Infectious disease is of major concern in good times or bad, and the family medic must be able to identify some of the deadliest. Having just written a book about infectious diseases and the antibiotics that treat them, we’ve done our research on some of the worst illnesses that can occur even in countries with advanced medical systems. There are infections out there, however, that are often fatal and can’t be treated with antibiotics. These are usually viral in nature.
Viruses are microscopic pathogens that, unlike most bacteria, can reproduce only inside the living cells of other organisms. Viruses are very simple entities that rarely consist of much more than a bit of genetic code covered by a protein coat (a “capsid”). Despite that, viruses like those we’ve mentioned previously in this last series of article can be more than enough to take down the healthiest human.
We haven’t, however, mentioned one of the most pandemic diseases of today’s age: Influenza.
Spanish Flu ward
During a typical flu season, up to 500,000 people worldwide will die from the illness, according to the World Health Organization (WHO). In the U.S., it’s usually about 30,000, mostly among the very elderly or immune-compromised. But occasionally, when a new strain emerges, a pandemic results with a faster spread of disease and, often, higher mortality rates. Last year, 80,000 U.S. residents failed to recover from the flu.
The deadliest flu pandemic, sometimes called the Spanish flu, began in 1918 and sickened up to 40 percent of the world’s population, killing an estimated 50-100 million people. Indeed, it was a factor in bringing about the end of World War I.
Could such a flu pandemic happen again? If a true long-term disaster scenario occurs, we’ll be thrown, medically, back to that era, so it’s possible. Despite this, many don’t take measures to prevent it.
Even with modern medical technology, you can’t avoid the occasional respiratory infection. Viral illnesses like colds and flus are common issues even for those who are perfectly healthy. You can expect influenza viruses to hit the U.S. anywhere from late fall to early spring.
Most people weather their illness just fine. Some folks, however, especially the very old, very young, and those with chronic medical conditions, may not survive, leading to influenza earning the title “the old man’s friend”, because it ends their suffering (by killing them).
Without strict adherence to hand washing and respiratory hygiene, it would be very easy for your entire community to come down with influenza, or any number of infectious diseases. In survival scenarios, the physical exertion related to daily activities will likely wear down the immune system and make it difficult to fight infection. At the very least, influenza can affect work efficiency at a time when everyone must be at one hundred percent. If you’ve had the flu, you know what I mean.
Human illness involves the respiratory tract more commonly than any other organ system. Germ-laden droplets are expelled during coughs and sneezes and enter the nose, mouth, or eyes of others. As a result, these infections are often highly contagious.
Influenzas are usually caused by Influenza type A (the most common) and Type B viruses. They are classified according to the proteins that exist on their surface. These are called Hemagglutinins (HA) and Neuraminidases (NA). There are more and more different HA and NA subtypes discovered every year. The Swine flu, for example, is H1 N1.
Symptoms of influenza begin anywhere from one to four days after exposure. They are similar to the common cold and include:
Severe muscle aches
Colds will resolve themselves over a week or so, but influenzas may last longer. The flu could weaken you enough that secondary bacterial infections will set in. Indeed, these secondary infections are the most probable causes of death related to flu cases. If this happens, you’ll notice that you are getting worse, not better, over time.
Treatments include medications like ibuprofen for muscles aches and fever, decongestants for nasal congestion, expectorants to thin out phlegm, cough suppressants, although they should be used only when there is difficulty breathing or sleeping, and others.
As the flu is a viral illness, it’s important to know that antibiotics will be ineffective. There are, however, a few anti-viral flu medications such as Oseltamivir (Tamiflu) or Zanamivir (Relenza). Tamiflu, the most popular, is taken twice a day for 5 days.
These drugs will shorten the course of the infection if taken in the first 48 hours after symptoms appear. After the first 48 hours, there’s less medicinal effect. Therefore, you might consider asking your doctor in normal times for a Tamiflu prescription at the beginning of every flu season, since it might be hard to get an appointment on short notice. For a caregiver with a number of flu patients to treat, taking a half dose daily for five days may decrease your chances of catching it.
(NOTE: On October 24th, 2018, Roche, the maker of Tamiflu, announced that the US Food and Drug Administration (FDA) approved Xofluza (baloxavir) for the treatment of acute, uncomplicated influenza in people 12 years of age and older. This is a one-day therapy that may prove superior to previous anti-virals. We’ll discuss this development in an article in the very near future.)
The CDC recommends the flu vaccine for everyone over 6 months of age, but it’s important to know that the effectiveness of the vaccine may be less in years that the current virus is different from the previous years. Therefore, it’s important to take measures to prevent the flu and to isolate those who are infected from those that are healthy.
Other actions you can take to decrease the chance of getting or spreading the flu are:
Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
If no tissue is available, cough or sneeze into your upper arm, not your hand.
Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.
Clean and disinfect surfaces and objects, like doorknobs, that may be contaminated with germs like the flu.
Establish an effective “survival sick room” that will decrease the chances of spread thoughout the entire family or group
Use face masks when sick or around others who are.
Wait 24 hours after the last episode of fever before exposing yourself to others.
The flu may be a bump on the road in your journey to preparedness, but it doesn’t have to be the end of the road.