Shake the flu

When temperatures drop, so do our immune systems.

Dr. Alamjit Virk, director of emergency medicine and hospitalists services, says flu vaccines are important, particularly for "high risk populations."

Cough into your sleeve, wash your hands often, and drink plenty of fluids. Only a handful of influenza cases have been detected on-Island so far, but local health professionals remind us it’s still early. As we approach the ascending bell curve of detected flu cases, a curve that peaks in February, now’s the time to take those necessary precautions.

The 2017-2018 flu season was one of the most severe in years. The vaccination was about 40 percent effective, a dip from prior years, which was a factor in the flu’s higher occurrence, according to the Centers for Disease Control (CDC). It’s hard to say what the 2018-2019 season will bring. Dr. Alamjit Virk, director of emergency medicine at Martha’s Vineyard Hospital, said it’s a guessing game.

“The influenza virus mutates so rapidly,” Dr. Virk said. “It’s a guessing game as to what viral components go into a vaccine for a given year. When they get it right, you’re provided with better immunity. If they get it wrong, there’s lower immunity among vaccinated populations, and that increases the number of people who get infected. Right now, there’s no sign of an epidemic or the large numbers we had last year. But that could change.”

The most effective way to prevent influenza is to get vaccinated, according to Dr. Virk. “It’s the No. 1 intervention people can take in terms of protecting themselves,” he said. Here’s where you can get the flu shot on-Island:

  • Vineyard Scripts, Vineyard Haven, walk-in
  • Stop & Shop Pharmacy, Edgartown, walk-in
  • Conroy’s Apothecary, West Tisbury and Oak Bluffs, walk-in
  • Island Health Center, Edgartown, walk-in for patients only
  • Martha’s Vineyard Hospital, through an appointment with a primary care physician only

“Not only will it prevent the disease, but it should reduce symptoms related to the disease, especially for high risk-populations,” Dr. Virk said.

“If you’re going to get the flu shot, now’s the time,” said Michael Savoy, R.N. patient care manager at Island Health Care.

The CDC recommends everyone 6 months and older get the flu vaccine, especially those who are high-risk. That population includes children ages 6 months to 2 years, adults 65 and up, women who are pregnant and two weeks postpartum, and individuals with chronic conditions like pulmonary disease, asthma, diabetes, and other immune deficiencies. The only time you shouldn’t get the vaccine is if you’re already sick.

It’s critical to treat the flu within the first 48 hours; otherwise, it’ll be harder to shake and easier to spread. Tamiflu is an antiviral drug treatment that if taken within the first 48 hours of onset of symptoms, will “markedly reduce the length of symptoms and make you feel a lot better a lot faster,” according to Savoy. Tamiflu is first-line recommended treatment, according to the CDC.

So how do you tell the difference between the flu and the common cold? “The common cold is like a little train chugging along; the flu is like getting hit by a freight train,” said Dr. Steven Feder, a primary care pediatrics physician at the Martha’s Vineyard Hospital.

Three things come with the flu — fever, cough, and a sore throat. “It’s a more rapid onset with higher severity,” Dr. Feder said.

“High fever, body aches, shaking chills, respiratory distress — things you can’t brush off as a case of the sniffles,” Savoy added.

Beware of shingles

Another disease to be wary of this winter is shingles. The Island sees a fair number of cases each year, and Dr. Feder notes that one in three Americans will have shingles in their lifetime. Shingles are especially common among adults 65 years and older. Martha’s Vineyard’s aging population makes it a disease of higher incidence compared with the rest of the state.

Shingrix is the new shingles vaccine recommended by the CDC. It is administered in two doses. It’s new, effective, and in high demand, in part because the CDC lowered the recommended age for receiving it from 60 to 50 last year. There’s been a statewide shortage of the vaccine for the past four to five months. It hasn’t been available on-Island, but that’s set to change soon.

“I’ve got 35 high-priority patients, and a limited amount of vaccines,” staff pharmacist Chris Delprete at Stop & Shop Pharmacy said.

“It just came out in 2017, so there are production and distribution issues leading to periodic shortages,” Dr. Feder said. “That should be a short-lived problem.”

Shingles is a reactivation of the chicken pox virus. It’s painful, itchy, and contagious by contact. As people age, their immune systems function less effectively, and that’s why shingles is more common among the aging population. Shingles are hemispheric, meaning they generally only appear on one side of the body. It stems from the spine and follows along the nerve routes.

“The nerves get kind of torched,” Savoy said.

Some need pneumonia shots, too

The pneumonia vaccine is recommended for adults ages 65 years and older, as well as anyone ages 18 to 65 with chronic conditions. Prevnar 13 is the first vaccine recommended by the CDC, followed by Pneumovax 23. They prevent the 36 most common strains of pneumonia. Vaccinations are available at Conroy’s Apothecary, Vineyard Scripts, and Stop & Shop Pharmacy.

Respiratory syncytial virus, or RSV, is another common respiratory disease to look out for.

“It’s a very strong virus in the winter,” Dr. Feder said. “In adults, it’s like any common illness. It affects babies much worse. If you have an infant 9 months or younger, it’s an illness you should be aware of.” RSV comes with asthma-like symptoms, according to Dr. Feder.

“I think the biggest thing is, people really need to be diligent about washing their hands,” infection control specialist Martha Bischoff at the Martha’s Vineyard Hospital said. “It’s such a simple task. Wash your hands with soap and water, and sing ‘Happy Birthday’ twice. It’s our biggest encouragement.”