NurseLife

The 5 “W’s” and the 5 “H’s” of InFLUenza: A Love Letter from your local BC Public Health Nurse

Image above by Arek Socha from Pixabay 

Dear Friend,

How are you and your family these days? Most of us are managing to survive this Covid era (yes, it is definitely still here silently mutating and invading our lives). But sadly, we were just shaken again during this winter (2022-2023) by another known virus in the northern hemisphere. What is more heartbreaking is the population directly affected by this. As a mother and a nurse, I could not bear hearing the tragic news that influenza caused recent deaths in children. I told myself, I really have to do more than what I do now. Although I am actively immunizing dozens of kids every shift in the community I serve; giving covid and flu vaccines concomitantly in our clinics; participating in the process as a flu coordinator–it was just not enough for me to save these children. Then I suddenly remember once I spoke to a mother over the phone, as I was obtaining consent prior to immunizing school-aged children for their school immunization blitz. Her words stood out as I had the exact same frustration. She uttered, “People need to be educated about these vaccines.” And she was so right. Ironically, we live in this golden age where we can easily overload ourselves with information, just with a touch of our fingertip. That is a problem right there, and so we have to learn to discern where to gather the right and credible information.

We, the public health nurses, are so passionate about prevention through education. A big part of my job in the school and wellness team is to provide the parents with evidence based information, so that they can make an informed decision regarding the specific vaccines their kids are due for. As of now, there is an emergent need to educate the public. So hear me out as I have pulled all of my credible resources to make a simple post, hoping I would make a difference to help our children (and high risk elderly population) get protected from this deadly flu.

 

WHAT is Influenza?

  • Influenza aka flu, “is an infection of the upper airway (the nose and throat), caused by an influenza virus. A person with influenza is also at risk of other infections. These include viral or bacterial pneumonia, an infection of the lungs.” (BC Centre for Disease Control, 2022).

Specifically, influenza is an RNA virus (single-stranded). Three of the 4 types are recognized in humans (the 4th type, Influenza D virus primarily affects cattles and is not known to cause illness in people). Here are the 3 types for you to take note on, as you may have heard a combination of these terms:

    • Influenza A viruses are further classified into subtypes according to the combinations of two surface proteins:
        • Hemagglutinin (HA) – H1, H2, H3
        • Neuraminidase (NA) – N1, N2

Since 1977 the human H3N2 and human H1N1 influenza A subtypes have contributed to influenza illness. Only influenza type A viruses are known to have caused pandemics.

    • Influenza B viruses are not classified into subtypes, but can be broken down into lineages. It has evolved into two antigenically distinct lineages since the mid-1980. Currently circulating influenza type B viruses belong to either one of these:
        • B/Yamagata 
        • B/Victoria
    • Influenza C viruses do not have neuraminidase (unlike Influenza A virus). It is detected less frequently than A or B viruses, usually causes mild infections, and does not occur seasonally.

WHO is affected by Influenza?

Although every human can be affected, the risk of complications is greater for seniors 65 years and older, very young children, and people who have lung or heart diseases, certain chronic health problems, or weakened immune systems.

WHERE does Influenza occur?

As per the World Health Organization, influenza circulates in all parts of the world.

Source: LearningHub-Influenza Immunization Competency Course: Foundations of Influenza Disease & Vaccines (Module 1: Influenza disease and population health. Epidemiological Triangle: Environmental Factors)

WHEN did Influenza start?

For the text version of the infographic above, please click this link:

Influenza Milestones 1917 – 2009 Timeline | Pandemic Influenza (Flu) | CDC

Source: Learninghub- Influenza Immunization Competency Course: Foundations of Influenza Disease & Vaccines (Module 1: Influenza disease and population health. Epidemiological Triangle – AGENT factors)

As we can see, it has been around for many many years, evolving into different variations or strains, and attacks into varying degrees of pandemics causing death.

WHY do I need to know this

In hopes of protecting the public on a macro level, I would like to give the right information, to help everyone make an informed decision about the importance of prevention. If everyone is well informed of this virus’ existence and the extent to which this virus is capable of, maybe we can help save the ones we love the most. Knowing that these subtypes, lineages, and strains just keep revisiting the human population in different variations, we can outsmart them. And we have the technology to do just that, and why not? Further down, you will see why there is a need to vaccinate yearly.

Now let’s explore the millions hows of influenza, by discussing the five main hows:

HOW Do I Know I Have Influenza?

