Yes folks, it’s that time of year again to get flu vaccinated and build up our winter defences against the debilitating effects of influenza. The official flu season typically spans from May to October each year. Flu vaccination is available from March/April.
You should get a new flu vaccination every year, because the flu virus is constantly changing and each new vaccine matches the current circulating strains of the virus. This year four (4) quadrivalent influenza vaccines are available, which contain protection against the four most prevalent flu strains (two A strains [Michigan and Hong Kong] and two B strains [Brisbane and Phuket]). The four vaccines are:
- FluQuadri Junior (Sanofi Pasteur) for children from six months to under three years of age.
- FluQuadri (Sanofi Pasteur) for people aged 3 years and over.
- Fluarix Tetra (GSK) for people aged 3 years and older.
- Afluria Quad (Seqirus) for people aged 18 years and older.
Where can I get the vaccine? Most major pharmacies and GP clinics offer a flu vaccine service under $20. However, the vaccine is FREE for people living with HIV (PLHIV) under the National Immunisation Program (NIP). Ask your pharmacy or clinic which vaccine they may be offering to you. Tell your pharmacist or clinic if you have a history of serious allergic reactions to eggs, since the vaccines are propagated (developed) in hens’ eggs. Seek further information about each of the available vaccines if needed.
Are the vaccines safe? Yes, the vaccines all contain inactivated ‘dead’ flu virus isolates, so you cannot catch the flu from the vaccine, and side effects are minimal (although most people wont get side effects) and they will generally resolve within 48 hours. PLHIV with low CD4 counts (below 200) may respond less well to the vaccine as it may not ‘take’, and the vaccine may cause slight drop in CD4 counts; although a greater CD4 decline can occur from a real attack of the flu. There is some evidence that that flu vaccine may lead to a short-term slight rise in HIV viral load, but this concern needs to be balanced against severity of flu and its complications- particularly among older people. There is no definite answer about whether or not to have the flu vaccine – the decision rests with you and your doctor, based upon your personal and clinical needs. Without good reason not to have the vaccine, it’s a good idea to have it, and it is commonly recommended for PLHIV.
When should I have the vaccine? It takes about 2-3 weeks for immunity to develop after receiving the flu vaccine (giving you full protection), so it’s best to get in early and have the vaccination – by March to May – before the peak flu season (which occurs from June and begins to fall around late August).
If you do get the flu despite being vaccinated, severe symptoms and complications of flu (including development of pneumonia and bronchitis) are often significantly reduced (due to a partial response from the vaccine). Antibiotics will not work against flu symptoms since they work against bacteria only, whereas the flu (and colds) are from viruses. However, antiviral treatments (such as Tamiflu) are available from your GP to treat flu within 48 hours of onset. Flu antivirals may reduce the severity of symptoms if caught early, although prevention through flu vaccination is best (since ‘prevention is better than cure’). Antivirals are more expensive than the vaccines, as they are not listed on the Pharmaceutical Benefits Scheme (PBS) for subsidy – therefore to access antiviral medications you would need to pay the full cost of the drug on prescription. Typically this may be about $40 to $50 (or more), whereas flu vaccination is FREE for people living with HIV (PLHIV), or usually below $20 for those who must pay for the vaccine.
Colds are not caused by cold weather, they are caused by a rhinovirus or coronavirus which predominates in the colder months (when people are in doors more), and are not of great concern to the immune system and generally will resolve within a week or two. The influenza virus is a different virus (called ‘orthomyxoviridae’) to the cold virus (which also predominates in the colder months) and can be longer lasting and more severe – including fever, chills, sore throat, headache, cough, stuffy head, runny nose, phlegm, watery eyes, loss of energy and muscle aches. The flu can affect the whole body, and in severe cases lead to death particularly in the elderly, children and people with severe immune compromised conditions. Medical help should be sought if symptoms of flu persist or get worse (particularly with fever above 38oC*) – see a doctor or call an ambulance (or home doctor service) if unable to get to the doctor.
* It’s a good idea to have a reliable thermometer at home in your medicine cabinet (available from most pharmacies), placed under the tongue for one minute then measured.
