By Brianne Fitzgerald RN, MPH

     Last week we discussed the reasons why one should get the flu vaccine this year.  Before we move on to Avian/bird Flu there are a few more facts that one should be aware of in regard to the flu.  Flu season in the U.S usually starts in November and goes until April, the peak being in between late December and early March.  It is a good idea to get the flu vaccine before you get the flu.  It takes about two weeks for the vaccine to work and the body to develop peak antibody protection.  The optimal time to get the vaccine is during late October and November. 

     There is no flu vaccine shortage this year, so the recommendations are that those at highest risk get the shot during October and the rest of us, during November.  Vaccine clinics will be held into December, as long as there is vaccine available. 

     Flu season in the Southern hemisphere is different than in the North.  Consult your primary care provider if you are traveling south of the equator. 

     Incubation period for the flu is 1-4 days.  A person with the flu can be contagious one day before he knows that he is sick and for about 5 days afterwards.  The incubation period for children is longer.

There are four currently licensed influenza antiviral agents available in the US: amantadine, rimantadine, zanamivir and oseltamivir.  They are to be used as an add –on to the vaccine for the control and prevention of the flu, not as a substitute for the flu vaccine.  You need to see you primary care provider and receive a prescription for any of these medications.

     Since December, 2003, a growing number of Asian countries have reported outbreaks of avian/bird flu.  The avian flu is named H5N1 (get familiar with this term).  The avian influenza is a contagious disease among animals caused by viruses that normally affect only birds, and less commonly, pigs. 

     To prevent the leap from animals to humans, The World Health Organization (WHO) is doing everything in its power to reduce the spread.    To control avian flu, the rapid destruction (culling) of exposed birds, quarantine, and disposal and disinfection of areas are the recommended practices.  Contact with bird feces (droppings) is the major mode of transmission.

     Humans have been infected with H5N1.  Some of those infected have died.  All of the cases of human H5N1 have occurred among persons who cared for infected birds/chickens.   This flu is highly unstable and its behavior cannot be pre-determined.  According to the WHO, at this point in time only Vietnam and Thailand have reported human cases of bird flu.  This writer does not believe this to be an accurate read. 

     There is no current vaccine available to protect usfrom H5N1 influenza in humans.

     However, there are currently two classes of drugs available for the prevention and treatment of influenza.  This column discussed them last week (amantadine, et al). 

     The issue of prevention and containment, should a worldwide pandemic occur, is the topic at many dinner tables, both here in Boston and in Washington.  Quarantines, the forced locking up of exposed cases vs. containment of those who are infected with the disease are two different areas being discussed. We have a public health law in Massachusetts that requires the state to lock up infectious person with TB who refuses to take their medicine.  The units that service this law are often times full, but rarely overflowing, because we here in Massachusetts have a way about encouraging people to take a personal responsibility for themselves and their families.  This column does not now have time to discuss the possibility of quarantine.  It is important to consider the idea and its ramifications.  In the meantime get your flu shot during these next 6 weeks.  Do not let the doctor or the nurse or the health department or CVS tell you that you don’t need it.  Bird flu and its possible arrival in the West is reason enough to protect yourself from the flu as we know it today.  For further information try National Immunization hotline @ 800.232.2522 (English) 800.232.0233 (Espanola) or www.cdc.gov/flu.  Ma. Department of Public Health 627.624.6000.  Clinical Mobility, a fee for service provider is doing flu shots all day long on 10/21, 22, 23 and 11/4, 5, 6 at the South Shore Mall.  For those with Medicare part B the immunization is free, for the rest of us the cost is $26.00 and you will receive a receipt to submit to your health insurance company (good luck).  Bfitz38@msn.com.