's a great article on the flu vaccine and Tamiflu and Relenza uses.

http://www.theatlantic.com/magazine/...matter/307723/

Really opens your eyes.

A broad summary: (1) we can't do placebo-controlled trials to veryify that the flu vaccine is, in fact, working because it would be unethical (we can't ethically withhold medicine that we know works from people who need it). (2) we don't actually know the flu vaccine works, and need to do placebo-controlled trials to learn more.

[doctorcoug]

Here's a great article on the flu vaccine and Tamiflu and Relenza uses.

http://www.theatlantic.com/magazine/...matter/307723/

Really opens your eyes.

A broad summary: (1) we can't do placebo-controlled trials to veryify that the flu vaccine is, in fact, working because it would be unethical (we can't ethically withhold medicine that we know works from people who need it). (2) we don't actually know the flu vaccine works, and need to do placebo-controlled trials to learn more.

I don't want to take the time to read the article now, but I will later. One thing I do want to say is that Tamiflu is probably the biggest crock of horse manure fed to the american public. Well, that is overly dramatic. The data for it is bad and its maker, Roche, has withheld data on its trials when a huge research organization wanted to do a big study about effectiveness. In essence, Roche ignored them, 5 times. This has raised enormous red flags in the medical community about its effectiveness. To top it off, however, is that the CDC continued to recommend treatment with tamiflu within 48 hours of diagnosis on an outpatient basis, even without evidence supporting its effectiveness. The first thing I thought when I read this is, "I want to see the CDC's disclosure report".

[calicoug]

I don't want to take the time to read the article now, but I will later. One thing I do want to say is that Tamiflu is probably the biggest crock of horse manure fed to the american public. Well, that is overly dramatic. The data for it is bad and its maker, Roche, has withheld data on its trials when a huge research organization wanted to do a big study about effectiveness. In essence, Roche ignored them, 5 times. This has raised enormous red flags in the medical community about its effectiveness. To top it off, however, is that the CDC continued to recommend treatment with tamiflu within 48 hours of diagnosis on an outpatient basis, even without evidence supporting its effectiveness. The first thing I thought when I read this is, "I want to see the CDC's disclosure report".

I'm pretty new to reading about these issues, but it is very surprising to me. Even if Tamiflu is effective (and as you note there seems to be a lot of questions around that point), it is so heavily used as to almost ensure resistant strains of the flu. Our response to the flu overall seems to be pretty poor.

[The_Douger]

I can count the number of times I've written for Tamiflu on one hand this flu season.

It's not that great.

[CardiacCoug]

I disagree with multiple parts of this statement.

1. Nobody should be doing flu swabs at this point in time unless you are on a ventilator in the ICU. Physicians are notoriously bad at interpreting lab results from rapid tests and a prime example is the rapid influenza test. I'd bet money that over 90% of physicians would not interpret the results of a rapid test accurately even 50% of the time during the flu season.
2. The influenza vaccine is a trivalent vaccine. The predominant strain this year has been H3N2, which is covered in the vaccine. There are still other strains that could infect a patient. The flu season has come very early this year and it is possible that we could see another surge of cases again with a different strain.

So, I would recommend immunization after a documented case of influenza. I don't know if there is data out there to support this, but it makes sense scientifically, although the probability of getting a second strain of influenza in one year seems low.

1. Did I say doctors should be doing flu swabs?

2. Yeah looks like the CDC agrees. UD should still get immunized even if he may have already had influenza:

http://www.cdc.gov/flu/about/season/...#vaccine-after

[UtahDan]

Thanks guys. I'll go get it tomorrow

[doctorcoug]

1. Did I say doctors should be doing flu swabs?

2. Yeah looks like the CDC agrees. UD should still get immunized even if he may have already had influenza:

http://www.cdc.gov/flu/about/season/...#vaccine-after

Sorry about that, my assumption.

In regards to cdc recommendations, after their influenza tamiflu snafu, I've decided to seriously consider the recommendations myself and evaluate what is being said because I have doubts to their ability to provide unbiased recommendations. I have yet to come up with another decent reason that they maintain their stance on recommending tamiflu. They took a couple of steps back in my opinion recently.

via a galaxy s3 far far away

[lambdacoug]

[calicoug]

Sorry about that, my assumption.

In regards to cdc recommendations, after their influenza tamiflu snafu, I've decided to seriously consider the recommendations myself and evaluate what is being said because I have doubts to their ability to provide unbiased recommendations. I have yet to come up with another decent reason that they maintain their stance on recommending tamiflu. They took a couple of steps back in my opinion recently.

via a galaxy s3 far far away

Did you have a chance to read the article? Curious about your thoughts.