Are You Prepared For the 2009 Flu Season?

February 4th, 2012

Are You Prepared For the 2009 Flu Season?
What You Need To Know and What You Need To Do.

Michael Garko, Ph.D.
Host – Let’s Talk Nutrition

Introduction

With the second wave of the Novel H1N1 (previously and mistakenly named the Swine flu) about ready to hit, there is considerable confusion, concern and communication about the upcoming flu season. Earlier this month, the President’s Council of Advisors on Science and Technology (PCAST) issued a report in which it stated that “… the expected resurgence of 2009-H1N1 in the fall poses a serious health threat to the United States” (Executive Office of the President, 2009, p. 1).

PCAST commented in its report that the exact impact of the resurgence of the H1N1 influenza in the fall is difficult to predict. Nevertheless, PCAST sketched what it called a “plausible scenario” in which 30%–50% of the U.S. population could become infected with the H1N1 flu virus this fall and winter, with approximately 20%–40% of the population (60–120 million people) experiencing symptoms and more than 50% of those who would become symptomatic seeking medical attention. Furthermore, PCAST (2009) included in its “plausible scenario” that during the epidemic there could be as many as 1.8 million hospital admissions and between 30,000 and 90,000 deaths in the United States (see Executive Office of the President, 2009).

Basic Characteristics of Viruses

Generally speaking, viruses are among the four major categories of microbes (other three being bacteria, fungi & protozoa). As microbes, they are living organisms capable of being viewed only under a microscopic, and, thus, are referred to as microorganisms. In fact, viruses are so small they cannot be seen with a conventional, light microscope but can be viewed only with an electron microscope. They are approximately one-millionth of an inch (17 to 300 nanometers) in length and are about a thousand times smaller in size than are bacteria.

More specifically, viruses are infectious microorganisms displaying a variety of morphologies or otherwise shapes and sizes (e.g., rod-shaped, sphere-shaped, helical-shaped or multi-sided) and constituted of molecules of genetic material (either DNA or RNA but not both), which contain the genes of the virus. The genes of the virus are surrounded by a durable, protective protein shell or coat. The individual proteins of the coat match-up with and attach to specific receptors located on the surface of a cell. Once attached to the surface of the cell, viruses then enter the cell and hijack its machinery so they can reproduce. It is important to remember that viruses are not cells. Rather, they are pieces of genetic material designed to attack the cells of a host (i.e., animal, plant or bacterium).

Viruses are host-dependent. They can only survive, reproduce and spread by invading a host. They can attack plants, animals (humans included) and even other microbes (i.e., bacteria). In terms of humans, viruses are capable of targeting specific cells of the tissues, organs and systems of the body (e.g., liver, brain, pancreas, respiratory system, blood cells, digestive system).
Another feature of viruses is that they can adapt and change by altering their genetic make-up. For example, they have the ability to develop resistance to drugs and vaccines. They can also jump from one type of host to another (e.g., pigs to humans, birds to humans). The ability of viruses to reproduce, adapt and move from one host to another is what makes them such a threat.   

Influenza Virus


As it turns out, more than five thousand different viruses have been identified and described, with most having yet to be identified (Wikipedia, 2009). The influenza (flu) virus and its various subtypes is just one type of virus.

Influenza As A Disease

Technically, influenza viruses cause the flu (i.e., influenza), which is a contagious respiratory illness. Once infected with an influenza virus, a person can experience mild to severe symptoms and in some cases even death.
The Centers for Disease Control and Prevention (CDC) estimate that millions of Americans, on average 5% – 20% come down with the flu each year. More than 200,000 people are hospitalized from flu complications, with young children, elderly people and those with compromised immune systems, respiratory problems and other serious health conditions being at higher risk for flu complications. Approximately 36,000 people die annually from flu-related causes (see Centers for Disease Control and Prevention,  2009b).

Types of Influenza Viruses

Influenza A, B and C are the three types of influenza viruses. Influenza type A and B viruses are responsible for the seasonal flu epidemics affecting tens of thousands of people and taking place nearly every winter. Influenza C virus infections can cause a mild respiratory illness but it is not considered to cause flu epidemics (see Centers for Disease Control and Prevention, 2009d).

There are two influenza A subtypes infecting people. They are influenza A (H1N1) and influenza A (H3N2). The two subtypes get their names from the two proteins, hemagglutinin (H) and the neuraminidase (N), located on the surface coat of the influenza A virus. In terms of the two proteins, there are 16 hemagglutinin subtypes and nine neuraminidase subtypes (see Centers for Disease Control and Prevention, 2009d).

