The 1918 Flu Pandemic: Why It Matters 100 Years Later

Group photo of Red Cross nurses in Boston wearing personal protective equipment.

100 years ago, an influenza (flu) pandemic swept the globe, infecting an estimated one-third of the world’s population and killing at least 50 million people. The pandemic’s death tollAmerican soldiers returning home on the Agamemnon, Hoboken, New Jersey was greater than the total number of military and civilian deaths from World War I, which was happening simultaneously.  At the time, scientists had not yet discovered flu viruses, but we know today that the 1918 pandemic was caused by an influenza A (H1N1) virus. The pandemic is commonly believed to have occurred in three waves. Unusual flu-like activity was first identified in U.S. military personnel during the spring of 1918. Flu spread rapidly in military barracks where men shared close quarters. The second wave occurred during the fall of 1918 and was the most severe. A third wave of illness occurred during the winter and spring of 1919.

Here are 5 things you should know about the 1918 pandemic and why it matters 100 years later.

1. The 1918 Flu Virus Spread Quickly

500 million people were estimated to have been infected by the 1918 H1N1 flu virus. At least 50 million people were killed around the world including an estimated 675,000 Americans. In fact, the 1918 pandemic actually caused the average life expectancy in the United States to drop by about 12 years for both men and women.Flu patients in Iowa

In 1918, many people got very sick, very quickly. In March of that year, outbreaks of flu-like illness were first detected in the United States. More than 100 soldiers at Camp Funston in Fort Riley Kansas became ill with flu. Within a week, the number of flu cases quintupled. There were reports of some people dying within 24 hours or less. 1918 flu illness often progressed to organ failure and pneumonia, with pneumonia the cause of death for most of those who died.  Young adults were hit hard. The average age of those who died during the pandemic was 28 years old.

2. No Prevention and No Treatment for the 1918 Pandemic Virus

In 1918, as scientists had not yet discovered flu viruses, there were no laboratory tests to detect, or characterize these viruses. There were no vaccines to help prevent flu infection, noPolicemen patrol the streets in masks in Seattle to ensure public safety. antiviral drugs to treat flu illness, and no antibiotics to treat secondary bacterial infections that can be associated with flu infections. Available tools to control the spread of flu were largely limited to non-pharmaceutical interventions (NPI’s) such as isolation, quarantine, good personal hygiene, use of disinfectants, and limits on public gatherings, which were used in many cities. The science behind these was very young, and applied inconsistently. City residents were advised to avoid crowds, and instructed to pay particular attention to personal hygiene. In some cities, dance halls were closed. Some streetcar conductors were ordered to keep the windows of their cars open in all but rainy weather. Some municipalities moved court cases outside. Many physicians and nurses were instructed to wear gauze masks when with flu patients.

3. Illness Overburdened the Health Care System

An estimated 195,000 Americans died during October alone. In the fall of 1918, the United States experienced a severe shortage of professional nurses during the flu pandemic because large numbers of them were deployed to military camps in the United States and abroad.A black-and-white advertisement for the Chicago School of Nursing. This shortage was made worse by the failure to use trained African American nurses. The Chicago chapter of the American Red Cross issued an urgent call for volunteers to help nurse the ill. Philadelphia was hit hard by the pandemic with more than 500 corpses awaiting burial, some for more than a week. Many parts of the U.S. had been drained of physicians and nurses due to calls for military service, so there was a shortage of medical personnel to meet the civilian demand for health care during the 1918 flu pandemic. In Massachusetts, for example, Governor McCall asked every able-bodied person across the state with medical training to offer their aid in fighting the outbreak.

As the numbers of sick rose, the Red Cross put out desperate calls for trained nurses as well as untrained volunteers to help at emergency centers. In October of 1918, Congress approved a $1 million budget for the U. S. Public Health Service to recruit 1,000 medical doctors and more than 700 registered nurses.

At one point in Chicago, physicians were reporting a staggering number of new cases, reaching as high as 1,200 people each day. This in turn intensified the shortage of doctors and nurses.  Additionally, hospitals in some areas were so overloaded with flu patients that schools, private homes and other buildings had to be converted into makeshift hospitals, some of which were staffed by medical students.

4. Major Advancements in Flu Prevention and Treatment since 1918

The science of influenza has come a long way in 100 years!A man dress in personal protective equipment in a laboratory. Developments since the 1918 pandemic include vaccines to help prevent flu, antiviral drugs to treat flu illness, antibiotics to treat secondary bacterial infections such as pneumonia, and a global influenza surveillance system with 114 World Health Organization member states that constantly monitors flu activity. There also is a much better understanding of non-pharmaceutical interventions–such as social distancing, respiratory and cough etiquette and hand hygiene–and how these measures help slow the spread of flu.

There is still much work to do to improve U.S. and global readiness for the next flu pandemic. More effective vaccines and antiviral drugs are needed in addition to better surveillance of influenza viruses in birds and pigs. CDC also is working to minimize the impact of future flu pandemics by supporting research that can enhance the use of community mitigation measures (i.e., temporarily closing schools, modifying, postponing, or canceling large public events, and creating physical distance between people in settings where they commonly come in contact with one another). These non-pharmaceutical interventions continue to be an integral component of efforts to control the spread of flu, and in the absence of flu vaccine, would be the first line of defense in a pandemic.

