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There are new flu vaccines on offer for 2024. Should I get one? What do I need to know?

<p><em><a href="https://theconversation.com/profiles/allen-cheng-94997">Allen Cheng</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p>Influenza is a common respiratory infection. Although most cases are relatively mild, flu can cause more severe illness in young children and older people.</p> <p>Influenza virtually <a href="https://pubmed.ncbi.nlm.nih.gov/33243355/">disappeared</a> from Australia during the first years of the COVID-19 pandemic when public health restrictions reduced contact between people. Since 2022, it has returned to a seasonal pattern, although the flu season has started and peaked a few months earlier than before 2020.</p> <p>It’s difficult to predict the intensity of the flu season at this point in the year, but we can sometimes get clues from the northern hemisphere. There, the season <a href="https://www.who.int/tools/flunet">started</a> <a href="https://gis.cdc.gov/grasp/fluview/flu_by_age_virus.html">earlier</a> than usual for the third year running (peaking in early January rather than late February/March), with a similar number of reported cases and hospitalisations to the previous year.</p> <p>Influenza vaccines are recommended annually, but there are now an increasing number of different vaccine types. Here’s what to know about this year’s shots, available from <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">this month</a>.</p> <h2>What goes into a flu vaccine?</h2> <p>Like other vaccines, influenza vaccines work by “training” the immune system on a harmless component of the influenza virus (known as an antigen), so it can respond appropriately when the body encounters the real virus.</p> <p>Influenza strains are constantly changing due to genetic mutation, with the pace of genetic change <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421855">much higher</a> than for SARS-CoV-2 (the virus that causes COVID). The strains that go into the vaccine are <a href="https://www.who.int/teams/global-influenza-programme/vaccines/who-recommendations">reviewed</a> twice each year by the World Health Organization (WHO), which selects vaccine strains to match the next season’s predicted circulating strains.</p> <p>All current influenza vaccines in <a href="https://www.tga.gov.au/resources/publication/meeting-statements/aivc-recommendations-composition-influenza-vaccines-australia-2024">Australia</a> contain four different strains (known as quadrivalent vaccines). One of the strains appeared to <a href="https://www.nejm.org/doi/full/10.1056/NEJMp2314801">disappear</a> during the COVID pandemic, and the WHO has recently <a href="https://cdn.who.int/media/docs/default-source/influenza/who-influenza-recommendations/vcm-southern-hemisphere-recommendation-2024/202309_qanda_recommendation.pdf?sfvrsn=7a6906d1_5">recommended</a> dropping this strain from the vaccine. It’s expected trivalent (three strain) vaccines will become available in the near future.</p> <h2>What’s different about new flu vaccines?</h2> <p>There are eight brands of flu vaccines <a href="https://www.health.gov.au/resources/publications/atagi-statement-on-the-administration-of-seasonal-influenza-vaccines-in-2024?language=en">available</a> in Australia in 2024. These include egg-based vaccines (Vaxigrip Tetra, Fluarix Tetra, Afluria Quad, FluQuadri and Influvac Tetra), cell-based vaccines (Flucelvax Quad), adjuvanted vaccines (Fluad Quad) and high-dose vaccines (Fluzone High-Dose Quad).</p> <p>Until recently, the process of manufacturing flu vaccines has remained similar. Since the development of the influenza vaccine in the <a href="https://www.who.int/news-room/spotlight/history-of-vaccination/history-of-influenza-vaccination">1940s</a>, influenza viruses were grown in chicken eggs, then extracted, inactivated, purified and processed to make up the egg-based vaccines that are still used widely.</p> <p>However, there have been several enhancements to influenza vaccines in recent years.</p> <p>Older people’s immune systems tend not to respond as strongly to vaccines. In some flu vaccines, adjuvants (components that stimulate the immune system) are included with the influenza antigens. For example, an adjuvant is used in the Fluad Quad vaccine, recommended for over 65s. Studies <a href="https://ncirs.org.au/sites/default/files/2021-02/Adjuvanted%20influenza%20vaccine%20vs%20standard%20dose%20influenza%20vaccine%20SoF%20EP%20E2D%20tables_26%20Feb%202021_Final.pdf">suggest</a> adjuvanted influenza vaccines are slightly better than standard egg-based vaccines without adjuvant in older people.</p> <p>An alternative approach to improving the immune response is to use higher doses of the vaccine strains. An example is Fluzone High-Dose Quad – another option for older adults – which contains the equivalent of four doses of a standard influenza vaccine. Studies <a href="https://ncirs.org.au/sites/default/files/2022-05/HD%20vs%20sIV%20SoF%20EP%20E2D_March%202022_Final.pdf">suggest</a> the high dose vaccine is better than the standard dose vaccine (without an adjuvant) in preventing hospitalisation and complications in older people.</p> <p>Other manufacturers have updated the manufacturing process. Cell-based vaccines, such as Flucelvax Quad, use cells instead of eggs in the manufacturing process. Other vaccines that are <a href="https://www.cdc.gov/flu/prevent/advances.htm">not yet available</a> also use different technologies. In the past, <a href="https://pubmed.ncbi.nlm.nih.gov/31151913/">manufacturing issues</a> with egg-based vaccines have reduced their effectiveness. Using an alternative method of production provides some degree of insurance against this in the future.</p> <h2>What should I do this year?</h2> <p>Given indications this year’s flu season may be earlier than usual, it’s probably safest to get your vaccine early. This is particularly <a href="https://www.health.gov.au/resources/publications/atagi-statement-on-the-administration-of-seasonal-influenza-vaccines-in-2024?language=en">important</a> for those at highest risk of severe illness, including older adults (65 years and over), those with chronic medical conditions, young children (six months to five years) and Aboriginal and Torres Strait Islander people. Influenza vaccines are also recommended in pregnancy to protect both the mother and the baby for the first months of life.</p> <p>Influenza vaccines are widely available, including at GP clinics and pharmacies, while many workplaces have occupational programs. For high-risk groups, <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">four of the vaccines</a> are subsidised by the Australian government through the <a href="https://www.health.gov.au/our-work/national-immunisation-program">National Immunisation Program</a>.</p> <p>In older people, a number of vaccines are now recommended: <a href="https://www.health.gov.au/sites/default/files/2024-03/atagi-statement-on-the-administration-of-covid-19-vaccines-in-2024.pdf">COVID</a> and influenza, as well as one-off courses of <a href="https://www.health.gov.au/sites/default/files/documents/2020/06/national-immunisation-program-pneumococcal-vaccination-schedule-from-1-july-2020-clinical-advice-for-vaccination-providers.pdf">pneumococcal</a> and <a href="https://www.health.gov.au/topics/immunisation/vaccines/shingles-herpes-zoster-immunisation-service">shingles</a> vaccines. In general, most vaccines can be given in the same visit, but talk to your doctor about which ones you need.</p> <h2>Are there side effects?</h2> <p>All influenza vaccines can <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">cause</a> a sore arm and sometimes more generalised symptoms such as fever and tiredness. These are expected and reflect the immune system reacting appropriately to the vaccine, and are mostly mild and short-term. These side effects are slightly more common in <a href="https://ncirs.org.au/sites/default/files/2021-02/Adjuvanted%20influenza%20vaccine%20vs%20standard%20dose%20influenza%20vaccine%20SoF%20EP%20E2D%20tables_26%20Feb%202021_Final.pdf">adjuvanted</a> and <a href="https://ncirs.org.au/sites/default/files/2022-05/HD%20vs%20sIV%20SoF%20EP%20E2D_March%202022_Final.pdf">high dose</a> vaccines.</p> <p>As with all medications and vaccines, allergic reactions such as anaphylaxis can occur after the flu vaccine. All vaccine providers are trained to recognise and respond to anaphylaxis. People with egg allergies should discuss this with their doctor, but in general, <a href="https://www.allergy.org.au/patients/food-allergy/egg-allergy-flu-vaccine">studies suggest</a> they can safely receive any (including egg-based) influenza vaccines.</p> <p>Serious side effects from the influenza vaccine, such as Guillain-Barré syndrome, a neurological complication, are very rare (one case per million people vaccinated). They are <a href="https://pubmed.ncbi.nlm.nih.gov/23810252/">thought</a> to be less common after influenza vaccination than after infection with influenza.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/226623/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/allen-cheng-94997">Allen Cheng</a>, Professor of Infectious Diseases, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/there-are-new-flu-vaccines-on-offer-for-2024-should-i-get-one-what-do-i-need-to-know-226623">original article</a>.</em></p>

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I think I have the flu. Should I ask my GP for antivirals?

