Sea Sick: by Keith Murray
Recently, I received a call from my friend Diane. We were supposed to go kayaking, but instead she was in bed sick. She told me that everyone in her office had been sick with the flu and now, apparently, it was her turn.
Last year’s influenza season in the U.S. was one of the most severe in recent memory. High rates of flu occurred all across the country simultaneously. After hearing from my friend, I decided it was time to go to the local pharmacy and get my flu shot – and to encourage Triton readers to get their shots, too.
Is this going to be another bad year for the flu virus? The U.S. experiences epidemics of seasonal flu each year. Our flu season typically occurs in winter, and the flu outbreaks generally start as early as October and can last into May.
The flu, short for influenza, is a highly contagious respiratory infection caused by viruses. Influenza virus generally enters the body through mucus membranes in the mouth, nose or eyes. Mucus membranes are tissues that line the body cavities or passages in the throat, nose, mouth, urethra, rectum and vagina. The membranes produce a thick, slippery liquid called mucus that protects them and keeps them moist.
In the U.S., up to 20 percent of the population gets the flu every year; it affects about 35 million people and kills between 2,000 and 56,000. Influenza can send more than 700,000 people to the hospital. Older adults, young children and people with compromised immune systems and other health conditions are at higher risk for serious flu complications.
Generally, when a flu-infected person coughs or sneezes, the virus becomes airborne. This live virus can then be inhaled by anyone in the area. Touching a contaminated surface such as a telephone or a door knob, then touching the nose or mouth can also transfer the virus. Infection risk is obviously greater in highly populated areas, such as schools, buses and crowded urban settings.
Why get the flu shot?
I often hear people say, “I don’t need the vaccine” or “I heard that it doesn’t work” or “My friend got the flu from the flu vaccine.” Let’s talk about these concerns. First, as for the effectiveness of the flu vaccine, recent studies show that the vaccines reduce the risk of flu illness by about 50 percent. So, let’s talk odds here. A $40 vaccine from the local pharmacy would reduce the odds of getting sick for weeks or perhaps dying by 50 percent. That’s a good bet, and $40 well spent.
New flu vaccines have been updated to better match the circulating flu viruses, but the effectiveness varies from season to season by vaccine type, and among different age and risk groups. Effectiveness depends on the match between the viruses used to produce the vaccines and the circulating viruses that happen each season.
In 2017, the overall vaccine effectiveness against influenza A viruses was 36 percent. The vaccine effectiveness of H3N2 viruses – the dominating virus linked to more severe illnesses during the 2017-2018 flu season – was 25 percent. The effectiveness against influenza B was 42 percent.
Now that we’ve discussed why to get the vaccine, the next question is when? The U.S. Centers for Disease Control and Prevention (CDC) recommends getting the flu shot by the end of October, and earlier if possible. After getting the vaccine, it takes about two weeks for the antibodies that protect against the flu to develop in the body.
Can a flu shot give us the flu? This is a common belief, but it is not true. According to the CDC, the flu vaccine cannot cause flu illness. The most common side effects from the shot are soreness, redness, tenderness or swelling at the site of the shot. Low-grade fever, headache and muscle aches can occur.
While the CDC recommends flu vaccine as the first and most important step in preventing flu, what if someone already has the flu? The second line of defense is antiviral drugs. Antiviral drugs are prescription medicines that fight against flu in the body. There are three FDA-approved antiviral drugs recommended by the CDC this season to treat influenza:
Tamiflu (generic name oseltamivir) is available as a pill or liquid.
Relenza (generic name zanamivir) is a powder that is inhaled. It is not for people with breathing problems, such as asthma or COPD.
Rapivab (generic name peramivir) is administered intravenously by a health-care provider.
When someone on board is sick
According to the CDC, symptoms of influenza can include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, and sometimes diarrhea or vomiting.
A passenger or crew member exhibiting influenza-like illness before leaving port should be advised against traveling until at least 24 hours after a fever naturally ends (meaning without the use of fever-reducing medications). If already underway, the person should be medically evaluated and remain isolated in their cabin.
When sending a guest or crew member with flu-like symptoms to a medical facility, notify the facility in advance and use care in transporting the sick person so as not to infect others along the way.
Someone with flu symptoms should be separated from other passengers and crew as much as possible. The sick should wear a facemask to prevent the airborne spread of the virus. A healthy roommate should be moved to another cabin if possible. Assign one person to deliver all meals and medication to the sick individual, and be sure the person delivering care wears a disposable mask and gloves. All others on board should be reminded to wash their hands often with soap and water or with an alcohol-based hand sanitizer.
In past articles I have talked about the importance of stocking a sufficient quantity of personal protective equipment (PPE), such as facemasks, N95 respirators and disposable gloves. Those who may have contact with sick people on board should be instructed in the proper use, storage and disposal of PPE.
EMT Keith Murray provides onboard CPR, AED and first-aid training as well as AED sales and service. His company can be found at TheCPRSchool.com. Comments are welcome below.