The fever. The headache. The chills. The achy muscles. The cough and the sore throat. The creeping, crawling, aching crud. It's that time again. Welcome to flu season in Iowa.
At the Buena Vista County Public Health Department, Sally Bonnesen and her crew are preparing to go to battle, armed with the latest fly vaccine, which this year will target two A-strain and one B-strain virus. "The A strains are usually harsher than the B strain," Bonnesen explains.
After last year's vaccine shortage disaster, officials in the know are making no promises, even though additional sources for vaccine have been sought.
"The government has not yet predicted just how much flu vaccine the nation will have this fall," Bonnesen said. "Because of the questions about the vaccine supply, federal officials want high-risk groups to get their flu vaccines first and have healthy adults wait until mid November to receive their vaccines."
The Center for Disease Control recommends that persons aged 65 or greater get their vaccine especially those with chronic conditions, anyone living in a long term care facility, children 6-23 months of age, pregnant women, health care workers that provide direct patient care and caregivers of children aged 6 months or less.
Buena Vista County Public Health expects to begin giving shots around the end of November, when their supply of vaccine is expected to arrive from the pharmaceutical company. Cost will be $20. Injections are also available through area physicians and clinics. An announcement will be made in the Pilot-Tribune when flu shots are being scheduled by Public Health.
What causes all this discomfort?
The influenza virus is behind a nasty infection of the respiratory tract and is transmitted airborne, rather than by direct contact, like the common cold, Bonnesen noted.
The flu particles hang by droplets in the air and are shared when a person coughs, sneezes, sings, or even speaks. These are microscopic particles and reproduce rapidly once ingested into a new host.
"The reason we need a flu vaccine every year is because the influenza virus has a protein coating that is ever changing, making it unrecognizable to our immune system," she said.
"From time to time the flu virus changes subtypes and a new strain arises causing a major public health concern," Bonnesen said.
Influenza comes on quickly. Sudden onset of those familiar symptoms - fever, headache, chills, muscle aches, cough, and sore throat - is the norm. If these persist longer than three to four days it is recommended that a physician be seen to prevent complications such as pneumonia or other serious infection of the lungs, Public Health officials warm.
"The best prevention of contacting the flu is receiving the flu vaccine," Bonnesen said this week. "It is also wise to avoid others that are sick, avoid public places that have a high incidence of illness, and good hand washing. In addition to hand washing, it is recommended that an antibacterial gel be used to continue to kill germs even after it is applied."
After last year's vaccine shortage, people will need to be reeducated about getting shots.
Dr. Patricia Quinlisk, state epidemiologist, said people will have to revise their thinking from last year, when only older people and higher risk individuals could get a flu shot. Only high-risk individuals will be able to get a flu shot through Oct. 24, but after that, the vaccine should be readily available to the general public, she said.
Chiron, one of the nation's two suppliers, was unable to produce any vaccine last year after its plant in England was shut down because of contamination. The company expects to provide up to 26 million doses of the vaccine to the United States this year.
Meanwhile, the Food and Drug Administration has approved another flu shot for this year.
About 8 million doses of Fluvirax will be available to adults 18 and over.
Another company, Sanofi-Pasteur, plans to supply up to 60 million doses of flu vaccine. Three million doses of Flu-Mist, a nasal-spray vaccine, also should be available this year.
Quinlisk said it's impossible to predict how severe the flu season will be, but she is optimistic that enough vaccine will be available.
She said it's a misconception that someone can get the flu from the vaccine.
"You can't get the flu from the flu shot," Quinlisk said. "There's no 100 percent guarantee you won't get a sniffle all winter. It does not protect you against colds.
"But the bottom line is, the flu shot does work."
In a statement this week, however, Senator Tom Harkin noted that the flu vaccine does not protect against bird flu, which officials warn is becoming a pandemic in Asia and may arrive in the U.S. this year.
Harkin is calling for $3.9 billion in additional spending to prepare for the illness and to stockpile medical supplies.
Avian flu has largely been confined to Asia but is now beginning to spread. In its early stages, the disease was transmitted from birds to small mammals, but since has spread from birds to people.
President Bush scheduled meetings with vaccine manufacturers about boosting stockpiles. Health and Human Services Secretary Mike Leavitt was headed to Asia to ensure international cooperation should an outbreak occur.
There have been periodic flu pandemics in the last century. As many as 50 million to 100 million people died in the pandemic of 1918, but Harkin said this strain is expected to be even more deadly.
"This virus is so virulent that 50 percent of the people who have gotten it died," said Harkin. "It will make the 1918-19 pandemic pale in significance."
Editor's Note: The Buena Vista County Public Health and Homecare office is located at 1709 E Richland in Storm Lake.