<p><em><a href="https://theconversation.com/profiles/lara-herrero-1166059">Lara Herrero</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/wesley-freppel-1408971">Wesley Freppel</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>, and <a href="https://theconversation.com/profiles/yong-qian-koo-1457640">Yong Qian Koo</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a></em></p> <p>If you test positive for COVID and you’re eligible for antivirals, you’ll likely ask your GP for a script to protect you from severe disease.</p> <p><a href="https://healthdispatch.com.au/news/immunisation-coalition-urging-people-with-flu-like-symptoms-to-g">Antivirals</a> are also available to fight influenza viruses, via a doctor’s prescription. But they have a mixed history, with their benefits at times <a href="https://theconversation.com/controversies-in-medicine-the-rise-and-fall-of-the-challenge-to-tamiflu-38287">overstated</a>.</p> <p>It can be difficult to get an appointment to see your GP. So when should you make the effort to see a GP for a prescription for influenza antivirals? And how effective are they?</p> <h2>What exactly is influenza?</h2> <p>The flu is primarily a viral infection of the respiratory system that can spread through sneezing, coughing, or touching contaminated objects then touching your nose or mouth.</p> <p>Common symptoms include headache, sore throat, fever, runny or blocked nose and body aches that last a week or more.</p> <p>Influenza is actually a group of viruses, divided into several <a href="https://www.cdc.gov/flu/about/viruses/types.htm#:%7E:text=There%20are%20four%20types%20of,global%20epidemics%20of%20flu%20disease,%20https://www.cdc.gov/flu/professionals/acip/background-epidemiology.htm">sub-groups</a>. Flu A and B are the <a href="https://www.health.gov.au/resources/collections/aisr?language=en,%20https://www.health.gov.au/resources/collections/australian-influenza-surveillance-reports-2023?language=en">most common groups</a> that circulate in humans.</p> <h2>What are flu antivirals?</h2> <p>Influenza antivirals, target specific parts of the viral life cycle, which prevents the virus replicating and spreading.</p> <p>Most flu antivirals <a href="https://www.nejm.org/doi/full/10.1056/NEJMra050740">target</a> neuraminidase, an important enzyme the virus uses to release itself from cells.</p> <p>On the other hand, COVID antivirals work by inhibiting other parts of the viral life cycle involved in the <a href="https://www.tga.gov.au/news/media-releases/tga-provisionally-approves-two-oral-covid-19-treatments-molnupiravir-lagevrio-and-nirmatrelvir-ritonavir-paxlovid">virus replicating itself</a>.</p> <p>Three influenza antivirals are <a href="https://australianprescriber.tg.org.au/articles/influenza-overview-on-prevention-and-therapy.html#r20">used in Australia</a>. Relenza (zanamivir) is an inhaled powder and Tamiflu (oseltamivir) is a capsule; both are five-day treatments. Rapivab (peramivir) is a single injection.</p> <p>These antivirals may also come with <a href="https://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm">side effects</a>, such as a headache, vomiting, cough, or <a href="https://www.immunisationcoalition.org.au/resources/antiviral-treatments-for-influenza/">fever</a>.</p> <p>Tamiflu and Relenza generally cost A$40-50 in Australia, plus the cost of the consultation fee with your doctor, if applicable.</p> <h2>How effective are antivirals for the flu?</h2> <p>Antivirals have the greatest effect if started 24-72 hours after symptoms. This is to prevent the virus from reaching <a href="https://www.mdpi.com/1660-4601/19/5/3018">high levels in the body</a>.</p> <p>Among healthy adults, if Relenza or Tamiflu are started within 48 hours from your first symptoms, they can <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008965.pub4/full">reduce the duration</a> of symptoms such as cough, blocked nose, sore throat, fatigue, headache, muscle pain and fever by just under a day.</p> <p>For people who have developed severe flu symptoms or who have existing health conditions such as heart disease or chronic obstructive pulmonary disease (COPD), antivirals that start later (but still before day five of symptoms) can still reduce the <a href="https://academic.oup.com/cid/article/52/4/457/378776?login=true">severity of infection</a> and reduce the <a href="https://thorax.bmj.com/content/thoraxjnl/65/6/510.full.pdf?frbrVersion=3">chance of</a> <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/215903">hospitalisation</a> and <a href="https://academic.oup.com/jac/article/72/11/2990/4091484?login=false">death</a>.</p> <p>In a study from the 2009 swine flu (H1N1) pandemic in the United States, treatment with antivirals (Tamiflu and Relenza) <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3358088/">reduced</a> the chance of needing to be hospitalised. Around 60% of hospitalisations prevented were among 18-64 years olds, around 20% in children 0-17 years, and 20% in adults aged over 65.</p> <p>The research is less clear about whether antivirals prevent the development of flu complications such as secondary bacterial pneumonia. They might, but so far the data aren’t clear.</p> <h2>Are flu antivirals becoming less effective?</h2> <p>Antiviral resistance to Tamiflu has been <a href="https://link.springer.com/article/10.1007/s10096-020-03840-9">reported</a> around the world, mostly in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223162/">immunocompromised people</a>, as they <a href="https://link.springer.com/article/10.1007/s10096-020-03840-9">have</a> a weakened immune system that allows higher viral loads and prolonged viral shedding.</p> <p>The impact of the antiviral resistance is unclear but there is evidence indicating resistant strains can uphold their ability to replicate effectively and spread. So far it’s not clear if these stains cause more severe disease.</p> <p>However, government agencies and surveillance programs are constantly monitoring the spread of antiviral resistance. Currently there is <a href="https://www.cdc.gov/flu/treatment/antiviralresistance.htm">minimal concern</a> for strains that are resistant to Tamiflu or Relenza.</p> <h2>Antivirals can also prevent the flu if you’ve been exposed</h2> <p>Tamiflu and Relenza can also be used to <a href="https://onlinelibrary.wiley.com/doi/10.1111/irv.12046">prevent flu infections</a>, if we’re exposed to the virus or come into contact with infected people.</p> <p>Some studies suggest Tamiflu and Relenza can <a href="https://www.bmj.com/content/326/7401/1235.long">reduce the chance of developing symptomatic influenza</a> by 70-90%.</p> <p>Many health agencies around the world <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8165743/">recommend</a> “prophylactic” treatment for high-risk patients in hospitals or age care setting when people have been in contact with others infected with influenza.</p> <h2>So who should talk to their GP about a prescription?</h2> <p><a href="https://www.health.nsw.gov.au/Infectious/factsheets/Pages/racf-antiviral-treatments-and-prophylaxis.aspx#:%7E:text=The%20Australian%20Therapeutic%20Guidelines*%20recommends,of%20severe%20disease%20from%20influenza.&amp;text=people%20with%20chronic%20conditions%20including,heart%20disease">Australian guidelines recommend</a> doctors offer antivirals to people with influenza who have severe disease or complications.</p> <p>Doctors can also consider treatment for people at higher risk of developing severe disease from influenza. This includes:</p> <ul> <li>adults aged 65 years or older</li> <li>pregnant women</li> <li>people with certain chronic conditions (heart disease, Down syndrome, obesity, chronic respiratory conditions, severe neurological conditions)</li> <li>people with compromised immunity</li> <li>Aboriginal and Torres Strait Islander people</li> <li>children aged five years or younger</li> <li>residents of long-term residential facilities</li> <li>homeless people.</li> </ul> <p>Doctors can prescribe antivirals for the prevention of influenza <a href="https://australianprescriber.tg.org.au/articles/influenza-overview-on-prevention-and-therapy.html#r20">in</a> vulnerable people who have been exposed to the virus.</p> <p>Antiviral treatment also can be <a href="https://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm#:%7E:text=Antiviral%20treatment%20also%20can%20be,48%20hours%20of%20illness%20onset">considered</a> for otherwise healthy symptomatic patients who have confirmed or suspected influenza, if they can start treatment within 48 hours of developing symptoms.</p> <p>In some instances a doctors can make a clinical diagnosis of influenza based on the symptoms and known close flu positive contacts of the patient. However, it is preferred to have flu diagnosed by one of the approved diagnostic tests, such as a <a href="https://24-7medcare.com.au/influenza/australian-gp-influenza-2023-guide/">rapid antigen test</a> (RAT) or the more accurate <a href="https://www.health.nsw.gov.au/Infectious/factsheets/Pages/influenza_factsheet.aspx">PCR test</a>, similar to what is perfomed for COVID. There are also now combo tests that can <a href="https://www.tga.gov.au/news/media-releases/first-combination-covid-19-and-influenza-self-tests-approved-australia">distinguish between SARS-CoV-2 and influenza virus</a>.</p> <p>Remember, the flu can cause <a href="https://www.abc.net.au/news/2023-07-23/flu-season-hitting-children-hard-antivirals-may-help/102633722">severe illness or death</a>, particularly among people from the high-risk groups. So if you think you might have the flu, wear a mask and stay away to avoid spreading the virus to others. <img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/210457/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/lara-herrero-1166059">Lara Herrero</a>, Research Leader in Virology and Infectious Disease, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/wesley-freppel-1408971">Wesley Freppel</a>, Research Fellow, Institute for Glycomics, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>, and <a href="https://theconversation.com/profiles/yong-qian-koo-1457640">Yong Qian Koo</a>, , <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a></em></p> <p><em>Image </em><em>credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/i-think-i-have-the-flu-should-i-ask-my-gp-for-antivirals-210457">original article</a>.</em></p>

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Taking an antidepressant? Mixing it with other medicines – including some cold and flu treatments – can be dangerous

<p><em><a href="https://theconversation.com/profiles/treasure-mcguire-135225">Treasure McGuire</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>In the depths of winter we are more at risk of succumbing to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7522168/">viral respiratory infections</a> – from annoying sore throat, common cold and sinusitis, to the current resurgence of respiratory syncytial virus (RSV), influenza and COVID.</p> <p>Symptoms of upper respiratory tract infection range in severity. They can include fever, chills, muscle or body aches, cough, sore throat, runny or stuffy nose, earache, headache, and fatigue. Most antibiotics target bacteria so are <a href="https://pubmed.ncbi.nlm.nih.gov/32495003/">not effective</a> for viral infections. Many people seek relief with over-the-counter medicines.</p> <p>While evidence varies, guidelines suggest medicines taken by mouth (such as cough syrups or cold and flu tablets) have a <a href="https://pubmed.ncbi.nlm.nih.gov/25420096/">limited but potentially positive</a> short-term role for managing upper respiratory infection symptoms in adults and children older than 12. These include:</p> <ul> <li>paracetamol or ibuprofen for pain or fever</li> <li>decongestants such as phenylephrine or pseudoephedrine</li> <li>expectorants and mucolytics to thin and clear mucus from upper airways</li> <li>dry cough suppressants such as dextromethorphan</li> <li>sedating or non-sedating antihistamines for runny noses or watery eyes.</li> </ul> <p>But what if you have been prescribed an antidepressant? What do you need to know before going to the pharmacy for respiratory relief?</p> <h2>Avoiding harm</h2> <p>An audit of more than 5,000 cough-and-cold consumer enquiries to an Australian national medicine call centre found questions frequently related to drug-drug interactions (29%). An 18-month analysis showed 20% of calls <a href="https://pubmed.ncbi.nlm.nih.gov/26590496/">concerned</a> potentially significant interactions, particularly with antidepressants.</p> <p>Australia remains in the “<a href="https://www.aihw.gov.au/mental-health/topic-areas/mental-health-%20prescriptions#Prescriptionsbytype">top ten</a>” antidepressant users in the <a href="https://stats.oecd.org/Index.aspx?DataSetCode=HEALTH_PHMC">OECD</a>. More than <a href="https://www.aihw.gov.au/mental-health/topic-areas/mental-health-prescriptions">32 million</a> antidepressant prescriptions are dispensed on the Pharmaceutical Benefits Scheme each year.</p> <p>Antidepressants are commonly prescribed to manage symptoms of anxiety or depression but are also used in chronic pain and incontinence. They are classified primarily by how they affect chemical messengers in the nervous system.</p> <p>These classes are:</p> <ul> <li><strong>selective serotonin reuptake inhibitors (SSRI)</strong> such as fluoxetine, escitalopram, paroxetine and sertraline</li> <li><strong>serotonin and noradrenaline reuptake inhibitors (SNRI)</strong> such as desvenlafaxine, duloxetine and venlafaxine</li> <li><strong>tricyclic antidepressants (TCA)</strong> such as amitriptyline, doxepin and imipramine</li> <li><strong>monoamine oxidase inhibitors (MAOI)</strong> such as tranylcypromine</li> <li><strong>atypical medicines</strong> such as agomelatine, mianserin, mirtazapine, moclobemide, reboxetine and vortioxetine</li> <li><strong>complementary medicines</strong> including St John’s wort, S-adenosyl methionine (SAMe) and L-tryptophan</li> </ul> <p>Medicines within the same class of antidepressants have similar actions and side-effect profiles. But the molecular differences of individual antidepressants mean they may have different interactions with medicines taken at the same time.</p> <h2>Types of drug interactions</h2> <p>Drug interactions can be:</p> <ul> <li><strong>pharmacokinetic</strong> – what the body does to a drug as it moves into, through and out of the body. When drugs are taken together, one may affect the absorption, distribution, metabolism or elimination of the other</li> <li><strong>pharmacodynamic</strong> – what a drug does to the body. When drugs are taken together, one may affect the action of the other. Two drugs that independently cause sedation, for example, may result in excessive drowsiness if taken together.</li> </ul> <p>There are many <a href="https://wchh.onlinelibrary.wiley.com/doi/pdf/10.1002/pnp.429">potential interactions</a> between medications and antidepressants. These include interactions between over-the-counter medicines for upper respiratory symptoms and antidepressants, especially those taken orally.</p> <p>Concentrations of nasal sprays or inhaled medicines are generally lower in the blood stream. That means they are less likely to interact with other medicines.</p> <h2>What to watch for</h2> <p>It’s important to get advice from a pharmacist before taking any medications on top of your antidepressant.</p> <p>Two symptoms antidepressant users should monitor for shortly after commencing a cough or cold medicine are central nervous system effects (irritability, insomnia or drowsiness) and effects on blood pressure.</p> <p>For example, taking a selective SSRI antidepressant and an oral decongestant (such as pseudoephedrine or phenylephrine) can cause irritability, insomnia and affect blood pressure.</p> <p>Serotonin is a potent chemical compound produced naturally for brain and nerve function that can also constrict blood vessels. Medicines that affect serotonin are common and include most antidepressant classes, but also decongestants, dextromethorphan, St John’s wort, L-tryptophan, antimigraine agents, diet pills and amphetamines.</p> <p><a href="https://reference.medscape.com/drug-interactionchecker">Combining drugs</a> such as antidepressants and decongestants that both elevate serotonin levels can cause irritability, headache, insomnia, diarrhoea and blood pressure effects – usually increased blood pressure. But some people experience orthostatic hypotension (low blood pressure on standing up) and dizziness.</p> <p>For example, taking both a serotonin and SNRI antidepressant and dextromethorphan (a cough suppressant) can add up to high serotonin levels. This can also occur with a combination of the complementary medicine St John’s Wort and an oral decongestant.</p> <p>Where serotonin levels are too high, <a href="https://pubmed.ncbi.nlm.nih.gov/15666281/">severe symptoms</a> such as confusion, muscle rigidity, fever, seizures and even death have been reported. Such symptoms are rare but if you notice any of these you should stop taking the cold and flu medication straight away and seek medical attention.</p> <h2>Ways to avoid antidepressant drug interactions</h2> <p>There are a few things we can do to prevent potentially dangerous interactions between antidepressants and cold and flu treatments.</p> <p><strong>1. Better information</strong></p> <p>Firstly, there should be more targeted, consumer-friendly, <a href="https://www.webmd.com/interaction-checker/default.htm">online drug interaction information</a> available for antidepressant users.</p> <p><strong>2. Prevent the spread of viral infections as much as possible</strong></p> <p>Use the non-drug strategies that have worked well for COVID: regular hand washing, good personal hygiene, social distancing, and facemasks. Ensure adults and children are up to date with immunisations.</p> <p><strong>3. Avoid potential drug interactions with strategies to safely manage symptoms</strong></p> <p>Consult your pharmacist for strategies most appropriate for you and only use cold and flu medications while symptoms persist:</p> <ul> <li>treat muscle aches, pain, or a raised temperature with analgesics such as paracetamol or ibuprofen</li> <li>relieve congestion with a nasal spray decongestant</li> <li>clear mucus from upper airways with expectorants or mucolytics</li> <li>dry up a runny nose or watery eyes with a non-sedating antihistamine.</li> </ul> <p>Avoid over-the-counter cough suppressants for an irritating dry cough. Use a simple alternative such as honey, steam inhalation with a few drops of eucalyptus oil or a non-medicated lozenge instead.</p> <p><strong>4. Ask whether your symptoms could be more than the common cold</strong></p> <p>Could it be influenza or COVID? Seek medical attention if you are concerned or your symptoms are not improving. <img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/208662/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/treasure-mcguire-135225">Treasure McGuire</a>, Assistant Director of Pharmacy, Mater Health SEQ in conjoint appointment as Associate Professor of Pharmacology, Bond University and as Associate Professor (Clinical), <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/taking-an-antidepressant-mixing-it-with-other-medicines-including-some-cold-and-flu-treatments-can-be-dangerous-208662">original article</a>.</em></p>

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What happens in our body when we encounter and fight off a virus like the flu, SARS-CoV-2 or RSV?

