4 August 2007

Influenza A comes to Canberra

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Four kids are dead in Perth, a four-year-old died in Brisbane, and now a busload of kids from the Gold Coast are sick in Canberra Hospital, all due to an outbreak of the dangerous “Influenza A”.

I’ve had first hand experience of this, as I spent a couple of hours yesterday in hospital with my two-year-old, who had a fever which wouldn’t go down. The good news is after a rough night of high temperatures, and 24 hours of force feeding him paracetamol and ibuprofen, he appears to be on the mend. They are apparently dropping like flies at his day care centre.

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To claify my comment about flu shots in the public service, I do not believe the government would be paying for desk jockeys to have flu shots unless it provides some sought of gain for them.

correction: logical

Okay maeliner, allow me to put this issue to rest, using language that will suite your apparanelty limited logicac thought abilities.

Firstly, I have provided facts from independant sources as well as what I have been told by doctors.

Secondly, in rrsponce to you comment “The Fluvax does not vaccinate you against this years virus”
I ask you, WHY SHOULD IT??? “This years virus[s]” will are not widespread yet and may not be for some time. The shot covers what is predicted to be the most probable, widespread and dangerous strains of flu. It’s no good being pedantic about covering the newest strain if few people would get it anyway, all the while people are getting the much more prvalent strain that has existed for a while. YOUR LOGIC IF FLAWED AND YOU PROVIDE NO EVIDENCE!

Thridly, in responce to ““predict”, “may show”, “even if it didn’t”, and “likely” – these are not words you want to use to reinforce your point”. I use these terms because these are common medical terms. Nothing is certain, and I don’t claim that anything is certain. Much to do with medicine is based on probability. The flu vaccine is based probabilty, the probability that it will cover the right strains, the probability that the vaccine will provide adequate protection against those strains and the probability of the vaccine being readily accepted by the body. Listen to any doctor and they won’t be saying this medicine WILL CERTAINLY protect you, they say it WILL LIKELY protect you.

“This is because this years virus has not been identified yet”
-Out-f**king-standing… great reasoning. Who would have thought that the experts haven’t identified the new strains before they’ve occured. Two thumbs up. But in your favour, you are correct. We we can’t be completely certain what this year’s flu is going to be.

Also, I would like to point out that the Commonwealth Public service (at least in some departments) offers free flu shots.

Finally, I would like to say that I don’t blindly support the flu vaccine. I have had the flu, and have made a choice that I will take steps to help prevent it in the future. But I do not claim claim nor do I beleive that every person should get it, nor does every person need it. I get it, but I’m not in a risk group for the flu. It’s simply a conveinience. But for some, the young, the old, pregnant women, etc, those in the danger group, the flue can be serious. A close relative of mine died years ago. He didn’t have the flu shot. Today, the biggest problem in gaurding against the flu is getting people at risk to have the vaccine. And comments such as yours do not help the situation. That’s why I am defending the vaccine and rebutting your ill thought and unsunstantiated postings. And they are unsubstatiated. I on the otherhand have provided links to onlne material that supports my claims. You on the otherhand have not. In academic terms, the person’s work who cites sources is always considered stronger than the work of someone who makes claims without supporting sources.

VYBerlinaV8 now_with_added grunt1:26 pm 07 Aug 07

I’ve never had a flu vaccine in my life, and am unlikely to start any time soon. So who cares?

Oh for crying out loud. Can’t you two put the big swinging dicks away and step back for a second? It’s obvious to everyone else that you’re both partially right – asp is right when he says that it’s not a vaccine against last year’s flu, it’s against what’s predicted to be this year’s flu; and Maelinar is right when he says that we can’t be completely certain what this year’s flu is going to be.

asp, in response to your questions, yes and yes.

As indicated by Thumper, I am also vaccinated against shit you’ve never even dreamed of. And yes they are current regardless of the fact I’m no longer in the military, on account of I was in PNG earlier this year and got updated.

So stick that in a needle and inject it.

A question in return. Why are you so vehemently protecting the medical industry’s guesswork project ?

