Viruses and Vaccines . . . .

It is widely advertised at this time of year for everyone to get a flu shot. At Good Shepherd we invited the MN Visiting Nurse Association (division of Hennepin County Medical Center) to come on a Sunday morning in September to offer flu vaccines to those who wished to have them here. MVNA also processes insurance information for payments and co-pays. They won't return until next year, so I would direct readers to the nearest pharmacy or clinic to become vaccinated against influenza this year. Yes, it's necessary to repeat this vaccine annually. Why? The influenza virus mutates its genetic map every year, and the World Health Organization researchers develop the formula for this year's flu vaccine based on the most prevalent viruses from the prior year. And that has been an effective way to reduce incidence and mortality of influenza.

At some times, and in some locations, a viral illness becomes such a potent and prevalent occurrence that it becomes labeled individually, such as Zika, West Nile, SARS, swine flu. Recently and locally we have heard of increased occurrence of Legionnaire's disease. Fortunately the local source has been identified and the has been cleaned or remediated to eliminate that virus from that source. The individuals who became ill from Legionnaires disease had long arduous treatment in hospital, and one individual succumbed to the disease. There are other illnesses that are of concern, but are not “influenza.” Lyme disease is spread by ticks, occasionally there are outbreaks of tuberculosis, as well as other viruses such as Ebola.

Vaccinations have been developed over the past many decades in history of medical care. Please help stop the scare tactics comparing the current strain of influenza to the Flu Epidemic of 1918. Yes, there were thousands of people who died, worldwide, at that time. It was during World War I, and one very ill soldier on a troop train traveling across the U.S. is thought to have been the source of the initial influenza cases at that time in this county. Ultimately, the most common cause of death from influenza – then and now – is pneumonia. Remember that in 1918 there were no antibiotics yet developed; intravenous therapy (IVs) was not yet developed as clinical treatment, and there were no respiratory support 'ventilators' at that time.

That pandemic in 1918 prompted aggressive scientific clinical research into cause, effect, treatment and prevention for all illnesses, globally, and that approach to illnesses continues today as the tools of research continue to evolve. Public health worldwide is the task of the World Health Organization, and each country has a designated health monitoring department. In the U.S. each state, county, and most major cities have their own branch of the state health department. Why all that organization? In under-developed areas of the world much of the effort of health promotion is basic hygeine of clean drinking water and sanitary sewage disposal. When that basic health need is in place, then it is the work of the health department to promote additional proven methods of prevention, to monitor outbreaks of illnesses, track prevalence and mortality. The goal is to keep people healthy through education, vaccines, and healthcare.

The reader has likely expected that this topic of information would eventually get around to vaccines, aka 'shots.' You may think that vaccines are only necessary for infants and children, but for adults there are also very necessary, useful, and highly recommended vaccines. A vaccine by definition is an injection by a killed-microbe (germ, bacteria, virus) in order to stimulate the person's own immune system against that particular microbe and thus prevent or lessen the illness associated with the particular microbe. In other words, vaccines increase the body's own defense against disease.

For some vaccines, one dose provides life-long protection; other vaccines require 'booster shots' to continue that immunity. Your primary healthcare provider is a good source of information on what vacines you have had, what are now available, and what additional care may be of benefit to you. Certain diseases, such as the flu, can be especially serious for older adults and/or those with chronic health conditions. For example, your primary physician will perhaps suggest that you get a booster of the vaccine which protects against hepatitis A and B. Other commonly used vaccines are Pneumovax 23 as well as Prevnar 13 which protect against several variants of pneumonia. As noted above, persons with certain diseases make them more susceptible to the flu, which can lead to serious problems: pneumonia which affects the lungs; meningitis which affects the brain; bacteremia which is an infection of the blood itself. All of these situations put the individual at risk for death. Let me note a few of the most common vaccines recommended for adults. The vaccine for shingles has been widely advertised and understandably so. Shingles not only causes severe pain at onset for adults of any age, but can have an on-going symptom of chronic severe nerve pain more prevalent in older adults. For those people on Medicare, it has happened that the shingles shot was not covered by the Medicare program; however, those individuals who called the customer service line of their Medicare carrier were encouraged to re-submit the claim for payment from another fund within Medicare.

Even in people who have received regular vaccines, the disease that was supposed to be prevented sometimes still happens. It is reassuring to know that in the majority of cases, if one gets sick despite the vaccine, the symptoms typically are less severe. Some individuals feel strongly that they get sick from the vaccine itself; please discuss this with your personal physician. It has been recommended for many adults to go home after receiving a vaccine, take two aspirin and take a nap. It can't hurt, and it might lessen any untoward effects of the shot.

To minimize the chance of becoming ill with influenza and spreading the virus to others, let me close with some general prevention suggestions. Many viruses are spread by “droplets” which means by the fluids naturally occurring in nasal passages and mouth, thus are spread by sneezing, coughing, talking. Cover your cough by coughing or sneezing into your elbow; make sure you wash your hands frequently and thoroughly with soap and water; use a paper towel in touching the handle of a public restroom door. The BEST prevention tip is to stay home when you are sick. A person is the most contagious with the common cold and/or the flu in the 24 hours prior to onset of symptoms and for a duration of 7 days after symptoms appear.

It is well-known that people in close quarters on a daily basis, such as in a classroom or small work space, catch viral illnesses easily from one another. For this reason one practice of prevention is frequent recess breaks outdoors, even in cold weather. And in your home, if possible, air out bedrooms frequently in winter months. The value of prevention in terms of rest, fresh air, and nutritious food dates back to Florence Nightingale in the Crimean War . . . and it still applies today, even with all the advances in medical care.