<p><em><a href="https://theconversation.com/profiles/lara-herrero-1166059">Lara Herrero</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> and <a href="https://theconversation.com/profiles/wesley-freppel-1408971">Wesley Freppel</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a></em></p> <p><a href="https://www.labcorp.com/coronavirus-disease-covid-19/covid-news-education/covid-19-vs-flu-vs-rsv-how-tell-difference">Respiratory viruses</a> like influenza virus (flu), SARS-CoV-2 (which causes COVID) and respiratory syncytial virus (RSV) can make us sick by infecting our respiratory system, including the nose, upper airways and lungs.</p> <p>They spread from person to person through respiratory droplets when someone coughs, sneezes, or talks and can cause death in serious cases.</p> <p>But what happens in our body when we first encounter these viruses? Our immune system uses a number of strategies to fight off viral infections. Let’s look at how it does this.</p> <h2>First line of defence</h2> <p>When we encounter respiratory viruses, the <a href="https://www.sciencedirect.com/science/article/pii/S193131281600038X?via%3Dihub/">first line of defence</a> is the physical and chemical barriers in our nose, upper airways, and lungs. Barriers like the mucus lining and hair-like structures on the surface of cells, work together to trap and remove viruses before they can reach deeper into our respiratory system.</p> <p>Our defence also includes our behaviours such as coughing or sneezing. When we blow our nose, the mucus, viruses, and any other pathogens that are caught within it are expelled.</p> <p>But sometimes, viruses manage to evade these initial barriers and sneak into our respiratory system. This activates the cells of our innate immune system.</p> <h2>Patrolling for potential invaders</h2> <p>While our acquired immune system develops over time, our innate immune system is present at birth. It generates “non-specific” immunity by identifying what’s foreign. The cells of innate immunity act like a patrol system, searching for any invaders. These innate cells patrol almost every part of our body, from our skin to our nose, lungs and even internal organs.</p> <p>Our respiratory system has different type of innate cells such – as macrophages, neutrophils and natural killer cells – which patrol in our body looking for intruders. If they recognise anything foreign, in this case a virus, they will initiate an attack response.</p> <p>Each cell type plays a slightly different role. Macrophages, for example, will not only engulf and digest viruses (phagocytosis) but also release a cocktail of different molecules (cytokines) that will warn and recruit other cells to <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/cmi.12580">fight against the danger</a>.</p> <p>In the meantime, natural killer cells, aptly named, attack infected cells, and stop viruses from multiplying and <a href="https://www.nature.com/articles/s41577-021-00558-3">invading our body further</a>.</p> <p>Natural killer cells also promote inflammation, a <a href="https://www.hindawi.com/journals/jir/2018/1467538/">crucial part of the immune response</a>. It helps to recruit more immune cells to the site of infection, enhances blood flow, and increases the permeability of blood vessels, allowing immune cells to reach the infected tissues. At this stage, our immune system is fighting a war against viruses and the result can cause inflammation, fevers, coughs and congestion.</p> <h2>Launching a specific attack</h2> <p>As the innate immune response begins, another branch of the immune system called the adaptive immune system is <a href="https://www.ncbi.nlm.nih.gov/books/NBK21070/">activated</a>.</p> <p>The adaptive immune system is more specific than the innate immune system, and it decides on the correct tools and strategy to fight off the viral invaders. This system plays a vital role in eliminating the virus and providing long-term protection against future infections.</p> <p>Specialised cells called T cells and B cells are key players in acquired immunity.</p> <p>T cells (specifically, helper T cells and cytotoxic T cells) recognise viral proteins on the surface of infected cells:</p> <ul> <li> <p>helper T cells release molecules that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3764486/">further activate immune cells</a></p> </li> <li> <p>cytotoxic T cells directly kill infected cells with a very great precision, <a href="https://www.frontiersin.org/articles/10.3389/fimmu.2018.00678/full">avoiding any healthy cells around</a>.</p> </li> </ul> <p>B cells produce antibodies, which are proteins that can bind to viruses, neutralise them, and mark them for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7247032/">destruction by other immune cells</a>.</p> <p>B cells are a critical part of memory in our immune system. They will remember what happened and won’t forget for years. When the same virus attacks again, B cells will be ready to fight it off and will neutralise it faster and better.</p> <p>Thanks to the adaptive immune system, vaccines for respiratory viruses such as the COVID mRNA vaccine keep us protected from <a href="https://www.health.gov.au/our-work/covid-19-vaccines/our-vaccines/how-they-work">being sick or severely ill</a>. However, if the same virus became mutated, our immune system will act as if it was a new virus and will have to fight in a war again.</p> <h2>Neutralising the threat</h2> <p>As the immune response progresses, the combined efforts of the innate and adaptive immune systems helps control the virus. Infected cells are cleared, and the virus is neutralised and eliminated from the body.</p> <p>As the infection subsides, symptoms gradually improve, and we begin to feel better and to recover.</p> <p>But recovery varies depending on the specific virus and us as individuals. Some respiratory viruses, like rhinoviruses which cause the common cold, may cause relatively mild symptoms and a quick recovery. Others, like the flu, SARS-CoV-2 or severe cases of RSV, may lead to more severe symptoms and a longer recovery time.</p> <p>Some viruses are very strong and too fast sometimes so that our immune system does not have the time to develop a proper immune response to fight them off. <img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/207023/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/lara-herrero-1166059">Lara Herrero</a>, Research Leader in Virology and Infectious Disease, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> and <a href="https://theconversation.com/profiles/wesley-freppel-1408971">Wesley Freppel</a>, Research Fellow, Institute for Glycomics, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-happens-in-our-body-when-we-encounter-and-fight-off-a-virus-like-the-flu-sars-cov-2-or-rsv-207023">original article</a>.</em></p>

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6 habits of people who don’t get sick

<p>Winter is a dangerous time. Although cold temperatures themselves don’t cause us to get sick, our winter habits invite the spread of germs and risk of contagion is high.</p> <p>If you find yourself sick every winter, here are some useful habits of those healthy people to take up.</p> <p><strong>1. They get enough sleep</strong></p> <p>It’s easy to experience disrupted sleep during winter. When air is too cold, it will negatively affect melatonin production and cause the body's sleep cycle to be disrupted. However, research shows that people who sleep only five to six hours a night have a 30 per cent chance of catching a cold when exposed to the virus; those who get more than seven hours reduce their risk to 17 per cent.</p> <p><strong>2. They pay extra attention to hygiene</strong></p> <p>With more germs in the air, now is the time to stay conscious about where they may be festering. Key areas include bathroom door handles, taps, fridges, elevator buttons and public transport. Keep antibacterial wipes on you so whenever you touch a high risk surface, you can cleanse you hand before eating, or touching your face and eyes.</p> <p><strong>3. They exercise regularly</strong></p> <p>Winter is notorious for zapping our work-out motivation. However, exercise strengthens the immune system and makes you less likely to catch upper respiratory infections.</p> <p><strong>4. The get their flu shot</strong></p> <p>Flu shots, approved for all adults, are effective 50 to 60 per cent of the time in preventing the flu and may also reduce the severity of symptoms.</p> <p><strong>5. They don’t smoke</strong></p> <p>Cigarette smoke appears to damage the mucus membranes, which act as the frontline barrier to infectious agents, making smokers twice as likely to catch a cold and several times more likely to develop the flu.</p> <p><strong>6. They enjoy a drink</strong></p> <p>Harvard University School of Public Health researchers found that red wine was particularly protective against colds, probably due to the anti-inflammatory action of the phenol, resveratrol. Just keep in mind that drinking more than two glasses a day raises the risk for infections.</p> <p><em>Image credit: Shutterstock</em></p>

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Should I get a flu vaccine this year? Here’s what you need to know

<p><em><a href="https://theconversation.com/profiles/paul-griffin-1129798">Paul Griffin</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>After having low rates of influenza (flu) transmission in recent years thanks to our COVID control strategies, case numbers are now rising.</p> <p>So far this year, Australia has had <a href="https://www.immunisationcoalition.org.au/news-data/influenza-statistics/">more than 32,000</a> lab-confirmed cases of the flu and 32 deaths.</p> <p>Getting a flu vaccine is the best way to protect against getting the flu. These are reformulated each year to protect against the most widely circulating strains – if our predictions are right.</p> <p>Below you’ll find everything you need to know about the 2023 flu vaccine. But first, some flu basics.</p> <h2>What are the different types of flu?</h2> <p>There are two main types of influenza: influenza A and influenza B. On the surface of the influenza virus there are two main proteins, the hemagglutinin (HA or H) and neuraminidase (NA or N).</p> <p>Different strains are named after their versions of the H and N proteins, as in H1N1 or “swine flu”.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/525044/original/file-20230509-15-c78c12.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/525044/original/file-20230509-15-c78c12.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=396&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/525044/original/file-20230509-15-c78c12.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=396&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/525044/original/file-20230509-15-c78c12.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=396&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/525044/original/file-20230509-15-c78c12.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=498&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/525044/original/file-20230509-15-c78c12.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=498&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/525044/original/file-20230509-15-c78c12.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=498&amp;fit=crop&amp;dpr=3 2262w" alt="" /><figcaption><span class="caption">HA is the yellow spike, while the NA is the green oval.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/structure-influenza-virus-infographics-vector-illustration-542924464?src=ixiW0w-59I3I17RpN4L3wQ-1-12">Shutterstock</a></span></figcaption></figure> <p>Minor changes in the proteins (HA and NA) on the surface are common because the enzyme the virus uses to make copies of itself is prone to errors.</p> <p>Sometimes the influenza virus can change more abruptly when it mixes up components from different influenza viruses – including influenza viruses that typically infect birds, pigs or bats – to create a virus that’s basically new.</p> <p>The regular change in the virus is the reason the vaccine is updated every year. The <a href="https://www.tga.gov.au/about-tga/advisory-bodies-and-committees/australian-influenza-vaccine-committee-aivc">Australian Influenza Vaccine Committee</a> meets late in the year to plan what should be included in the vaccine for the following season, after considering what happened in our last flu season and in the Northern hemisphere winter.</p> <h2>What strains does this year’s flu shot protect against?</h2> <p>Modern flu vaccines typically protect against four strains. For this year’s vaccine, the committee <a href="https://www.tga.gov.au/resources/publication/meeting-statements/aivc-recommendations-composition-influenza-vaccines-australia-2023">has recommended</a> it includes:</p> <ul> <li> <p>an A/Sydney/5/2021 (H1N1)pdm09-like virus</p> </li> <li> <p>an A/Darwin/9/2021 (H3N2)-like virus</p> </li> <li> <p>a B/Austria/1359417/2021 (B/Victoria lineage)-like virus</p> </li> <li> <p>a B/Phuket/3073/2013 (B/Yamagata lineage)-like virus.</p> </li> </ul> <p>The naming of the viral components can sometimes be confusing. The name is <a href="https://www.cdc.gov/flu/about/viruses/types.htm">derived from</a> the virus type (A or B)/the place it was first isolated/strain number/year isolated (virus subtype).</p> <p>This year’s vaccine therefore includes an influenza A virus similar to the 2009 pandemic-causing H1N1 isolated from Sydney in 2021 and a second influenza A virus (H3N2) isolated in Darwin in 2021.</p> <p>Influenza B viruses are classified into 2 lineages: Victoria and Yamagata. This year’s vaccine includes an influenza B isolated from Austria in 2021 (Victoria lineage) and an influenza B isolated in Phuket in 2013 (Yamagata lineage).</p> <h2>Who should get a flu shot?</h2> <p>Health authorities <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">recommend</a> everyone aged six months of age or over should get the flu vaccine every year.</p> <p><a href="https://www.health.gov.au/news/2023-national-immunisation-program-influenza-vaccination-early-advice-for-vaccination-providers">Some groups</a> are at greater risk of significant disease from the flu and can access the flu vaccine for free. This includes:</p> <ul> <li> <p>Aboriginal and Torres Strait Islander people aged six months and over</p> </li> <li> <p>children aged six months to five years</p> </li> <li> <p>pregnant women at any stage of pregnancy</p> </li> <li> <p>people aged 65 years or over</p> </li> <li> <p>people aged five years to 65 years who have certain underlying health conditions affecting the heart, lungs, kidneys or immune system, and those with diabetes.</p> </li> </ul> <h2>How can I get it?</h2> <p>You can get a flu shot from your local general practice or pharmacy. Or you may have an opportunity to get vaccinated at your workplace if your employer supplies it.</p> <p>While the vaccine is free for those in the <a href="https://www.health.gov.au/sites/default/files/2023-02/fighting-flu-starts-with-you-consumer-fact-sheet.pdf">above groups</a>, there can be a consultation or administration fee, depending on where you get your vaccine.</p> <p>If you aren’t eligible for a free vaccine, it usually costs around A$20-$30.</p> <h2>Are there different options?</h2> <p>For over 65s, whose immune systems may not work as well as when they were younger, a <a href="https://www.health.gov.au/sites/default/files/2023-03/atagi-advice-on-seasonal-influenza-vaccines-in-2023.pdf">specific vaccine</a> is available that includes an adjuvant which boosts the immune response. This is free for over-65s under the national immunisation program.</p> <p>A high-dose vaccine is also available for people aged 60 and over. However this isn’t currently funded and costs around $70 on a private prescription.</p> <p>People with egg allergies can safely get the egg-based flu vaccine. However there is also a cell-based immunisation for people who don’t want a vaccine made in eggs. When vaccines are grown in eggs, sometimes the virus can change and this might affect the level of protection. Cell-based vaccines aim to address this issue.</p> <p>The cell-based vaccine isn’t funded so patients will pay around $40 for a private prescription.</p> <h2>How well do they work?</h2> <p>The vaccine’s effectiveness depends on how well the strains in the vaccine match those circulating. It generally <a href="https://www.health.gov.au/resources/publications/aisr-2022-national-influenza-season-summary">reduces</a> the chance of being admitted to hospital with influenza by <a href="https://www.health.gov.au/sites/default/files/documents/2022/08/influenza-vaccine-efficacy-effectiveness-and-impact-explained.docx">30-60%</a>.</p> <h2>What are the side effects?</h2> <p>You can’t get the flu from the vaccine as there’s no live virus in it.</p> <p>When people get a flu-like illness after the vaccine, it can be due to mild effects we sometimes see after vaccination, such as headaches, tiredness or some aches and pains. These usually go away <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine#possible-side-effects-of-influenza-vaccination">within a day or two</a>.</p> <p>Alternatively, symptoms after getting a flu shot may be due to another respiratory virus such as respiratory syncytial virus (RSV) that circulates in winter.</p> <h2>When’s the best time to get your flu shot?</h2> <p>The vaccine provides <a href="https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/influenza-flu#vaccine-information">peak protection</a> around three to four months <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine#when-to-get-the-influenza-vaccine">after</a> you get it.</p> <p>The <a href="https://www.immunisationcoalition.org.au/news-data/influenza-statistics/">peak of the flu season</a> is usually between June and September, however this changes every year and can vary in different parts of the country.</p> <p>Given this, the best time to get the vaccine is usually around late April or early May. So if you haven’t already, now would be a good time to get it.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/203406/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/paul-griffin-1129798">Paul Griffin</a>, Associate Professor, Infectious Diseases and Microbiology, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/should-i-get-a-flu-vaccine-this-year-heres-what-you-need-to-know-203406">original article</a>.</em></p>

