Health Check: how long should you stay away when you have a cold or the flu?



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Symptoms of the flu generally develop more quickly and are more severe than the common cold.
By txking/Shutterstock

Nadia Charania, Auckland University of Technology

Most adults get around two to three colds a year, and children get even more. In terms of the flu, there are around 3-5 million severe cases of influenza worldwide each year and 290,000 to 650,000 deaths.

The symptoms of a cold and the flu are similar, so it’s hard to tell the difference. But the flu is usually more severe and develops more quickly than a cold.

Colds and flus can be easily passed from person to person through the air, when an infected person coughs or sneezes, and touch, when a person touches an infected surface or object like doorknobs and light switches.

So what’s the difference between colds and flus, and how long should you stay away?

Colds

Cold symptoms include a sore throat, cough, runny or stuffy nose, tiredness and headache.

Most people become contagious with cold symptoms one to two days after exposure to a cold virus. These symptoms usually peak two to four days later. The common cold usually lasts about ten days.




Read more:
I’ve always wondered: why is the flu virus so much worse than the common cold virus?


There is nothing you can take to shorten the duration of a cold, and most people will get better without needing to see a doctor. But some over-the-counter medications can help alleviate the symptoms. These include anti-inflammatories (to reduce inflammation or swelling), analgesics (to reduce pain), antipyretics (to reduce fever) and decongestants (to relieve nasal congestion).

But be careful you follow the instructions and recommended dosage for these medications. A recent study of US adults who used paracetamol, the active ingredient in many cold and flu medicines, found 6.3% of users exceeded the maximum recommended daily dose. This mostly occurred during the cold and flu season.

For your own and others’ health, the best place for you to be when you’re sick is at home.
Shutterstock

Natural products such as vitamin C and echinacea are sometimes recommended to prevent and treat a cold, but there is limited evidence to support their effectiveness.

The flu

Common symptoms of the flu include fever (a temperature of 38°C or higher), cough, chills, sore throat, headache, runny or stuffy nose, tiredness and muscle aches.

An infected person can spread the flu for five to seven days after becoming infected. The infectious period can begin 24 hours before the onset of symptoms. This means you can spread the flu without even knowing you’re sick.

Influenza viruses can cause mild to severe illness in people of all ages. Most people will fully recover within one to two weeks and won’t require any medical attention. Similar to a cold, people can take some over-the-counter medications and other remedies to help alleviate symptoms.




Read more:
Explainer: what’s new about the 2018 flu vaccines, and who should get one?


But some people can become acutely unwell with the flu. They may require antiviral medication and, in severe cases, hospitalisation. Those at high risk include pregnant women, children, the elderly, and people with certain medical conditions such as HIV/AIDS, asthma, diabetes and heart and lung diseases.

The flu virus strains that circulate usually change every year, so the best way to prevent getting the flu is to get the annual flu vaccine. The vaccine is moderately effective and recommended for adults and children over the age of six months. Some common side effects may occur, such as temporary soreness, redness and swelling at the injection site, fever, headache, muscle aches and nausea.

Wash with soap for at least 20 seconds to kill the germs.
Shutterstock/Alexander Raths

Avoid passing it on

If you feel unwell, stay home from work or school and rest (and get plenty of fluids) until you feel better. If you’ve had a fever, stay home for at least 24 hours after the fever has broken.

When you go back to work or school, you may still be infectious, so avoid passing the virus on by:

  • regularly washing your hands with soap and water for at least 20 seconds and drying them properly – if soap and water are not available, use an alcohol-based hand sanitiser

  • practising good cough and sneeze etiquette: cover your mouth and nose with a tissue or your upper shirtsleeve when you cough or sneeze, and throw away used tissues immediately

  • not touching your eyes, nose and mouth

  • The Conversationfrequently cleaning the surfaces and objects you’ve touched.

Nadia Charania, Senior Lecturer, Public Health, Auckland University of Technology

This article was originally published on The Conversation. Read the original article.

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Health Check: should I take vitamin C or other supplements for my cold?



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Once you have a cold, taking vitamin C supplements won’t do anything.
From shutterstock.com

Clare Collins, University of Newcastle

Last week I had a shocking cold. Blocked nose, sore throat, and feeling poorly. This made me think about the countless vitamins and supplements on the market that promise to ease symptoms of a cold, help you recover faster, and reduce your chance of getting another cold.

