Autumn Feature

Reducing your 'flu risk

Influenza questions answered

Written Asthma Action Plans - Autumn review

Reducing your 'flu risk*

While some respiratory infections – such as the common cold – are generally easy to recover from, others like influenza can result in serious illness and even death. This is particularly the case for people who have underlying medical conditions which put them at greater risk of complications from respiratory infection.

When does the 'flu hit

In Australia and other developed countries more people die during the winter months,¹ when respiratory infections are more common.

For Australia’s temperate regions this means that people are much more likely to catch infections such as influenza²  from June through to September.

For those living in tropical Queensland, the risk of infection is much more evenly spread across the year.

Reduce the spread - what you can do

There are some easy things which we can all do to reduce the spread of infection – and our risk of contracting any such viruses.

The impact of 'flu

There have been three major pandemic outbreaks of influenza over the past 100 years causing millions of deaths. It has been estimated that over the same period more deaths were caused by the accumulative impact of annual influenza epidemics.³ This makes annual outbreaks of influenza an ongoing threat to Australians nationwide.

Who should get vaccinated

Vaccination against influenza is recommended for all people with underlying medical conditions.⁴ The Federal Government funds free vaccination against influenza to everyone aged 65 or over, and the vaccine is available on the PBS for those under 65 with specific medical conditions.

Vaccination also has many benefits among younger age groups. In the U.S., free influenza vaccine is provided for everyone aged 50 or over. An estimated one in three people aged 50-64 has an underlying high-risk medical condition⁵ – such as respiratory disease or diabetes – which puts them at increased risk of complications from infection.

Benefits of vaccination

Because the majority of Australians aged under 65 who have an underlying medical condition don’t get vaccinated, the Influenza Specialist Group (ISG), an independent committee consisting of medical and scientific specialists and patient support group representatives, has been encouraging this group to reconsider the benefits of vaccination.

• A recent study found the risk of suffering a heart attack increases by nearly five times – and the risk of suffering a stroke by over three times – within the first three days after developing an acute respiratory tract infection.⁶ Respiratory tract infections can be caused by several agents, including viruses and bacteria commonly found in Australia like influenza.
   
• Anyone who is in close contact with a person at greater risk from influenza should carefully consider being vaccinated against the disease, in order to help prevent spreading the virus to their family or friends.

'Flu quick facts

• It is estimated that, on average, each year in Australia approximately 1,500 people die from influenza.⁷
• Influenza is a debilitating viral illness with common symptoms including fever, headaches, muscle aches and pains.
• Influenza can also lead to viral pneumonia (infection of the lungs).
• Influenza is spread by infected people coughing or sneezing into the air, transmitting droplets which are breathed in by other people.

References

Useful links

Asthma & Influenza - the Facts

Vaccine Update for people with asthma, COPD, or diabetes

Influenza questions answered*

What is influenza?

How easily is it transmitted?

How contagious is influenza?

Who is at particular risk of complications from influenza?

How does it affect Australians?

How can you reduce your risk of catching influenza?

What can you do if you catch influenza?

What is influenza?

Influenza is a debilitating illness whose affects are felt throughout the whole body, with symptoms including fever, headaches, muscle aches and pains.

Even healthy young adults may take several weeks to recover from influenza, and for some people it can lead to hospitalisation or even death.

Many people confuse the common cold with influenza. However, colds are much less serious with different symptoms and less potential for severe or life-threatening illness.

How easily is it transmitted?

Influenza is a virus which is spread when infected people cough or sneeze into the air, transmitting droplets which are breathed in by other people.

• One cough or sneeze can transmit the virus up to two metres
• It is estimated that a person who has influenza could pass it on to up to a dozen other people

The infection can also be acquired by contact by hand to face (mouth, eye) contact with contaminated surfaces.

How contagious is influenza?

Influenza is highly contagious.
 

After someone coughs or sneezes the virus can survive for: Up to an hour in the air in enclosed environments1 More than eight hours on hard surfaces such as stainless steel and plastic2 Up to five minutes on hands after transfer from other surfaces2

Who is at particular risk of complications from influenza?

People at particular risk of severe complications from influenza are those with heart conditions, asthma and other lung conditions, diabetes, kidney problems, those with weakened immune systems, residents of nursing homes and other long-term care facilities, as well as anybody aged 65 and over regardless of their health status.³

Australia has had great success in vaccinating people 65 years and over, with around 80% of this age group getting vaccinated, whereas only 42% of people  under 65 with at-risk conditions receive the annual influenza vaccination.⁴

Studies in the USA and UK have shown that up to a quarter^5,6 of all people who die from influenza are under 65 years of age

In addition, it is important that people who care for – or are in close contact with – people who are at particular risk, also avoid infection to avert passing it on to them.

