Fall is the time of the year when doctors begin seeing more patients with sneezes, coughs, and fevers. It’s also the time of the year when flu season ramps up. For most, these are just inconveniences. For those with chronic conditions (lung disease, asthma, diabetes, heart disease, BMI greater than 30, cancer, or HIV) colds, and flu can quickly become more serious issues.
Several factors contribute to the increased incidence of colds and flu as Fall sets in. With cooler weather, people are indoors more with more opportunities for exposure. Of course, it doesn’t help that the kids are back in school, picking up germs your immune system has never been challenged by. For those with Fall allergies, the added stress can suppress immunity. A contributing factor is that viruses like the flu and the common cold thrive in lower temperatures. Add Halloween to the mix, with sugar-laced treats, and the immune system can get wrecked long enough to make almost anyone’s cough within 30 feet become your cough or fever.
A study by researchers at Loma Linda University determined that when you consume 100 grams (3.5 oz) of sugar, your white blood cells are 40 percent less effective at killing germs for 5 hours. In other words, you can cripple your immune system with one small Halloween candy bar. The problem isn’t limited to sucrose. It’s the total quantity of sugar consumed over a short time. Excess glucose and fructose can also significantly decreased the activity of neutrophils to engulf bacteria. Ok, if you haven’t studied cell biology, neutrophils are the “first responders” of white blood cells when they encounter invading microbes. This suppression of immunity due to sugar is not news. Linus Pauling’s research in the 1970s revealed that when you eat sugar, it directly competes for space in your immune cells with Vitamin C. The more sugar in your system, the less Vitamin C can get into your white blood cells – the result being a weakened defense against infections.
It’s no wonder that the common cold becomes more frequent during the September/October time frame and onward. With the typical abundance of treats from Halloween until New Year, most of the country lives in a state of suppressed immunity. Once the viruses are spread, it’s only a matter of time until our immune system gets a wakeup call. What happens next depends on whether our immune system is up to the job.
The flu (influenza) virus provides a unique challenge. It’s a clever virus with the ability to mutate in ways that can surprise vaccine manufacturers and of course, also surprise our immune system. In the 2018-2019 flu season, flu put about 300,000 Americans in the hospital. During the previous flu season, that rose to 900,000 hospitalizations, with 80,000 deaths. The largest group of people needing hospitalization for flu were adults 65 and older, with the second-largest group being children four and younger.
The flu pandemic of 1918 set the record by affecting an estimated 500 million worldwide. We now know that the 1918 pandemic was caused by an H1N1 virus with genes of avian origin. Animals raised in factory farms with poor sanitation help the flu virus mutate. When the virus jumps to humans, that’s when our problems begin. So many illnesses can be traced to factory farming of animals. Unfortunately, trying to meet the world’s seemingly insatiable desire for animal protein has only increased the cesspool of diseases that may eventually be our demise. Diseases that have the ability to jump from factory raised animals to humans share a characteristic with earthquakes, volcanoes, tornadoes, and hurricanes. You know that the next surprise isn’t a matter of if, but rather when.
While colds and flu can bring enough misery, there is more lurking around as fall approaches. That’s when viral meningitis also makes an uptick in occurrences. This infection affects the brain and spinal cord’s protective covering. Symptoms include headaches, stiff neck, fever, fatigue, and sensitivity to light. Bacterial meningitis also becomes more common, especially with large groups of people living together, like in college dorms. The symptoms of bacterial meningitis are similar to viral meningitis but more severe.
The norovirus presents another Fall challenge. Like colds and flu, it’s also associated with people being in close quarters. It’s also a very contagious virus that spreads easily from person to person. Symptoms include diarrhea, vomiting, stomach pain, fever, and aches.
Given that life as a hermit probably isn’t your idea of fun, you may want to do the next best thing. As a first precaution, avoid touching your face with unwashed hands. To help protect others, always cover your sneezes and coughs with a tissue or shirt sleeve. In either case, when washing hands, use hot soapy water. While antibacterial soaps provide some value, they don’t eliminate viruses.