When it comes to the common cold (also called upper respiratory tract infections) there is no magic cure (I wish) but some supplements may deliver very minor improvements. Here is what the latest research evidence says.




Read more:
Health Check: can you treat the common cold?


Vitamin C

For the average person, taking vitamin C does not reduce the number of colds you get, or the severity of your cold.

In terms of how long your cold lasts, some studies have looked at people taking vitamin C every day, while others have focused on participants taking it once they develop a cold.

In 30 studies comparing the length of colds in people regularly taking at least 200 milligrams of vitamin C daily, there was a consistent reduction in the duration of common cold symptoms.

However, the effect was small and equates to about half a day less in adults, and half to one day less in children. These types of studies also found a very minor reduction in the amount of time needed off work or school.

Among studies where vitamin C was only started once a cold had developed, there was no difference in duration or severity of a cold.

There are some risks to taking vitamin C supplements. They can increase the risk of kidney stones in men, and shouldn’t be taken by people with the iron storage disease haemochromatosis, as vitamin C increases iron absorption.




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Special considerations

Although in the general population vitamin C has no impact on the number of colds people get, there is an exception. For people who are very physically active – such as marathon runners, skiers and soldiers exercising in very cold conditions – vitamin C halved their chance of getting a cold.

Many people take vitamin C supplements in hope it will treat their cold.
From shutterstock.com

A few studies have also found some benefit from vitamin C supplements of at least 200 milligrams a day for preventing colds among those with pneumonia.

However, taking vitamin E supplements in combination with a high intake of vitamin C from food markedly increased the risk of pneumonia.

Zinc

A review of studies testing zinc supplements in healthy adults found starting daily supplements of at least 75 milligrams within 24 hours of the onset of a cold shortened the duration by up to two days or by about one-third. It made no difference to the severity of the cold.

There was some variability in the results across trials, with insufficient evidence related to preventing colds. Researchers suggested that for some people, the side effects such as nausea or a bad taste from zinc lozenges might outweigh the benefits.

Take care to stop zinc supplements as soon as your cold resolves because taking too much zinc can trigger a copper deficiency leading to anaemia, low white blood cell count, and memory problems.

Garlic

Only one study has tested the impact of garlic on the common cold. Researchers asked 146 people to take garlic supplements or a placebo daily for 12 weeks. They then tallied the number and duration of their colds.

The group that took garlic reported fewer colds than those who took the placebo. The duration of colds was the same in both groups, but some people had an adverse reaction to the garlic, such as a rash, or found the garlic odour unpleasant.

Because there is only one trial, we need to be cautious about recommending garlic to prevent or treat colds. We also need to be cautious about interpreting the results because the colds were tracked using self-report, which could be biased.




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Science or Snake Oil: will horseradish and garlic really ease a cold?


Probiotics

In a review of 13 trials of probiotic supplements that included more than 3,700 children, adults and older adults, those taking supplements were less likely to get a cold.

Their colds were also likely to be of shorter duration and less severe, in terms of the number of school or work days missed.

There is some evidence that probiotics, which can be found in yoghurt, may reduce the incidence of colds.
From shutterstock.com

Most supplements were milk-based products such as yoghurt. Only three studies used powders, while two used capsules.

The quality of the all the probiotic studies, however, was very poor, with bias and limitations. This means the results need to be interpreted with caution.

Echinacea

Echinacea is a group of flowering plants commonly found in North America. These days you can buy echinacea products in capsules, tablets or drops.

A review of echinacea products found they provide no benefit in treating colds. However, the authors indicated some echinacea products may possibly have a weak benefit, and further research is needed.

Chicken soup

Yep, I’ve saved the best until last.

In a novel experiment on 15 healthy adults, researchers measured the participants’ nasal mucus flow velocity – our ability to break down and expel mucus to breathe more clearly. They tested how runny participants’ noses were after sipping either hot water, hot chicken soup or cold water, or sucking them through a straw.

Sipping hot water or chicken soup made participants’ noses run more than cold water, but sipping chicken soup worked the best. The researchers attributed this to the chicken soup stimulating smell and/or taste receptors, which then increased nasal mucus flow.

Another study on chicken soup found it can help fight infection and recovery from respiratory tract infections.

The ConversationOther researchers have shown comfort foods, such as chicken soup, can help us feel better.

Clare Collins, Professor in Nutrition and Dietetics, University of Newcastle

This article was originally published on The Conversation. Read the original article.