5. Risk of a Flu Pandemic is Ever-Present, but CDC is on the Frontlines Preparing to Protect Americans

Four pandemics have occurred in the past century: 1918, 1957, 1968, and 2009. The 1918 pandemic was the worst of them. But the threat of a future flu pandemic remains. A pandemic flu virus could emerge anywhere and spread globally.A crowd of people with the Washington Monument in the distance.

CDC works tirelessly to protect Americans and the global community from the threat of a future flu pandemic. CDC works with domestic and global public health and animal health partners to monitor human and animal influenza viruses. This helps CDC know what viruses are spreading, where they are spreading, and what kind of illnesses they are causing. CDC also develops and distributes tests and materials to support influenza testing at state, local, territorial, and international laboratories so they can detect and characterize influenza viruses.  In addition, CDC assists global and domestic experts in selecting candidate viruses to include in each year’s seasonal flu vaccine and guides prioritization of pandemic vaccine development. CDC routinely develops vaccine viruses used by manufacturers to make flu vaccines. CDC also supports state and local governments in preparing for the next flu pandemic, including planning and leading pandemic exercises across all levels of government. An effective response will diminish the potential for a repeat of the widespread devastation of the 1918 pandemic.

Visit CDC’s 1918 commemoration website for more information on the 1918 pandemic and CDC’s pandemic flu preparedness work.

6 Things You Need to Know About This Flu Season

Sick boy lying in bed having his temperature taken with a thermometer.

Seasonal flu activity has been intense this season.  As of February 16, 2018 most of the United States continues to experience intense and widespread flu activity, with record-breaking levels of influenza-like-illness and hospitalization rates recorded. While H3N2 viruses are still most common, there is an increasing number of influenza B viruses being detected. It’s not uncommon for second waves of B virus activity to occur during a flu season. It’s likely that flu activity will continue for several more weeks.

Here are some important things to know right now to protect yourself and your loved ones from flu:

1.  What are the symptoms of flu?

Flu viruses can cause mild to severe illness, and at times can lead to death. The flu is different from a cold. The flu usually comes onIf you have the emergency warning signs of flu sickness, you should go to the emergency room. These include: In children • Fast breathing or trouble breathing • Bluish skin color • Not drinking enough fluids • Not waking up or not interacting • Being so irritable that the child does not want to be held • Flu-like symptoms improve but then return with fever and worse cough • Fever with a rash; In addition to the signs above, get medical help right away for any infant who has any of these signs: • Being unable to eat • Has trouble breathing • Has no tears when crying • Significantly fewer wet diapers than normal; In adults • Difficulty breathing or shortness of breath • Pain or pressure in the chest or abdomen • Sudden dizziness • Confusion • Severe or persistent vomiting • Flu-like symptoms that improve but then return with fever and worse cough. suddenly. People who have the flu often feel some or all of these symptoms:

  • Fever* or feeling feverish/chills
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Muscle or body aches
  • Headaches
  • Fatigue (tiredness)
  • Some people may have vomiting and diarrhea, though this is more common in children than adults

* It’s important to note that not everyone with flu will have a fever.

2.  What do I do if I get sick?

Most people with the flu have mild illness and do not need medical care or antiviral drugs. If you get flu symptoms, in most cases you should stay home and avoid contact with other people, except to get medical care.

CDC recommends that antiviral drugs be used early to treat people who are very sick with the flu (for example, people who are in the hospital) and people who are sick with the flu and are at high risk of serious flu complications, either because of their age or because they have a high risk medical condition.

3. Is it too late to get a flu shot?

No!  As long as flu viruses are still circulating, it is not too late to get a flu shot.  Flu vaccination is the best way to prevent flu illness and serious flu complications, including those that can result in hospitalization. Unfortunately, flu vaccines don’t work as well against H3N2 viruses, which means that some people who got vaccinated will still get sick; however, there are some data to suggest that flu vaccination may make illness milder. Flu vaccines usually work better against H1N1 viruses, which is another good reason to get vaccinated, since H1N1 is circulating too.

4.  Why should I get a flu shot?

In addition to protecting yourself, getting vaccinated also protects people around you, including people who are more vulnerable to serious flu illness, like babies and young children, older people, pregnant women and people with certain chronic health conditions.

5.  Does the flu shot work?

Vaccine effectiveness data for this season are not available yet, but we know that flu vaccines do not work as well against H3N2 viruses, which are predominant so far this season.

6.  What else can I do to protect myself from flu?

Definitely try to avoid close contact with sick people.  If you do get sick, limit contact with others as much as possible to keep from infecting them. Stay home for at least 24 hours after your fever is gone without the use of fever-reducing drugs (unless you need medical care or other necessities).

