TIME: Almanac 1993/TIME Almanac 1993.iso/time/021290/0212350.000

Text File | 1992-08-28 | 5.3 KB | 121 lines

                                                                                MEDICINE, Page 61

Laid Low by the Flu


Americans are suffering the worst epidemic in five years


    It comes in winter and is harder to dodge than a speeding
snowball. This year the debilitating and sometimes deadly
scourge of influenza is unusually virulent. So many people have
taken to their bed with chills, aching muscles and fever that
doctors are overwhelmed, offices are decimated, and some
schools have temporarily shut their doors. Nearly 8,100
Americans, most of them elderly, are known to have died of flu
and flu-related illnesses, and the figure is rising daily. The
Centers for Disease Control has officially declared it an
epidemic, the worst outbreak of flu in the U.S. in at least
five years.

    The first widespread cases of flu appeared in Montana, New
Mexico and Utah in mid-December, slightly earlier than normal.
Within weeks, the disease broke out in Texas, Mississippi and
Georgia and then along the Eastern Seaboard. Says Dr. Margaret
Tipple, an epidemiologist at the CDC: "At this point, it's
virtually coast to coast."

    In fact, it spans most of the northern hemisphere. From
Britain to the Soviet Union, the flu has hit millions of
Europeans, including Pope John Paul, Queen Elizabeth and
Princess Diana. Britain was hit so badly that staff shortages
and patient overloads forced hospitals to put off surgery that
could wait. Several trials at London's Old Bailey had to be
delayed.

    The flu is hard to contain because it is highly contagious,
comes in many varieties, and can originate almost anywhere. It
has plagued humanity at least since 412 B.C., according to an
account by the Greek physician Hippocrates. By far the most
devastating flu season on record was in 1918-19, when some 20
million people worldwide -- including 500,000 in the U.S. --
died of the "Spanish flu."

    Scientists first isolated a flu virus, named type A, in 1933
and subsequently found two other variants, now known as types
B and C. Individual strains are named for the place where they
are first identified. Most of this season's flu has been
triggered by a nasty strain of influenza A, called A-Shanghai.
A few cases of A-Taiwan and B-Yamagata (Japan) have also turned
up.

    The classic symptoms of flu, which begin to appear about 48
hours after exposure to the virus, include a sudden fever,
chills, sore throat, headache, muscle pains, lethargy and a
persistent dry cough. Although most of the symptoms subside
after two to three days, victims remain contagious for an
additional three or four days.

    The virus spreads easily, traveling in droplets spewed into
the air by sneezing and coughing or through contact with mucus
on hands or objects. Transmission is faster in places with poor
ventilation, such as rooms with closed windows, crowded
classrooms, nursing homes and public transportation systems.
On planes, where the air is continuously recirculated, just one
flu-ridden passenger can infect all the rest.

    For most patients, a bout of flu means a few missed days of
work or school. But for people 65 and over and for those who
have chronic heart or respiratory problems, diabetes, asthma
or weakened immune systems, the disease can easily be fatal.
Less able to fend off infections, these individuals are more
susceptible to bronchitis, pneumonia and, occasionally, kidney
failure and heart attacks. In an average year, flu is a factor
in about 20,000 deaths in the U.S. The majority of A-Shanghai
victims have been elderly, and all 50 states have discovered
outbreaks in nursing homes and other long-term-care facilities.


    Flu shots are the best protection. Though a vaccine does not
necessarily prevent the disease, it can lessen the severity.
But designing the right vaccine is difficult because the
viruses mutate, changing their chemical profile from year to
year. Today's A-Shanghai may soon be supplanted by one that is
substantially different. What is more, entirely new types of
flu viruses appear every few years. Months before each flu
season, scientists must guess which strains will be most active
and then tailor a vaccine to combat them. Sometimes their
forecast is wrong, and the vaccine is virtually useless. In
1976, for example, the anticipated swine-flu epidemic never
materialized.

    This year the vaccine seems to work, but not enough people
have received it. Ordinarily, the CDC recommends the shots for
senior citizens, nursing-home residents, people with AIDS,
anyone who is susceptible to lung and heart ailments, and for
health workers and others who deal with flu patients. This
A-Shanghai strain is so virulent, however, that anyone who
wants to avoid it should probably be inoculated.


By Andrea Dorfman. Reported by Don Winbush/Atlanta.



____________________________________________________________ NOW
THAT YOU'VE GOT IT

     Once the flu bug bites, there is no quick cure. A doctor
will recommend bed rest and plenty of liquids. It is important
to stay home, especially since co-workers and schoolmates can
easily catch the disease. For high-risk patients, physicians
may prescribe amantadine, an antiviral drug that reduces fever
and respiratory problems caused by strains of influenza A.