A strong immune system helps ward off colds and flus, but it’s not the only factor



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Winter bugs are impossible to escape.
Shutterstock

Hui-Fern Koay, University of Melbourne and Jesseka Chadderton, University of Melbourne

It’s peak flu season. You’re cold, rugged up and squashed on public transport or in the lift at work. You hear a hacking cough, or feel the droplets of a sneeze land on your neck. Will this turn into your third cold this year?

No matter how much we try to minimise our exposure to respiratory viruses, it’s far more difficult in winter when we spend so much time in close proximity to other people.

On top of this, viruses tend to be more stable in colder and drier conditions, which means they stick around longer.




Read more:
Health Check: how long should you stay away when you have a cold or the flu?


The common cold is caused by more than 200 different viruses, the most common of which are rhinoviruses (rhino meaning nose). Rhinovirus infections tend to be mild; you might get a sore throat and a head cold lasting just a few days.

Influenza, or the flu, is generally caused by type A or B influenza viruses. The flu is far more aggressive and often includes a fever, fatigue and body aches, in addition to all the classic cold symptoms.

The flu tends to be more severe than the common cold.
healthdirect

When it comes to getting sick, there’s always an element of bad luck involved. And some people, particularly those with young children or public transport commuters, are likely to come into contact with more viruses.

But you may have noticed that illness often strikes when you’re stressed at work, not sleeping properly, or you’ve been out partying a little too much. The health of our immune system plays an important role in determining how we can defend against invading cold and flu viruses.

How the immune system fights viruses

Your skin and saliva are key barriers to infection and form part of your immune system, along with cells in every tissue of your body, including your blood and your brain.

Some of these cells migrate around to fight infection at specific sites, such as a wound graze. Other cells reside in one tissue and regulate your body’s natural state of health by monitoring and helping with the healing process.

The cells that make up your immune system need energy too, and when you’re low on juice, they’ll be on low-battery mode. This is when our natural immune defences are weakened and normally innocuous bugs can begin to cause strife.

Our immune system requires a lot of energy to defend our bodies. Feeling tired and achy, overheating, and glands swelling are all signs that our immune system is busy fighting something.




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Explainer: how does the immune system work?


Boosting our natural defence system

Our immune system has evolved to naturally detect and eliminate viral infections. And we can actively strengthen our immunity and natural defences by looking after ourselves. This means:

  • getting adequate sleep. Sleep deprivation increases the hormone cortisol, which suppresses immune function when its levels are elevated

  • exercising, which helps the lymphatic system, where our immune cells circulate, and lowers levels of stress hormones

  • eating well and drinking enough water. Your immune system needs energy and nutrients obtainable from food. And staying well hydrated helps the body to flush out toxins

Good food feeds your immune system.
Anna Pelzer
  • not smoking. Smoking, or even secondary smoke, damages our lungs and increases the vulnerability of our respiratory system to infection.



Read more:
Health Check: should I take vitamin C or other supplements for my cold?


Educating our immune system

Natural defences aren’t always enough to keep us safe and we need the help of flu vaccinations.

Vaccines are designed to educate an army of B and T cells which make up your adaptive immune system. This arm of your immune system learns by exposure and provides long-term immunity.

These T and B cells need a bit of time from the initial influenza exposure before they can be activated. This activation lag time is when you feel the brunt of the flu infection: lethargy, body aches, extreme fatigue and unable to get off the couch for a day or two.

To overcome this delay and protect people before they are exposed to potentially harmful flu strains, flu vaccination introduces fragments of the influenza virus into the body, which acts like prior exposure to the bug (without actual infection).

You can still get the flu if you’ve been vaccinated but you might not get as sick.
VGstockstudio/Shutterstock

Seasonal vaccines are designed to match currently circulating strains and target those strains before you’re infected.

You can still catch the influenza virus if you are vaccinated. But because of this pre-education, the symptoms will likely be milder. The immune system has been trained and the army of B and T cells can move into action quicker.

Already have a cold or the flu?

If you’ve been sniffling and sneezing your way through winter, be comforted by the fact that these bugs are strengthening your immune system. Our body remembers the particular strain of rhinovirus or influenza we get, so it can recognise and mount a stronger defence if we encounter it again.


The Conversation


Read more:
Explainer: what’s new about the 2018 flu vaccines, and who should get one?