Other tips for stopping the spread of germs:

  • Make sure you cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
  • Wash your hands often with soap and water.
  • Avoid touching your eyes, nose, and mouth. Germs spread this way!
  • Clean and disinfect surfaces and objects that may be contaminated with germs like the flu.

Everyone can be a flu vaccine advocate!

Little girl getting a bandaid.
Children, especially those younger than 5 years, are at higher risk for serious flu-related complications. The flu vaccine offers the best defense against getting the flu and spreading it to others.

With the holidays quickly approaching, there will be more opportunities to spend time with family and friends.  Now is the time to ensure that you and those around you are protected from flu. Now is the time to get your seasonal flu vaccine if you haven’t already gotten it. It takes about two weeks after vaccination for antibodies that protect against flu to develop in the body.—so it’s  important to get vaccinated now, before the flu begins circulating in your community.

Whether you are a doctor, school nurse, grandchild, best friend, or coworker, you can play a role in reminding and encouraging  other people to get their flu vaccine. Get your flu shot and talk to others about the importance of everyone 6 months and older getting a flu shot every year.

Talking to Friends and Family about Flu ShotsGet yourself and your family vaccinated.

Need some tips for talking about the importance of flu vaccine? CDC is a great source of information about the serious risk of flu illness and the benefits of flu vaccination, as well as information to correct myths about the flu vaccine. Below are several examples of the benefits of flu shots and corrections of common flu myths. Find out more about the benefits of getting your annual flu vaccine on CDC’s Vaccine Benefits webpage, here.

  • Flu can be a serious illness, even for otherwise healthy children and adults. While most people will recover from flu without complications, anyone can experience severe illness, hospitalization, or death. Therefore, getting vaccinated is a safer choice than risking serious illness for yourself or those around you.
  • The flu vaccine CANNOT give you the flu. Flu shots do NOT contain flu viruses that could infect you and cause flu illness. Flu shots either contain flu vaccines viruses that have been “inactivated” (or killed) and therefore are not infectious, or they do not contain any flu vaccine viruses at all (recombinant influenza vaccine).
  • Flu vaccination can keep you from getting sick with flu. Flu vaccines can reduce your risk of illness, hospitalization.
  • Getting vaccinated yourself may also help protect people around you, including those who are more vulnerable to serious flu illness, like babies and children, older people, and people with certain chronic health conditions.

Making a Flu Vaccine Recommendation to Your Patients

Woman talking to her doctor
Talking to patients about vaccines can be difficult. CDC has resources to help you make a strong flu vaccine recommendation.

For health care providers, CDC suggests using the SHARE method to make a strong vaccine recommendation and to provide important information to help patients make informed decisions about vaccinations. Remind patients that it is not too late for them to get vaccinated, and follow the SHARE strategies below:

  • S- SHARE the reasons why the influenza vaccine is right for the patient given his or her age, health status, lifestyle, occupation, or other risk factors.
  • H- HIGHLIGHT positive experiences with influenza vaccines (personal or in your practice), as appropriate, to reinforce the benefits and strengthen confidence in flu vaccination.
  • A- ADDRESS patient questions and any concerns about the influenza vaccine, including side effects, safety, and vaccine effectiveness in plain and understandable language.
  • R- REMIND patients that influenza vaccines protect them and their loves ones from serious flu illness and flu-related complications.
  • E- EXPLAIN the potential costs of getting the flu, including serious health effects, time lost (such as missing work or family obligations), and financial costs.

Be an advocate for flu vaccination. Get your flu vaccine and remind those around you to do the same! Visit www.cdc.gov/flu for more information and tips on flu vaccination and prevention.

Interested in learning more about flu? Check out other CDC Flu Blog-a-thon post throughout the week for personal stories, advice, and tips on flu and flu prevention. You can see all the participating blogs here: https://www.cdc.gov/flu/toolkit/blog-a-thon.htm.

Public health labs aren’t just on the frontlines of vaccine-preventable outbreaks. They’re often the only line.

Public health labs aren’t just on the frontlines of vaccine-preventable outbreaks. They’re often the only line. | www.APHLblog.org

by Kim Krisberg

In the U.S., rates of vaccine-preventable diseases are so low that many commercial labs don’t even have the ability to test for them anymore. The shift reflects the hard work of decades-long immunization efforts. But it also means that when there is a vaccine-preventable outbreak, just about all of our rapid diagnostic capacity resides in one place: the public health lab.

The latest example of this is in Minnesota, where a measles outbreak hit 78 confirmed cases as of June 16. The state is typically home to less than a handful of measles cases each year — most years, the case count is between zero and two. At the Minnesota Department of Health’s Public Health Laboratory, which is the only lab in the state that can do real-time reverse-transcription polymerase chain reaction (rRT-PCR) testing for measles, staff have received more than 800 specimens for measles testing since April, with a goal of fully processing each one the same day it’s received. To stop an outbreak, both speed and accuracy are critical.

Fortunately, Minnesota lab workers are trained and ready to provide both. But sustaining that kind of surge capacity over the long run and in the face of new and emerging disease threats is always challenging — even in the best funding environments.