You yourself in your rebuttals are using the following words when making up the fluvax “predict”, “may show”, “even if it didn’t”, and “likely” – these are not words you want to use to reinforce your point, as they reinforce mine.

What I have continued to say, and I’ll say this very slowly now: The Fluvax does not vaccinate you against this years virus.

This is because this years virus has not been identified yet.

Please, I continue welcoming your reinforcement of my above statement, as you continue to attempt to rebut my comment. Unless you want me to 3 character space you, it might pay to come up with some facts that support your point of view though.

correction: I know the flu vaccine is not part of the schedule and is more of a “luxury”, but the way you talk is like that of people who don’t beleive in vaccinations full stop.
For the record, I AM fully immunised as per the sechedule, as well as having two optional immunisations.

maeliner, May I ask you. Are you fully immunsied as per the Australian Immunisation Schedule? And if you have any kids, are they fully immunised as per that schedule?

I know the flu vaccine is not part of the schedule na dis more of a “luxury”, but thae way you talk I like that of people who don’t beleive in vaccinations full stop.
For the record, I AM fully immunised as per the sechedule, as well as having two optional immunisations.

maeliner, BS!
“The flu vaccine immunises you against the previous year’s major strains of flu. – I was summarising the 3 selected virus strains into ‘major’. The selection is made from the previous years most virulent strains.”
— Not nessesarily. In some cases this is true, but in many years, they include strains which have not been very active for years because they predict a flare up. In other words, a strain that was very bad in 1985, may show signs of becoming a problem in 2009 and therefore they will include it, even if it didn’t become a major strain in 2008.

“Essentially they are playing catchup with the virus. – They make the selection from the PREVIOUS YEARS most virulent strains, by taking a ‘guess’ at what is the most likely to be a problem virus THIS YEAR. I summarised this as playing catchup.”
—This is mostly wrong. The new vaccine is not automatically based on the previous years most virulent strains. They are based on the likely strains for the next year. And in many cases, these are strains which have not be around for a while such as Wisoncisn, which I have to seen in the Aussie vaccine for a while.

“The Flu vaccine will not immunise you against this years virus strain. – Again, I stand by this comment. The Flu vaccine will NOT immunise you against THIS YEARS virus, as THIS YEARS virus has not been identified, nor has there been sufficient time for the medical industry to prepare a medical response. The Flu vaccine WILL immunise you against the most likely strains , but it cannot be fully expected to protect you against a morphed strain.”
— You are technically correct, but misguided. Yes, the flu vaccine will not protect you against new strains/mutations that appear in the year the shot is valid for. The vaccine will protect you against the top three most dangerous/probable strains that will hit in that flu season. And that is the way it should be. Take the following example:
A new strain of Influenza A appears, lets call it A/Melbourne/123 in the 2007 (current) flu season. The 2007 vaccine won’t protect against this strain. And why should it. The 2007 vaccine protects against relatively widespread and dangerous strains. The A/Melbourne/123 strain is new and is only in a tiny part of the population. It is not widespread and will not cause as much damage as the more established strains. A/Melbourne/123 may also be a weaker form of the virus which is not easily transfered from person to person, in which case vaccination would be unessesary.
So therefore, you are argument about the flu shot not protecting against this year’s strain is correct, thogh missing the point. Because if it were to protect against the new strains that form every year, it would be useless as these new strains are still in there infancy and not widespread. The current vaccine however protects against current widespread and quite dangerous strains.

I’d guess you had the A/Wyoming/3/2003 X 147 reassortant, but on account of you had the injection, you were preprepared. Lucky you didn’t get the A/Wisconsin/3/2007 X 150 variant.

***Disclaimer***
I made that up. But it accentuates my point nicely. And I don’t like Wisconsin much.

VYBerlinaV8 now_with_added grunt11:59 am 06 Aug 07

My wife and I have both had flu for the last 2 and a half weeks. Not a bad strain, but enough to leave you feeling crappy. Interesting, our 2 year old has barely been symptomatic. He had a bit of a cough for a few days, then a runny nose, but seems just about back to normal. Maybe it’s because I’m getting old…

asp, pray tell which part of my comment was either BS, misleading or wrong or a combination of all 3 ?