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Are flu cases already 100 times higher than last year? Here’s what we really know about the 2023 flu season

<p>Alarming <a href="https://www.9news.com.au/national/flu-cases-australia-update-warning-vulnerable-numbers-rise-100-fold-last-year/55ccbb1d-9613-4e45-85aa-43c905efc8e6">headlines</a> and media coverage <a href="https://www.sbs.com.au/news/article/the-flu-nearly-disappeared-during-the-pandemic-now-cases-are-soaring-in-australia/a98cybrj8">have said</a> we’ve had 100 times as many influenza cases in the first two months of 2023 compared with the same time the previous year.</p> <p>The coverage suggested we’re in for a bumper flu season, starting early and your best protection was to get a flu vaccine, when available.</p> <p>But that scary sounding 100 figure is misleading. Here’s what’s behind the figures and what we can really expect from the 2023 flu season.</p> <h2>Comparing apples with oranges</h2> <p>In the first two months of 2023, there were 8,474 laboratory-confirmed cases of influenza. In 2022, over the same period, there were 79 cases.</p> <p>So it might seem this year’s figures are indeed more than 100 times higher than last year’s. But we shouldn’t be alarmed. That’s because in early 2022, influenza cases were artificially low.</p> <p>Strict COVID measures <a href="https://www.bmj.com/content/379/bmj.o2998">almost eliminated</a> influenza outbreaks in 2020 and 2021. Shutting international borders, quarantining, social distancing and mask-wearing stopped influenza coming into the country and spreading.</p> <p>Many COVID restrictions weren’t relaxed until late February/March 2022. So, in January and February of that year there were fewer opportunities for us to mingle and spread the influenza virus. It’s hardly surprising there were few cases then.</p> <p>In fact, the rate of flu in 2023 is actually very similar to pre-COVID years (that is before 2020).</p> <p>As always, the reported cases represent just a fraction of the actual influenza cases. That’s because many people do not seek medical care when infected with influenza or their GP doesn’t always test them for it.</p> <h2>How about an earlier flu season?</h2> <p>Every year, it seems, influenza throws a new curve ball making predictions tricky.</p> <p>Flu rates in the northern hemisphere <a href="https://www.cnet.com/health/medical/early-signs-point-to-this-years-flu-season-being-the-worst-one-in-years/">largely peaked</a> in December 2022, two months earlier than usual.</p> <p>But there has been some late-season influenza B activity in the northern hemisphere this year. This is one type of influenza that causes seasonal flu. So travellers arriving/returning from the northern hemisphere have been bringing influenza to Australia for several months.</p> <p>So we expect more cases of influenza. Australia may even have an autumn surge. This occurred <a href="https://www.bmj.com/content/379/bmj.o2998">last year</a>, where influenza cases rose sharply in May, and peaked by June. That’s two months earlier than the five-year average pre-COVID.</p> <p>Before COVID, influenza cases usually began to rise in April/May. This progressed to a full epidemic from June to August, often extending into September, before waning in October.</p> <h2>So what can we expect in 2023?</h2> <p>The start, length and severity of influenza seasons vary and are often unpredictable.</p> <p>Community immunity will be less than in pre-COVID times. That’s because of fewer influenza infections during COVID restrictions plus <a href="https://ncirs.org.au/influenza-vaccination-coverage-data/national-influenza-vaccination-coverage-all-people">lower influenza vaccine uptake</a> in recent years.</p> <p>So the 2023 flu season may be at least moderately severe. This remains speculation. Flu routinely surprises us.</p> <p>The severity of the coming Australian influenza season will be influenced by the types of influenza that circulate, when the surge starts and when the season peaks. The effectiveness, uptake and timing of vaccinations and the degree of remaining herd immunity will all be important.</p> <h2>Plan to get vaccinated</h2> <p>Only about 40% of those eligible were vaccinated against influenza in 2022, according to the <a href="https://www.servicesaustralia.gov.au/australian-immunisation-register">Australian Immunisation Register</a> database. Rates <a href="https://ncirs.org.au/influenza-vaccination-coverage-data/national-influenza-vaccination-coverage-all-people">were highest</a> in people aged 65 or older.</p> <p>However, as we saw an early influenza season in 2022 (peaking in May/June) this meant many Australians were not vaccinated during the early stages of the epidemic.</p> <p>With this knowledge, it’s important to be vaccinated in April/May before influenza becomes common.</p> <p>Now is a good time to start preparing to get your flu vaccine. Ask your GP or pharmacist when you can book yourself in.</p> <p>Vaccination is our best defence against influenza and is recommended from the age of <a href="https://www.health.gov.au/news/2023-national-immunisation-program-influenza-vaccination-early-advice-for-vaccination-providers">6 months</a>. Younger infants <a href="https://www.health.gov.au/influenza-vaccination-in-pregnancy">receive protection</a> if their mum was vaccinated during pregnancy.</p> <p>The 2023 vaccine has been updated to protect against more recently circulating strains. There are also <a href="https://www.health.gov.au/sites/default/files/2023-03/atagi-advice-on-seasonal-influenza-vaccines-in-2023.pdf">different types</a> of influenza vaccine, some more effective in elderly people, some free under the <a href="https://www.health.gov.au/resources/publications/national-immunisation-program-schedule?language=en">National Immunisation Program</a>, some not. Other vaccines are available for people with egg allergies and for small children. It’s best to discuss the vaccine options with your GP or pharmacist.</p> <p><em>Image credit: Shutterstock</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/are-flu-cases-already-100-times-higher-than-last-year-heres-what-we-really-know-about-the-2023-flu-season-201559" target="_blank" rel="noopener">The Conversation</a></em></p>

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What is my PCR test testing for?

<p>As <a href="https://cosmosmagazine.com/australia/2022-flu-season-australia-influenza/" target="_blank" rel="noreferrer noopener">COVID and flu collide</a> to create a <a href="https://cosmosmagazine.com/health/covid-changing-flu-season-flurona/" target="_blank" rel="noreferrer noopener">winter of sick days</a>, it’s not obvious <a href="https://cosmosmagazine.com/australia/explainer-do-i-have-covid-or-flu/" target="_blank" rel="noreferrer noopener">which illness you have</a>. And some people undergoing PCR (polymerase chain reaction) tests for COVID have discovered that their samples are also being tested for influenza and other bugs.</p> <p>How does this work, and where are COVID tests being used to find more than just COVID?</p> <p>At this point, we’re all well-versed on the <a href="https://cosmosmagazine.com/health/covid/rise-of-rapid-antigen-testing/" target="_blank" rel="noreferrer noopener">different COVID tests you can get</a> – RATs can be done at home but are less accurate, while <a href="https://cosmosmagazine.com/science/what-is-pcr/" target="_blank" rel="noreferrer noopener">PCR tests</a> are more reliable.</p> <p>In brief, PCR tests work by identifying and amplifying viral DNA or RNA.</p> <p>If you’re looking for the presence of SARS-CoV-2, you add a <em>primer</em> (a specific type of DNA) for SARS-CoV-2 to the sample and it amplifies the presence of SARS-CoV-2 in the sample. (You can learn about PCR tests in more detail in <a href="https://cosmosmagazine.com/science/what-is-pcr/" target="_blank" rel="noreferrer noopener">these</a> <a href="https://cosmosmagazine.com/science/how-is-rt-pcr-used-to-diagnose-covid-19/" target="_blank" rel="noreferrer noopener">articles</a>.)</p> <div class="newsletter-box"> <div id="wpcf7-f6-p196191-o1" class="wpcf7" dir="ltr" lang="en-US" role="form"> </div> </div> <p>Looking for influenza uses the same trick: you just use an influenza primer rather than one for SARS-CoV-2. The DNA primer added has a different “code”, but all the other parts of the test and equipment used to do it are the same.</p> <p>You can also use PCR to find other viruses that cause cold symptoms – like rhinoviruses, respiratory syncytial viruses (RSV), or adenoviruses.</p> <p>All of these tests can be undertaken using the same original swab sample.</p> <p>If it’s possible to test for all these viruses with PCR, why haven’t we been doing so until recently? Many of us over the past two years have used a PCR test to establish we don’t have COVID, but we definitely have <em>something</em>.</p> <p>Testing for a variety of things is often done on healthcare workers or people with specific vulnerabilities, but most people don’t benefit from knowing whether they’re sick with a rhinovirus or an adenovirus. Additional tests use additional resources for little advantage.</p> <p>However, with the unusually early arrival of the flu season, it has become more useful to monitor for influenza. Private providers, in particular, may check for viruses other than SARS-CoV-2, depending on the resources and government rebates available to them.</p> <p><img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=196191&amp;title=What+is+my+PCR+test+testing+for%3F" width="1" height="1" /></p> <div id="contributors"> <p><em><a href="https://cosmosmagazine.com/health/pcr-covid-influenza-rsv/" target="_blank" rel="noopener">This article</a> was originally published on <a href="https://cosmosmagazine.com" target="_blank" rel="noopener">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/ellen-phiddian" target="_blank" rel="noopener">Ellen Phiddian</a>. Ellen Phiddian is a science journalist at Cosmos. She has a BSc (Honours) in chemistry and science communication, and an MSc in science communication, both from the Australian National University.</em></p> <p><em>Image: Getty Images</em></p> </div>

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Why can you still get influenza if you’ve had a flu shot?

