Flu as such is a disease of respiratory tract occurring in outbreaks during the winter months. The disease is of sudden onset presenting with fever, headache, body ache, weakness, cough and sore throat. The illness runs its course over 2-5 days and people generally recover within a week’s time. This is typical of an uncomplicated case, and it is very unlikely that healthy people would develop any complications. Flu associated with complications involves multiple organs. Complications of influenza are the main cause of death.
Pneumonia is the most common and one of the dreaded complications in influenza. Cause of pneumonia may be primary influenza pneumonia, secondary invasion by bacteria or mixed infection by both viruses and bacteria. Persistence of fever beyond 3-5 days of illness and increase in sputum productivity, changes in color of sputum to greenish yellow and cough with difficulty in breathing- all point towards development of pneumonia. Influenza can worsen underlying respiratory diseases like chronic obstructive pulmonary disease, asthma, chronic bronchitis and increases the mortality rate in this group of patients.
It may lead to myocarditis and ultimately heart failure. It also worsens underlying heart diseases in the patients.
Central nervous system complications like encephalitis, transverse myelitis and Guillain-Barre syndrome.
Musculoskeletal system complications like myositis, rhabdomyolysis and myoglobinuria are also responsible for death in a number of complicated cases of flu.
SPECIAL VULNERABLE GROUPS-
Children and elderly persons above age of 65 years are another group in which influenza causes significant number of deaths. The immune system in children is immature to deal with the infection, whereas in elderly, the immune system is on a wane due to process of ageing. This is also responsible for increased incidence of complications in them.
DON’T IGNORE A CASE OF FLU-
As common cold and flu are very much similar in presentation and uncomplicated cases of flu are difficult to differentiate from common cold, many a times people ignore an attack of flu thinking it as common cold. But it is only when they find the complications developed, that they realize they are suffering from flu. Many of them have to pay the price for their negligence with their lives.
INADEQUACY OF TREATMENT-
Treatment for flu consists of specific antiviral drugs like oseltamivir and zanamivir which need to be given within 48 hours of onset of symptoms to be effective. Beyond this time period, drug treatment is ineffective and the risk of complications and death rises. Severely ill patients require ventilator and hemodynamic support in an intensive care setup, and unavailability of such facilities results in inevitable death.
Injudicious use of salicylates like aspirin in children for relief of symptoms may result in REYE’S SYNDROME (a form of hepatic encephalopathy) which is responsible for a number of deaths in this group of patients. For this reason only, use of aspirin in children during flu or any other viral illness is unwise and acetaminophen is recommended. Irrational use of drugs without dose adjustment in elderly and children can precipitate kidney dysfunction resulting in acute renal failure and death. In some rare instances, idiosyncratic reactions (development of severe side effects at doses normally used for treatment) to drugs used in treatment may occur and result in complications.
NEWER ATTACK OF NOVEL VIRUS STRAINS-
During pandemics, the strains of virus prevalent are very different from those in the previous season and people lack effective immunity against the former. It forms an important reason for which complications and deaths during pandemics are much higher as the immune system of the body is not able to deal with these pathogens effectively.
In recent years, BIRD FLU has emerged as a disease of major public health concern. The disease has been associated with high mortality rate due to multi-system dysfunction, encountered frequently in complicated cases of bird flu.
Vaccination forms an important aspect of prevention of influenza in the community. But, on very rare occasions, Guillain-Barre syndrome may develop in those vaccinated and cause death due to respiratory muscle paralysis seen in this syndrome. However, this should not stop us from going for the vaccine when required, as the benefit from vaccination outweighs the risks associated with vaccination.
ROLE OF PREVENTION STRATEGY-
Number of deaths from influenza have reduced considerably due to effective vaccination and advanced treatment facilities. These treatment modalities are successful many a times, baring a few occasions. Various organizations, local and global, working hand in hand with the government, have been able to reduce the mortality rate due to this disease. WHO has been creating awareness among people all over the world, and regulating the vaccine preparation by dictating the strains against protection has to be provided. This way the number of deaths has been brought down to a very small figure.
It is definitely better if the disease can be prevented and not wait to be treated on being affected, failure of which (treatment), may lead to complications and eventually death. Thus not wrongly it is said that prevention is better than cure.
Published by me in Helium under pen name Dev Senapati.