The 2018 influenza season has been one of the longest.... now entering its 13th week!

Influenza A was the primary infection seen until a few weeks ago when it seemed like the long illness season was about to end and then influenza B came marching on! Influenza B is the primary cause of influenza illness currently and symptoms are similar to influenza A.

So what's the difference between these 2 viruses and what are some options for treatment? For prevention?

Influenza A is the most common flu virus and is the one that is responsible for most epidemics and pandemics. It is characterized by H and N subtypes.  H stands for hemagglutinin and N for neuraminadase. There are 16 H subtypes and 9 N subtypes. Influenza A can occur in animals and in humans.  The 3 H&N combinations for human illness are H1N1, H2N2 and H3N2.  

In 1918:  The Spanish flu pandemic around the world was caused by H1N1 strain 
In 1957:  Asian flu epidemic caused by H2N2
In 1968:  Hong Kong flu epidemic caused by H3N2
In 2009:  Swine flu epidemic caused by a new H1N1 strain (novel strain)
In 2018:  H3N2 influenza A predominantly with some H1N1 influenza A also

Influenza B occurs only in humans. It generally causes less severe symptoms. There are no H and N subtypes for influenza B.

As of end of March 2018, 142 pediatric deaths were reported due to influenza illness.  Only 22% of these children had received the influenza vaccine.  Less than 50% of the pediatric deaths were in children with underlying high risk conditions such as a heart condition. Of note for this flu season, the death rate was slightly higher among previously healthy children. 

So what about the vaccine?  This year's vaccine was not as effective as expected.  However, a 2017 study was the first of its kind to show that flu vaccination can significantly reduce a child’s risk of dying from influenza. Flu vaccination also may make your illness milder if you do get sick. Another 2017 study showed that flu vaccination reduced deaths, intensive care unit (ICU) admissions, ICU length of stay, and overall duration of hospitalization among hospitalized flu patients.

Conventional medical treatment for influenza A and B is primarily Tamiflu (oseltamivir) which is a neuraminadase inhibitor.  Neuraminadase is an enzyme that the influenza viruses utilize to multiply and spread. Tamiflu works best when given with in 48 hours of start of illness and is most helpful in young children and the elderly who are most at risk for complications and death. 

Other options:

Elderberry:  herb shown to impair propagation of influenza viruses

Vitamin C:   Known antioxidant to protect cells.  Viral infections deplete vitamin C reserves in the body.  Influenza A has been shown to reduce concentration of vitamin C in lung fluid samples.  
A dosing regimen of 1000mg every 1 hour for 6 hours, then 1000mg 3x daily reduced symptoms by 85%

Green Tea:  Inhibits neuraminadase enzymes

Zinc:  Improves cell immunity; reduces cold symptoms and increases interferon, a protein found in our body that inhibits viral replication

Handwashing, getting enough rest and fluids are also important strategies for getting through an influenza illness.  Using elderberry, green tea, vitamin C and zinc can be supplemental efforts to aid the body's healing process.  Seek attention if symptoms are worsening especially a cough, dehydration becomes a concern or for any changes in mental status.  Discuss with your doctor whether vaccination is a good option for your family.

This too shall pass but it comes around every year!  Hopefully, next year is a more mild illness season. 

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