The Beat January 2003

Q: So many people have been sick this year with serious colds and the flu. Why has this year been so bad? Do you have any special advice on prevention or cure?

The flu is caused by the influenza virus, which is subdivided into A, B and C based on kinds of viral surface antigens. While influenza C causes mild disease and does not matter in a clinical sense, influenza A and B can pose a potentially lethal threat to health.

Influenza virus has been known to undergo frequent antigenic changes as it infects animals (wild birds or pigs), which enables the virus to evade body defense mechanisms. Antibodies are able to recognize a pathogenic virus by its specific antigens and attack it; if a virus changes antigenic shapes, the antibody formed before against it, which would otherwise recognize it, will fail to recognize and attack the virus because of changed antigens. That is why protection rate of the flu vaccine is only partial (about 70%).

When such antigenic changes are abrupt and marked, a catastrophic worldwide epidemic (pandemic) like the epidemics seen in 1918, 1957, and 1968, could ensue, because almost everyone is vulnerable, for he or she has no antibody against it in the body. The type of virus responsible for the recent local outbreak has been identified to be influenza A/Panama (H3N2).

The flu is transmitted by airborne virus particles from cough and nasal discharges, and so is highly contagious. Virus particles come out of a patient from a day before the onset of symptoms until 3-7 days after he or she feels sick. Incubation period (the time elapsed after entry of the virus into the body until start of symptoms) is 1 to 4 days. Fever, headache, cough, runny nose and muscular ache, weakness and fatigue are common symptoms. In children, gastrointestinal symptoms like vomiting and diarrhea may occur.

The best and simplest way to avoid the flu is to get a flu shot. Due to antigenic changes, you should get it every year before the flu season (December through February) sets in, preferably from late September to mid-October, as four weeks are needed for the formation of adequate amounts of antibodies.

Complications include viral pneumonia, laryngitis, and infections of sinus or middle ear. Treatment is mainly symptomatic, that is, to alleviate or suppress symptoms like fever, headache, muscular ache and cough. Antivirals like Tamiflu (oseltamvir) or Relenza (zanamvir), inhalation discs or Rivavirin may give some help if taken within two days of the onset of symptoms. Patients are advised to take absolute rest and sufficient sleep. Water drinking (I think honey tea is a good drink) is also encouraged to prevent dehydration. Personal hygiene (hand washing and tooth brushing on coming home from outings) cannot be overemphasized.

Oriental medicine doctors regard viral infection as a set of bad factors (energy). They treat the flu by expelling bad factors and supplying Ki (energy) and nutrition (blood), using herbal medicines, acupuncture and moxibustion. I think western modern medicine handles acute symptoms better than oriental medicine. So when mild symptoms drag on, you may well visit an oriental medicine clinic. A tea made of fruit of an herb plant called omija (academic name: Schizandrae fructus) may be of some value in relief of flu symptoms. You can buy it at a nearby supermarket or department store or you can make for yourselves by putting about 12 g of the dried fruit into 500 cc of water and boiling to half (250cc) and drinking it several times a day.

For more details, I would readers like to refer to Influenza section of Center For Disease Control and Prevention website. http://www.cdc.gov/nip/flu/

Have a question for the doctor? Write to us at [email protected] with the heading “Ask the Doctor”.

Or visit Dr. Choi at Dr. Choi‘s Basquiat Clinic for Obesity and Skin Diseases near the Dongnae Lotte Department Store. Tel. 553-3800.