Especially taking into consideration the further information posted by ant.

An expanded version of my comment:

The flu vaccine immunises you against the previous year’s major strains of flu. – I was summarising the 3 selected virus strains into ‘major’. The selection is made from the previous years most virulent strains.

Essentially they are playing catchup with the virus. – They make the selection from the PREVIOUS YEARS most virulent strains, by taking a ‘guess’ at what is the most likely to be a problem virus THIS YEAR. I summarised this as playing catchup.

The theory behind this concept is that your body will be pre-prepared to fight strains of flu that are similar, or will react to last years virus. – I am referring to the ‘guess’ made by selecting the most virulent strains as a theory, and the concept is referring to injecting yourself with these strains in an attempt to immunise yourself against whatever strain morphs this year. I stand by this comment.

The Flu vaccine will not immunise you against this years virus strain. – Again, I stand by this comment. The Flu vaccine will NOT immunise you against THIS YEARS virus, as THIS YEARS virus has not been identified, nor has there been sufficient time for the medical industry to prepare a medical response. The Flu vaccine WILL immunise you against the most likely strains , but it cannot be fully expected to protect you against a morphed strain.

A lot of the data I am referring to, actually comes from your extensive posts. I just read the other parts of it.

Bah. I’ve not had a cold or flu for years. And no flu shots either.

But then, I come from a good pedigree – you know, crossing the Alps with elephants, taking on the Roman army & winning, etc…not a problem. It’s all in the genes.

asp’s stuff was worthy, if lengthy. The vaccine is not perfect, but it’s a lot better than nothing and I work somewhere that has seen its beneficial overall effects on absences. With a thing like a virus that can change rapidly, it’s not possible to anticipate and deal with every possible mutation in advance or immediately.

el is dead right. Someone who comes in when he or she is crook is not a hero but a saboteur. If it was only the boss/the government that took a hit, I’d be less worried. But it’s important to remember that someone in the work group might be (or be related to) someone especially vulnerable for whom the flu may be catastrophic. Subject to WorkChoices (ha!) people get sick leave for a reason and with the intent that it be used when they’re sick.

People catch flu because other people give it to them. stop tolerating people who come to work and school sick as dogs, and make it more laudatory for them to stay home rather than “soldiering on”.

Couldn’t agree more! Nothing shits me more than someone coming to work and coughing/spluttering all over the place.

Flu vaccine does indeed work, but it only works against strains that are IN the vaccine, as others have said above. Every year, they have to make a call as to which flus will be the bad ones, and put them in the vaccine. They can’t put them all in, and also because viruses mutate wildly, the vaccine just can’t cover you against every flu. They just try to vaccinate against the most virulent, nasty ones.

When you have a vaccine and then the next day or so, feel like you have flu, no the vaccine did not give you flu. The vaccine has found some of that flu already in your system, and it all fires up briefly, and then disappears. Also, if you are catching flu when you get the vaccine, chances are it’s too late and that flu will take its course. Takes a few weeks for the vaccine to take effect.

People catch flu because other people give it to them. stop tolerating people who come to work and school sick as dogs, and make it more laudatory for them to stay home rather than “soldiering on”.

The earliest stages of the illness are the most infectious, but even at the sneezing and coughing everywhere stage, they are spreading germs. If you touch a surface that they have touched, or that their cough or sneeze has infected, and then you touch your face, bingo. Flu is in the house.

I was getting it last friday. Could work down the flu checklist, ticking off everything. But I went to bed that night and woke flu-free. Immune system beat it up.

They reckon flu moves from here and goes east, to the Americas, but I always seem to do better after having been in the US (where I often get illnesses) and come back here.

So in conclusion
-the pros of taking the vaccine out weigh the cons, especially if you are in a risk group or are pregnant
-the vaccine will protect you from the most likely strains at the right time (in other words the 2007 vaccine will protect you in 2007)
-the vaccine contents is developed by comittees worldwide and everyone from ACT Health right up to the WHO reccomend it.
-for $20 or $30, you save yourself a week or two of being stuck in bed drinking Lemsip. Crucial if you are a student or need to earn a living.

