Some Useful Influenza Facts, by Dr. Bob

Monday, Sep 5, 2011

In my head it sounds like the start to a Schoolhouse Rock song...."innnn flu enza!  It's contagious, it's outrageous...influenza a virus that ..."  Anyway, enough reminiscing about my childhood and on to the topic.  First things first:  "flu" is one of the most overused and improperly used terms in all of medicine--arguable the king of misused medical words.  Influenza is a respiratory virus.  It is not what most people call "flu" or "stomach flu".  It is not a little cold that you have that people call into work for because they just feel sniffly.  Influenza is an enveloped RNA virus classified by its core protein subtype A, B, C.  To make it even more confusing, each virus is further categorized by its hemagglutinin and neuraminidase surface proteins.  For example, the Influenza A H1N1 virus is adorably named "swine flu" by the media and generally people are familiar with it due to the massive hype it received a few years ago.  Avian flu comes in many different types too, most notably Influenza A H5N1 among bird populations in Eurasia.  Big deal, some nerds somewhere get to figure out numbers to subtype influenza and not impress chicks, what does the normal person need to know? Classic influenza symptoms are:  fever, cough, body aches, headache (usually from the cough), sometimes sore throat (again from the cough), shakes, chills.  What influenza is not is congestion, productive cough, sinus symptoms, and gastrointestinal symptoms.  To be fair, this H1N1 "swine flu" run we had a while back did give some kids GI symptoms with their usual influenza symptoms, making it a little harder to diagnose and a little confusing for people.  Let's just ignore that for the sake of planning for TEOTWAWKI.  

Fever and cough within 48 hours of symptoms is the best predictor of influenza.  That means a real cough and real fever.  Feeling "warm" is not a fever.  Nor is a temperature of 100.1 a fever.  Don't care if you usually run "low".  And the cough is a real cough, not just a tickle and not every hour.  (It's the real deal wish you had a lung brush to scrub out your bronchus cough.)  And the joy of influenza is that it is easily spread from one person to another at your local Megalomart, school, or Thanksgiving dinner table. So, in terms or preppers, what can we do.  First, the nastiest, deadliest flus need lots of transmission and cross infection to take off and kill like the flu of WWI.  That is unlikely in TEOTWAWKI long as you are avoiding the government tent cities people will be dependent on if they screw up and don't take care of themselves.  That's not you, so you can relax a little bit there.  But, complete isolation is usually a bad thing (sorry, JWR) for most of us, and there will always be a chance of influenza infection with population mixing in any form.  Complications of influenza usually are only dangerous to older folks, pregnant women, kids under 2 years old, serious complicating illnesses, immunosuppression, Indians and Eskimos, and morbidly obese people.  Healthy adults, even without treatment, will usually be moderately to severely ill with an influenza outbreak; but then pop back up like a dandelion in Spring.  That usually is not enough for most worried survivalists, so we can talk about treatment. Treatment for influenza is done with antiviral medications that are effective against the Influenza A and B ideally.  The most effective and easiest to use is oseltamivir (Tamiflu).  It comes in liquid for kiddies, it does not have to be inhaled like another choice zanamivir (or Relenza) which cannot be used for people with pulmonary issues like asthma or COPD.  Tamiflu is unfortunately heavily controlled and monitored by the government, making stockpiling tricky.  It is also very expensive to get, usually over $100 per person per treatment.  Adds up quick.  And Relenza is even more expensive than the Tamiflu usually.  There are two other choices that are a little less expensive: rimantadine and amantadine which are both generic.  The CDC usually recommends against their use due to resistance.  Unfortunately, many of the influenza infections from 2008 and 2009 were also resistant to Tamiflu, making solid recommendations for preppers difficult at best and therefore a tough call on proper use of dollars for sense. One thing all grannies can tell you about take care of people the old fashioned way and they tend to get better.  Soup, acetaminophen (Tylenol), ibuprofen (Advil, Motrin), and fluids does help.  Cough medicines are usually a waste of time and money with influenza.  

IMPORTANT NOTE:  children should NEVER be given aspirin with any viral illness that has a chance of being influenza!  Kids can develop a serious problem called acute toxic-metabolic encephalopathy, or Reye Syndrome.  The last thing any of us would want to do to our kids is to make their brains and livers fail due to our stupidity.  Follow the basic rule of kids and aspirin don't mix and you will be fine.  There is always acetaminophen and ibuprofen for kids and there has not been any link found to Reye Syndrome with these medications. Final question all preppers are still asking themselves:  should there be a stockpile of Tamiflu on the shelves with my food and ammo?  Depends on your underlying medical conditions, your ability to avoid mixing with the infected population, and isolating those suspected to have influenza quickly.  Most of the Tamiflu taken now is to help people get back to work quicker and feel better faster. WTSHTF it is doubtful that we are going to care too much about that.  But, if your entire security force is laid up for a week sicker than dogs and your place is overrun by healthy pirates, then you will wish you had some.  Cost/benefit analysis on this one is really mentioned so many times in the past you will have to be the judge and trust yourself on this call.  Stay strong.

JWR Adds: Dr. Bob is is one of the few consulting physicians in the U.S. who dispenses antibiotics for disaster preparedness as part of his normal scope of practice. His web site is:

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