Your Health Matters
By Claudia Parks, R.N.

FLU SEASON! "It's that time again! My children and my grandchildren are very fortunate, in that they have a slew of "grandmas." Two great and two regulars! Lest we not forget the two grandpas!

I was not as fortunate. My mother's mother was one of the 675,000 Americans and 40 million victims around the world that died in the 1918-19 global Spanish flu pandemic.

There has never been an epidemic like the 1918 flu. The medieval Black Death killed as many people-possibly 50 million Europeans, one out of every three-but it took 150 years to do it.

The Spanish flu was more efficient. From March 1918 to the following February, it sickened and killed families, cities, and regiments on the battlefield.

In Atlanta, where 750 died, all public gatherings were banned. In San Francisco, the entire population was required to wear surgical masks.

Apocryphal stories from New York City, said people got on subway trains and died before they reached the end of the line.

The toll was so great that it reduced average U.S. life expectancy by 13 years. It may even have changed history: Woodrow Wilson was sick with the flu during the negotiations of the Treaty of Versailles that ended World War I but set the stage for World War II.

It was not what we think of now as flu-the cough and sniffles, fever and muscle aches that send sufferers to bed for up to several weeks and lead, in the unlucky few, to potentially fatal pneumonia. The Spanish flu killed in days; its preferred victims were not the young and old, the usual targets of infectious diseases, but those in their 20s (my would-have-been grandmother was 26).

It killed horribly, triggering a massive immune reaction that saturated the lungs of its victims with blood and fluid, so they drowned from within. Contemporary accounts describe corpses as slate-blue from lack of oxygen and hemorrhage into the skin.

The Spanish flu killed more Americans than World War I, World War II, the Korean War, and the Vietnam War combined; yet it is now barely remembered. Unlike AIDS, the other great plague of this century, it produced almost no art, no theater, and no literature of grief. Only one slender novella, Katherine Anne Porter's "Pale Horse, Pale Rider," memorializes it.

Yet it remains an urgent threat. The influenza virus mutates unpredictably every year; every few decades, it changes sharply enough to cause a worldwide pandemic. The last two, in 1957 (70,000 Americans died) and 1968 (34,000 Americans died), were mild in comparison to 1918-but no one can predict for certain when such a deadly flu will come again. This is spooky and scary, and worth our serious notice!

The Atlanta-based CDC helps to manage a worldwide detection system that tracks major labs-in Atlanta, London, Tokyo and Melbourne, Australia-and then is examined at a yearly late-winter meeting of the World Health Organization (WHO) to predict which viruses will circulate in the next flu season.

The meeting dictates each year's vaccine, a juggling of the previous year's flu, the chances of change and the hard reality that it takes six months to produce enough vaccine to be useful. A vaccine probably would not be available in the early stages of a pandemic. If a pandemic occurs, it is expected that the U.S. government will work with many partner groups of scientists around the world to make recommendations to guide the early use of vaccine.

At this time there are four different influenza antiviral medications (amantadine, imantadine, oseltamivir (Tamiflu), and zanamivir), which are approved by the U.S. Food and Drug Administration for the treatment and/or prevention of influenza. However, sometimes influenza virus strains can become resistant to one or more of these drugs, and thus the drugs may not always work. For example, the influenza A (H5N1) viruses identified in human patients in Asia in 2004 and 2005 have been resistant to amantadine and rimantadine. Monitoring of avian viruses for resistance to influenza antiviral medications is continuing.

Go to one of the search engines such as Google and keep up to date on this subject. Don't PANIC-just be ALERT and INFORMED! Get your annual flu shot in October or November! Next week, I'll give you some more key facts about influenza and who should receive the vaccine.

Claudia Parks, RN, is a former doctor's office and emergency room nurse and retired as an educator from Fulton County Schools. She writes Your Health Matters as a public service; the information here is designed to help you make informed choices about your health. It is not intended as a substitute for the advice of your physician. Claudia and her husband make their home in the beautiful north Georgia Mountains. You may contact Claudia at yhm@windstream. net .