The latest evidence worldwide suggests the flu shot is if most effective for three to four months after the vaccine is administered, Dr Richard Gair says.
The latest evidence worldwide suggests the flu shot is if most effective for three to four months after the vaccine is administered, Dr Richard Gair says.

Jab or no jab for influenza is the big question for parents

THE Far North could be sniffling, coughing and aching its way into a record-breaking flu season, leading many parents to wonder whether children should be vaccinated against influenza.

Figures show that Tropical Public Health Services in Cairns has already received 731 notifications for influenza across Far North Queensland - more than four times the average for this time of year, for the previous five years.

Significantly, 30 per cent of notified flu cases this year to date have been for children aged 0-14 years, almost double the percentage in 2018.

There were 945 notifications of laboratory-confirmed influenza in residents of Far North Queensland in 2018, with 16 per cent for children aged 0-14 years.

In 2018, 58,824 cases of influenza were reported nationally, compared with nearly 250,000 cases in 2017.

The decrease in flu notifications last year coincided with a record 11 million Australians getting a flu shot in 2018 - nearly a third more than the previous year.

While adults are routinely reminded about the benefits of having the influenza vaccine, with some workplaces footing the cost for employees' annual jab, the figures raise the question of whether parents and carers should consider influenza vaccination for children.

Cairns Tropical Public Health director Dr Richard Gair suggests the flu shot for children would be particularly beneficial.

"Influenza is very infectious, it is spread via coughing and sneezing but it is also spread from touching objects that have been in contact with saliva or mucus from an infected individual/child.

"With this in mind children are often the spreaders of influenza infection in our community," he said.

"Healthy children can still become unwell and require hospitalisation from influenza."

Dr Gair said getting vaccinated every year was the best way to protect yourself against the flu.

"The latest evidence worldwide suggests that the flu shot is most effective for three to four months after the vaccine is administered," Dr Gair said.

 

Director of Tropical Public Health, Cairns Dr Richard Gair. Picture: Josh Woning.
Director of Tropical Public Health, Cairns Dr Richard Gair. Picture: Josh Woning.

 

"Influenza remains a common cause of hospitalisation and death in Australia.

"The influenza vaccine can prevent you from becoming unwell with influenza, reduce the risk of hospitalisations and GP visits.

"Flu viruses are constantly changing. The vaccines change each season to include circulating virus strains. That is why it is important to receive the influenza vaccine annually.

"The more people that are vaccinated in our community the less likely the spread of the influenza virus."

The reality is, people do die from influenza, mostly due to the patient developing pneumonia, a nasty side-effect of the original illness.

Dr Lachlan McIntosh of Thrive Medical Centre says people died from the horrendous influenza season two years ago

"In 2017 there were quite a few people who died as a consequence of influenza," he said. The common cause being "severe respiratory distress".

Dr McIntosh said in children those high risks presented as dehydration and febrile convulsions and those aged 6 months to less than 5 years were eligible for free flu shots.

He said older children with health conditions could also be eligible for the free vaccine.

"To protect yourself (through the influenza vaccine) helps protect you and others around you from having influenza spread," Dr McIntosh said.

"We've certainly been seeing a bit of a spike so far this year. We are seeing patients with the flu or flu-like symptoms. We don't test everyone but those we have been testing are positive for influenza A."

At what point does influenza become so serious that the hospital is necessary?

"The main thing we worry about is dehydration, if they are becoming quite dry around the mouth and there is less urine output," he said.

 

"Also if people are becoming short of breath and finding it quite hard to breathe."

Dr McIntosh said pale and mottled skin was an indicator to see a doctor.

"A lot of it is about supporting the body to look after itself," he said.

"Making sure the body recovers of its own accord."

That's where the basics, such as good hand hygiene, were so important, Dr McIntosh said.

But just what is influenza?

It is a virus, not a bacterial infection, which renders antibiotics useless against it.

Dr McIntosh said once a virus had taken hold, riding it out, while regularly taking pain killers was the only option.

"Each year the influenza vaccine is slightly different from the previous year," he said.

"Under the World Health Organisation guidance, they try to identify the four most likely strands and use specific markers for those strains."

Those four common culprits are influenza A, B, C and D, which can change characteristics and even mutate.

For instance, swine flu and bird flu were the result of animals contracting the disease, which mutated and then infected people. The result can be an even more potent form of the virus.

"Certainly I will get the flu shot myself," Dr McIntosh said.

"Absolutely I would be vaccinating my children If I had them. It is 30 seconds of pain for long-term health gain.

"I wouldn't want to put them at the risk of complications."

The big kick in the guts to the roaring start to the flu season is the fact the vaccine is not yet available.

According to Dr Gair, the government-funded influenza vaccine for people over 65, and for 5 to 64-year-olds will be available in early April.

 

The government-funded influenza vaccine will be available in early April.
The government-funded influenza vaccine will be available in early April.

 

"Pharmacies will obtain a private stock for private purchase usually a couple of weeks earlier," Dr Gair said.

Dr Gair also urged expectant mothers to get vaccinated.

"Pregnancy increases the risk of severe influenza," he said. "Vaccinating pregnant women helps protect the pregnant women from illness and hospitalisation and it has also been shown to protect the baby from influenza infection during the first few months after birth.

"Pregnant women and young babies are at an increased risk of developing serious complications from influenza."

Meanwhile, according to a recent article in the Cairns Post, already a record-breaking 25,000 Australians have been hit by the virus in the past four months.

The unusual summer outbreak has raised questions about whether we should shift to providing a second free flu jab each year, along with urgent calls for pregnant women to get vaccinated now.

Chief Medical Officer Professor Brendan Murphy said this year's flu vaccine, available from April, had protection against a new A strain (H3N2) and a new strain for the B Victoria linage in the vaccine.

Professor Van Buynder is worried that last year's mild flu season will mean people won't bother getting immunised this year.

"We need a message that says do not be complacent go out and get vaccinated," he said.

 

SIMPLE PRECAUTIONS

AS with all vaccinations, there is always the risk of side-effects associated with receiving the influenza vaccine.

Dr Richard Gair, director and public health physician at Tropical Public Health Services (Cairns), said the most common side-effects included pain and redness at the site of injection. "Influenza vaccine can cause some mild symptoms that may resemble a cold," he said.

However, he said influenza vaccines currently registered did not contain the live virus, so they could not cause the influenza virus.

All children and adults are recommended to wait 15 minutes after their vaccination before they leave the clinic.

Dr Gair said pain and redness at the injection site should ease quickly and did not usually require intervention. A cold compress may ease the symptoms.

He said any further symptoms should be followed up by your GP or the service that provided your vaccine.

 

VACCINATIONS

Who can get free vaccinations

A government-funded flu vaccine is available for eligible Queenslanders, including:

children aged 6 months to less than 5 years

pregnant women during any stage of pregnancy

persons 65 years of age or older

Aboriginal and/or Torres Strait Islander children aged 6 months to 5 years

Aboriginal and/or Torres Strait Islander people 15 years of age or older

persons 6 months of age or older who have certain medical conditions which increase the risk of influenza disease complications



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