You’ve probably heard about this season’s flu outbreak, because it is more severe than in year’s past. In this week’s blog, Dr. Callahan, who recently joined the BCBSKS staff, shares more details about the flu vaccination and if a universal vaccine could replace annual flu shots.

Influenza can be identified by the protein molecular make up of the virus and is given the H and N designation for Hemagglutinin (H) and Neuraminidase (N). There is further differentiation with 18 H and 11 N subtypes. The virus can be even further broken down from these subtypes to strains in this manner. For example, a strain of H1N1 is responsible for the influenza outbreak of 1918. As mutations occur in the world, the strain changes and some emerge as dominant strains.

How are annual flu vaccinations determined?

By careful monitoring, the strain most likely to cause flu outbreaks are chosen for production of flu vaccinations. Vaccination with antigens of strains has become the staple of influenza protection. The flu virus is identified in the eastern part of the world, then cultured and incubated (in eggs originally) for distribution prior to outbreaks in the western part of the world. Vaccination allows the body to develop immunity, making for a less naïve immunity. Each fall and winter prior to flu outbreaks, the immunization of the population can prevent severity and pandemic. While an imperfect and arduous task each year; this, along with improved public health and hygiene, has prevented another pandemic.

Avoiding a case of the flu this year may be more difficult because this year’s flu shot is being reported as only 10 percent effective. Most years the effectiveness is 40-60 percent range. It is difficult to always get the correct strain of flu since the virus is constantly mutating. Currently, the strain that is circulating and causing the majority of cases is the H3N2.

According to a recent article in the New England Journal of Medicine the strain chosen to make the flu shot this year may not have been the right one, or a protein within the egg culture was able to modify the virus. The article discusses why chasing of the flu strain each year highlights the need for a universal flu vaccine.

Universal vaccine: The end of annual vaccinations?

The universal flu vaccine is a key focus of future development in flu prevention and is being researched at National Institutes of Health. While still on the horizon, this effort involves use of influenza viral genetic material that does not change from year to year. It can potentially offer long-term immunity and avoid the need for annual flu shot.

By utilizing a portion of the H protein. The H protein is fashioned in a head and stem appearance under electronic microscopy. It has been determined that the head and stem portion of the virus, allows the virus to enter the human cell. Currently, the flu vaccine induces the body to create antibodies against the head and stem of the H protein. This portion of the virus changes seasonally and requires a new vaccine to be developed. Discovery of the portion of the H protein’s stem that does not change every year has led to refining the research.  By developing immunity to that unchanging portion, a universal vaccination could be developed and eliminate the need for an annual flu shot.

Take steps to avoid spreading flu germs

• If you have the flu, remain home until you have been fever-free and drug-free for 24 hours.
• If you are sick, avoid large crowds and attempt to maintain social distance of six feet.
• Cover your cough and sneezes with a tissue or in your sleeve.
• Frequently wash hands.
• Use sanitizer often.
• Clean the surfaces you touch with your hands in your work area at least once a week. (Examples: desk, phone, mouse, keyboard, desktop, calculator, writing utensils)
• Avoid touching eyes, mouth or nose with your hands or fingers and after you touch other surfaces.

Prevention

Everyone 6 months of age and older should get a flu shot. Immunization should include high risk (heart disease, diabetes, long term care facilities), pregnant females and people 65 and older.

Symptoms

• Fever, cough, sore throat, muscle-body aches, headache, and fatigue are the common symptoms.
• Condition can be mild to severe, and can develop in to pneumonia or other serious conditions.
• The common cold and flu are similar but different viruses. The common cold usually has milder symptoms such as runny nose and congestion. Testing can help with telling the difference.

Treatment

The use of antiviral medication can improve outcomes and can be started at the first signs of flu symptoms, even before testing.

Recovery

Typically, the flu lasts three to five days; but can last up to two weeks.

Flu season occurs generally from November through March each year. The Centers for Disease Control and Prevention tracks the flu closely. Additional information can be found at:

• CDC.gov
• National Institute of Allergy and Infectious Diseases

Daryl Callahan, D.O., joined BCBSKS in 2017 with 28 years of experience in the medical profession. He is board certified in family practice, and served as a family physician at the Phillips County Hospital and physician partner of HealthCare Associates Medical Center in Phillipsburg. Dr. Callahan served 30 years in the National Guard. He retired as a colonel and was the state surgeon for the Kansas Army National Guard.