“We’ve spent a lot of time increasing our capacity over the last 10 years and we’re seeing that capacity being put to work,” said Sara Vetter, PhD, manager for infectious diseases at the Minnesota Public Health Laboratory. Vetter noted that Minnesota last experienced a measles outbreak in 2011 — “and that one seemed huge and it was just 26 cases of measles.”

This year’s measles outbreak is almost entirely concentrated in a Somali community in Minnesota’s Hennepin County, home to more than 1 million residents. The outbreak officially began on April 10, the same day the lab confirmed the first positive case. Nearly all the cases are among unvaccinated children younger than 4 years old. No deaths have occurred, though about a quarter of infections have led to hospitalization.

Inside the public health lab’s Virology/Immunology Unit, technicians track the measles outbreak using a rRT-PCR test, which allows them to detect the highly contagious virus much quicker than private labs that can perform serological testing for measles antibodies. That quickness is key, said Anna Strain, PhD, supervisor of the Virology/Immunology Unit, because it means the health agency’s epidemiology team can then quickly locate people who may have been infected and get ahead of the outbreak before it spreads.

The rRT-PCR test may be quicker than serological testing — it detects measles RNA, as opposed to measles antibodies, and is less confounding than serology — but it’s not completely definitive, Strain said. After conducting rRT-PCR testing on each of the more than 800 specimens that come into the lab, any positive specimens undergo genotyping to determine if the patient is infected with a wild-type measles strain or if the rRT-PCR is simply picking up on the live attenuated virus that’s contained in the measles-mumps-rubella vaccine. Genotyping can also determine if the case is related to the larger outbreak. (On a side note: In addition to its regular testing responsibilities, the Minnesota Public Health Lab is partnering with the Centers for Disease Control and Prevention and Canadian public health officials to develop a PCR test that’s specific to the vaccine strain of measles. Such an test would be particularly helpful in an outbreak, Strain said, because technicians could then forgo the extra step of genotyping.)

“It’s actually meant quite a lot of maneuvering,” Strain said, referring to the logistics of responding to the surge in measles testing. “In some ways, we were lucky that it happened in April when flu season was dying down — otherwise a number of testing staff trained for measles testing would have also been doing flu testing. If the (measles outbreak) had happened any sooner, it would have been really hard to keep up.”

From start to finish, the measles test takes about five hours, Strain said. Lab staff can process 10 measles specimens at a time and up to 30 specimens in day — though that’s a stretch, she noted. In comparison, the lab can process up to 150 flu samples in day and often does.

“As hard as it’s been in the lab, it’s been even harder for our epidemiologists — they’ve had more than 7,000 contacts to trace and to follow up on,” said Joanne Bartkus, PhD, director of the Minnesota Public Health Laboratory. “It’s been daunting for all of us.”

Vetter said that most of the lab’s current surge and response capacity is thanks to federal public health preparedness funding as well as funding from CDC’s Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) Program, both of which currently sit on the budgetary chopping block. On preparedness, President Trump’s fiscal year 2018 budget proposal calls for cutting CDC’s emergency preparedness budget by $136 million — that’s on top of years of preparedness cuts public health agencies have already absorbed. (In total, Trump’s budget calls for cutting CDC’s budget by $1.2 billion, or a whopping 17 percent.) The ELC, on the other hand, is wholly entwined with the Affordable Care Act’s Prevention and Public Health Fund, which allocates $40 million in annual ELC funds to state and local health departments in every state. Under current ACA repeal-and-replace bills in Congress, the Prevention and Public Health Fund would disappear.

And while ELC and preparedness monies don’t categorically support the Minnesota lab’s vaccine-preventable disease work, Vetter said the funds have been essential in ensuring the lab can quickly scale up its response, regardless of whether the emergency is vaccine-preventable or not. In other words, the Minnesota lab has spent years building an all-hazards response system that readies it to face any health threat that lands at its doorstep. Being able to sustain that nimbleness, however, would be at risk if funding declined.

“Without that funding, we’d probably have to choose what we respond to because we’d run out of people and out of machines — we just couldn’t keep up,” Vetter said. “If our funding gets cut, we can’t maintain our machines, we can’t replace machines, we can’t train more people … what we do is very complex.”

At the same time the Minnesota Virology/Immunology Unit has been responding to the measles outbreak, it’s also been responding to a mumps outbreak on the University of Minnesota-Twin Cities campus, providing surge testing for a mumps outbreak in Washington state that recently hit nearly 900 cases, and taking in and testing about 20 specimens a week for Zika virus. All of that is in addition to its more regular duties, like rabies and West Nile monitoring.

In the wake of the measles outbreak, Minnesota Health Commissioner Edward Ehlinger, MD, MSPH, called on state policymakers to create and support a public health response contingency fund. Such a bill was introduced into the Minnesota House of Representatives for consideration in May.

“Our commissioner always says that data are the coins of public health,” Bartkus said. “And it’s the public health lab that creates that data.”

As of late May, Strain said the Minnesota measles outbreak — which exceeded total U.S. cases for all of 2016 — seemed to be entering a “tapering phase.” As she said that, however, she paused — and quickly added “we all just knocked on wood.”