Unlike influenza type A viruses, influenza type B viruses do not have subtypes but can be divided into different strains. Compared to influenza A, influenza B viruses cause milder symptoms and do not raise pandemic flu concerns. Currently, influenza B causes infections only in seals and humans (see Centers for Disease Control and Prevention, 2009d).

According to the CDC (2009c), during flu season different (i.e., Influenza A & influenza B) and subtypes of influenza A can circulate and change, a process called ‘antigenic drift’ (see Centers for Disease Control and Prevention 2009c).

Annual/seasonal influenza vaccines are made-up of subtype strains of influenza A (H1N1) and A (H3N2), along with influenza B. Thus, flu vaccines protect against influenza A and B viruses but they do offer protection against influenza C virus (Centers for Disease Control and Prevention, 2009d).

How Influenza Viruses Are Spread

Influenza viruses spread primarily from person to person by way of respiratory droplets from coughs or sneezes. When a person coughs or sneezes, respiratory droplets are propelled in the form of an aerosol through the air and come in contact with another person’s mouth or nose. They can also be transmitted when a person touches or comes in contact with the infected respiratory droplets on another person or contaminated object (e.g., table, desk top, restaurant counter, computer keyboard, telephone, doorknob, clothing, bedding, etc.) and then touches his/her mouth or nose or another person’s mouth or nose.

Novel H1N1 Influenza Virus

As the term “novel” indicates, novel H1N1 influenza virus is new influenza type A virus and is contagious. It first appeared in the United States back in April of 2009 in Southern California and near Guadalupe County, Texas. At that time, it was called “swine flu” because it was genetically similar to viruses which infect pigs. Upon further laboratory analysis, scientists and health officials determined that it was more complicated genetically than swine flu and renamed it “novel H1N1 influenza virus” (also referred to as “novel H1N1 influenza,” “novel H1N1 influenza (flu) virus” & “novel influenza A H1N1 virus infection”) (see New York State, Department of Health, 2009).

The designation “novel” indicates that this particular virus is a new influenza virus. Novel H1N1 influenza is new because it is a genetic combination of virus genes from pigs, birds and humans. This is why describing this virus as Swine flu is incorrect. Novel H1N1 is referred to as a “quadruple reassortant” virus in that it is constituted of four influenza genes derived from pigs, birds and humans (see Centers for Disease Control and Prevention, 2009a).

It is important to remember that although it has genes from pigs and birds, novel H1N1 is not Swine flu or avian/bird flu. Nor is it the same as seasonal flu.

How Novel H1N1 Influenza Virus Is Spread

The novel H1N1 influenza virus is spread in the same way other flu viruses such as the seasonal flu are transmitted (see discussion above on How Influenza Viruses Are Spread).

Symptoms of the Novel H1N1 Influenza Virus

The signs and symptoms of the novel H1N1 influenza virus are rather similar to those of seasonal influenza. They include fever, cough, sore throat, runny or stuffy nose, body aches, headaches, chills, fatigue, along with diarrhea and vomiting in some people.

Prevention and Treatment

At the current moment, there is not a vaccine for the novel H1N1 influenza virus. Clinical trials are being conducted at this time to test the efficacy of a vaccine. A vaccine is not anticipated to be ready until mid-October. In the meanwhile, there are everyday precautions that people can take to remain healthy and protect themselves and others from becoming infected with either the novel H1N1 influenza virus or the seasonal influenza.

Hygiene & Other Prevention Practices

The CDC (2009a) offered the following everyday recommendations to protect yourself and others from becoming infected with an influenza virus:

• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
• Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners* are also effective.
• Avoid touching your eyes, nose or mouth. Germs spread this way.
• Try to avoid close contact with sick people.
• If you are sick with flu-like illness, CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.) Keep away from others as much as possible to keep from making others sick.
• Follow public health advice regarding school closures, avoiding crowds and other social distancing measures.
• Be prepared in case you get sick and need to stay home for a week or so; a supply of over-the-counter medicines, alcohol-based hand rubs, tissues and other related items might could be useful and help avoid the need to make trips out in public while you are sick and contagious (p. 1).

Practice Prevention

There is no cure for the flu. Therefore, the best defense against contracting the seasonal flu or novel H1N1 influenza virus is to practice prevention. A key way to prevent an infection from flu is to keep the immune system in tip top, battle-ready condition. The immune system is the sentinel of the body. It protects the body against viral invasions so long as things are done to keep it vital, vigilant and virulent against flu viruses, which are virulent themselves.