P.S. In future, I’ll post only the links. I just wanted the evidence front and center before anyone took the claims against the vaccine seriously. Sorry for any resulting eye strain.

And this from Wikipedia, a well referenced article about the Vaccine (not specifically FluVax):

The flu vaccine is a vaccine to protect against the highly variable influenza virus.

The annual flu kills an estimated 36,000 people in the United States each year. The annually updated trivalent flu vaccine for the 2006–2007 season consists of hemagglutinin (HA) surface glycoprotein components from influenza H3N2, H1N1, and B influenza viruses.[1]

Each year the influenza virus changes and different strains become dominant. Due to the high mutability of the virus a particular vaccine formulation usually only works for about a year. The World Health Organization co-ordinates the contents of the vaccine each year to contain the most likely strains of the virus to attack the next year. The flu vaccine is usually recommended for anyone in a high-risk group who would be likely to suffer complications from influenza.

Flu vaccine virus selection
Selecting viruses for the vaccine manufacturing process is very difficult.

At the U.S.’s Food and Drug Administration’s (FDA) Center for Biologics Evaluation and Research’s Vaccines and Related Biological Products Advisory Committee’s 101st meeting of February 16, 2005, an extensive discussion and vote was held concerning next year’s flu vaccine virus selection; but began with a summary of the previous year:

Influenza B
“For Influenza B, the question was asked: are there new strains present? And the answer was yes, and in 2004, the majority of the viruses were similar to a strain called B/Shanghai/361/2002, which is from the so-called B/Yamagata/1688 hemagglutinin lineage. That lineage was not the one that was being used in the vaccine that was current last year. In a minority of the strains that were found during the epidemiologic studies were similar to the strain that was in the vaccine for last year, which was B/Hong Kong/330/2001, which belongs to the HA lineage that we represent with the strain B/Victoria/287. In answer to the question were these new viruses spreading, the answer, of course, is definitely yes. The Fujian-like viruses had become widespread around the world and were predominant everywhere, and these B/Shanghai-like strains at the time we were holding this meeting in February were predominant not only in North America and the United States, but also in Asia and Europe.”

New viruses
“Were the new viruses that were identified and spreading, were those inhibited by the current vaccines? And this question, as it sometimes is, was not a very definite no or yes. It was a little bit difficult to interpret, but it seemed like many of the A/Fujian-like viruses were not well inhibited by the current vaccines, although some of them were. For the B/Shanghai-like strains, of course, we’ve known for a long time that these two divergent hemagglutinin lineages are not that well inhibited one by the other, and as time has gone on and antigenic drift has occurred in these strains, that has become truer. Generally we also know that for the B/Yamagata-like strains and the B/Victoria-like strains, that very young children and people who haven’t been immunologically primed, exposure to one of these does not seem to immediately give antibodies that cross-react with the other HA lineage.”

Manufacturing issues
“So were there strains that were suitable for manufacturing? And the answer was yes. Of course, we all know that for inactivated vaccines and for live attenuated vaccines manufacturing depends on having egg adapted strains, either the wild-type or reassortant, and in the case of the live vaccine, of course, it has to be a reassortant for the attenuation phenotype. But there were A/Fujian-like strains that were available, and there was a high growth reassortant that was being used in manufacturing for the Southern Hemisphere already, the A/Wyoming/3/2003 X 147 reassortant. For the B strain, there were a number of wild-type isolates that seemed to be suitable for manufacturing, including B/Jilin/20/2003 and B/Jiangsu/10/2003, in addition to the B/Shanghai/361 strain itself.”

Strains selected
“So based on that, the strains that were selected for this year include A/New Caledonia/20/99-like strain, which in this case really is A/New Caledonia/20/99. For the B/Shanghai/361/2002-like recommendation that was made, there were all three of these strains, B/Shanghai, B/Jilin, and B/Jiangsu. And for the A/Fujian/411/2002-like recommendation that was made and the A/Wyoming/3/2003 strain was chosen or is the one that has become widely used for vaccine preparation. Now, the implications of the strain selection were that preparation of the vaccines was on schedule throughout the year. All of the strains seemed to be typical and easy to adapt for manufacturing purposes, and going into the summer, the supply of vaccine was expected to match the demand predicted by previous years’ experiences.”

