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home : columns : ask the doctors November 19, 2018

3/1/2018 8:09:00 AM
Reader's plea a reminder that the flu can be deadly for many

DEAR READERS: With this year's flu season on a pace to be the worst in almost a decade, we want to take a moment to share an important letter that we received from a reader. As of this writing, at least 37 children have died from influenza infection. Because of the time lag in identifying and reporting flu deaths, officials suspect the true number is significantly higher.  

Medical centers throughout the United States have admitted close to 12,000 people with confirmed cases of the flu, in many instances overwhelming the facilities. Here in California, some hospitals have resorted to setting up "surge tents" to house the crush of flu patients. Nurses and other medical personnel are being flown in from surrounding areas to help. And the capper is that, driven by H3N2, a particularly nasty strain of the influenza A virus, scientists at the Centers for Disease Control and Prevention warn that things will probably get worse.

Which brings us to the letter -- it's a plea, really -- from one of our readers. She begins by sharing that, in the five years after her diagnosis of rheumatoid arthritis, she has managed to find a treatment regimen that helps her live with this difficult disease. However, this includes medications that make her particularly vulnerable to infection. We'll let her take it from here:

"The same medications that keep my disease under control also suppress my immune system and leave me vulnerable to catching colds and other viruses that my body is unable to fight off," she writes. "As a result, I am very careful about being around other people in public places or in crowds. My request is that you please let others know that if you are not feeling well or are sick to please stay home! Those with compromised immune systems cannot fight off illness the way that you can. This has been a bad year for the flu, but it can be deadly to someone like me."

Research shows you're capable of spreading the influenza virus a day or so before you realize that you're sick. You'll continue to be capable of spreading the virus for another five to seven days. For children, it can be even longer. So the minute you recognize the onset of your own flu symptoms, whether it is fever, chest congestion or body aches, know that you're contagious. Always cover your mouth when you cough. Sneeze into a tissue. Wash your hands. Stay at home.

We have long understood that flu is transmitted via the fine mist of aerosolized droplets from a sick person's cough or sneeze. Now a new study, funded by the CDC, suggests the virus is passed along on an infected person's breath, whether or not they cough or sneeze. People are particularly infectious early in their illness, yet another argument for staying home.

The advice for staying healthy has long been frequent hand-washing, keeping surfaces clean and steering clear of individuals who are ill. While this all still holds true, researchers in the study say staying away from enclosed public spaces is equally important.

And, we would add, get your flu shot. This year's version isn't as robust as one would have wished, but it does offer a measure of protection.

(Eve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health.)

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)





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