<p>Restrictions have eased, international borders are open and influenza is back in Australia after a two-year absence.</p> <p>Suddenly, major <a href="https://www.abc.net.au/news/2022-06-08/medical-evacuations-as-flu-arrives-early-in-nt/101132294" target="_blank" rel="noopener">flu outbreaks</a> are occurring across the country, catching many off guard.</p> <p>Flu vaccinations aim to protect against four influenza viruses that cause disease in humans (two subtypes from influenza A and two from influenza B).</p> <p>But vaccine-mediated protection varies each year depending on how well the vaccine matches the disease-causing influenza viruses that are circulating at a given time. Vaccine effectiveness – a real-world measure based on the proportion of vaccinated people who still develop the flu – <a href="https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm" target="_blank" rel="noopener">ranges</a> from <a href="https://www.clinicaltrialsarena.com/comment/us-flu-vaccine-efficacy/" target="_blank" rel="noopener">16%</a> to <a href="https://www1.health.gov.au/internet/main/publishing.nsf/Content/cda-surveil-ozflu-flucurr.htm/%24File/Vacc-efficacy-effect-impact-Oct18.pdf" target="_blank" rel="noopener">60%</a>.</p> <p>However, it’s still important to get your flu shot. If you’ve been vaccinated and still get the flu, you’re <a href="https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm" target="_blank" rel="noopener">less likely</a> to get as sick.</p> <h2>Why it’s difficult to predict which subtypes will dominate</h2> <p>Of the four types of influenza viruses that exist in nature, two cause significant disease in humans: influenza A and influenza B.</p> <p>The 2022 influenza vaccine is quadrivalent (targets four distinct viruses): two influenza A viruses (subtypes H3N2 and H1N1) and two influenza B viruses from distinct lineages.</p> <p>Within each flu A subtype further genetic variation can arise, with mutations (known as genetic drift) generating many viral variants that are classified into “clades” and sub-clades.</p> <p>H3N2 is particularly good at generating lots of diversity in this way. So predicting exactly which H3N2 virus to target in the vaccine is especially difficult.</p> <p>A key challenge for flu vaccines is the decision for which virus to target has to be made months ahead of time. The the H3N2 virus in the Australian flu vaccine (A/Darwin/9/2021) was chosen in September 2021 to enable the vaccine to be manufactured and distributed in time for the 2022 winter.</p> <p>There is no guarantee a different H3N2 virus that isn’t so well targeted by the vaccine won’t arrive in the country in the months leading into winter and start causing disease.</p> <p>Another factor that has made predicting which H3N2 virus to target in the vaccine uniquely difficult for 2022 is the lack of data on which viruses were dominant in the preceding flu seasons, both in Australia and on the other side of the Equator.</p> <p>With travel restrictions easing towards the end of 2021, flu cases did start to reappear during the northern hemisphere 2021-22 winter. But the lack of flu cases during the preceding seasons (due to COVID) meant the data used to predict which viruses to target was inadequate.</p> <p>The US Centers for Disease Control (CDC) analysed data from more than 3,000 children and <a href="https://www.clinicaltrialsarena.com/comment/us-flu-vaccine-efficacy/" target="_blank" rel="noopener">found</a> a vaccine effectiveness of just 16% protection from mild to moderate disease from H3N2. Protection from more severe disease was just 14%.</p> <h2>We don’t know which subtypes will circulate in Australia</h2> <p>Data about flu vaccine effectiveness in the southern hemisphere 2022 winter isn’t yet available, and it’s unclear how protective the current vaccine is against the currently circulating disease-causing subtypes.</p> <p>While H3N2 viruses appears to be <a href="https://www1.health.gov.au/internet/main/publishing.nsf/Content/cda-surveil-ozflu-flucurr.htm/%24File/flu-05-2022.pdf" target="_blank" rel="noopener">driving some disease now</a>, other flu viruses may become more prevalent later in the season.</p> <p>The flu vaccine is a quadrivalent vaccine, so in addition to influenza A H3N2, it will protect against another influenza A subtype (H1N1) and two distinct lineages of influenza B virus. These viruses don’t change as rapidly as H3N2, so it’s more likely the vaccine will give better protection against these other influenza viruses.</p> <p>Even if vaccine protection against H3N2 is lower than usual this year, the vaccine <a href="https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm" target="_blank" rel="noopener">could make the difference</a> between recovering at home versus ending up in hospital.</p> <h2>So who should get a flu shot and when?</h2> <p>The flu vaccine offers the highest level of protection in the first three to four months months after vaccination. The season <a href="https://www.health.gov.au/health-topics/immunisation/vaccines/influenza-flu-vaccine" target="_blank" rel="noopener">generally peaks</a> between June and September – although this year we have seen a much earlier than usual start to the flu season. It’s unclear whether this early start will mean a longer flu season or an early finish. So it’s not too late to get vaccinated.</p> <p>Flu vaccines <a href="https://www.health.gov.au/health-topics/immunisation/vaccines/influenza-flu-vaccine" target="_blank" rel="noopener">are recommended</a> for everyone aged six months and over, but are particularly important for people who are more at risk of complications from influenza, including:</p> <ul> <li>Aboriginal and Torres Strait Islander people aged six months and over</li> <li>children aged six months to five years</li> <li>pregnant women</li> <li>people aged 65 years or over</li> <li>people aged six months or over who have medical conditions that mean they have a higher risk of getting serious disease.</li> </ul> <h2>What if you still get the flu?</h2> <p>If you develop flu symptoms, isolate and <a href="https://www.health.gov.au/health-topics/flu-influenza#diagnosis" target="_blank" rel="noopener">see your GP</a> for an influenza PCR test to determine whether you are indeed infected with influenza, particularly if you’re in the higher-risk groups.</p> <p>Specific antivirals for influenza <a href="https://www.health.gov.au/health-topics/flu-influenza#treatment" target="_blank" rel="noopener">can help</a>, if given early. To ensure rapid access to particularly vulnerable aged-care residents, aged-care facilities are being <a href="https://www1.racgp.org.au/newsgp/clinical/plans-ramp-up-for-tamiflu-deployment-in-aged-care" target="_blank" rel="noopener">stocked</a> with the flu antiviral drug Tamiflu.</p> <p>In New South Wales, free <a href="https://www.newsofthearea.com.au/4cyte-drive-through-covid-19-testing-centres-to-conduct-conduct-influenza-and-rsv-testing-94671" target="_blank" rel="noopener">drive-through clinics</a> now offer testing for influenza, respiratory syncytial virus (RSV) and SARS-CoV-2, the virus that causes COVID. Other states and territories may follow.</p> <p><em><strong>This article originally appeared on <a href="https://theconversation.com/why-can-you-still-get-influenza-if-youve-had-a-flu-shot-184327" target="_blank" rel="noopener">The Conversation</a>.</strong></em></p> <p><em>Image: Shutterstock</em></p>

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13 foods doctors eat when they have a cold

<p>That age-old advice is dead-on: when you’re sick, your body needs extra fuel in the form of kilojoules to defend against germs and mount an immune response. “What you eat can be one of the best weapons in your arsenal,” says pulmonologist, Dr Gustavo Ferrer. The right nutrients can give your immune system a much-needed boost, help clear up some of those irritating symptoms, and get you back on your feet faster. Doctors shared their favourite home remedies when they feel a cold coming on – and some of their recommendations may surprise you.</p> <p><strong>Chicken soup</strong></p> <p>It’s not just for your soul – chicken soup may actually help fight upper respiratory tract infections, according to an older, but classic study published in the journal Chest that looked at how immune cells responded in the laboratory. “When we get attacked by a virus, our natural defences can cause an inflammatory response,” says Dr Ferrer. Some combination of ingredients in the soup may inhibit the white blood cell activity that can cause inflammation.</p> <p><strong>Strawberries</strong></p> <p>These berries are brimming with antioxidant power – they’re among the top 20 richest fruits when it comes to free radical slaying compounds – particularly vitamin C. And last year, a study in the journal Nutrients found that getting up to eight grams of vitamin C a day can help shorten the length of a cold. Adding a cup of sliced strawberries to your smoothie will net you about 100 milligrams of vitamin C.</p> <p><strong>Garlic</strong></p> <p>This potent bulb contains a compound known as allicin, which has antibacterial and antiviral properties that may help fight off the common cold. Chopping or crushing garlic activates this compound, so for maximum results, prep it and let it sit for several minutes before eating it. In research published in the Cochrane Database of Systemic Reviews, people who took a garlic supplement daily reported fewer colds over a three-month span than those who popped a placebo.</p> <p><strong>Honey</strong></p> <p>Sore throat? The sticky, sweet nectar was found to be superior to many over-the-counter cough suppressants, Dr Ferrer says. For a soothing elixir that’s the bee’s knees, combine honey with lemon juice for a little vitamin C antioxidant action, he adds.</p> <p><strong>Carrots</strong></p> <p>These may be one of the ingredients that give chicken soup its curative properties. Carrots and other orange-hued produce contain beta-carotene. Your body converts this compound to vitamin A, a building block of your immune system, says Dr Eudene Harry.</p> <p><strong>Onions</strong></p> <p>These aromatics contain quercetin, an antioxidant with antiviral and anti-inflammatory properties. “A lot of the symptoms you get when you’re sick is your body hyper-responding to things that are not necessarily a threat,” says Dr Harry. “Antioxidants help quell some of that response so it doesn’t get out of control. They remove waste products and reduce inflammation,” she says.</p> <p><strong>Capsicum</strong></p> <p>Research shows that being cold may suppress your immune system a bit, but vitamin C has natural immune-boosting properties. Loading up on C-rich foods can be a good way to compensate for a suppressed immune function during the chillier months, Dr Harry says. A cup of chopped capsicum has two times as much vitamin C as a medium orange.</p> <p><strong>Green tea</strong></p> <p>Fluids are important when you’re sick because, Dr Harry says, “Everything works better when you’re hydrated.” Green tea is a good choice because it contains the potent antioxidants catechins, along with theanine, an amino acid. Both have been linked to immunity, research shows.</p> <p><strong>Ginger</strong></p> <p>If the dreaded stomach flu is going around, stock up on this relieving root. It’s known for its anti-nausea properties. It also contains compounds known as gingerols that have an anti-inflammatory effect, which makes it an ideal addition to a cup of tea for soothing a sore throat. Dr Harry likes to take hers with ginger, pomegranate and lemon.</p> <p><strong>Mushrooms</strong></p> <p>These fungi are one of the few edible sources of vitamin D, which we normally get from the sun. Shorter daylight hours during the autumn and winter months can mean we’re not getting enough of that nutrient, which can open the door to lowered immunity. Mushrooms don’t naturally contain that much vitamin D, but if they are grown in the presence of ultraviolet light they will produce more. (Check the package for actual content of vitamin D.)</p> <p>Shiitake mushrooms, in particular, may help in this regard, says associate professor of medicine, Dr Gerard Mullin.  A study published in the Journal of the American College of Nutrition showed that people who ate 5 or 10 grams of shiitake mushrooms a day had improved markers of immunity, including better-functioning gamma delta T cells and reductions in inflammatory proteins in their blood.</p> <p><strong>Hot sauce</strong></p> <p>A big hit of wasabi or sriracha can feel like it’s clearing your sinuses even when you’re not sick – and it turns out, that could very well be the case. A Cochrane review of research on nasal sprays containing capsaicin, the active compound in chilli peppers and other spicy foods, improves symptoms of nonallergic rhinitis (aka sneezing, congestion) better than a placebo, possibly because of its anti-inflammatory effect. Plus, spicy peppers are another good source of vitamin C.</p> <p><strong>Turmeric</strong></p> <p>Spiking your coffee with this spice, aka a golden latte, won’t hurt. Curcumin, the active compound in the vibrant yellow powder, has anti-inflammatory, antibacterial and antiviral properties. “Oxidative stress goes up when your body is under attack,” says Dr Mullin. That can cause residual damage beyond what the invading germs cause. Turmeric, he says, can help with that.</p> <p>YoghurtFermented dairy products may not be your go-to when you’re feeling under the weather, but they should be, says Dr Mullin. “Most of your immune system is in your gut,” he explains, and probiotic-containing foods like yoghurt help keep your gastrointestinal tract teeming with healthy bacteria. Indeed, research has found that the benefits go beyond digestive health: a 2017 study in the journal Nutrients found that eating yoghurt daily increase the activity of killer T cells, whose job it is to destroy infected cells in the body. And there’s no evidence that dairy creates phlegm or contributes to congestion, so spoon away!</p> <p><em>This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/13-foods-doctors-eat-when-they-have-a-cold" target="_blank" rel="noopener">Reader’s Digest</a>.</em></p>

