Almost everybody you meet these days seems to be complaining of a runny nose, sore throat and cough. This is not surprising given the bad weather conditions we are currently experiencing island wide. If you are caught unawares in a heavy shower and have forgotten your brolly the result of staying in wet clothes till you got home could easily be a mild fever, eye pain, headache, muscle pains and of course those all too common symptoms of a runny nose and cough.
However, the good news is that the majority of cases are self limiting, with patients making a full recovery without any complications. Yet, in certain cases where high risk individuals are concerned the highly contagious disease can lead to complications. These high risk persons include persons over 65 years, children below 2 years, pregnant women and those with chronic illnesses, chronic lung, heart, liver or neurological illnesses whose lowered immune systems are unable to withstand complications that could be caused by the more acute form of influenza.
Meanwhile, the Health Ministry has issued guidelines to hospital staff when caring for pregnant women admitted with flu like symptoms. They have urged all staff including public health nurses and midwives to initiate immediate preventive measures to avoid transmission of infection when attending to pregnant women, and stressed that no one with respiratory symptoms should provide care for pregnant women or the mother and newborn baby. It has also stated that care for symptomatic pregnant women should be organized in a separate area in the clinic or OPD whenever possible.
So what is influenza? Since not many people know about this disease and how it is transmitted, we asked Consultant Medical Virologist Dr Jude Jayamaha from the National Influenza Centre, Medical Research Institute to tell us how it is transmitted, detected and most importantly how we can prevent its spread.
Excerpts from his interview with the Sunday Observer
Q. Right now there are many people walking about with runny noses, coughs, muscle aches and even diarrhoea. Is this due to the viral flu that is currently said to be circulating in the country?
A. We have observed that there is a slight trend in the rise of influenza activity and it is expected to rise in the coming two months due to the rains. Usually, we see more influenza cases during December to February, compared to other months of the year due to the monsoons but this is natural. There is no outbreak and no need to panic.
Q. So tell us what Influenza is.
A. Seasonal influenza (or “flu”) is an acute viral infection caused by type A or B influenza viruses.
Q. How many types of influenza viruses are there? Which of them cause human influenza seasonal outbreaks?
A. There are four types namely, Influenza A, B, C and D. Influenza A and B are the types that commonly cause disease and outbreaks in humans while Influenza C rarely causes disease. Influenza type D causes disease only in animals.
Q. Which of these viruses is currently trending in Sri Lanka?
A. At present, influenza B is the predominant type but influenza A is also circulating.
Q. Is influenza B less deadly than influenza A?
A. First of all, influenza infection in the majority is a self limiting disease which will be overcome by our immunity system and death is a very rare event in a healthy individual. Both viruses cause severe infection which can lead to complications.
Q. Is it a highly contagious disease? How does it spread?
A. It is contagious through respiratory droplets (generated by sneezing and coughing) and to a lesser extent by objects such as, door knobs, handles, bars in public transport, etc.
It is spread by direct contact and through nasal droplets.
Q. What are the symptoms?
A. Fever, cough, cold (runny nose), sore throat, body ache. Some may experience difficulty in breathing.
Q. What should individuals with flu like symptoms do?
A. Getting adequate rest is most important, especially, in adolescents and young patients. They must refrain from attending school or work until they are fully fit.
They should drink plenty of fluids to hydrate themselves, avoid aspirin for body aches, and take only paracetamol for fever. Also to prevent spreading the infection, use a tissue when sneezing/coughing and discard it appropriately in a separate container with a firm lid to prevent droplets from escaping and polluting the environment.
Q. What are the complications that influenza can have on the human body?
A. Mainly pneumonia. Kidney, heart failure and other organ failure is seen rarely.
Q. How can you prevent these adverse effects?
A. By seeking medical advice and treatment in the early days of the illness. The Ministry of Health has strongly advised high risk patients, especially, pregnant women to visit a qualified medical practitioner on the first day or two of the illness.
Q. Who according to age are most at risk?
A. Children below 2 years, elderly people over 65 years.
Q. Others at risk?
A. Pregnant mothers, chronic lung and heart disease patients, diabetics.
Q. Is influenza different from a cold and fever? Are there typical
symptoms to look for?
A. Influenza cannot be differentiated from a cold and fever by symptoms. However, the typical symptoms to look out for are: fever, cough, cold (runny nose) sore throat, body ache and in some instances, difficulty in breathing.
Q. The Medical Research Institute
(MRI) in Sri Lanka I understand plays an important role in identifying influenza types. As an active member of the research team, tell us more about the role of the MRI with regard to influenza.
A. The MRI plays a pivotal role in identifying influenza types (A or B) and subtyping of influenza A as H1N1 or H3N2 and by culturing viruses for further characterization as per WHO recommendations. It also disseminates influenza data to the Health Ministry and other stakeholders for action and policy decisions.
Q. Does treatment of individual patients depend on identifying the specific virus?
A. No, it does not depend on whether it is influenza A or B as treatment would be the same.
Q. Does getting a viral flu stop you from getting it again? If not why?
A. Influenza virus changes its genetic material and causes new strains with time, and not due to lowered immunity following an attack.
Q. Have you any easy to follow Dos and Don’ts to avoid infection?
A. To prevent it , one should follow simple personal hygiene rules such as: washing hands with soap and water frequently, covering mouth and nose while sneezing and coughing with a tissue or a handkerchief , disposing tissue and masks in no touch receptacles, cleaning and disinfecting the immediate environment and equipment used. Avoiding large crowds is also advisable.
Q. Briefly, your message to our readers.
A. Influenza is seasonal .There is a peak in influenza circulation from November to April and April to June each year . So a slight rise in influenza is to be expected at this time due to the rains.
You can protect yourself by adhering to personal hygiene such as, constantly washing hands with soap and water when you return home after using public transport ,or touch areas infected by sick persons. If you feel unwell stay at home and rest. Drink plenty of fluids to keep hydrated. Adhere to cough etiquette if you are unwell with the symptoms..
Tips on how to prevent influenza:
- Avoid unnecessary travel, crowded places and public transport as much as possible.
- If you have fever and flu like symptoms be advised to stay at home and to practise cough and sneeze etiquette (covering mouth and nose when coughing or sneezing. If your child has flu like symptoms don’t send him/her to school or day care centres as he requires rest and could infect other children.
- Pregnant women and new mothers should be especially careful. They should avoid providing care for persons with influenza like illnesses except for their newborns.
- Antenatal clinic visits should be reduced to the minimum and women with low risk pregnancies should be advised to postpone clinic visits in early pregnancy during the outbreak.
- Pregnant mothers should consult a qualified physician (either in government or private sector) immediately if they have flu like symptoms
(The above facts have been uploaded from the Epidemiology Unit gov. lk web page)