 

For more on the Minnesota measles outbreak, visit www.health.state.mn.us/divs/idepc/diseases/measles.

 

 

 

The post Public health labs aren’t just on the frontlines of vaccine-preventable outbreaks. They’re often the only line. appeared first on APHL Lab Blog.

How CDC Is Using Advanced Molecular Detection Technology To Better Fight Flu!

Lab worker

Flu (influenza) is a serious disease caused by influenza viruses. Flu viruses change constantly. They are among the fastest mutating viruses known. These changes can impact how well the flu vaccine works, or can also result in the emergence of new influenza viruses against which people have no preexisting immunity, triggering a pandemic. Year round, scientists from CDC, World Health Organization (WHO), and other partners monitor the influenza viruses that are infecting people. These scientists study the viruses in the laboratory to see how they are changing.

CDC is using next-generation gene sequencing tools to analyze flu viruses as part of CDC’s Advanced Molecular Detection (AMD) initiative. The technology allows CDC to study more influenza viruses faster and in more detail than ever before. AMD technology uses genomic sequencing, high-performance computing, and epidemiology to study pathogens and improve disease detection. CDC is using this Next Generation-Sequencing (NGS) technology to monitor genetic changes in influenza viruses in order to better understand and improve the effectiveness of influenza vaccines.

To share more information about this revolutionary NGS technology and its impactful work, CDC expert John Barnes, PhD, Team Lead of the Influenza Genomics Team within the Virology, Surveillance, and Diagnosis Branch within CDC’s Influenza Division took part in a Reddit Ask Me Anything digital Q & A, to answer the public’s question on AMD technology and how these tools are helping to improve influenza virus monitoring and the development of better-performing influenza vaccines. This post includes some highlights from that discussion.

Question 1: What exactly does the AMD technology platform do that is different from the current approaches used to guide vaccine development? And what are the most common reasons that we “guess wrong” in terms of which viral strains will be responsible for the next season’s flu?

Dr Barnes after Reddit Ask Me Anything Q&ADr. Barnes: One example of how AMD technology is used in vaccine development is to address mutations that may occur in vaccine viruses during growth in eggs used in the production of vaccine viruses. These mutations can change the vaccine virus so much that the immune response to vaccination may not protect as well against circulating viruses. This means that vaccinated people may still get sick. CDC is using AMD technology to try to solve this problem. Scientists are looking at the genetic sequences of 10 generations of H3N2 flu viruses as they grow and evolve in eggs. CDC will test all of the viruses to find out what genetic changes cause a good immune response and good growth in eggs. Once the “good” genetic changes are identified, CDC will then synthesize H3N2 viruses with those properties that can be used to make vaccine that offers better protection against H3N2 flu infection. One of the main reasons that the virus is challenging, is due to its’ RNA polymerase. The polymerase of influenza is very mistake prone and causes the virus to mutate rapidly. For example, in some years certain influenza viruses may not appear and spread until later in the influenza season, making it difficult to prepare a candidate vaccine virus in time for vaccine production. This can make vaccine virus selection very challenging. We are currently using AMD techniques to sequence all clinical specimens that come into the CDC to improve our ability to find and track mutations that may be of concern.

Question 2: Why are chicken embryos typically the go-to for flu vaccine cultivation?

Dr. Barnes: Thanks for this question – it’s one we get a lot!  Flu vaccines have been made using an egg-based manufacturing process for more than 70 years. In the past, when making a vaccine for production manufacturers utilized eggs as a safe host to make the vaccine and to provide high yield.  As birds are the natural reservoir host for flu, influenza typically grows well in eggs and maintains a safe distance between species you’re using to make the vaccine and the target.  Mammalian cell lines were subjected to extensive safety testing to establish a cell line that is human pathogens free, while maintaining sufficient vaccine yield. You can learn more about how AMD technology is improving the development of flu vaccines made using egg-based technology, here.

Question 3: What about the flu virus causes it to mutate so quickly from year to year requiring a new vaccine every season? For example with chickenpox there is one virus and one vaccine, why then with the flu are there countless strains and a new vaccine every year?

Dr. Barnes: As you know, influenza is a virus and can only replicate in living cells. Influenza viruses survive by infecting host cells, multiplying, and then exiting host cells. The enzyme influenza uses to copy itself is very error prone which causes the virus to rapidly mutate. Each host has its own defense mechanisms and these defenses are collectively referred to as environmental pressures. It’s difficult to predict how a virus will mutate when attempting to get around a host’s immune defenses, but the changes can happen rapidly, as you said.

Because flu viruses are constantly changing, the formulation of the flu vaccine is reviewed each year and sometimes updated to keep up with changing flu viruses. More information about how influenza viruses can change is available here.

Question 4: Do you have any insight on the universal vaccine that was developed?

