In many ways Influenza is an impressive force of nature that has successfully adapted to human efforts to defeat it – ever since there were humans.
The early efforts were common sense and as primitive as the times – stay away from the cave where everyone got sick and died. That was somewhat successful, until someone in your cave succumbed. The influenza virus couldn’t be too deadly, or it could wipe itself out in a single season.
The simple tug of war between the influenza virus and humans has evolved over the eons.
The virus resides safely in birds, pigs and various domestic animals where it continuously reinvents itself. Developing countries do not engage in industrial farming. A pig or cow is the most valuable possession they own, the one that will feed the family; so they keep it within close range.
The virus, always mutating, always changing, is always around your house and family in various unsuccessful forms. By luck, the virus stumbles on a change that makes it contagious to you, and equally importantly, makes it able to be passed person to person by airborne transmission (juicy coughing).
A star of sorts is born. A new influenza virus is ready to go on its world tour.
Fortunately, we know the trick in the 21st century and have WHO and CDC scientists close by to take samples of the new bugs. We hold a few auditions and pick the top-three contenders for world infamy.
Then over the course of three months we make pure colonies, break them up into the pieces most stimulating to our immune systems, and create about 160 million doses of four kinds of flu vaccine (regular, high-dose for the elderly, intradermal, and nose spray).
Now the fun part begins. We have a couple of nasty flu viruses waiting in the wings for their opening, and we must somehow convince most of the population to get vaccinated, preferably in the next four weeks. A vast network has distributed the 160 million vaccines to virtually every community in the country.
And sadly, often times that’s where they sit.
A certain percentage of the population doesn’t need much convincing. They are in poor health and know a bad case of flu will be the end of them. People who have had influenza in the past are eager to avoid a repeat of that experience.
But the rest of us, lucky in the past, perhaps foolish in the present, don’t put getting a flu shot very high on the list. I will go on a diet tomorrow, quit smoking as soon as work settles down, and get a check-up next week. Yet the weeks go by and the multimillion dollar influenza vaccine, the magic bullet against the current strains of flu, sits in the refrigerator.
So we remind everyone that 15,000 to 40,000 people will die in the U.S. of flu this winter. We talk about herd immunity – protect your friends and loved ones.
And a wave of demand slowly builds and some of that vaccine gets used. Some of us get sick with the flu and motivate our friends. People start noticing friends absent from work and school, resulting in a few more getting vaccinated.
In the end, most of the vaccine is used – some way too late – and we still manage to lose 15,000 to 40,000 people, and ponder how to do better next year.
The CDC recommends influenza vaccine for everyone before the start of the flu season. That is a sensible and simple recommendation.
Do it today, and you can save yourself, and start that diet next week.
Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic.
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