Seasonal Influenza

Key Messages - 2006

1. Being Fit And Healthy Will Not Protect You From Influenza

2. Influenza Is Not A Bad Cold. It Can Kill.

3. Protect Yourself And Your Family – For Many, Immunisation Is Free

4. Immunisation And Avian (Bird) Influenza

Being Fit And Healthy Will Not Protect You From Influenza

Influenza doesn’t care how fit, active or healthy you are: it can infect and strike down even the healthiest of people, as well as those whose immune systems are compromised or are in poor physical health. Influenza is easily transmitted and everyone is at risk of catching it

Influenza Is Not A Bad Cold. It Can Kill.

Influenza carries the risk of severe illness. No matter how fit, healthy or tough you are it may leave you unable to do just about anything, make you seriously ill and confine you to bed for a week.

Influenza has a sudden onset and is accompanied by some or all of the following symptoms:

• a cough,
• headache,
• fever or chills,
• body aches and pains,
• fatigue
• and generally feeling miserable.

Complications can include pneumonia and heart failure. Existing medical conditions can
be made worse. In some cases influenza can be life threatening.

• Between 10 and 20% of the population are infected with influenza each year ¹ – (380,000 to 760,000 people).
• On average, 2.7% of the population (53,000 to 156,000 people) will consult a GP because of influenza each year ¹
• 266 to 874 New Zealanders end up in hospital each year because of influenza ¹
• 4 to 95 New Zealanders could die as a result of being infected with influenza. This is likely to be an underestimate with the actual excess mortality being much greater ¹

The burden of looking after you will fall on your family or others around you and they can become infected too. Every year thousands of New Zealanders need the attention of their doctor or are hospitalised with influenza; some die.

Protect Yourself And Your Family

Prevention of influenza starts with the basics – paying attention to hygiene, in particular hand washing, is important to avoid many infectious diseases. Stay at home if you are unwell to prevent spreading the virus. When coughing, cover your mouth and use disposable tissues. An influenza vaccination offers proven, effective immunity against the virus. It cannot give you influenza because it contains no live viruses. Other respiratory illnesses are common at the same time of year and sometimes wrongly blamed on the vaccination.

For Many, Immunisation Is FREE

The influenza vaccine is free to eligible people as soon as it becomes available from the
supplier (usually early March) until the end of June each year.

People who are eligible for FREE influenza immunization are those at high-risk of complications, either because of their age (65 years and over) or because they have an ongoing medical condition:

A – all people 65 years of age and over

B – people under 65 years of age, including children with: cardiovascular disease (ischaemic heart disease, congestive heart failure, rheumatic heart disease, congenital heart disease, cerebrovascular disease) chronic respiratory disease (asthma if on regular preventive therapy; other chronic respiratory disease with impaired lung function) diabetes chronic renal disease any cancer, excluding basal and squamous skin cancers if not invasive other conditions (autoimmune disease, immune suppression, human immunodeficiency virus (HIV), transplant recipients, neuromuscular and central nervous system diseases, haemaglobinopathies, children on long term aspirin).

The following conditions are excluded from funding:

• Asthma not requiring regular preventative therapy
• Hypertension and/or dyslipidaemia without evidence of end-organ disease
• Pregnancy in the absence of another risk factor

Annual immunisation is also wise for many healthy individuals, especially all health care
professionals and those who are in close contact with people vulnerable to complications, e.g.
staff in nursing homes and other chronic care facilities and home care providers for the elderly.

Some organisations offer subsidised vaccine for staff. Please check with your organisation to
see if the influenza vaccine is subsidised for you.


Differences in influenza strains in vaccine and the influenza
circulating in the community does not mean the vaccine is ineffective

The influenza virus does keep changing and new vaccines are made for each
northern and southern hemisphere influenza season to keep up with these changes.

A common misconception is that the influenza vaccine is useless if it does not correspond
exactly to the influenza strain(s) that appear each year. Protection is not all or nothing
and partial protection can occur, even if there is a greater than expected difference
between the circulating strains and the vaccine. Effectiveness is reduced by the degree
of difference between virus and vaccine strains, but not completely lost.
Immunise early and immunise each year

Vaccinate as soon as possible after the vaccine becomes available, because it takes up to two
weeks to induce immunity. Ideally, immunisation should be carried out as soon as the vaccine
is available – before the main influenza activity in May to September.

High-risk individuals can be immunised at any time during the influenza season, but the vaccine is only free until the end of June for those in the high-risk groups.

The influenza vaccine provides optimum protection in elderly people for about six months and
in younger, healthier adults for up to a year. So annual vaccination is necessary, even if the
vaccine strains do not change.

Influenza immunisation cannot cause influenza because it dose not contain live viruses

The vaccine contains fragments of disrupted (inactivated) virus. It stimulates the immune
system to make antibodies that protect against circulating influenza viruses.

Many other viruses are also present throughout the year, so the results of coincidentally
catching a different respiratory infection or other ’flu-like’ virus may wrongly be blamed on
the influenza vaccination.

The influenza vaccine is generally well tolerated. Some side effects most commonly reported
are fever, mild aches and pain at the injection site, and these usually disappear within one to
two days without treatment.

• Systemic reactions (eg, fever, malaise, myalgia) may occur ²,³.
• Mild local reactions may occur with low frequency during the 48 hours after vaccination. These reactions include inflammation (for example swelling, redness, tenderness and/or pain), ecchymosis, and induration ²,³.
• Serious adverse effects are very rare ²,³.

Immunisation And Avian (Bird) Influenza

Immunisation against seasonal influenza is unlikely to protect against an influenza
pandemic (which may have its origin from an avian (bird) influenza), but it’s still a
smart choice to keep you as well as possible in the event of a pandemic

Influenza pandemics occur when a new influenza virus emerges that is able to infect humans
and be passed efficiently on from human to human.

In the past pandemic viruses have emerged either by mutation, as possibly happened in 1918, or by reassortment of a human virus and an avian virus as in 1957 and 1968.

As no human pandemic virus currently exists, a pandemic vaccine cannot be prepared. However, protecting yourself against other strains of influenza means you are far less likely to have had influenza and be debilitated should an influenza pandemic occur.

Increasing the immunisation rates will protect more people from seasonal influenza and also ensure that systems for the use and distribution of influenza vaccines are able to operate on a large scale in the event of a pandemic.
Follow Ministry of Health guidelines on preventing the spread of pandemic influenza

Immunisation can help protect an individual against seasonal influenza but if a human pandemic strain of influenza emerges, the seasonal vaccine is very unlikely to protect against it.

Pandemic influenza will be a different influenza virus from the viruses covered by the seasonal vaccine. Ministry of Health guidelines on getting ready for an influenza pandemic need to be followed as we are unsure when the next pandemic is going to arrive. It is important to be prepared, to have a personal/family plan, build up emergency supplies, and ensure good hygiene. For more information visit www.moh.govt.nz/pandemicinfluenza

Note: Many of the recommendations in these guidelines will also assist significantly in reducing the spread of seasonal influenza, particularly covering your mouth when coughing or sneezing, using disposable tissues, scrupulous hand washing and staying at home when sick

References:

1. Jennings L, Huang Q S, Baker M et al 2001. Influenza surveillance and immunisation in New Zealand, 1990-1999 New Zealand Public Health Report 8: 9-11
2. Fluvax® Prescribing Information
3. Vaxigrip® Prescribing Information

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