• People aged 65 years or over.
• People who have a chronic health condition eg asthma, diabetes, a heart of lung condition.
• Women who are pregnant.

$30.00 is the fee for a non-subsidised flu vaccine and no appointment is necessary.

Influenza can be a serious illness

Influenza, commonly called the flu, can be a serious illness that is sometimes fatal. Infection with the influenza virus may lead to a stay in hospital, for any age group, but particularly if you are elderly or have an ongoing medical condition. 

Even if you do not end up in hospital, influenza can keep you in bed for a week or mor, preventing you from doing work, sport or just about anything that requires leaving the house.

Influenza virus is different from a cold virus. A cold virus only affects the nose, throat and the upper chest and lasts for a few days

Influenza spreads very easily and up to 1 in 5 people still get influenza every year.

By immunising against influenza you can protect yourself and decrease the chance of bringing it home to a baby, older relative, or someone with a medical condition who could develop serious complications from influenza.

Influenza 2012 Annual influenza immunisation is recommended to get optimum protection against the likely circulating strains in 2012 and these strains usually change every year. We are, however, in an unusual situation in 2012 because the virus strains covered by the vaccine are the same as in 2010 and 2011.

People should still be vaccinated this year because the immunity offered by current vaccines lessens over time. A further vaccination is, therefore, likely to offer better protection for the 2012 season.

Common questions people have about Flu Vaccination…

Q. If I receive a flu vaccination, how long does the protection last?

Immunity to the strains in a flu vaccine wanes within 6 – 12 months following vaccination, so it is important that annual vaccinations be administered 

Q. How long does it take for the flu vaccine to work in my body?

The vaccine takes approximately 10 – 14 days to provide protection after vaccination. It is therefore recommended that the flu vaccine be given March – April, before the influenza transmission season begins. If you are exposed to a flu virus shortly before, or within 14 days of being vaccinated, you may still catch the flu.

Q. Does flu vaccination work?

The flu vaccine does work. It is up to 90% effective in healthy adults. Influenza vaccination reduces hospitalisation and deaths by 20% to 50%.

Q. Will having the seasonal flu vaccine protect me from getting “swine flu”.

The 2012 vaccine contains an A/California/7/2009 (H1N1) – like virus strain that covers pandemic (H1N1) 2009 “swine flu” virus.

Q. What strains does this year’s flu vaccine protect me from?

The antigen composition and strains for the approaching influenza season are determined by the World Health Organisation (WHO) and the Commission of the European Community.

Q. Why should I have a flu vaccination every year?

Immunity to the strains in a flu vaccine wanes within 6 – 12 months following vaccination. The changing nature of the influenza virus means that new strains are constantly appearing. In most years, a new flu vaccine is developed to protect against the predominant flu strains predicted by the World Health Organisation (WHO) to circulate in that particular year. WHO devotes significant resources to maintaining global surveillance on dominant flu strains each year in the Northern and Southern hemispheres.

Q. Can you get influenza (“the flu”) from having the vaccine?

NO. Flu vaccines do not contain the whole virus – only the part of the virus that triggers your body to produce antibodies.

Q. Will receiving a flu vaccination protect me against the common cold?

NO. By vaccinating against the flu, you are providing protection against a serious viral illness. Flu vaccination does not protect you against the common cold. A flu vaccination will only provide protection against the strains of influenza virus present in the vaccine.

Q. Will an anti-viral prevent me developing influenza?

NO. Antivirals will only help relieve symptoms but not prevent infection from the influenza virus.The best protection is still flu vaccination.

Q. Are there any side effects?

Pain, swelling, redness, and / or, tenderness around the injection site are the most frequent side effects, but, in general, occur in only a small number of patients. The majority of side effects disappear within 1-2 days.

Q. Can anyone have a flu vaccination?

NO. People who are known to be allergic to egg protein (including chicken meat, chicken feathers & eggs) should not have the flu vaccine as trace amounts of egg protein may remain in the flu vaccine. If you have a temperature before vaccination, or have had a previous reaction to any vaccination, please discuss this with the vaccinator.