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Three reasons you haven’t caught Covid yet

<p dir="ltr">Most of us have been in close contact with someone who contracted Covid but never tested positive ourselves.</p> <p dir="ltr">It raises questions as to why you would not test positive yourself despite being in the same room as a positive case, sharing food and drink despite how infectious the virus is.</p> <p dir="ltr">There are three possible reasons as to why you still haven’t caught Covid, despite the situation leaving doctors stumped. </p> <p dir="ltr">Australian National University lecturer and epidemiologist Dr Katrina Roper helps explain the three main reasons why some don’t test positive. </p> <p dir="ltr"><strong>Common cold</strong></p> <p dir="ltr">Before Covid, we’d all be exposed to the common cold which would help build immunity against other viruses. </p> <p dir="ltr">“Having a prior infection to another cold virus can confer some protection to Covid, or other respiratory viruses,” Dr Roper told <a href="https://www.news.com.au/lifestyle/health/health-problems/a-doctor-explains-why-you-havent-caught-covid-yet/news-story/d57a08a08278abf27f43c29fcfe87196" target="_blank" rel="noopener">news.com.au</a>.</p> <p dir="ltr">”Exposure to other respiratory viruses can prime parts of the immune system, leading to better defence against infection by the SARS CoV-2 infection”.</p> <p dir="ltr">Research published in the Nature Communications journal in January 2022, confirmed the theory that being exposed to Covid won’t always cause an infection.</p> <p dir="ltr">“Being exposed to the SARS-CoV-2 virus doesn’t always result in infection, and we’ve been keen to understand why,” lead author Dr Rhia Kundu wrote.</p> <p dir="ltr">“We found that high levels of pre-existing T cells, created by the body when infected with other human coronaviruses like the common cold, can protect against COVID-19 infection.”</p> <p dir="ltr">Immunologist Professor Stuart Tangye insists that there’s also a possibility that you were infected with Covid but you didn’t know it. </p> <p dir="ltr"><strong>Your immune system</strong></p> <p dir="ltr">When it comes to avoiding Covid it could be that your immune system is pretty strong, or the vaccine worked better for you. </p> <p dir="ltr">Dr Roper however did point out that it could also all depend on the individuals’ circumstance - such as their age, weight and how healthy they are.</p> <p dir="ltr">She noted that even the healthiest of people could still have weakened immune systems - citing professional athletes who push themselves and in turn feel worse afterwards. </p> <p dir="ltr"><strong>The exposure</strong></p> <p dir="ltr">Again, everyone has been exposed differently to Covid and while some may have contracted it, you didn’t. </p> <p dir="ltr">The circumstances of where you are could be affected such as a large house but only two people living there, giving you ample space to stay away despite sharing the same areas.</p> <p dir="ltr"><strong>Genetics</strong></p> <p dir="ltr">Professor Tangye suggested a fourth reason as to why you haven’t contracted Covid despite your exposure.</p> <p dir="ltr">Put simply, your genetics. </p> <p dir="ltr">“There are going to be people who are less susceptible to viral infection because they have differences in their genes, such as genes that are important for viral entry into your cells,” he said.</p> <p dir="ltr"><em>Image: Shutterstock</em></p>

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New swine flu with pandemic potential found in China

<p>Researchers in China have discovered a strain of swine flu that is capable of triggering another pandemic.</p> <p>A report published in peer-reviewed science journal <em>Proceedings of the National Academy of Sciences</em> earlier this week identified the G4 EA H1N1 strain of flu, which is genetically descended from the H1N1 strain that caused a pandemic in 2009.</p> <p>It has “all the essential hallmarks of a candidate pandemic virus”, scientists at Chinese universities and China’s Center for Disease Control and Prevention said in the study.</p> <p>Researchers took 30,000 nasal swabs from pigs between 2011 and 2018. A total of 179 swine flu viruses were isolated, the majority of which were a new kind that has been dominant among pigs since 2016.</p> <p>Following various experiments, G4 was found to be highly infectious, replicating in human cells and causing more severe symptoms in ferrets than other viruses do.</p> <p>Any immunity humans gain from exposure to seasonal flu does not protect against G4, <a rel="noopener" href="https://www.cbsnews.com/news/new-swine-flu-china-researchers-pandemic/" target="_blank">tests also showed</a>.</p> <p>As many as 4.4 per cent of the general population appeared to have been exposed to the virus, therefore showing that it has passed from animals to humans. There is no evidence yet that the virus can be passed between humans.</p> <p>“Controlling the prevailing G4 EA H1N1 viruses in pigs and close monitoring in human populations, especially the workers in swine industry, should be urgently implemented,” the study authors said.</p> <p>The World Health Organisation will read the Chinese report carefully, spokesman Christian Lindmeier told a Geneva briefing on Tuesday.</p> <p>“It … highlights we cannot let our guard down on influenza and need to be vigilant and continue surveillance even in the coronavirus pandemic,” he said.</p> <p>There is no imminent threat of a new pandemic despite the virus’ capability to infect humans, said Carl Bergstrom, a biologist at the University of Washington.</p> <p>“There’s no evidence that G4 is circulating in humans, despite five years of extensive exposure,” he said on Twitter. “That’s the key context to keep in mind.”</p> <p>The new swine flu is still “in the stage of examination”, said Anthony Fauci, the director of the US National Institute of Allergy and Infectious Diseases.</p> <p>It’s not “an immediate threat where you’re seeing infections, but it’s something we need to keep our eye on, just the way we did in 2009 with the emergence of the swine flu.”</p>

Travel Trouble

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Fleas to flu to coronavirus: how ‘death ships’ spread disease through the ages

<p>One of the haunting images of this pandemic will be stationary cruise ships – deadly carriers of COVID-19 – at anchor in harbours and unwanted. Docked in ports and feared.</p> <p>The news of the dramatic spread of the virus on the <a href="https://www.bmj.com/content/369/bmj.m1632">Diamond Princess</a> from early February made the news real for many Australians who’d enjoyed holidays on the seas. Quarantined in Yokohama, Japan, over 700 of the ship’s crew and passengers became infected. To date, <a href="https://www.cruisemapper.com/accidents/Diamond-Princess-534">14 deaths</a> have been recorded.</p> <p>The Diamond Princess’s sister ship, the Ruby Princess, brought the pandemic to Australian shores. Now under <a href="https://www.smh.com.au/national/nsw/police-to-probe-second-ruby-princess-voyage-as-part-of-criminal-investigation-20200417-p54kpo.html">criminal investigation</a>, the events of the Ruby Princess forced a spotlight on the petri dish cruise ships can become. The ship has been <a href="https://www.theguardian.com/australia-news/2020/may/05/ruby-princess-was-initially-refused-permission-to-dock-over-coronavirus-fears-inquiry-told">linked to 21 deaths</a>.</p> <p>History shows the <a href="https://www.ncbi.nlm.nih.gov/pubmed/29737663">devastating role ships can play</a> in transmitting viruses across vast continents and over many centuries.</p> <p><strong>Rats in the ranks</strong></p> <p>Merchant ships carrying rats with infected fleas were transmitters of the <a href="https://academic.oup.com/past/article-abstract/244/1/3/5532056?redirectedFrom=fulltext">Plague of Justinian</a> (541-542 AD) that devastated the Byzantine Empire.</p> <p>Ships carrying grain from Egypt were home to flea-infested rats that fed off the granaries. Contantinople was especially inflicted, with estimates as high as <a href="https://www.history.com/news/microbe-behind-black-death-also-caused-devastating-plague-800-years-earlier">5,000 casualties a day</a>. Globally, up to 50 million people are estimated to have been killed – half the world’s population.</p> <p>The <a href="https://www.historyextra.com/period/medieval/plague-black-death-quarantine-history-how-stop-spread/">Black Death</a> was also carried by rats on merchant ships through the trade routes of Europe. It struck Europe in 1347, when 12 ships docked at the Sicilian port of Messina.</p> <p>Subsequently called “death ships”, those on board were either dead or sick. Soon, the Black Death spread to ports around the world, such as Marseilles, Rome and Florence, and by 1348 had reached London with devastating impact.</p> <p>The Italian writer, poet and scholar, Giovanni Boccaccio, <a href="https://www.historyextra.com/period/medieval/black-death-oh-father-why-have-you-abandoned-me/">wrote</a> how terror swept through Florence with relatives deserting infected family members. Almost inconceivably, he wrote, “fathers and mothers refused to nurse their own children, as though they did not belong to them”.</p> <p>Ships started being <a href="https://www.historyextra.com/period/medieval/plague-black-death-quarantine-history-how-stop-spread/">turned away</a> from European ports in 1347. Venice was the first city to close, with those permitted to enter forced into a 40-day quarantine: the word “quarantine” derives from the Italian <em>quarantena</em>, or 40 days.</p> <p>By January 1349, mass graves proliferated outside of London to bury the increasing numbers of dead.</p> <p>Army and naval ships, as well as travellers around the globe, also carried cholera pandemics throughout the 19th century. In the first pandemic <a href="https://www.history.com/topics/inventions/history-of-cholera">in 1817</a>, British army and navy ships are believed to have spread cholera beyond India where the outbreaks originated.</p> <p>By the 1820s, cholera had spread throughout Asia, reaching Thailand, Indonesia, China and Japan through shipping. British troops spread it to the Persian Gulf, eventually moving through Turkey and Syria.</p> <p>Subsequent outbreaks from the 1820s through to the 1860s relied on trade and troops to spread the disease across continents.</p> <p><strong>At war with the Spanish Flu</strong></p> <p>The Spanish influenza of 1918-1919 was originally carried by soldiers on overcrowded troop ships during the first world war. The rate of transmission on these ships was rapid, and soldiers died in large numbers.</p> <p>One New Zealand rifleman <a href="http://dx.doi.org/10.3201/eid1811.AD1811">wrote</a> in his diary in September 1918:</p> <p><em>More deaths and burials total now 42. A crying shame but it is only to be expected when human beings are herded together the way they have been on this boat.</em></p> <p>The flu was transmitted throughout Europe in France, Great Britain, Italy and Spain. Three-quarters of French troops and over half of British troops fell ill in 1918. Hundreds of thousands of US soldiers travelling on troop ships across the Atlantic and back provided the perfect conditions for transmission.</p> <p><strong>The fate of cruising</strong></p> <p>A new and lethal carrier in the 21st century has emerged in the pleasure industry of cruise ships. The <a href="https://www.forbes.com/sites/joemicallef/2020/01/20/state-of-the-cruise-industry-smooth-sailing-into-the-2020s/#364b397665fa">explosion</a> of cruise holidays in the past 20 years has led to a proliferation of luxury liners plying the seas.</p> <p>Like historical pandemics, the current crisis shares the characteristic of rapid spread through ships.</p> <p>The unknown is in what form cruise ships will continue to operate. Unlike the port-to-port trade and armed forces that carried viruses across continents centuries ago, the services cruise lines offer are non-essential.</p> <p>Whatever happens, the global spread of COVID-19 reminds us “death ships” are an enduring feature of the history of pandemics.</p> <p><em>Written by Joy Damousi. Republished with permission of <a href="https://theconversation.com/fleas-to-flu-to-coronavirus-how-death-ships-spread-disease-through-the-ages-137061">The Conversation.</a></em></p>

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Health check: How long should you stay away when you have a cold or the flu?

