man with flu in bedYou may not be thinking about the flu, but pharmacists and other health care professionals have already begun planning for the upcoming flu season.

“Flu” or influenza is a highly infectious viral illness which was first described about 450 years ago. Influenza outbreaks occur each year and lead to periodic “pandemics” in which the illness spreads around the world. The Spanish Flu pandemic spread at the end of World War I and eventually infected about 1/3 of the world population and killed about 21 Million people, more than the number of those killed in the war itself. The Spanish Flu still serves as a major motivation for public health officials to vaccinate and control influenza each year.

The influenza virus is “named” based on the chemical characteristics of its surface coat. There is an “H” component (hemagglutinin) and an “N” component (neuraminidase). As the virus changes over time, it gets renamed. The Spanish Flu following World War I was H1N1. The current vaccine targets newer virus strains. Strains are also associated with locations of initial outbreaks; since Spain was neutral and uncensored during World War I, newspaper reports of the flu led it to be associated with Spain, hence the “Spanish” flu.

The flu season runs October through May. Last season (2017-2018), flu was widespread across the US during the peak months of December, January and February. The Centers for Disease Control (CDC) tracks the flu during each season; the US map showing the progression of flu is available at: https://www.cdc.gov/flu/weekly/usmap.htm

There was some concern that last year’s vaccines were “generally less effective than hoped for”. While this was widely publicized, it reflected only outpatient medical visits for flu. Vaccinations for the 2016-2017 flu season are estimated to have prevented thousands of influenza deaths and over 100,000 hospitalizations for influenza.

The World Health Organization chose four influenza strains for this year’s vaccines: two strains, H1N1 and N3N2, from the more severe Influenza A virus, and two strains from the more common but less severe Influenza B virus. Vaccine production began months ago and vaccine makers have adjusted growth conditions to help improve the newer vaccines. Pharmacists, physician offices and clinics are already reserving vaccination doses for this year’s flu season.

The influenza vaccination is recommended for just about all patients who have not had a prior adverse reaction to the vaccine. Flu is more dangerous for some people. Infants and young children, people 65 years of age and older, pregnant women, and people with certain health conditions or a weakened immune system are at greatest risk. Vaccinations will begin to be available later this month. Patients should get their flu shots before October to have coverage during the entire flu season. Many community pharmacists administer the flu vaccine and other vaccinations. Take good care of yourself. Ask your pharmacist about receiving your flu vaccine this year.

About Dr. Peter J. Rice

Dr. Peter J. Rice is a professor of Pharmacology emeritus at the East Tennessee State University Quillen College of Medicine and Professor of Clinical Pharmacy at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences. --------------------------------------------------------------------------He received his BS in pharmacy from Northeastern University, PhD in pharmacology from the Ohio State University and PharmD from the University of Kentucky. He is a Board Certified Pharmacotherapy Specialist and practices in the ambulatory care and community pharmacy settings. Professor Rice is the author of Understanding Drug Action: An introduction to pharmacology (APhA, 2014) and is a fellow of the American Pharmacists Association. --------------------------He welcomes interesting medication questions and suggestions for future columns.