Hui-Fern Koay, Research Fellow in Immunology, University of Melbourne and Jesseka Chadderton, PhD Candidate, University of Melbourne

This article was originally published on The Conversation. Read the original article.

Most people don’t benefit from vaccination, but we still need it to prevent infections



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Everyone has to be vaccinated for immunisation programs to work.
from http://www.shutterstock.com

Allen Cheng, Monash University

A recent article in The Conversation questioned whether we should all get flu vaccinations, given 99 people would have to go through vaccination for one case of flu to be prevented.

But this position ignores the purpose of immunisation programs: whole populations of people need to take part for just a small number to benefit. So how do we decide what’s worth it and what’s not?




Read more:
The flu vaccine is being oversold – it’s not that effective


Decision-making in public health

When we consider a treatment for a patient, such as antibiotics for an infection, we first consider the evidence on the benefits and potential harms of treatment. Ideally, this is based on clinical trials, where we assume the proportion of people in the trial who respond represents the chance an individual patient will respond to treatment.

This evidence is then weighed up with the individual patient. What are the treatment options? What do they prefer? Are there factors that might make this patient more likely to respond or have side effects? Is there a treatment alternative they would be more likely to take?

In public health, the framework is the same but the “patient” is different – we are delivering an intervention for a whole population or group rather than a single individual.

We first consider the efficacy of the intervention as demonstrated in clinical trials or other types of studies. We then look at which groups in the population might benefit the most (such as the zoster vaccine, given routinely to adults over 70 years as this group has a high rate of shingles), and for whom the harms will be the least (such as the rotavirus vaccine, which is given before the age of six months to reduce the risk of intussusception, a serious bowel complication).

Compared to many other public health programs, immunisation is a targeted intervention and clinical trials tell us they work. But programs still need to target broad groups, defined by age or other broad risk factors, such as chronic medical conditions or pregnancy.




Read more:
Explainer: what is herd immunity?


Risks and benefits of interventions

When considering vaccination programs, safety is very important, as a vaccine is being given to a generally healthy population to prevent a disease that may be uncommon, even if serious.

For example, the lifetime risk of cervical cancer is one in 166 women, meaning one woman in 166 is diagnosed with this cancer. So even if the human papillomavirus (HPV) vaccine was completely effective at preventing cancer, 165 of 166 women vaccinated would not benefit. Clearly, if we could work out who that one woman was who would get cancer, we could just vaccinate her, but unfortunately we can’t.

It’s only acceptable to vaccinate large groups if clinically important side effects are low. For the HPV vaccine, anaphylaxis (a serious allergic reaction) has been reported, but occurs at a rate of approximately one in 380,000 doses.

An even more extreme case is meningococcal vaccination. Before vaccination, the incidence of meningococcal serogroup C (a particular type of this bacterium) infection in children aged one to four years old was around 2.5 per 100,000 children, or 7.5 cases for 100,000 children over three years.

Vaccination has almost eliminated infection with this strain (although other serotypes still cause meningococcal disease). But this means 13,332 of 13,333 children didn’t benefit from vaccination. Again, this is only acceptable if the rate of important side effects is low. Studies in the US have not found any significant side effects following routine use of meningococcal vaccines.

This is not to say there are no side effects from vaccines, but that the potential side effects of vaccines need to be weighed up against the benefit.

For example, Guillain Barre syndrome is a serious neurological complication of influenza vaccination as well as a number of different infections.

But studies have estimated the risk of this complication as being around one per million vaccination doses, which is much smaller than the risk of Guillain Barre syndrome following influenza infection (roughly one in 60,000 infections). And that’s before taking into account the benefit of preventing other complications of influenza.




Read more:
Is the end of Zika nigh? How populations develop immunity


High schools are bigger, so immunisation is easier than at primary schools.
from http://www.shutterstock.com

What other factors need to be considered?

We also need to consider access, uptake and how a health intervention will be delivered, whether through general practices, council programs, pharmacies or school-based programs.

Equity issues must also be kept in mind: will this close the gap in Indigenous health or other disadvantaged populations? Will immunisation benefit more than the individual? What is the likely future incidence (the “epidemic curve”) of the infection in the absence of vaccination?

A current example is meningococcal W disease, which is a new strain of this bacteria in Australia. Although this currently affects individuals in all age groups, many state governments have implemented vaccination programs in adolescents.