Dr. Barnes: Great question! Yes, I can provide some insight. A longer-term goal for seasonal flu vaccines is the development of a single vaccine, or universal vaccine, that provides safe, effective, and long-lasting immunity against a broad spectrum of different flu viruses (both seasonal and novel). Right now, CDC is a part of an inter-agency partnership coordinated by the Biomedical Advanced Research and Development Authority (or BARDA) that supports the advanced development of new and better flu vaccines. These efforts have already yielded important successes (i.e. a high dose flu vaccine specifically for people 65 years and older that creates a stronger antibody response), but a part of this effort is the eventual development of a universal vaccine. A number of government agencies and private companies have already begun work to advance this type of vaccine development, but, as you can imagine, this task poses an enormous scientific and programmatic challenge.    

Question 5: How would you convince someone who is staunchly against flu vaccines that they’re a good thing?

 Dr. Barnes: Help address misconceptions about the flu. Remind people that a flu shot cannot cause flu illness. They should understand that anyone can get the flu, and each year, thousands of people in the United States die from flu, and many more are hospitalized.  It’s important to stress that the flu vaccine can keep people from getting flu, make flu illness less severe if they do get it, AND keep them from spreading flu to their family and other people that could be at high risk of severe flu complications.

Interested in learning more? Check out Dr. Barnes’ full Reddit AMA here.

John Barnes, Ph.D., is Team Lead of the Influenza Genomics Team (IGT) at the Virology, Surveillance, and Diagnosis Branch of the CDC’s Influenza Division. He earned his Ph.D. degree in Biochemistry and Molecular Biology from University of Georgia in Athens, Georgia. Dr. Barnes began his career at CDC in the Influenza Division in 2007 after working at a postdoctoral fellow at the Emory University Department of Human Genomics. His current work includes managing a staff of nine to serve the sequencing and genetic analysis needs of the Influenza Division. Current numbers of viruses sequenced by the IGT make CDC’s Influenza Division the largest contributor of influenza sequence data among the WHO Influenza Collaborating Centers.

My Daughter Died From a Vaccine Preventable Disease

Scarlet Anne Taylor with her mother Rebecca Hendricks.

Scarlet Anne Taylor was only 5 when she became sick with the flu and was sent home from school in December 2014. Two days later, Scarlet was admitted to the hospital because she was having trouble breathing.  Once admitted, her condition only seemed to worsen. Four hours after bringing her daughter to the hospital, her mother, Rebecca Hendricks, learned that she had died of complications from flu. “My daughter died from a vaccine preventable disease,” Rebecca recounts.

At that time, Rebecca did not realize that children younger than 5 years old who are otherwise healthy are at high risk of serious flu-related complications simply because of their age. In addition, children 2 years old and up to their 5th birthday are more likely than healthy, older children to be taken to a doctor, an urgent care center, or the emergency room because of flu.

Turning tragedy into actionInfluenza (flu) is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness. Serious outcomes of flu infection can result in hospitalization or death. People of every age, including those in good health, are at risk of flu. The best way to protect yourself and your family this flu season is by getting a flu vaccine.

Since her daughter’s death, Rebecca now understand the risks of flu and the benefits of a flu vaccine.  She has taken her daughter’s story and used it to educate the people around her, especially families. “Before, I thought everyone got over the flu,” says Rebecca. “I chose not to vaccinate my family simply because I didn’t know the facts. Our family now gets vaccinated against flu every year. We are educated about what flu is, what the symptoms are, and how each one of us plays an important role in our community in stopping the spread of flu.”

Rebecca started Fight the Flu Foundation in 2015, hoping that she could save the lives of others from flu by sharing her story and spreading awareness about the dangers of flu.

Fight the Flu Foundation’s mission is to “fight the flu, and win.” The foundation aims to educate families and communities around the nation about flu, as well as make flu vaccination a yearly practice for those who may not regularly vaccinate their families.

Spreading the word

Rebecca Hendricks getting her flu shot.At first, Rebecca took to Facebook and shared her new foundation’s page with her friends and family. Before long, other families across the United States heard about the foundation’s mission and began reaching out to Rebecca to share similar stories about their family’s own loss from flu. The foundation gained a small following online and served as an avenue for those who have lost a child or loved one to the flu. Educating families about the importance of flu vaccination online and in local communities, the foundation hopes tragic flu stories will speak to others, and help families realize that their young children can also be at risk for flu.
Since it started, Rebecca has taken her foundation’s work into local communities. As her foundation grows, so do her goals. Rebecca wants to ensure that everyone has access to a flu vaccine by providing flu vaccinations to underserved populations. In August 2016, Fight the Flu Foundation hosted its first awareness and fundraising drive in Tacoma, Washington, bringing flu awareness to families in need. It was the foundation’s first successful event, with 25 different community vendors supporting the cause.

Though her foundation is still growing, Rebecca’s most valued achievement thus far is “the letters we receive from people who have been impacted by Fight the Flu Foundation’s stories,” she said. She receives letters from mothers and families regularly thanking her for the work that she’s doing. “It’s receiving those highlights that remind me that I’m doing exactly what I set out to do. Fight the flu.”

