Infectious disease is a serious medical issue in good times or bad, and the family medic must be able to identify some of the deadliest. The respiratory tract is more commonly affected 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. This year, influenza seems to be running rampant almost everywhere, with 11 million cases, 130,000 hospitalizations, and 5000 deaths so far, including nine children.
Influenza Virus
Influenza virus is a microscopic entity that stretches the definition of a living being. Unlike most bacteria, it can’t reproduce unless it has entered living cells of other organisms. In general, viruses are very simple in structure, rarely consisting of more than a bit of genetic code covered by a protein coating.
Influenza A virus (the most common type) spreads throughout the U.S. from Fall through Spring. 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 H1N1.
In the last few years, flu cases were eclipsed by the COVID pandemic, but this year they have returned with a vengeance. There are many variants: The strain dominating this season is thought to be a variant of H3N2 known as “subclade K.”. This version is somewhat different than your standard influenza A virus; as a result, more cases have ended up hospitalized or worse.
Symptoms of Influenza
Signs of influenza begin anywhere from one to four days after exposure. They are similar to the common cold and include:
- High fever
- Cough
- Headache
- (Severe) fatigue
- (Severe) muscle aches
How can you tell the difference? Colds will resolve themselves over a week or so, but influenzas may last longer. The flu could weaken you enough that secondary bacterial infections 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.
Having said that, most people weather the symptoms well. Some, 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).
Treatment of Influenza.
Generally, most cases of influenza are treated “symptomatically.” This means you are allowing the illness to run its course; medicine is taken to decrease the discomfort of symptoms. Common medications like ibuprofen for muscles aches and fever, pseudoephedrine for nasal congestion, and expectorants to thin out phlegm are popular options. Cough suppressants are also used, although they are most beneficial when they interfere with, say, sleeping. Adequate hydration is also important, so push fluids.
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), baloxavir marboxil (Xofluza) or Zanamivir (Relenza). Tamiflu, the most popular, is taken twice a day for 5 days.
It should be noted that a recent study suggests that Xofluza may be even better. Xofluza is a convenient single dose treatment, and appears to be at least as effective as Tamiflu. Avoid taking with dairy products or antacids, as it tends to weaken the effect.
Anti-viral 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 benefit. Therefore, you might consider asking your doctor before you get ill, since it might be hard to see them in person on short notice. For a caregiver, taking a half dose of Tamiflu daily for five days may decrease your chances of catching it.
It should be noted that Xofluza, Tamiflu, or other antivirals will have no effectiveness whatsoever against bacterial respiratory infections. For that, you need antibiotics. To learn how to tell the difference between bacterial and viral illness, how to use antibiotics wisely, and much more off the grid, consider a copy of our book “Alton’s Antibiotics and Infectious Disease: The layman’s guide to available antibacterials in Austere Settings”, available on Amazon or at our website at store.doomandbloom.net.
Preventing Influenza
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 (or may not) 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 throughout 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 above strategies are referred to as “respiratory hygiene” and are key to preventing community-wide outbreaks.
The Flu In Survival Settings
Respiratory infections like influenza should be concerning to every family medic, regardless of whether times are good or bad. 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.
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. Plan to prevent it, and you’ll save lives.
Joe Alton MD
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