This is because young adults in their late teens and early 20s carry the bacteria more than any other group, so vaccinating them will reduce transmission of this strain more generally.

But it’s difficult to get large cohorts of this age group together to deliver the vaccine. It’s much easier if the program targets slightly younger children who are still at school (who, of course, will soon enter the higher risk age group).

In rolling out this vaccine program, even factors such as the size of schools (it is easier to vaccinate children at high schools rather than primary schools, as they are larger), the timing of exams, holidays and religious considerations (such as Ramadan) are also taken into account.




Read more:
What is meningococcal disease and what are the options for vaccination?


For government, cost effectiveness is an important consideration when making decisions on the use of taxpayer dollars. This has been an issue when considering meningococcal B vaccine. As this is a relatively expensive vaccine, the Pharmaceutical Benefits Advisory Committee has found this not to be cost effective.

This is not to say that meningococcal B disease isn’t serious, or that the vaccine isn’t effective. It’s simply that the cost of the vaccine is so high, it’s felt there are better uses for the funding that could save lives elsewhere.

While this might seem to be a rather hard-headed decision, this approach frees up funding for other interventions such as expensive cancer treatments, primary care programs or other public health interventions.

Why is this important?

When we treat a disease, we expect most people will benefit from the treatment. As an example, without antibiotics, the death rate of pneumonia was more than 80%; with antibiotics, less than 20%.

The ConversationHowever, vaccination programs aim to prevent disease in whole populations. So even if it seems as though many people are having to take part to prevent disease in a small proportion, this small proportion may represent hundreds or thousands of cases of disease in the community.

Allen Cheng, Professor in Infectious Diseases Epidemiology, Monash University

This article was originally published on The Conversation. Read the original article.

The flu vaccine is being oversold – it’s not that effective



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The protection of the flu vaccine is minimal, and may not be worth it.
from shutterstock.com

Chris Del Mar and Peter Collignon, Australian National University

Winter has started, and with it, flu season. Inevitably, all of us (young, old and sick) have been implored to be immunised against influenza, with some eligible for a subsidised vaccine. And people are heeding the message, to the point that there is now a shortage of available vaccines.

At the same time, findings from three important Cochrane reviews on the effectiveness of the influenza vaccination aren’t consistent with the advice we’re been given.

Cochrane reviews are independent systematic reviews, which are comprehensive analyses of most of the literature relevant to a research topic. Cochrane reviews summarise the results in a multitude of studies, and are regularly updated to absorb new research.

These three Cochrane reviews have been recently updated, as well as stabilised, which is what happens when it looks as if it seems unlikely new research would be published that would change the conclusions.

What the reviews found

The first Cochrane review looked at the effects of the influenza vaccine in healthy adults from 25 studies conducted over single influenza seasons in North America, South America, and Europe between 1969 and 2009. It found the vaccine reduced the chance of getting laboratory confirmed influenza from 23 cases out of 1,000 to 9 cases out of 1,000.

While this seems to be a reduction of more than 50%, that seems less optimistic expressed in absolute terms.

The infection rate in adults drops from 2% per year to 1%. You could say that’s halved, but it effectively only drops by 1%. So this means that out of every 100 healthy adults vaccinated, 99 get no benefit against laboratory confirmed influenza.




Read more:
What you need to know to understand risk estimates


The second Cochrane review – which looked at trials in children over single influenza seasons in the US, Western Europe, Russia, and Bangladesh between 1984 and 2013 – found similar results.

The third Cochrane review looked at vaccines for the elderly in nursing homes. It found much less good evidence, with only one randomised trial – considered the gold standard in clinical trials as it establishes causation rather than correlation.

While observational studies (that draw inferences from a population to establish associations) have been done to show benefits of the vaccines, bias means we cannot rely on their results.

There are also potential harms from influenza vaccines noted in the reviews. They range from serious (a neurological disease called Guillain Barre) through to moderate (fevers, in children especially – some of which will cause febrile convulsions), and trivial (a sore arm for a couple of days).

Why are we so scared of the flu?

There is a special concern about influenza from a public health point of view. This comes about from its potential to cause pandemics. The first in modern history was the Spanish influenza pandemic of 1918-19, when tens of millions of people died worldwide.

There’s good evidence to show face masks protect against influenza.
from shutterstock.com

There have also been been several, less severe pandemics. These include the most recent swine flu that, although while affecting some (unexpected) groups of people (including pregnant women, those who were obese, and had asthma), caused little more effect on the overall population than the usual seasonal influenza.