<p>Most adults get around <a href="https://www.cdc.gov/features/rhinoviruses/index.html">two to three colds a year</a>, and children get even more. In terms of the flu, there are around <a href="http://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal)">3-5 million severe cases of influenza</a> worldwide each year and 290,000 to 650,000 deaths.</p> <p>The symptoms of a cold and the flu are similar, so it’s hard to tell the difference. But the flu is usually more severe and develops more quickly than a cold.</p> <p>Colds and flus can be easily passed from person to person through the air, when an infected person coughs or sneezes, and touch, when a person touches an infected surface or object like doorknobs and light switches.</p> <p>So what’s the difference between colds and flus, and how long should you stay away?</p> <p><strong>Colds</strong></p> <p>Cold <a href="https://www.cdc.gov/features/rhinoviruses/index.html">symptoms</a> include a sore throat, cough, runny or stuffy nose, tiredness and headache.</p> <p>Most people become contagious with cold symptoms one to two days after exposure to a cold virus. These symptoms usually peak two to four days later. The <a href="https://www.ncbi.nlm.nih.gov/pubmed/17397266">common cold usually lasts</a> about ten days.</p> <p>There is nothing you can take to shorten the duration of a cold, and most people will get better without needing to see a doctor. But some over-the-counter medications can help alleviate the symptoms. These include anti-inflammatories (to reduce inflammation or swelling), analgesics (to reduce pain), antipyretics (to reduce fever) and decongestants (to relieve nasal congestion).</p> <p>But be careful you follow the instructions and recommended dosage for these medications. A <a href="https://www.ncbi.nlm.nih.gov/pubmed/29516533">recent study of US adults</a> who used paracetamol, the active ingredient in many cold and flu medicines, found 6.3% of users exceeded the maximum recommended daily dose. This mostly occurred during the cold and flu season.</p> <p>Natural products such as <a href="https://www.ncbi.nlm.nih.gov/pubmed/23440782">vitamin C</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4068831/">echinacea</a> are sometimes recommended to prevent and treat a cold, but there is limited evidence to support their effectiveness.</p> <p><strong>The flu</strong></p> <p><a href="https://www.cdc.gov/flu/index.htm">Common symptoms of the flu</a> include fever (a temperature of 38°C or higher), cough, chills, sore throat, headache, runny or stuffy nose, tiredness and muscle aches.</p> <p>An infected person can <a href="https://www.cdc.gov/flu/keyfacts.htm">spread the flu</a> for five to seven days after becoming infected. The infectious period can begin 24 hours before the onset of symptoms. This means you can spread the flu without even knowing you’re sick.</p> <p>Influenza viruses can cause mild to severe illness in people of all ages. Most people will fully recover within one to two weeks and won’t require any medical attention. Similar to a cold, people can take some over-the-counter medications and other remedies to help alleviate symptoms.</p> <p>But some people can become acutely unwell with the flu. They may require <a href="http://www.who.int/features/qa/seasonal-influenza/en/">antiviral medication</a> and, in severe cases, hospitalisation. Those at <a href="http://www.who.int/features/qa/seasonal-influenza/en/">high risk</a> include pregnant women, children, the elderly, and people with certain medical conditions such as HIV/AIDS, asthma, diabetes and heart and lung diseases.</p> <p>The flu virus strains that circulate usually change every year, so the <a href="https://www.cdc.gov/flu/protect/vaccine/general.htm">best way to prevent getting the flu</a> is to get the annual flu vaccine. The vaccine is <a href="https://www.sciencedirect.com/science/article/pii/S147330991170295X">moderately effective</a> and recommended for adults and children over the age of six months. Some common side effects may occur, such as temporary soreness, redness and swelling at the injection site, fever, headache, muscle aches and nausea.</p> <p><strong>Avoid passing it on</strong></p> <p>If you feel unwell, stay home from work or school and rest (and get plenty of fluids) until you feel better. If you’ve had a fever, <a href="https://www.cdc.gov/flu/takingcare.htm">stay home for at least 24 hours</a> after the fever has broken.</p> <p>When you go back to work or school, you may still be infectious, so avoid passing the virus on by:</p> <ul> <li>regularly washing your hands with soap and water for at least 20 seconds and drying them properly – if soap and water are not available, use an alcohol-based hand sanitiser</li> <li>practising good cough and sneeze etiquette: cover your mouth and nose with a tissue or your upper shirtsleeve when you cough or sneeze, and throw away used tissues immediately</li> <li>not touching your eyes, nose and mouth</li> <li>frequently cleaning the surfaces and objects you’ve touched.</li> </ul> <p><em>Written by Nadia Charania. Republished with permission of </em><a href="https://theconversation.com/health-check-how-long-should-you-stay-away-when-you-have-a-cold-or-the-flu-98702"><em>The Conversation</em></a><em>.</em></p>

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You can’t get influenza from a flu shot – here’s how it works

<p>Influenza is a moving target for vaccines. Each year, up to four different strains circulate, and they are constantly evolving to escape our immune system.</p> <p>So rather than childhood jabs giving long lasting immunity, we need annual flu shots to provide optimal protection against influenza.</p> <p>But while you might sometimes get sick after having a flu shot, it’s a myth that having a flu shot can give you the flu.</p> <p><strong>A quick history of the flu vaccine</strong></p> <p>Influenza vaccines were first developed in the 1930s and 1940s, starting with the isolation of the influenza virus.</p> <p>Back then, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2554195/pdf/bullwho00626-0133.pdf">we learned</a> there were many different influenza strains. To be effective, early research showed the vaccine needed to be matched to the circulating strains, and to be able to stimulate a response from the immune system.</p> <p>The process to produce modern influenza vaccines now occurs on a much more refined and industrial scale. Hundreds of thousands of influenza viruses are collected by hundreds of national influenza centres around the world.</p> <p>From these, four strains are <a href="https://www.who.int/influenza/vaccines/en/">selected</a> for the annual flu vaccine, based on the viruses that are circulating at that time, how well the vaccines activate the immune system, how the strains are evolving, and the effectiveness of previous vaccines.</p> <p>Most modern vaccines are <a href="https://www.cdc.gov/flu/prevent/how-fluvaccine-made.htm">manufactured</a> by growing large quantities of live virus – mostly in chicken eggs or less commonly animal cells – which are then purified, deactivated and split into smaller components. These vaccines are inactive and cannot replicate.</p> <p>There are also two new “enhanced” vaccines that are used in older people, who don’t tend to respond as strongly to vaccines: <a href="https://www.ncbi.nlm.nih.gov/pubmed/25119609">Fluzone High Dose</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3447603/">Fluad</a>, which is designed to better stimulate immunity and draw immune cells to the site of vaccination.</p> <p><strong>How the immune system fights the flu</strong></p> <p>The human immune system has several strategies to protect against infection. For viral infections such as influenza, the key strategy is known as adaptive immunity. This part of the immune system can “remember” previous exposure to pathogens.</p> <p>When you get an influenza infection, the virus enters and hijacks the machinery of the host cell to replicate itself, before releasing these copies to infect more cells.</p> <p><a href="https://www.immunology.org/public-information/bitesized-immunology/c%C3%A9lulas/cd8-t-cells">T lymphocyte cells</a> of the immune system can recognise this viral incursion. T cells protect against further spread of the virus by activating pathways that cause infected cells to trigger a “suicide” process.</p> <p>Another strategy the body uses is to produce antibodies, which are molecules produced by B cells that recognise components of the viral capsule. These <a href="https://www.immunology.org/public-information/bitesized-immunology/c%C3%A9lulas/b-cells">antibodies</a> work by sticking to the surface of the influenza virus to prevent it spreading and facilitating disposal.</p> <p><strong>Flu shots help mount a quicker defence</strong></p> <p>On a first exposure to a pathogen, our B cells take at least two weeks to ramp up production of antibodies. However, on subsequent challenges, antibody production occurs much more quickly.</p> <p>Influenza vaccines harness this arm of the immune system, known as “humoral” immunity. By “practising” on viral components, vaccines allow the immune system to react more quickly and effectively when faced with the real virus.</p> <p><strong>So why do you sometimes get sick after a flu shot?</strong></p> <p>There are several reasons why you might feel a bit off after getting your flu shot.</p> <p>First, your flu shot only protects you against influenza and not other respiratory illness which might causes similar cold or flu symptoms. This includes RSV (<a href="https://www.health.nsw.gov.au/Infectious/factsheets/Pages/respiratory-syncytial-virus.aspx">respiratory syncytial virus</a>), which is common in late autumn and early winter.</p> <p>Second, stimulating the immune system can result in <a href="https://beta.health.gov.au/services/flu-influenza-immunisation-service">symptoms</a> similar to that of influenza, although much milder and short-lived. These include local inflammation (redness, pain or swelling at the site of the vaccine) and more general symptoms (fever, aches and pains, tiredness).</p> <p>Third, vaccine-induced protection isn’t complete. In some years, the vaccine is not well <a href="https://www.who.int/influenza/vaccines/virus/recommendations/201502_qanda_vaccineeffectiveness.pdf">matched</a> to circulating strains. Usually this is due to mutations that may develop in circulating strains after the vaccine strains are selected.</p> <p>The flu vaccine also doesn’t “kick in” for two weeks after vaccine administration. In some people, particularly those who are older and those who have weakened immune systems, antibody production is not as strong, and the level of protection is lower.</p> <p>Despite this, studies have consistently shown that vaccinated people are <a href="https://www.ncbi.nlm.nih.gov/pubmed/22032844">less likely to get influenza or complications from the flu</a> than those who aren’t vaccinated.</p> <p><strong>A better way to protect against the flu</strong></p> <p>A problem with current vaccines is the reliance on eggs, which results in a relatively slow and labour-intensive production process.</p> <p>Current <a href="https://cmr.asm.org/content/26/3/476">work</a> is aiming to speed up this process by using different technologies so that vaccine manufacturers can react more quickly to changes in circulating viruses.</p> <p>The “<a href="https://theconversation.com/a-universal-flu-vaccine-is-still-some-time-off-18525">holy grail</a>” for influenza vaccines is to stimulate an effective immune response to a component of influenza that doesn’t change each year, so annual vaccination is not required.</p> <p>These efforts have proved <a href="https://www.fiercebiotech.com/biotech/gsk-dumps-universal-flu-vaccine-after-interim-data-readout">elusive</a> so far.</p> <p>A better strategy might be to harness T cell immunity. Recent <a href="https://www.ncbi.nlm.nih.gov/pubmed/30778243">work</a> has shown that a type of T cell, known as “killer” T cells, can recognise other parts of the influenza virus, and therefore can provide broad protection against seasonal and pandemic strains.</p> <p>But while we wait for a better alternative, getting an annual flu shot is the best way to avoid the flu.</p> <p><em>Written by Allen Cheng. Republished with permission of </em><a href="https://theconversation.com/you-cant-get-influenza-from-a-flu-shot-heres-how-it-works-118916"><em>The Conversation</em></a><em>.</em></p>

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How to prepare for winter with essential oils

<p>Essential oils have long been used in food, beauty products and health-care practices. However, not all essential oils are the same or created equally, meaning the health benefits to us are compromised. It’s important to ensure the essential oils you use are 100% pure, plant-based oils that are extracted from the seeds, bark, stems, roots, flowers and other parts of plants – and have not been made or blended with synthetics.</p> <p><strong>How do essential oils work?</strong></p> <p>Essential oils can be used to help benefit a wide range of emotional and physical wellness challenges. The three best ways to use essential oils are aromatically, topically and ingesting (such as in food in place of herbs and other flavourings in cooking, or as a dietary supplement in a vegetable capsule or added to water).</p> <p><strong>1. Aromatic</strong></p> <p>Our sense of smell is a tool that can elicit powerful physiological, mental and emotional responses. Essential oils are quickly absorbed by our smell receptors, which have a direct link to the part of our brain that supports a variety of functions, including smell, emotions, behavior and memory. For this reason, essential oils have an especially powerful effect when used aromatically in your home. Some essential oils induce uplifting or invigorating effects, while others are more calming. Using a cold steam diffuser is one of the simplest methods for using essential oils aromatically, but you can also apply essential oils to a cotton ball and place in the air vents of your car, mix oils in a glass or metal spray bottle with water to mist over furniture, carpet or linen, or use in place of your household surface cleaners and make your own toxic-free cleaning products in glass or metal spray bottles.</p> <p><strong>2. Topical</strong></p> <p>Topical application is a very effective method for applying essential oils because they are quickly absorbed into the bloodstream and easily penetrate the skin. Some of the most beneficial areas to apply essential oils are: neck, forehead and temples, chest and abdomen, wrists, behind your ears, legs and bottom of feet. It’s always best to dilute an essential oil with a carrier oil first, such as fractionated coconut oil, sweet almond oil, jojoba oil, grapeseed oil or olive oil, to test your skin’s sensitivity. You can also add essential oils to your moisturiser, add a few drops to a warm bath, or make a hot or cold compress.</p> <p><strong>3. Ingest</strong></p> <p>Certain essential oils have a rich culinary history and can be used in food. When you sprinkle cinnamon on your oats, sip a mug of peppermint tea, or add fresh basil leaves to your spaghetti, you are actually consuming some essential oil compounds. When ingested, essential oils directly enter our blood stream via the gastrointestinal tract, where they are transported throughout the rest of the body. We can effectively use oils internally by replacing herbs and spices with oils in our cooking, add oils to our drinking water, smoothies, milk, tea or other drinks, or add a small amount of essential oil to yoghurt and healthy treats and desserts.</p> <p><strong>Top 3 essential oils as a preventative measure in the lead-up to cold and flu season</strong></p> <p><strong>1. On Guard</strong> – This germ-fighter is perfect to build up your body’s immune defence in winter and help to protect you from any nasty colds and flu doing the rounds. Apply with a carrier oil like fractionated coconut oil to bottoms of feet, back of neck and chest, or gargle with water for an irritated throat and diffuse.</p> <p><strong>2. Easy Air</strong> – This ‘respiratory blend’ is the go-to when your chest, nose, head or throat all feel compromised during the colder weather. Apply with a carrier oil to bottoms of feet, back of neck and chest and diffuse.</p> <p><strong>3. Tea Tree</strong> – You can use this as a powerful cleaning product in your house. This essential oil also has a fresh, clear aroma when diffused, which comes as a welcome change in those stuffy winter months.</p> <p><strong>Top 5 essential oils every household should have</strong></p> <p><strong>1. Lavender</strong> – Calming for both the mind and body. Promotes restful sleep and is great for soothing the skin.</p> <p><strong>2. Wild Orange</strong> – Invigorating and supportive to our emotional wellbeing and uplifting to both mind and body.</p> <p><strong>3. Peppermint</strong> – Combine 1-2 drops with Wild Orange in the palms of your hands and inhale. Or diffuse in a diffuser. This is a great pick-me-up first thing in the morning or when the afternoon slump rolls around. Peppermint oil also makes a fantastic mouth wash and breath freshener.</p> <p><strong>4. Lemon</strong> – A natural cleaner for your home, it gives that ‘umphh’ to a main course or dessert, and it has an energising aroma when diffused, promoting those big, deep breaths we often forget to take.</p> <p><strong>5. On Guard</strong> – As mentioned above, this ‘protective blend’ is warm, spicy and woody and fantastic for keeping seasonal threats at bay as the cold and flu season hits. It includes ingredients such as Wild Orange Peel, Clove Bud, Cinnamon Leaf, Cinnamon Bark, Eucalyptus Leaf, and Rosemary Leaf/Flower.</p> <p>doTERRA Wellness Advocate Skye Kennett offers free, individualised consultations on essential oils. Visit <a href="https://www.mydoterra.com/skyekennett/#/">Skye's website</a>.</p> <p><em>Please note: When using essential oils, safety guidelines must be followed. Please contact Skye for further information. </em></p> <p><em>The products mentioned are not intended to diagnose, treat, cure or prevent any disease.</em></p>