One of the primary strategies to create an effective immune system defense against flu viruses is to avoid committing on a regular basis what I refer to as The Seven Deadly Lifestyle and Nutritional Sins. Collectively they reflect a poor diet and unhealthy lifestyle habits, which undermine health and well-being and weaken the immune system.

Eating a diet primarily constituted of (1) stripped-down, refined, high-glycemic carbohydrates in the form of processed white sugar, white flour & white rice, (2) saturated & trans fats, (3) sodium in excess, (4) stimulants (tobacco & coffee) and suppressants (alcohol) (5) surplus calories and leading a lifestyle characterized by frequent episodes of (6) stress & sleep deprivation, along with a (7) sedentary existence undermine the health and nutritional status of a person and promote inflammation and free-radicals, all of which compromise the immune system, thereby, increasing the likelihood that the sentinel of the body will be unable to combat a flu virus.

In contrast, eating a diet rich in fresh fruits and vegetables, whole grains, fiber, nuts, seeds and legumes, along with adequate rest and regular exercise go a long way in keeping the immune system healthy. Although it focuses on cardiovascular health, it is recommended the reader visit www.letstalknutrition.com and read my December, 2006 issue of Healthful Hints to learn more about diet and lifestyle recommendations which will promote a healthy immune system.

It is recommended further that the reader refer to the book by Balch (2006) called Prescription for Nutritional Healing, and read the sections on influenza. Balch (2006) provides a host of dietary and nutritional supplement recommendations in conjunction with lifestyle recommendations to help prevent and treat colds and flu. Yet another recommendation for the reader is to examine Lorna Vanderhaeghe’s book, Healthy Immunity, to learn about the immune system, how it works and ways to keep it functioning at an optimal level, especially during cold and flu season.

Finally, readers can listen to archived shows of Let’s Talk Nutrition focusing on the immune system, influenza, a healthy diet and lifestyle, importance of sleep and rest, regular physical activity/exercise, among other many topics to remain healthy and help practice prevention. Visit www.letstalknutrition.com and click on the link, Show Schedule for archived shows.

Conclusion

The worst case scenario of novel H1N1 influenza virus killing as many as 90,000 people this coming fall is to say the least sobering. Coupled with the fact that seasonal flu will also be in play this fall and it on average takes approximately 36,000 lives each year makes health matters worse.

The best defense against the novel H1N1 influenza virus and seasonal flu is prevention. It would be prudent for people to follow the CDC’s recommendations presented above to protect themselves and others. It would also be wise to consider and put into practice the nutritional and lifestyle recommendations discussed above so as to keep one’s nutritional status at an optimal level and immune system healthy.

As the old saying goes, “Hope for the best but prepare for the worst.”
References

Balch, P.A. (2006). Prescription for nutritional healing (4th edition). New York: Avery.

Centers for Disease Control and Prevention (2009a). Questions & answers: Novel H1N1 (Swine flu) and you. Retrieved August, 15, 2009, from http://www.cdc.gov/H1N1flu/qa.htm

Centers for Disease Control and Prevention (2009b) Influenza: The disease. Retrieved September 20, 2009 from http://www.cdc.gov/flu/about/disease/index.htm.

Centers for Disease Control and Prevention (2009c). The Influenza (Flu) Viruses. Retrieved August, 15, 2009, from http://www.cdc.gov/flu/about/viruses/index.htm

Centers for Disease Control and Prevention (2009d) Types of Influenza Viruses. Retrieved August 15, 2009, from  http://www.cdc.gov/flu/about/viruses/types.htm

Executive Office of the President (2009). Report to the President on U.S. preparations for 2009-H1n1 influenza. Retrieved August, 15, 2009 from http://www.whitehouse.gov/assets/documents/PCAST_H1N1_Report.pdf

Garko, Michael (2006, December). Cardiovascular health – Part VIII: Diet and nutrition as part of a personal prevention program to combat coronary heart disease. Healthful Hints. www.letstalknutrition.com.

New York State, Department of Health (2009). Novel H1N1 influenza: Frequently asked questions and answers. Retrieved August, 15, 2009, from http://www.health.state.ny.us/diseases/communicable/influenza/
h1n1/questions_and_answers.htm

Vanderhaeghe, L. R. (2002). Healthy Immunity. New York: Kensington Publishing Corp.

Wikipedia (2009). Virus. Retrieved August, 15, 2009, from http://en.wikipedia.org/wiki/Virus.


Comments are closed.