Read more:
Four of the most lethal infectious diseases of our time and how we’re overcoming them


Public health experts worry about another pandemic that can be more harmful and contagious, which could be devastating. But it’s important to note the vast majority of deaths from Spanish influenza were from secondary bacterial infections and predated the antibiotic era.

The reasons influenza virus has this ability to cause new pandemics comes from its instability – it changes genetically easily, making it more difficult for our immune systems to recognise newer strains. The effect is that new vaccines must be prepared every year for a best-guess at next year’s virus, and we need vaccination every year.

Influenza can also undergo a more radical change, such as when a new form of the virus emerges from an animal host (wild or domesticated birds or pigs, for example). This moving target makes it more difficult to vaccinate against – especially with the genetic shifts of pandemics. Just when we need protection most, vaccines can provide it least.

So what, if not the vaccine?

There are physical barriers that can prevent the spread of influenza. These are the masks (to reduce the spread of aerosol-borne virus particles), hand washing (to reduce the spread if virus from hands onto shared surfaces), and quarantine measures (isolating infected people to reduce their infectivity).




Read more:
I’ve always wondered: why many people in Asian countries wear masks, and whether they work


The ConversationThere is now reasonable evidence such measures reduce infections considerably. It might take a bit of effort to change the psyche of Australians to make wearing a facemask acceptable if you have an acute respiratory infection. Even the heroic “soldiering on to work” (or school) with your virus needs to be reversed as a public health act.

Chris Del Mar, Professor of Public Health and Peter Collignon, Professor, infectious diseases and microbiology, Australian National University

This article was originally published on The Conversation. Read the original article.

Here’s why flu vaccinations should be mandatory for Aussie health workers in high-risk areas



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Despite the numerous campaigns promoting the flu vaccine to Australian health workers, uptake has been documented to range from only 16-60%.
Tatiana Chekryzhova/Shutterstock

C Raina MacIntyre, UNSW and Holly Seale, UNSW

On June 1, health workers in New South Wales will be required to have a flu vaccination if they work in high-risk clinical areas, such as wards for neonatal care, transplants and cancer. Otherwise staff are required to wear surgical masks during the flu season or risk being redeployed.

NSW is the only state to make flu vaccination mandatory for some health workers. It aims to protect vulnerable patients and the health system from another disastrous flu season like in 2017. While the federal government has told aged care providers they must offer the flu vaccine to their staff this winter, there is no requirement for staff to accept the vaccine.

Despite the numerous campaigns promoting the flu vaccine to Australian health workers, uptake has been documented to range from only 16-60%, with an even lower rate reported among aged-care workers.




Read more:
Protecting our elderly: beating flu outbreaks in nursing homes


The most effective way to improve vaccination rates among health workers is to make it mandatory. State, territory and Commonwealth governments should consider making the flu shot mandatory for all health workers in high-risk clinical areas and aged care facilities.

Why health workers need to be vaccinated

For most of us, vaccination is for individual protection. In the case of those caring for sick and vulnerable people such as children and the elderly, vaccination protects others from devastating illness, complications and even death.

Hospitals and aged care facilities can experience explosive outbreaks of influenza.
Aged care facilities may have to close their doors to new admissions, which can also have a significant economic impact. It’s also important that staff absenteeism in hospitals is kept low, especially in areas with limited specialist expertise.

Some argue vaccination of health workers is a moral duty, while others state individual freedom of choice is more important than protection of patients.

Mandating vaccination

The use of immunisation mandates for health-care workers is not new in Australia. In most states and territories, staff are required to have vaccines for (or show evidence of protection against) measles, mumps, rubella, diphtheria, tetanus, pertussis, hepatitis B, and varicella (chicken pox).

NSW, for example, introduced mandatory vaccination of health care workers for several vaccines (but not the flu) in 2007. NSW health workers generally accepted this change in policy, with only 4% objecting.

Making the flu shot mandatory, as NSW has done this year, would simply add the the list of vaccinations health workers are required to have.

NSW is the only state to make flu vaccination mandatory for some health workers.
from http://www.shutterstock.com

The evidence suggests it’s worth it; a five-year study in one hospital in the United States showed mandatory hospital policies can raise coverage rates to close to 100%.

Institutions that have implemented a mandatory policy have dramatically reduced employee sick days as well as flu in hospitals, thereby improving patient safety and reducing health care costs.