National Influenza Vaccination Week

For National Influenza Vaccination Week (NIVW), CDC reminds everything that it is not too late to get a flu vaccine.  For those at high risk of developing serious flu-related complications, the flu vaccine is even more important.  Rebecca Hendricks’s daughter was a healthy, lively 5-year-old when she caught the flu. CDC recommends everyone 6 months of age and older get a flu vaccine every season.  This holiday season, make sure your loved ones get a flu vaccine, and make sure to get one yourself to protect your loved ones who are at high-risk for the flu.

For more information, visit People at High Risk of Developing Flu-Related Complications and Get Vaccinated.

Join the Blog-A-Thon!CDC Flu Blog-A-Thon

During NIVW, CDC is encouraging partners to post blogs on the importance of flu vaccination.  Look for other participating blogs throughout this week and share your own post on social media using the hashtags #NIVW. For those want to take part in the Blog-a-thon, an NIVW Badge is available to include with your post to show your participation. Help us spread the word that it is not too late to get a flu vaccine this season.

Check out HealthinAging.org’s Blog-a-thon post today, December, 5 and Verywell.com’s Cold and Flu section for their Blog-A-Thon post tomorrow, December 6. For more information about the Blog-a-thon, contact FluInbox@cdc.gov.

Protect Your Child this Flu Season: Get a Flu Shot!

Brave patient is a good patient

As fall approaches, cold weather isn’t the only thing you and your family need to prepare for. Flu season is on its way, and it will be here before you know it. Now is the time to make sure that you and your family are protected from flu by getting your flu vaccine by the end of October, if possible.

 The Best Way to Protect Your Family

Even healthy children can get the flu. Did you know that children, especially school-aged children or children in day care, are more likely to get sick from flu? Your child is likely to be exposed to flu in a classroom or daycare setting, and millions of children get sick with flu every season. It’s important to make sure that your child is protected this flu season, and the first and most important step in protecting you and your family from flu is by getting everyone an annual flu vaccine.

Nasal Spray Flu Vaccine is Not Recommended This Season

Young mother kissing her toddler sonFlu shots can sometimes be difficult, scary, and uncomfortable for kids (and parents). For several years, some parents have opted to get their children the nasal spray flu vaccine, commonly known as FluMist®, to avoid another shot for their kids. Doctors and scientists also appreciated having the nasal spray flu vaccine as an option that might help encourage needle-averse people to get vaccinated. Studies done soon after the nasal spray flu vaccine was approved showed it was performing as well as (and sometimes better than) flu shots.

Unfortunately, recently there have been problems with how well that vaccine has worked. The reason for this is not known, but experts are looking into the situation with the hopes that nasal spray flu vaccine might again be an option for kids and parents. In the meantime, CDC and the American Academy of Pediatrics (AAP) recommend flu shots this flu season, not the nasal spray flu vaccine. Flu shots work and can keep your child from getting sick!

As you are planning to get your family vaccinated this fall, remember that some children 6 months through 8 years of age require two doses of flu vaccine. If your child is 6 months through 8 years and is getting vaccinated for the first time, or has only previously gotten one dose of vaccine, then they should get two doses of vaccine this season. The two doses need to be given at least four weeks apart.  For children who will need two doses of flu vaccine, the first dose should be given as early in the season as possible to allow time for the second vaccine to kick in before flu starts to spread in your community.

For other children, it is good practice to get them vaccinated by the end of October; however, getting vaccinated later can still be protective as long as flu viruses are circulating. Ask your child’s doctor or other health care professional if your child needs two doses of flu vaccine.

Visit Children, the Flu, and the Flu Vaccine for more flu and flu vaccine information specific to children.

Flu Can Be Dangerous for Some Children

The flu may be more serious than the common cold for children. Flu symptoms can be severe and flu illness can lead to serious complications that require hospitalization.

Some children are at especially high risk of serious flu-related complications:Close up of baby looking at camera with blue eyes

  • Children younger than 6 months old are too young to be vaccinated. The best way to protect them is to make sure you and others around them are vaccinated.
  • Children aged 6 months up to their 5th birthday, even those that are healthy, are at risk simply because of their age.
  • In some studies, American Indians and Alaskan Natives are more likely to have severe flu illness that may result in hospitalization or death.
  • Children aged 6 months through 18 years with certain chronic health problems, such as asthma, diabetes, or neurological and neurodevelopmental conditions.

It’s important to make sure young children and children with certain chronic health problems are vaccinated against flu, as well as any family members and caregivers in contact with your family.

Vaccinate the Whole Family

CDC recommends that everyone 6 months of age and older get a seasonal flu vaccine. You and your family should be vaccinated every year for the best protection against flu. Many children get sick from flu every flu season, and some of those illnesses result in death. Every year in the United States, an average of 20,000 children younger than 5 years old are hospitalized due to flu complications. Flu vaccination can reduce flu illness, doctors’ visits, and missed work and school due to flu, as well as prevent flu-related hospitalizations for you and your family.