Q. I am (or could be) pregnant. Can I have the flu vaccine?

YES. There is no evidence that influenza vaccine prepared from inactivated virus causes damage to the foetus. The seasonal flu vaccine is strongly recommended for women who will be pregnant during the flu season).  

Q. I don’t need a flu vaccination – I’m too healthy.

Healthy individuals are still at risk of influenza and may have symptoms for up to 10 days. On average, people with the flu will miss 3-5 work days.

Q. Last year there wasn’t much flu about. Won’t this year be the same?

The strains of influenza virus that reachNew Zealandeach year are usually different from the season before. AlthoughNew Zealandhad a relatively mild influenza season in 2011, this may not be the case in 2012. The virulence of strains can vary from year to year or a new strain can emerge to which people are not immune.

Q. Why do I need immunisation every year?

Annual immunisation is recommended for two reasons: first, because protection lessens over time; and second, because each year influenza can be caused by different influenza viruses, that are not represented in the previous year’s vaccine.

Q. Can’t I build up a natural immunity to influenza?

Immunity develops after you have been exposed to a particular strain of the virus through infection or immunisation. Influenza immunisation prepares and boosts your immune system to help you fight the influenza viruses expected to be circulating each year.

Q. Can the vaccine give me influenza?

No. You cannot get influenza from the vaccine, as it does not contain any live viruses. However, some people will experience mild side effects such as muscle aches or headaches for a short time after vaccination.

In Summary…

There are obvious advantages to influenza vaccination: less time off work – less loss of income, less burden on your family, relatives and work colleagues, less strain on medical resources reduced absenteeism at work – YOU don’t feel miserable!

Viruses are unique organisms because they cannot reproduce without a host cell. After contacting a host cell, a virus will insert genetic material into the host and take over the host’s functions. The cell, now infected, continues to reproduce, but it reproduces more viral protein and genetic material instead of its usual products.

It is this process that earns viruses the classification of “parasite”.

A short video on how viruses cause infections

Viral infections

Many common infections of the nose, throat, sinuses, ears, and chest are caused by viruses. Flu-like illnesses are also caused by viruses.

Diarrhea and/or vomiting are often due to a viral infection of the gut.

If you are normally well, your immune (defence) system is good at fighting off many types of viral infection.

An antibiotic is not needed if a virus is causing an infection.  This is because:

• Antibiotics do not kill viruses. Antibiotics only kill bacteria.
• Antibiotics may cause side-effects such as diarrhea, rashes, feeling sick, etc.
• Overuse of antibiotics when they have not been necessary has led to some bacteria becoming resistant to them. This means that some antibiotics might not be as effective when they are really needed.

You may feel unwell for several days or more until a viral infection clears. Treatment aims to ease symptoms and common management protocols advised for viral infections include the following:

• Paracetamol or ibuprofen to reduce a high temperature (fever), and to ease aches, pains, and headaches.
• Make sure you drink enough to prevent mild dehydration. Dehydration may develop if you have a high temperature, and it can make a headache and tiredness much worse.
• Do not wrap up, but try to cool down if you have a high temperature. This is particularly important in children. If a child has a high temperature, then take their clothes off (in a warm, but not hot, room) and consider giving some paracetamol.
• Other advice may be given for specific symptoms. For example, decongestants for a blocked nose, etc. Ask a pharmacist for advice.

What about bacterial infections?

A person’s immune system can eradicate most bacterial infections.  Studies have demonstrated that antibiotics usually do little to speed up recovery of bronchitis, or most ear, nose, and throat infections that are caused by bacteria. However, you do need antibiotics if you have certain serious infections caused by bacteria, such as meningitis or pneumonia. When you are ill, doctors are skilled at checking you over to rule out serious illness, and to advise if an antibiotic is needed.

What if symptoms change?

