Only one significant factor separates pandemic influenza from the flu that visits humans every year — immunity.
“If you understand seasonal influenza, you understand 90 percent of pandemic flu, just like that,” said Dr. Howard Rodenberg, director of health for the Kansas Department of Health and Environment.
Rodenberg spoke Monday night at a public Flu Forum held at the Lyon County Courthouse. Rodenberg has been traveling across the state to educate communities about pandemic flu and flu in general.
Seasonal flus come around regularly enough that most people have some immunity to varieties of existing flus.
The difference between those and pandemic flu is that pandemic flu “is one that humans have not seen before,” Rodenberg said. “... So, we’re dealing with the fact that nobody has seen this strain, so nobody has any immunity.”
Rodenberg took a few minutes to explain flu basics to an audience made up primarily of health-care workers and emergency preparedness task force members.
He said that influenza is caused by three types of virus: A, B and C. The latter is not found in people.
“A is usually more severe, but every year A and B viruses are still out there,” he said. “There’s flu virus everywhere. You take an air sample of this room and you’re going to find some flu virus.”
Because most people are immune to many of them, the flu viruses in the room would not provoke a pandemic.
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Flu Forum
“In a pandemic, we all have equal immune systems, which is to say that we have no immunity,” Rodenberg said.
A pandemic is global outbreak of a “novel” virus, he said, “something humans have never seen.”
The virus has the same distinctive characteristics that define a flu virus, and the variations in the proteins attached identify the specific flu it causes. In simple terms, he said, their first names are different — like the bird flu, H5N1 — but their last names are the same: influenza.
Without immunity to fight a flu virus, the resulting pandemic could create havoc within communities and countries. That is why many communities such as Lyon County have created plans to cope with widespread flu, and Rodenberg congratulated Lougene Marsh, executive director of the Flint Hills Community Health Center, for bringing segments of the community together to prepare for handling a pandemic.
Rodenberg said that deaths from seasonal flu most commonly occurs among elderly people and those with weakened immune systems. Those deaths are not unexpected and do not generate fear among the community.
“They’re not the people who are making society’s infrastructure run, so in a normal flu season we don’t really think about the effects on society,” he said.
If flu debilitates vital functions — law enforcement, military, health-care workers, school teachers, workers at the water-treatment plant, truck drivers who bring food in to grocery stores, for example — society in general would be affected.
“That’s why you hear these catastrophic predictions,” Rodenberg said.
The burgeoning population worldwide, and the ability to fly anywhere within 24 hours, would contribute to a pandemic outbreak.
Rodenberg said that four pandemics were reported in the 1900s and almost 30 years have passed since the last pandemic. History teaches that it could be time for a pandemic within the next five to 10 years.
Rodenberg was skeptical that when the next pandemic comes, it will arrive as bird flu.
“Even if we knew when the pandemic was coming, we don’t know if it will be bird flu,” he said. To date, transmission has been from bird to human, and the 253 victims known to have contracted the flu all lived in “incredibly close contact with poultry. They had birds running through huts, urinating, defecating on the floor. If the bird was sick, you couldn’t sell it at the market. You kill it and eat it.”
Seven people living in the same room in a poor section of Indonesia were not able to use good hygiene habits; they shared cups, towels, utensils, “everything they had.”
“When you look at the science, you get a sense that a pandemic is going to happen sooner rather than later,” he said. Viruses were stable until the last 10 years. “All of a sudden, you’ve got a bunch of new viruses. You just get the sense that ... the dam is going to break.
“You can try to plan, try to mitigate, but Mother Nature does what she wants to do and she does it best.”
Rodenberg presented general advice about prevention, symptoms, and treatments for flu.
The symptoms of all flus are the same: sudden onset, fever more than 102 degrees Fahrenheit, all-over body aches, headache, excessive tiredness, and a cough that often is dry and unproductive because flu causes lower-respiratory problems. Physicians usually will not prescribe antibiotics for the flu because they are ineffective in fighting it, he said.
Some antivirus treatments, such as Tamiflu and Symmetrel, are available, though Rodenberg did not recommend them as panaceas for the flu.
“Last flu season, 100 percent (of the flu viruses) were resistant to Symmetrel,” he said. “Twenty percent were resistant to Tamiflu.”
Rodenberg said it is important to know what the term influenza means.
“We all kind of use flu as a wastebasket term of anything that happens in winter,” Rodenberg said. “Stomach flu. It’s not the flu. Flu is a respiratory virus.” The common cold is “a rhino virus or a cold virus, it’s not influenza.”
Although nothing guarantees defense against the flu, Rodenberg said there are preventive measures to improve the odds.
“The things your grandparents told you are actually the right things to do,” he said. “They weren’t wrong on this sort of thing.”
These include:
- Wash hands with soap and water, wet napkins, or gels for 15 to 20 seconds to remove viruses.
- Cover your mouth when you cough.
- Stay home when you’re sick, and keep children home when they are sick, too.
- Avoid crowds during outbreaks.
- Maintain healthy habits — eat right, get plenty of sleep, keep high blood pressure or diabetes under control as much as possible.
- Get a vaccination against the flu.
“Vaccines don’t cause the flu,” he said. Flu-like reactions a day or two after a shot is “simply your body revving up the immune system.”
Those who are especially at-risk of experiencing complications from the flu, which commonly is pneumonia, are people over 65, residents of long-term care facilities, children 6 to 35 months whose immune systems are not developed, people who are taking drugs to suppress the immune system, pregnant women, people aged 2 to 64 years who suffer from conditions that make them at-risk, health-care personnel and child-care givers or those who have household contact with children under 6 months or under. The latter age group becomes protected by protecting the people around them.