Staff vaccination programs

Most workplaces run intensive vaccination programs, which may include mass immunisation clinics, mobile carts, posters and email reminders. But in most cases, these programs aren’t successful at boosting vaccination levels above 60%.

Some hospitals have been able to achieve higher vaccination rates in the short term through easy access to vaccines, education, reminders and multiple opportunities for vaccination. But these initiatives require ongoing resources and continual efforts – a one-off vaccination day is not enough.




Read more:
Flu vaccine won’t definitely stop you from getting the flu, but it’s more important than you think


The Victorian health system used a slightly different approach in 2014 when it made high rates of flu vaccination a hospital performance target. The government also provided the vaccine free to all Victorian hospitals.

This raised vaccination rates among Victorian hospital staff from 60% to 75% overall (higher in some hospitals). But higher rates may be achieved through mandatory flu vaccination.

But it’s not always the best policy

For each situation, we need to consider the overall risks and benefits of mandatory vaccination, as well as the gains in protection and vaccination coverage.

For infant vaccination, for example, vaccination rates are already at a high baseline of more than 93%. So, the risk of coercive policies may be greater than the relatively small gains achieved by coercive methods. Similar results may be achieved through other methods.

There’d be little point mandating vaccines for infants since they already have high rates of vaccination.
from http://www.shutterstock.com

In the case of health and aged-care workers, however, we start with a lower base of vaccine coverage, of 16-60%. Adding financial incentives or disincentives, or making it mandatory, would result in much larger gains in vaccination rates.

Vaccinating health-care workers also has benefits beyond their individual protection: it reduces the risk of their patients contracting influenza and maintains the health workforce capacity. This shifts the balance in favour of mandatory vaccination.

The ConversationGiven large potential gains and low resource requirements, mandatory flu vaccination for all health workers in high-risk areas is a good idea. Governments should consider this and other strategies to improve flu vaccination rates health and aged care workers.

C Raina MacIntyre, Professor of Global Biosecurity, NHMRC Principal Research Fellow, Head, Biosecurity Program, UNSW and Holly Seale, Senior Lecturer, UNSW

This article was originally published on The Conversation. Read the original article.

Explainer: what’s new about the 2018 flu vaccines, and who should get one?


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The flu shot is free for at-risk groups, and available to others for around $10-$25.
Shutterstock

Kanta Subbarao, The Peter Doherty Institute for Infection and Immunity

As winter draws closer, many Australians are wondering whether this year’s influenza season will be as bad as the last, and whether they should get vaccinated.

For most of us, influenza (the flu) is a mild illness, causing fever, chills, a cough, sore throat and body aches, that lasts several days. But some people – especially the elderly, young children and those with chronic diseases – are at risk of serious and potentially deadly complications.

While not perfect, the seasonal influenza vaccine is the best way to protect against influenza viruses. It’s free for at-risk groups, and available to others for around A$10A$25 (plus a consultation fee if your GP doesn’t bulk bill). In some states people can also get influenza vaccines from pharmacies.

Different viruses

There are four influenza viruses that cause epidemics: two type A viruses, called A/H1N1 and A/H3N2 and two type B influenza viruses, called B/Yamagata and B/Victoria viruses. All four cause a similar illness called influenza.

In any season, one of the viruses may dominate, or two or even three viruses could circulate.




Read more:
Influenza: The search for a universal vaccine


Last year’s influenza seasons in Australia and the United States were caused by A/H3N2, while B/Yamagata viruses predominated in Asia, and a mix occurred in Europe.

Influenza A/H3N2 viruses cause more severe epidemics that affect the entire population, from the very young to the very old.

In contrast, influenza B and A/H1N1 viruses tend to cause disease in children and young adults, respectively, sparing the elderly.

Developing the vaccine

Although influenza activity around the world is monitored throughout the year, influenza viruses mutate continuously and we can’t predict which virus will dominate. For this reason, the influenza vaccine includes components that are updated to protect against all four influenza A and B viruses.

Vaccination is the best option to prevent influenza and is offered in the autumn, in anticipation of influenza season in the winter. Typically, the influenza season begins in June, peaks by September and can last until November.

For best protection, you need a flu vaccine each year. Roberty Booy, Head of the Clinical Research team at the National Centre for Immunisation Research and Surveillance, explains why (via the Australian Academy of Science).