Approximately, only 50% of infected individuals will develop symptoms, influenza disease may not be easily recognized especially in healthy people such as health care providers or others who care for vulnerable people. Even though symptoms may not be present, those infected can still transmit the virus to their patients. Cold & flu symptoms may be similar, but there are differences. As per HealthLink BC, 2022:

HOW Do I Treat This Flu?

Home Treatment

If you do get sick with the flu, home treatment can help to ease symptoms. Home treatment may include:

  • Get plenty of rest. Bed rest will also help you avoid spreading the virus to others.
  • Drink plenty of extra fluids to replace those lost from fever.
  • Avoid smoking/vaping nicotine products such as cigarettes, and breathing other people’s smoke.
  • Breathe moist air from a hot shower or from a sink filled with hot water to help clear a stuffy nose.
  • Anti-influenza drugs or antivirals are available by prescription, but these must be started early. They will shorten symptoms by about three days if given within 12 hours, and by about 1.5 days if given within two days of the start of symptoms.
  • Over-the-counter medications can help relieve symptoms such as pain and fever. These are not recommended for children under six years of age. Non-prescription flu remedies are also available at the pharmacy.

When Should I See A Doctor?

If you do not start to feel better in a few days or your symptoms get worse, you should see a doctor. Call a doctor if you get sick and you have the following health concerns:

  • Heart or lung disease
  • Any chronic health concern that requires regular medical attention
  • An immune system weakened by disease or medical treatment, or
  • You are frail or at risk of serious illness or complications

Source: BCCDC, 2022

http://www.bccdc.ca/health-info/diseases-conditions/influenza

HOW Do I Prevent and Protect Myself from Influenza?

We are so well acquainted with hand hygiene by now, and I am not about to stop promoting this number one step!

1. Wash hands regularly. And I’m sure by now you also own a sanitizer!

If we are not bombarded with these main healthy habits yet, here you go again!

2. Eat and drink well (nutritious food of course, and water of course)

3. Exercise (get that blood flowing and that heart pumping)

And I’m really gonna sound like a nurse here:

4. Go get your Influenza Vaccine NOW

HOW Will This Flu Shot Help Me? HOW Does It Work Anyway?

Please watch this video to start, in order to understand the detailed mechanism of our immune system:

Click this link if video above not showing: https://www.youtube.com/watch?v=PzunOgYHeyg

Many people say they don’t get the flu vaccine because it makes them sick. This is true in a sense, because you are introducing a “portion” of the virus to your body. But you’re not giving yourself the actual virus. The flu vaccine is either “inactivated”, which is made of killed influenza viruses or parts of the viruses given as an injection, or “live attenuated” given as a flu mist (HealthLinkBC, 2022). For those who opt to get their children the flu mist, a weakened form of the live vaccine is given, which is still not going to give the body the real flu. What you are really doing is training your immune system, aka your body’s defenses, to know exactly what to do the next time this familiar virus enters your body again. And when this actual virus is here, guess what? Your army is well equipped, well prepared, and way smarter! 

Watch how our amazing immune system soldiers work up close:

https://www.youtube.com/watch?v=yjAZXlMpw3k

Then, watch how vaccines really work below:

I have mentioned the types of flu vaccines above (inactivated or live attenuated) and are either trivalent (protecting against 3 strains) or quadrivalent (protecting against 4 strains). The right vaccine for you to receive will be based on your age, risk factors, and availability, but will be guided by the recommendations as per this page: http://immunizebc.ca/influenza

Diving more into the details, what combination do we need to be protected from this particular year? The World Health Organization recommended viral composition of the influenza vaccines for the 2022/23 influenza season in the northern hemisphere include the following:

    • A/Victoria/2570/2019 (H1N1)pdm09-like virus
    • A/Darwin/9/2021 (H3N2)-like virus (new this year)
    • B/Austria/1259417/2021 (B/Victoria lineage)-like virus (new this year)
    • B/Phuket/3073/2013 (B/Yamagata lineage)-like virus (in quadrivalent vaccines only)

These recommendations are available in February of each year for the upcoming season in the Northern Hemisphere. Yes, every year is different, and this year,  two new strains are added to the flu vaccine. This makes it important for us to note that yearly vaccination is vital for optimal protection. 

Getting sick from the actual flu and getting the vaccine to prevent flu are both forms of active immunity. But why suffer and endure the full blown illness (leading to death) when we can lessen its severity and time? 

Hope this helps at all, and please pass it along to others as well. Wishing you and your family the best of health.

Much Love and Service,
Vernice Bambilla, RN, BScN
LHU Flu Coordinator
Population and Public Health

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