Many otherwise healthy Australians can’t afford to get influenza, such as those who are self-employed, single parents, carers or people who can’t afford to take any time off work. Falling victim to influenza could mean that important life events and activities are missed, resulting in unnecessary suffering as well as economic hardship for many Australians.

How does it affect Australians?

In the last century more people died from annual seasonal influenza than in the three influenza pandemics⁷.and twice as many Australians die of influenza and pneumonia than in traffic accidents.⁸

An Australian study from the early 1990s estimated that influenza was annually responsible for:⁹

• 1 million medical consultations
• 20,000-40,000 hospitalisations
• 1.5 million days off work
• A total economic cost of about $600 million – a cost which could be expected to have increased since

Recent research has shown that the cost of influenza infection on those with at-risk conditions under 65 years of age amounts to $130m per year in Australia¹⁰

In Australia, significant levels of influenza occur most years with more severe outbreaks every 2-3 years

Influenza pandemics have occurred at irregular and unpredictable intervals. The world experienced three pandemics last century¹¹

Estimated Deaths

• 1918-19 (Spanish) 21-50 million
• 1957 (Asian) 1-2 million
• 1968-69 (Hong Kong) 1 million

How can you reduce your risk of catching influenza?

There are a number of things people can do to protect themselves against influenza, whether it’s a future influenza pandemic or this winter’s seasonal influenza:

• Vaccination is the best way of helping protect yourself against influenza
• Hand washing and personal hygiene, such as trying not to touch your mouth or nose are also important preventative measures
• Where possible, avoid crowds when influenza is prevalent
  (Note that in controlled trials remedies such as vitamin C and echinacea have been shown to be ineffective in preventing influenza)
• A new vaccine is formulated every year to ensure that Australians are given the best possible protection – the vaccine protects people against three strains of influenza which the World Health Organization identifies as the most likely to cause outbreaks for that season.
• The 2006 Southern Hemisphere influenza vaccine includes the following influenza strains:
  - A/New Caledonia
  - A/New York
  - B/Malaysia

No vaccine is 100% effective; however influenza vaccination is very effective in protecting against the severe consequences of infection. Studies have convincingly shown it greatly reduces the cases of pneumonia, hospitalisation due to respiratory illness and the total deaths occurring during an influenza season.¹²

For most parts of Australia influenza vaccination is best carried out in the autumn, before serious outbreaks can begin to occur. The majority of people will become infected between July-September. You should visit your GP now, before the winter season starts, to get vaccinated against influenza.

In the far north of Australia influenza outbreaks can occur early in the year and vaccination should be practiced as early as possible.

Many people who should be vaccinated are not, because they believe being fit and healthy will protect them against influenza. This is not the case.

What can you do if you catch influenza?

There are specific antiviral medications available on prescription which can help limit the effect of influenza if they are taken early after the onset of symptoms (within the first two days of the illness).

If you think you are getting influenza and wish to reduce the time and severity of your illness it’s important that you see your GP immediately.

The availability of treatments does not lessen the need for people to still get vaccinated – it is important that all those in risk-groups, as well as others who can’t afford to get influenza, get vaccinated every year as their first line of defence.

References:

* Note: This information has been developed from material provided by the ISG - Influenza Specialist Group

Written Asthma Action Plans - Autumn review

Part of good asthma management is to have a written Asthma Action Plan so that you can better recognise when asthma symptoms worsen and take appropriate action.  Autumn is also a good time to review your written Asthma Action Plan and how you might cope with the inevitable colds and influenza that are always about.

Feeling Unwell

When you are not well you may have one or more of 

• increasing night-time wheeze or cough or chest tightness 
• symptoms regularly in the morning when you wake up 
• a need for extra doses of reliever medication 
• symptoms which interfere with exercise

and if you continue to get worse this is an acute attack. 

Acute Asthma Attack

You will have one or more of the following: 

• wheeze, cough, chest tightness or shortness of breath and 

• need to use your reliever medication at least once every 3 hours or more often.

   Importantly,

• if your symptoms get worse very quickly 
• if wheeze or chest tightness or shortness of breath continue after using reliever medication or return within minutes of taking reliever medication 
• if you experience severe shortness of breath, inability to speak comfortably or blueness of lips 
   

• then immediate action is needed: call an ambulance.

The Benefits of Written Asthma Action Plans

If you do not have a written Asthma Action Plan please discuss this with your doctor next time you visit because being well means you will: 

• be free of regular night-time wheeze or cough or chest tightness 
• have no regular wheeze or cough or chest tightness on waking or during the day 
• be able to take part in normal physical activity without getting asthma symptoms 
• need reliever medication less than 3 times a week (except if it is used before exercise)

and certainly be in a better to position to fight off colds and 'flu.

Useful links:

Asthma Action Plans

Managing Acute Asthma

Managing exacerbations

First Aid Chart