If medical treatment is not required, you can treat a severe cold or flu in similar ways at home. The following home remedies may help to alleviate symptoms:
- KEEP WARM. Stay in bed where possible; a hot water bottle can help to keep your feet or body warm. A long steamy shower (but not too hot with good ventilation) can help clear your airways and any mucus in your sinuses. If you’re feeling weak, sit on a stable plastic stool or chair in the shower
- DRINK PLENTY OF FLUIDS. Sip some sweet fluids, such as lemonade, which can help to keep your energy levels up a bit. Hot drinks containing water, lemon and honey can also help. You can add to this a mixture of herbs (steeped in herb teapot for 3 or 4 minutes) such as echinacea**, chamomile, sage, thyme, fenugreek, ginger, garlic, rosehips, and cayenne pepper. A few drops of Cod Liver Oil (which contains vitamins A, E & D) can also be added to help boost immunity and recovery. You can make large quantities of herbal tea mixtures and store in fridge, then just warm or add hot water when needed. Easy-to-prepare (or pre-made) fresh soups with fresh chopped vegetables will provide some sustainable energy and nutrition. In-season fruit and vegetables, including citrus, can also help, especially when juiced. Eliminating dairy products for the duration of their cold or flu helps reduce any mucus build-up in the nasal and chest cavities.
** Echinacea (E.) angustifolia may be the most potent and effective species, as compared to E.purpurea. Echinacea may assist in faster recovery time from colds and flu. It’s use should be limited to short term only, since the herb can increase an immune system chemical called ‘TNF-alpha’ which is linked to HIV disease progression. In addition, the herb may interact with Protease Inhibitors (PIs).
- ANTIHISTAMINES, NASAL DECONGESTANTS AND STEAM INHALATIONS CAN HELP REDUCE THE STUFFINESS AND BRING UP CONGESTION. Steam inhalers are available at chemists, but the simplest method is to fill a bowl with steaming hot water, to which you have added a drop of any menthol oil, including eucalyptus, wintergreen, tea tree, peppermint, lemon, mountain (winter) savory, lavender (or a mixture of these). Place in a bowl of steamy water, then place a towel over your head and inhale the fumes (slowly at first). Keep your eyes closed, because the vapours can irritate your eyes.
- WARM SALT-WATER GARGLE MAY ALSO HELP CLEAR THE THROAT AND HAVE A STERILISING EFFECT. You can also place a single drop of peppermint oil at the back of the roof of your mouth to help ease a sore throat; not more than a single drop, though — too much and it’ll burn.
- ZINC THROAT LOZENGES MAY BE EFFECTIVE IN SHORTENING RECOVERY TIME FROM COLDS AND FLU. Zinc supplements (that you swallow) will not work as well for localised treatment of sore throat as the zinc lozenge needs to coat the lining of the throat. Zinc supplements work better to prevent infections (by boosting immunity to infections), but they may also improve recovery time and help build resistance to further infections if taken at the onset of (or before) a cold or flu.
- PARACETAMOL, ASPIRIN, OR IBUPROFEN MAY HELP REDUCE ANY FEVER, HEADACHE AND MUSCLE ACHES, but they won’t reduce the course of infection. Use only as directed and if you are very unwell and running a high fever, call your doctor or home visiting doctor.
- CHEST VAPOUR RUBS AND COUGH MEDICINES MAY HELP NIGHT COUGH, CONGESTION AND SLEEP.
- VITAMIN C IN HIGH DOSES (UP TO TWO GRAMS) CAN HELP REDUCE THE SEVERITY AND DURATION OF A COLD, but it may have minimal benefit for the flu (except in chewable form it can help soothe a sore throat). High doses can cause diarrhoea, so don’t overdo it, gradually build up to a high dose! The standard dietary recommended daily dose of vitamin C is 25- 50mg, although higher doses during a cold are beneficial.
- DISINFECTING HOUSEHOLD SURFACES AND WASHING HANDS IN SOAPY HOT WATER IS PARTICULARLY IMPORTANT TO PREVENT COLDS AND FLU. If you are unwell stay at home (other than needing to see your doctor) to prevent further spread of the flu to others.
- National Immunisation Program (NIP) http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/immunise-influenza
- National Influenza Surveillance: http://www.health.gov.au/flureport
- Queensland Influenza Surveillance: https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/diseases-infection/surveillance/reports/flu