2006–2007 season (Northern Hemisphere)
The 2006–2007 influenza vaccine composition recommended by the World Health Organization on February 15, 2006 and the U.S. FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) on February 17, 2006 use:

an A/New Caledonia/20/99 (H1N1)-like virus;
an A/Wisconsin/67/2005 (H3N2)-like virus (A/Wisconsin/67/2005 and A/Hiroshima/52/2005 strains);
a B/Malaysia/2506/2004-like virus from B/Malaysia/2506/2004 and B/Ohio/1/2005 strains which are of B/Victoria/2/87 lineage.[54]

[edit] 2007 season (Southern Hemisphere)
The composition of influenza virus vaccines for use in the 2006 Southern Hemisphere influenza season recommended by the World Health Organization on September 20, 2006 [55] was:

an A/New Caledonia/20/99(H1N1)-like virus,
an A/Wisconsin/67/2005(H3N2)-like virus (A/Wisconsin/67/2005 and A/Hiroshima/52/2005 were used at the time),
a B/Malaysia/2506/2004-like virus
[56] [57]

[edit] 2007-2008 season (Northern Hemisphere)
The composition of influenza virus vaccines for use in the 2007–2008 Northern Hemisphere influenza season recommended by the World Health Organization on February 14, 2007 [58] was:

an A/Solomon Islands/3/2006 (H1N1)-like virus;
an A/Wisconsin/67/2005 (H3N2)-like virus (A/Wisconsin/67/2005 (H3N2) and A/Hiroshima/52/2005 were used at the time);
a B/Malaysia/2506/2004-like virus
[59] [60]

[edit] 2008 season (Southern Hemisphere)
The WHO vaccine recommendation for the 2008 season will be made after the bi-annual meeting scheduled for 17–19 September 2007. [61]

And this information from CSL who make FluVax is just the tip of the iceberg of evidence against your claims:

“Fluvax® vaccine is available only with a doctor’s prescription. This year (2007) the viruses are A/New Caledonia/20/99 (H1N1)-like strain, A/Wisconsin/67/2005 (H3N2)-like strain and B/Malaysia/2506/2004-like strain.

Vaccination against influenza is recommended every year, for anyone wanting to lower their chance of catching influenza.

Influenza vaccination is particularly recommended for the following groups of people who are considered at high risk from influenza:
• those 65 years of age or older,
• Aboriginal and Torres Strait Islanders 50 years of age or older,
• Aboriginal and Torres Strait Islanders 15 to 49 years of age with medical conditions,
• those 6 months of age or older who have heart, lung or blood circulation diseases. This includes, for example, people with heart problems, people with cystic fibrosis,
• those 6 months of age or older who have other chronic illnesses such as: diabetes, kidney problems, poor immunity (including people with HIV) or abnormal haemoglobin (for example sickle cell disease),
• people living in nursing homes, hostels or other long-term care facilities,
• people who have contact with anyone from the groups of people listed above.
Fluvax® vaccine is also likely to benefit:
• people with asthma, especially those with severe asthma,
• children 6 months to 10 years on long-term aspirin therapy,
• people in the workforce, especially if influenza is very common,
• travellers
• women who are planning to become pregnant, in advance of both the pregnancy and the influenza season,
• women who will be 4 to 9 months pregnant during the influenza season.

NOTE: There is no convincing evidence of risk to the foetus from immunisation of pregnant women using inactivated virus vaccines, bacterial vaccines or toxoids.

How Fluvax® vaccine works
Fluvax® vaccine works by causing your body to protect itself against infection by the influenza viruses, types A and B, that are in the vaccine. The body makes substances, called antibodies. Antibodies fight the influenza virus. If you have been vaccinated, when you come into contact with the influenza viruses killed to make the vaccine, your body is usually able quickly to destroy the virus. This prevents you from getting influenza.
Your body takes a few weeks after vaccination to fully develop protection against the influenza virus.