Caring

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A humorous poem about “man flu”

<p><em><strong>Barbara Binland is the pen name of a senior, Julie Grenness, in Melbourne, Victoria, Australia. She is a poet, writer, and part-time English and Maths tutor, with over 40 years of experience. Her many books are available on Amazon and Kindle.</strong></em></p> <p align="center"><span style="text-decoration: underline;">Colds for Older Men</span></p> <p align="center">Wifey flings open the bedroom door,</p> <p align="center">Not gazing kindly, a picture she draws,</p> <p align="center">Wife blows her nose, her cheeks a’rose,</p> <p align="center">Her husband lies there, full of moans,</p> <p align="center">Her husband begs,</p> <p align="center">Wifey takes a breath,</p> <p align="center">“Yes, dear, I know you have a man-cold,</p> <p align="center">But, dear, I too, have a man-cold,</p> <p align="center">But women are not allowed to groan,</p> <p align="center">or nag, says men, you are alone,</p> <p align="center">I, too, have a cold,</p> <p align="center">But, well, this washing’s getting old,</p> <p align="center">I’m cooking tea, and minding the grandkids,</p> <p align="center">No, I shan’t make soup like your mother did,</p> <p align="center">Yes, dear, the undertakers are near,</p> <p align="center">Here’s your last will for your man-cold,</p> <p align="center">Your whinging, is like, well, old!</p> <p align="center">I have to iron your shirts now,</p> <p align="center">Yes, dear, I know I am a fat old cow,</p> <p align="center">But, dear, I have your balls in my purse,</p> <p align="center">I do hope our man-colds don’t get any worse!</p>

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Immunise – your best protection

<p>Older people are more vulnerable to a number of diseases that can be prevented through immunisation, particularly influenza, shingles and tetanus.</p> <p>As you get older, your immune system may no longer work as well so you may be at increased risk of catching an infectious disease.</p> <p>Free immunisation is offered at age 65 onwards to protect against these serious diseases.</p> <p><strong>Recommended immunisations to protect against serious diseases: </strong><br /> <br /><strong>Influenza ‘flu’ immunisation</strong> is free and recommended every year for those aged 65 and older. For your best protection, it's best to get immunised in autumn, before the winter peak arrives.</p> <p>Every year, the influenza vaccine is adjusted to protect against strains of the virus that are likely to be circulating the following winter, as these change from year to year. This year, the influenza vaccine protects against four strains of the virus including the ‘Australian flu’ which caused many deaths in Australia and across the northern hemisphere.</p> <p>Influenza is different to the common cold. Complications from influenza can be more likely when you are older and it can make an existing medical condition, such as asthma, emphysema or diabetes, a lot worse. Each year in New Zealand, around 400 people die of influenza and its complications from influenza, mostly older people. Immunisation is the most effective way to help protect against these diseases.</p> <p><strong>Shingles immunisation</strong> is now free at age 65, and until 31 March 2020, anyone aged 66 to 80 is also eligible for a free dose of the vaccine. Shingles is a painful rash that can affect 1 in every 3 people and is more common in older people. If you have had chickenpox in the past, you are at risk of getting shingles.</p> <p>Immunisation against shingles is recommended at any time of the year. The next time you visit your doctor, ask about getting immunised against shingles.</p> <p><strong>Combined tetanus and diphtheria immunisation</strong> is also recommended at age 65 to help boost your immunity against tetanus and diphtheria. Most people were immunised against these diseases as children, but the vaccine’s protection can wear off over time. </p> <p>Ask your doctor whether a combined tetanus, diphtheria and whooping cough vaccine is recommended for you. Your general practice may charge a small fee to administer this vaccine.</p> <p><strong>Whooping cough immunisation</strong> is recommended if you spend time with babies or young grandchildren, you can talk to your doctor or nurse about getting immunised to protect against whooping cough. It’s not free, but most adults aren’t immune. If you become infected, you could pass the disease on to babies or young children, for whom it can be very serious.</p> <p>Make sure you’re up-to-date with your immunisations. Call your general practice to book your free immunisations today.</p> <p>For more information:</p> <ul> <li>Talk to your doctor, practice nurse or vaccinating pharmacist.</li> <li>Visit: <a href="http://www.health.govt.nz/imms-older-adults?utm_source=Over%2060's&amp;utm_medium=display&amp;utm_campaign=Imms%20Week%202018&amp;utm_content=65%2B%20Sponsored%20Content">https://www.health.govt.nz/your-health/healthy-living/immunisation/immunisation-older-adults </a></li> <li>Read: <a href="https://www.healthed.govt.nz/system/files/resource-files/HE2540_Immunisation%20for%20older%20people.pdf">https://www.healthed.govt.nz/system/files/resource-files/HE2540_Immunisation%20for%20older%20people.pdf</a></li> </ul>

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81-year-old catches flu on cruise and ends up with $2,000 bill

<p>Part of what makes cruises so appealing to many travellers is the all-expenses-paid element of the trip, but as one couple who had the dream trip to the Mediterranean end on a sour note found out, unfortunately this isn’t always the case.  </p> <p><a href="https://www.thescottishsun.co.uk/news/2127356/flu-cruise-po-taxi-banned-coach-glasgow-southampton/" target="_blank"><span style="text-decoration: underline;"><em><strong>The Scottish Sun reports</strong> </em></span></a>UK residents Margaret Allen and husband Robert, both 81, had to fork out for a 450-mile taxi ride from Southampton to Glasgow after staff barred Margaret, who had caught the flu overseas, from the prebooked coach.  </p> <p>Margaret had reportedly been struck down by influenza B barely a week into the cruise and has been forced to stay in her cabin before the ship headed back to the UK.</p> <p>To add insult to injury, on returning home the couple were told by P&amp;O staff they wouldn’t be able to travel on the coach home and would have to find their own way back.</p> <p>Margaret told <a href="https://www.thescottishsun.co.uk/news/2127356/flu-cruise-po-taxi-banned-coach-glasgow-southampton/" target="_blank"><span style="text-decoration: underline;"><em><strong>The Scottish Sun</strong></em></span></a>: “It was a nightmare.</p> <p>“My husband went down to reception on the day we were leaving and he came back and said: “You’re not going to believe this – they’re not going to take you on the coach.</p> <p>“We have to get a taxi from Southampton to Glasgow.</p> <p>“They organised the taxi and told us it was £1250 ($AU 2,227). Then there was VAT on top of that.</p> <p>“We waited for over an hour in a drafty terminal waiting on the taxi to show up.</p> <p>“We left Southampton just after 2pm and didn’t get home until 10pm.</p> <p>“They told us beforehand how much it would cost. But what could we do?</p> <p>“The coach wouldn’t take us so we had to pay. I just wanted to go home.</p> <p>“They said they couldn’t let me on because I’d had the flu. They said we would have to pay ourselves. It was shocking.”</p> <p>The stunned couple are now reportedly battling to get their cash back.</p> <p>Margaret added: “The taxi driver only stopped twice. I was in some state.</p> <p>“The ship had a norovirus at the same time but I didn’t have that.</p> <p>“It was delayed by hours going out because they had to sanitise the ship and the captain kept making announcements telling people to wash their hands.</p> <p>“I think they were concerned about it but a nurse had already told me I had the flu.</p> <p>“We are going to try and get the money back for the taxi.”</p> <p>What are your thoughts?</p>

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Can chicken soup really ease a cold?

<p>Chicken soup has long been touted as the perfect dish for cold and flu sufferers – since the <a href="https://theconversation.com/can-chicken-soup-really-cure-body-and-soul-52357" target="_blank"><strong><span style="text-decoration: underline;">second century BC, in fact</span></strong></a> – but does it actually beneficial for health? Or is it just a much-needed comfort for those of us with the sniffles?</p> <p>According to Sydney chef and nutritionist, Teresa Cutter, “there’s nothing better” than a chicken soup made from homemade stock, garlic, ginger and turmeric. “Garlic, ginger and turmeric are all anti-inflammatory and detoxifying,” she explains to <a href="http://www.sbs.com.au/food/article/2016/07/13/can-chicken-soup-really-help-your-cold" target="_blank"><strong><span style="text-decoration: underline;">SBS</span></strong></a>. “They clear out mucus and they’re intensely hydrating.”</p> <p>Funnily enough, <a href="http://time.com/money/4226215/colds-flu-soup-grubhub-zocdoc/" target="_blank"><strong><span style="text-decoration: underline;">research</span></strong></a> by US food delivery service GrubHub in 2014 found that as the number of cold- and flu-related doctor’s appointments increased, so did the number of soup orders. “Mentions of having a sore throat, being sick or having the flu are 283 per cent more likely to appear in delivery instructions of orders containing soups than orders without,” they found.</p> <p>As it turns out, there’s some scientific backing to this delicious miracle cure. <a href="https://www.ncbi.nlm.nih.gov/pubmed/359266" target="_blank"><strong><span style="text-decoration: underline;">A 1978 study</span></strong></a> found that drinking chicken soup was more beneficial for clearing nasal congestion than hot (or cold) water. Two years later, Dr Irwin Ziment found that chicken soup (particularly spiced soup) helped thin out mucous in the lungs. His findings were again backed up in 2000 by <a href="https://www.unmc.edu/news.cfm?match=9973" target="_blank"><strong><span style="text-decoration: underline;">Stephen Rennard</span></strong></a>, who found that by reducing the mucous in the lungs, chicken broth inhibited the movement of white blood cells, enabling them to concentrate on repairing the upper respiratory tract.</p> <p>So, what’s the best chicken soup recipe to soothe a cold or flu? <a href="https://www.unmc.edu/publicrelations/media/press-kits/chicken-soup/recipe.html" target="_blank"><strong><span style="text-decoration: underline;">Here’s the exact recipe</span></strong></a> Stephen Rennard used in his landmark study, but if you want something quick and easy, <a href="http://www.oversixty.com.au/lifestyle/food-wine/2015/07/chicken-vegetable-soup/)" target="_blank"><strong><span style="text-decoration: underline;">give our recipe a go</span></strong></a>.</p> <p>Tell us in the comments below, do you believe chicken soup has curative properties? We’d love to see your recipe!</p>

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