Your second line of defense is your general health. This is where sleep, diet, exercise, stress reduction, and social connections play a part in determining how responsive your immune system will be to the next virus or bacteria.
The third line of defense is vaccinations. For the common cold, you will have to wait for scientists to create a vaccine. For the flu, vaccines vary in effectiveness from year to year. On the plus side, they help with most of the strains you are likely to encounter. Unfortunately, the flu’s ability to mutate makes the creation of a perfect vaccine unlikely. You may wonder if this year’s flu vaccine will be worth taking. According to the CDC, it’s impossible to predict how well a flu vaccine will work in the future. However, the vaccine for this year has so far been a much better match for the flu strains circulating than in previous years.
As for meningitis, there is no vaccine available for viral meningitis. For bacterial meningitis, vaccines are available for children ages 11-12 years old and for children 17-18 years old.
As a doctor, I’m careful about keeping my immune system in tip-top shape. Unknown to most of my patients, I do get sick from time to time. The typical scenario is a high fever that my body fights off very quickly. Fortunately, this only happens about once every three years and by luck on weekends when I had time to recover. No doubt, keeping my immune system in peak condition has made a difference, given that I haven’t lost a workday to illness since 2001. So, if wondering how doctors stay well, let me assure you that we don’t have a secret pill. The ones that obey their body’s need for rest, good diet, exercise, and social connections tend to be very healthy. The ones that ignore the rules have no better health than the general population.
Nancy Neighbors, MD
How Flu Vaccines Are Made?
During flu season, experts study samples of the viruses circulating to evaluate how well the vaccine protected against circulating viruses. They use that information to help make their decision for what to include in the next year’s vaccines. This year, the vaccine will protect against two A strains — H1N1 and H3N2 — and a B strain. A special quadrivalent vaccine will protect against an additional B strain.
Like all other vaccines, the one for flu isn’t perfect, but it does typically reduce the risk of illness from 30% to 60% in the general population. A lot depends on which strains are circulating. In general, vaccines work better against influenza B and influenza A (H1N1) viruses than they do against influenza A (H3N2) viruses.
If wondering if your chance of improving your odds of avoiding the flu by only 30% is worth it, consider an analogy that might get you motivated. If there were a way for the average person to improve their success at the blackjack tables or in the stock market by 30%, they would in short order become one of the richest people in the world. A 30% improvement is nothing to sneeze at.
What types of flu shots are available this year?
For the 2018-2019 season, there are several vaccines:
- Trivalent vaccines, which protect against three flu strains: two A and one B
- Quadrivalent vaccines, which protect against fours strains: two A and two B
- A high-dose vaccine that protects against two A and one B strain, meant for adults 65 and above, who usually have weaker immune systems
- An adjuvanted vaccine, made using an ingredient that helps trigger a stronger immune response, is also an option for older adults. It protects against two A strains and one B strain.
- A recombinant vaccine is an egg-free option for people with egg allergies. It protects against two A strains and one B strain.
- A nasal spray vaccine for people ages 2 to 49 that protects against four strains: two A and two B. It is not for pregnant women and people with weakened immunity, among other conditions.
- Children who have never been vaccinated against influenza will need two doses, spaced at least 4 weeks apart.
Don’t Throw Your Pumpkin Away!
Pumpkins have quite a history as a food that provides excellent nutrition. Because pumpkins keep well, Native Americans ate pumpkins as a winter time food. They also ate pumpkin seeds and used them as medicine. Fortunately, the pilgrims also discovered that pumpkins were a nutritious food for without them they might not have survived. One of the first American folk songs has these lyrics: “We have pumpkins at morning and pumpkins at noon; If it was not for pumpkins we should be undone.” For more about the story of the pumpkin and a few delicious and nutritious recipes read, “Proven Health Benefits of Pumpkins + 9 Truly Healthy Pumpkin Recipes (That Taste Delicious!).