Protection against influenza requires one dose of Fluvax® vaccine. Sometimes, a follow up (booster) dose may also be given. Your doctor will tell you if you or your child need another dose.
Most people make satisfactory antibodies against the influenza virus. However, as with all vaccines, 100% protection cannot be guaranteed.
The chance of having a severe unwanted reaction after having Fluvax® vaccine is very small. Whereas, the risks from not being vaccinated against influenza may be very serious.”

Maelinar, I don’t know where you got that information. It goes against official information from ACT Health, from CSL, from two GPs I have gone to and the WHO.

And further more, it is ilogical. The “theory behind [the] concept” is both illogical and not medically sound. You say it will make your body pre-prepared to fight “similar strains”. Well, technically H5N1 Bird Flu and H1N1 Human Flue are both similar strains of Influenza A, but FluVax is not going to protect you against the former.

The vaccine is updated every year. “Each year the Australian Influenza Vaccine Committee and the New Zealand Ministry of Health decide which three types of virus are most suitable.”
They make their desision of which three strains to include based on research that determines what three strains will be most dangerous and/or most prevalent in the coming season. It is not automatically the previous years strains, especially since there are dozens of strains in existance, with new ones occuring every year.

You also state “the flu vaccine will not immunise you against this years virus strain”. That is both completely wrong and quite dangerous to say. First, CSL states that the vaccine currently available for this flu season is designed to immunise against three of the strains likely to occur IN 2007! It is the 2007 Vacine. This is confirmed by a GP (who happens to be the head of AMA-ACT Branch) and other sources.

I would ask you to name your sources. Because some of what you have said is wrong, total BS, some is misleading and could easily sway people from having the shot.

Take it from me, I use to get the flu. Miss a week of two of school. Then I started getting these shots every year and I DO NOT GET THE FLU! And I’m healthy. So for people in the danger catogories, it is especially important.

The brief (official) given to me in a nutshell.

The flu vaccine immunises you against the previous year’s major strains of flu. Essentially they are playing catchup with the virus. The theory behind this concept is that your body will be pre-prepared to fight strains of flu that are similar, or will react to last years virus.

The Flu vaccine will not immunise you against this years virus strain.

Hmm, I am suspicious about this whole flu vaccine business…does it actually do any good?

I know for people with compromised immune systems it’s recommended (eg oldies), but otherwise is it really necessary? I would be interested to hear from someone that knows about this medicine business.

There is a vaccince, though its not like the MMR or Polio vaccines which are fairly static and defend against the same disease in each shot. Its a vaccine that is tweaked every year to defend against against the top three probable strains for the oncomming flu season. It lasts for a year, and costs around $20-40 from a GP.

Reffering to Influenza as A, B and C, it’s not quite that easy. Within those three categories are different strains and mutations. Within the Influenza A category are many types of human flu, pig flu, and yes… you guessed it, bird flu.

This years flu vaccine, marketed under the brand name FluVax and made by CSL is an Inactivated Inclfuenza Vaccine (Split Virion). It gaurds against the following starins of Influenza A:
A/New Caledonia/20/99(H1N1)-like strain
A/Wisconsin/67/2005(H3N2) -like strain
And the following type of Influenza B
B/Malaysian/2506/2004 -like strain

I had this shot, as I have for the last six years. Never had the flu, nor has the shot caused anything more than a slightly painful arm for a day. I would highly reccomend the vaccine to everyone. Children and the elderly should really have it, because for them, flu is not just an annoyance, it could easily be a life threatening conditions.

More information :
http://www.csl.com.au/VaccinesRespiratory_VaccinesFluvax.asp
http://en.wikipedia.org/wiki/Influenzavirus_A
http://en.wikipedia.org/wiki/Influenzavirus_b

I thought there was a vaccine for Influenza A, B and C?

Fair enough on your two year old (a little young for the vaccine), but why weren’t the Gold Coast kids vaccinated?

Must be what I’ve had for the last week also

I read somewhere that doctor’s were taken by surprise by the severity of this flu strain, which is the worst they’ve seen in years.

I hope your little one is feeling better.

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