Flu vaccines are offered in many locations, including doctor’s offices, clinics, health departments, pharmacies, and college health centers, by many employers, and even some schools. You may not have to see your doctor to get your child a flu shot! There are plenty of locations available that provide vaccinations. The Vaccine Locator is a useful tool for finding areas in your community offering flu vaccine.

More information for parents is available at: http://www.cdc.gov/flu/parents/index.htm.

Spring Adventures: 6 Apps for Healthier Travels

Map with camera, compass, plane and journal

It’s that time of the year again! Students and parents are packing their bags for Spring Break! Before you set out on your next big adventure, be sure to take a look at these helpful mobile apps to prepare for your trip.

TravWellTravWell app

CDC’s TravWell app helps you plan for safe and healthy international travel. This app allows you to get vaccine recommendations for specific destinations, a checklist of tasks to prepare for travel, and a customizable, healthy packing list. You can also use this app to keep your medication and immunization records and set reminders to take medicines or get vaccine booster doses while you’re traveling. This would be especially important for someone taking medicines like malaria prophylactics (drugs to prevent malaria). TravWell also lets you take pictures of important documents (passport, visa, etc.) and store them on the app as a backup in case they get lost. This app also has up-to-date recommendations from CDC for international travelers. Another great bonus is that many features are available offline, so you don’t need a data connection to access information. The app also includes local emergency service phone numbers for each country.

Can I Eat This?

Can I Eat This? appThe dreaded Montezuma’s revenge, Delhi belly, or travelers’ diarrhea—whatever you call it, can really zap the fun out of international travel. Download CDC’s Can I Eat This? app to help keep your stomach steady. First, select the country you’re in and the app will ask you a few questions about what you’re preparing to eat or drink (e.g. Does the water have ice in it? Is the meal from a street vendor?). The app will tell you whether it’s likely to be safe to eat. With this app in your corner, you can be more confident about making healthy choices abroad so you won’t spend your international trip in the bathroom. Another advantage of this app is that a data connection is not needed for access.

Yellow Book app2016 Yellow Book

We’re not talking about that old phone book! CDC Health Information for International Travel (commonly called the Yellow Book) is published every two years by CDC as a reference for health professionals. However, you may find it to be a useful reference to make sure you’re following CDC recommendations for immunizations. This app is a good resource if you are planning to meet with your healthcare provider before traveling internationally. It also has advice on how to monitor yourself for illnesses after returning from international travel, which is especially important if there is a current disease outbreak where you are traveling. The app has a simple display, is easy to understand, and includes maps for several countries.

FEMA App

FEMAYou don’t need to leave the continent to practice personal preparedness! The FEMA app is a great resource for preparedness alerts and safety tips while traveling within the U.S. Not only does the app allow you to set up alerts from the National Weather Service, but it also provides FEMA safety tips on how to stay safe in over 20 types of emergency situations. When you are traveling in an unfamiliar area, it’s also important to be aware of local disaster resources. The FEMA App provides driving directions to local shelters and other disaster recovery centers. The app is also available in Spanish.

Safe Traveler appSmart Traveler

Stay safe and be smart while traveling abroad. The Smart Traveler app, developed by the State Department, gives you easy access to official country information, including maps and U.S. embassy locations. Get travel alerts and warnings all in one place and create personal itineraries and organize your trips. The app also allows you to enroll in the Smart Traveler Enrollment Program (STEP) for free. This program helps the State Department assist you in an emergency, including natural disasters. It can also help your family and friends get in contact with you if there is an emergency.

First Aid

First Aid appThis American Red Cross First Aid app gives you expert first aid advice for your day-to-day emergencies. The app provides step-by-step instructions for first aid situations you might encounter in your day to day life. You can also get safety and preparedness tips for a variety of emergencies, including winter weather, hurricanes and tornados. No internet access is required and the content is available in Spanish.

For more information on making international travel plans, visit CDC’s Traveler Health page. Happy trails!

Science for the People: Mandatory Vaccination

sftpThis week, we’re talking about disease prevention, public health, and whether or not some types of vaccinations should be mandatory. We’ll spend the hour in a panel discussion with Barry Bloom, Harvard University’s Distinguished Service Professor of the Department of Immunology and Infectious Diseases, University of Toronto public health ethicist Alison Thompson, pediatrician and University of Pennsylvania vaccinology professor Paul Offit, and Nicholas Little, Vice President and General Counsel at the Center for Inquiry.


Filed under: This Mortal Coil Tagged: Alison Thompson, Barry Bloom, Disease, ethics, Harvard University, law, medicine, Nicholas Little, Paul Offit, Podcast, public health, science for the people, University of Pennsylvania, University of Toronto, Vaccination

Trump and GOP candidate docs debate science! Should vaccine schedule be slowed?

GOP CANDIDATES DEBATE EARLY VACCINATION Oh, goody. Donald Trump again, this time at Wednesday night’s debate among the legions of Republican Presidential candidates, repeating his long-standing declaration that childhood vaccination causes autism. A claim that–need I even say it?– has … Continue reading »

The post Trump and GOP candidate docs debate science! Should vaccine schedule be slowed? appeared first on PLOS Blogs Network.