What you need to know about the flu!

What is the flu vaccine?

The flu vaccine is a weakened or dead form of the virus that causes influenza or “the flu”.¹ The vaccine is either given as an intramuscular (IM) or intradermal shot or via the intranasal route. The IM vaccine is indicated for people aged 6 months and older, whereas, the intradermal vaccine may be given to those aged 18 to 64. The intranasal inhalation is indicated for healthy individuals 2 to 49 years old. Vaccination against the flu and strategies to prevent the flu are the main tools to fight the flu.²

On July 18^th, the Food and Drug Administration (FDA) approved the formulation of flu vaccine that will be available in autumn 2011 for the 2011-2012 influenza season.³ This formulation contains 3 strains of the influenza virus that the FDA, Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), and other public health entities have determined will be those most likely to cause flu in the upcoming flu season. These strains are:

●      A/California/7/09 (H1N1)-like virus (pandemic (H1N1) 2009 influenza virus)

●      A/Perth/16/2009 (H3N2)-like virus

●      B/Brisbane/60/2008-like virus

Additionally, a new formulation of the flu vaccine became available this year.³ The Fluzone Intradermal vaccine produced by Sanofi Pasteur Inc. was approved in May for individuals aged 18 to 64 for intradermal (into the skin rather than into the muscle) administration.^3,4 The Fluzone Intradermal vaccine is associated with more injection site reactions, such as itchiness, swelling, and redness, than the IM vaccine; however, the intradermal shot is associated with less pain after administration.⁴

Who should get vaccinated and when?

Currently, the CDC recommends that all people older than 6 months get vaccinated against the flu as soon as the vaccine for the upcoming flu season is available.² Typically, the vaccine for the upcoming flu season is available in September or October, but the timing of availability does vary from location to location.

Where can I get the flu shot?

As the importance of vaccination for protection against the flu has become more apparent, the number of sites at which you can receive the flu shot has increased. The flu shot is available at two UIC Pharmacy locations; University Village Pharmacy/UVP, 722 W. Maxwell St. suite 206 and at Wood St. Pharmacy, 840 S. Wood St. /Pharmacy. The flu shots are offered for only $20. You can also get your flu shot at your doctor’s office. Some community and employee health fairs may also offer the vaccine.

  

What are symptoms of flu?

A large percent of the United States population, between 5% and 20% every year, gets sick with the flu, so you or someone you know will likely get the flu in your lifetime.³ While most people recover from the flu without any medical assistance, the flu and related complications are responsible for approximately 3,000 to 49,000 deaths every year, so it is important that you are able to recognize the common signs and symptoms of the flu. These include:

●      Nausea and vomiting, especially in children⁵

●      Fever

●      Muscle ache

●      Headache

●      Cough

●      Sore throat

●      Runny nose

Who is at an increased risk for complications of the flu?

●      Pregnant women⁵

●      Those older than 50

●      Those living in a nursing home or other long term care setting

●      Individuals with chronic cardiovascular disorders

●      Individuals with a chronic disease of the lungs

●      Children and adolescents being regularly treated with aspirin

●      Those at an increased risk for aspiration due to any medical condition

●      Those who have been hospitalized or have required regular checkups with their doctor because of

○      Diabetes

○      Kidney disease

○      Blood diseases

○      A weakened or compromised immune system

○      HIV

●      Anyone between 6 and 59 months old

What are warning signs that someone may need more advanced medical care for the flu?

Oftentimes advanced medical care is not necessary for people sick with the flu; however, in some cases the CDC recommends that medical care should be sought if you or a person you are caring for develops any of the following signs or symptoms:⁶

●      In children

○      Rapid breathing

○      Blue skin coloration

○      Reduced consumption of fluids

○      Not waking up

○      Not wanting to be held as a result of irritability

○      Improvement in flu symptoms that then worsen with return of cough

○      Fever with a rash

●      In infants

○      All of the above stated for children, plus

○      Inability to eat

○      Trouble breathing

○      Less wet diapers than normal

○      Crying that does not result in tears

●      In adults

○      Difficulty breathing or shortness of breath

○      Pain or pressure in the chest or abdomen

○      Dizziness that occurs suddenly

○      Confusion

○      Severe or persistent vomiting

○      Improvement in flu symptoms that then worsen with return of cough

What treatments can be used to help with the flu?

           

Non-drug treatments:

●      Get plenty of sleep⁵

●      Avoid strenuous activity whenever possible

●      Stay well hydrated, drinking around eight 8 oz glasses of water daily, so that you rarely feel thirsty

●      Warm drinks or soup may help soothe a sore throat

            Drug treatments: antivirals zanamivir (Relenza) and oseltamivir (Tamiflu)

●      What should I know about these antivirals?⁵

○      Both zanamivir and oseltamivir are in a class of antivirals called neuraminidase inhibitors

○      Zanamivir

                                          ■         Available as an inhalable powder

                                          ■         May be used in children aged 7 years and up

                                          ■         May only be used in people without breathing problems or heart disease

○      Oseltamivir

                                          ■         Available as an oral capsule and suspension

                                          ■         May be used in children aged 1 year and up

●      Who should use these drugs?⁷

○      Patients severely ill with the flu

○      People with certain diseases at a higher risk for complications related to the flu

●      What are some common side effects of these medications?

○      Oseltamivir

                                          ■         Nausea

                                          ■         Vomiting

○      Zanamivir

                                          ■         Dizziness

                                          ■         Runny or stuffy nose

                                          ■         Cough

                                          ■         Headache

●      These medications are most effective if used in the first 2 days of flu symptoms

●      Both of these medications may be used in pregnant women; however, oseltamivir is preferred to treat pregnant women with the flu

How can I help stop the spread of the flu?

●      Wash your hands with soap and water regularly²

●      Cover your sneeze or cough in a tissue and dispose of the tissue after it has been used

●      Stay home from work or school while you are sick, at least 24 hours after you no longer have a fever

●      Do not touch your face with your hands

References

1. Hayney MS. Vaccines, toxoids, and other immunobiologics In: Dipiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy: A Pathophysiologic Approach. 7th ed. New York, NY: McGraw-Hill; 2008:2041-2063.

2. Centers for Disease Control and Prevention. CDC says “take 3” actions to fight the flu. www.cdc.gov/flu/protect/preventing.htm. Accessed July 19, 2011.

3. Food and Drug Administration. FDA approves vaccines for 2011-2012 influenza season. www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm263319.htm. Accessed July 19, 2011.

4. Fluzone [package insert].Swiftwater, PA: Sanofi Pasteur Inc; 2011.

5. Hermsen ED, Rupp ME. Influenza In: Dipiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy: A Pathophysiologic Approach. 7th ed. New York, NY: McGraw-Hill; 2008:1791-1799.

6. Centers for Disease Control and Prevention. The flu: what to do if you get sick. www.cdc.gov/flu/takingcare.htm. Accessed July 19, 2011.

7. Centers for Disease Control and Prevention. What you should know about flu antiviral drugs. www.cdc.gov/flu/antivirals/whatyoushould.htm. Accessed July 26, 2011.

Written by:

Kristian Campbell, Pharm.D. candidate, Class of 2013

UIC College of Pharmacy
UIC Pharmacy