It takes about two weeks for the vaccine to induce immunity and the resulting protection lasts about six months.

The 2017 influenza season was severe in all states except WA. The epidemic began earlier than usual, there were more reported cases than in previous years, and there were a large number of outbreaks in residential care facilities in several jurisdictions.




Read more:
Here’s why the 2017 flu season was so bad


Who is most affected?

People of all ages can get influenza but some people are at greater risk of severe illness and complications that require hospitalisation. These groups include:

  • older adults who are over 65 years of age
  • children aged under five years and especially children under one
  • pregnant women
  • Aboriginal and Torres Strait Islander persons
  • people with severe asthma or underlying health conditions such as heart or lung disease, low immunity or diabetes.
Anyone can get a flu vaccine but some people have to pay for it.
Shutterstock

While the National Immunisation Program provides vaccines free of charge for the groups listed above, anyone who wants to reduce their risk of influenza can get vaccinated.

What’s new this year?

There are two notable changes.

One change is that several states (Tasmania, Victoria, New South Wales, Queensland, Western Australia and the ACT) are now offering free vaccination for children under five years of age.




Read more:
Thinking about getting your child the flu vaccine? Here’s what you need to know


This is important because children are prone to severe illness and they spread the virus to their contacts, at home and in daycare. Previously, only WA offered children the influenza vaccine free of charge.

The second change is “enhanced” vaccines are available for adults over the age of 65. The standard influenza vaccine is not optimally effective in older adults.

Two products have been developed to improve the immunity offered by the vaccine: one is a high-dose vaccine four times the strength of the standard vaccine and the second is an “adjuvanted” vaccine, that contains an additive that boosts the immune response to the vaccine.




Read more:
Here’s what you need to know about the new flu vaccines for over-65s


These vaccines have been available in other countries for many years but are being introduced in Australia for the first time in 2018. Older adults will be offered one of the two enhanced vaccines for free.

What happens if you still get influenza?

Even if you’re vaccinated, you can still get influenza.

The effectiveness of the seasonal influenza vaccine varies and is usually around 40-50%. But last year’s vaccine was only around 33% effective overall, because it was not effective against the A/H3N2 virus though it was effective against the A/H1N1 and influenza B viruses.

While vaccines are given ahead of time to prevent influenza, antiviral drugs are available via GP prescription for people who get infected.

The antiviral drugs for influenza are most effective when taken within two days of illness and are only effective against influenza viruses. But they’re not effective against other respiratory viruses that cause colds and respiratory symptoms.

Influenza is a contagious virus that spreads through contact with respiratory secretions that are airborne (such as coughs and sneezes) or that contaminate surfaces (after wiping a runny nose, for instance). If you have influenza, stay home to avoid spreading the virus.

The ConversationUnfortunately, we can’t predict whether the 2018 influenza season will be mild or severe. Once we know which virus or viruses are circulating, we may be in a better position to predict how severe the season will be for older adults.

Kanta Subbarao, Professor, The Peter Doherty Institute for Infection and Immunity

This article was originally published on The Conversation. Read the original article.

Hot & Bothered – Cold & Shivering


I came home from work early today – just after 9.00 a.m. actually. Why? Because I’m not too well just at the minute. I’ve had a flu shot earlier in the year, so I’m hoping it is just a cold. Having said that though, my back is really sore ~ one minute I’m hot and bothered ~ the next I’m cold and shivering. I also have a really sore throat and runny snoz … Sounds like a flu-like thing doesn’t it? Frown

So I’m trying to keep rugged up and trying not to get too sick – if that is possible. The problem is, if I do get really sick it may cause me to relapse into the illness I’m forever suffering from – just as I’ve got over it. So that’s the real worry I guess. Still, no use going there in my mind when I’m not there in body – makes sense to me.

DOWN A LITTLE


I have just recently wrote an Email to an old friend and told her that I feel a little down at the moment. I told her it’s hard to put a finger on why it is the case at the moment. I just can’t really explain why I feel down.

I have had all these injuries over the last couple of months that I have got from the place I work (I work fulltime as well as being the pastor of the church), getting over the flu and yet another injury today as well. So I suppose it could be physical.

The other thing is the small size of the church, for which I’m sure I have a right attitude about. But not knowing what exactly is causing my ‘blues,’ I simply can’t rule that out yet as being the thing I’m down about.

Oh well, you just have to soldier on I think through times like these and pray.