Occasionally, a viral infection or minor bacterial infection develops into a more serious infection. See a doctor to review the situation if the illness appears to change, becomes worse, does not go after a few days, or if you are worried about any new symptom that develops.

References

• Antimicrobial Resistance, Health Protection Agency (2007)
• Antibiotic resistance. Department of Health. Various documents, various dates.
• Antimicrobial Resistance. European Centre for Disease Prevention and Control. Various documents, various dates.

 Measles is a serious and highly infectious viral disease that can make people very sick and can lead to hospitalisation or, in rare cases, death.

The infection is spread by contact with droplets from the nose, mouth, or throat of an infected person. Sneezing and coughing can put contaminated droplets into the air. Just being in the same room as someone with measles can lead to infection if you are not immunised. One person with measles can pass on the disease to 13 other people who have not been immunised. If you are not immunised you could have measles and spread it without even knowing it. Those who have had an active measles infection or who have been vaccinated against the measles have immunity to the disease which prevents them from getting very sick. Before widespread vaccination, measles was so common during childhood that most people became sick with the disease by age 20. The number of measles cases dropped over the last several decades to almost none in theU.S. and Canada. However, rates have started to rise again recently.

 What might happen if I get measles?

A person may be developing measles and not be aware until they actually feel ill – symptoms usually take about 10 days to develop but it might take as long as 18 days.

Symptoms may include:

• Bloodshot eyes
• Cough
• Fever
• Light sensitivity
• Muscle pain
• Rash
• Usually appears 3 – 5 days after the first signs of being sick
• May last 4 – 7 days
• Usually starts on the head and spreads to other areas, moving down the body
• Rash may appear as flat, discoloured areas (macules) and solid, red, raised areas (papules) that later join together
• Itchy
• Redness and irritation of the eyes (conjunctivitis)
• Runny nose
• Sore throat
• Tiny white spots inside the mouth (Koplik’s spots)

Complications<

Up to one in three people may develop complications of measles infection may include:

• Bronchitis – chest infection
• Encephalitis (about 1 out of 1,000 measles cases) – infection around the brain
• Ear infection (otitis media)
• Pneumonia

Acute encephalitis (brain inflammation) develops in 1 in 1000 cases, some of whom die and more than one third are left with permanent brain damage.

One in 1000 people with measles may die.

One in 10 cases will end up in hospital.

Who is at risk of getting measles?

If you were born after January 1969, and haven’t had two doses of measles vaccine, or have not had measles already, you are at risk of catching the disease.

It is not just babies – older children, teenagers and adults who are not immunised are also at risk from getting sick from measles.

Maori children in theAucklandregion are particularly at risk as the percentage of 18 month old Tamariki who have received one dose of MMR is only 67%.

The percentage of children who have received one dose of MMR by age 18 months in theAucklandregion is low at 79%. Anyone with a weakened immune system (for example, people who are receiving chemotherapy or radiotherapy for cancer or people who take high-dose steroid medications) is at risk of measles infection. Pregnant women who are not immunised and who get measles are at risk of miscarriage, still birth and low birth weights for their babies. Non immune pregnant women should not be immunised but it is very important their family and close contacts are immunised to protect the pregnant mother and unborn baby.

When measles is widespread a very small proportion of people who have been immunised may also get measles.

Signs and tests

• Measles serology – blood test
• Viral culture (throat swab )

Treatment

There is no specific treatment for the measles.  However, the following may relieve symptoms:

• Isolate
• Paracetamol
• Bed rest
• Humidified air

Some children may need vitamin A supplements.

The only thing that can stop you or your child catching measles is getting immunised. If you suspect you or your child is sick with measles phone your GP or Healthline on 0800 611 116. For more information on immunisation, please call the Immunisation Advisory Centre free on 0800 IMMUNE (0800 466 863) or visit their website http://www.immune.org.nz

Dr Richard Parker

Dr Lalani Udalamatta

Dr Lize Upton