In South Africa as autumn has hit our country it is time to gear up for the flu season. Now this year we can expect a bumper crop of flu viruses to hit us since we are hosting the FIFA Soccer World Cup in June. This means an influx of foreigners from all over the world bringing their dollars, pounds and their bugs on the plane with them.
So, if you are HIV positive how are you going to prepare for this season? i advise a 3 step approach:
1) Maximise your health to protect against the flu
2) Get your flu vaccination in the next 8 weeks
3) Be armed and ready to treat the flu if it hits you.
1) So, this is the proverbial healthy lifestyle that all experts advise but so few of us really embrace. It's all about stocking your body with vitamins and antioxidants (the good guys that soak up and neutralise toxins in the body). Get lots of veggies and fruits - variety will give you a range of vitamins.
Excellent vitamins to boost are Vitamin C 1000mg, D 400 IU and E . These are important in the immune system to fight infection. Echinacea and garlic are also useful to add but doses are variable and not standardised.
It is also a good idea to take a probiotic ( a tablet containing beneficial gut bacteria that will help to protect the gut from invading organisms) although there is no evidence that it will prevent the flu but it seems to shorten the severity and duration of it.
Anyone who does Yoga or is familiar with Ayurvedic medicine may be aware of the Neti pot which looks a little bit like Aladdin's lamp. It is used to pour water through the one nostril while tilting the head and the water then flows out the other nostril. Interestingly, this is effective to cleanse the nasal passages and assist in preventing colds, flu and sinus problems. For those of you not so adventurous, a simple saline nasal spray is also good. A couple of bursts of this a day will help to cleanse the nasal passages which are the main port of entry of viruses.
Finally, good hygiene and handwashing practices will also help to spread viruses (especially important if you have kids).
2) Flu Vaccination. For some reason the topic of vaccination always seems to get people hot under the collar. If you are nervous about vaccinations or have heard stories about vaccines causing other illnesses then your first stop should be here MMR-autism link myth.
Each year a flu vaccine is produced and offered to the public. If you are HIV+ this is an extremely good idea to be vaccinated yearly. However, the lower your CD4 count, the less effective the vaccine may be but still worth doing.
What does the flu vaccine do? Well, it vaccinates you against the 3 strains of flu that have caused the most severe illness around the world. The vaccine will stimulate your immune system to develop protection against these 3 strains specifically. So, in answer to your next question (How come I get the flu even though I had the vaccination?) - the flu vaccine does not stop you from getting the flu at all, but will protect you from the most serious forms of flu. This is why it is still possible to get the flu even though you have had the vaccine.
You need to get your flu vaccine every year because it is a newly developed vaccine that has the most recent viral strains included. Now is the right time to get vaccinated so that you have a few weeks to build up your immune response before the season hits in full strength. Check out the NICD page for swine flu and flu updates South Africa
3) If you are unfortunate to get the cold or flu this season, then don't panic. Remember the old wisdom: 'treat the flu with drugs and it will be gone in a week, treat it at home and it will be gone in seven days'. Most people will develop a fairly mild illness that affects the upper airways (the nose/sinuses/throat/voicebox) which may be uncomfortable but not a serious illness. Some will however, develop the 'real' flu which will consist of all the former symptoms as well as general body aches, fever, fatigue and possible nausea and vomiting. The flu really packs a mean punch and can result in a week off work - so, best to have a plan of attack if you are struck by it.
I recommend that you keep some useful over the counter medications at home for these occasions (because the flu always seems to strike after the shops have closed). Personally, I advocate symptomatic relief for pain and fever with anti inflammatories like : MedLemon, Nurofen, Compral.
A good old fashioned hot toddy works wonders and even has an evidence basis to it: take a cup of boiled water, add 2 tsps lemon juice and 2 tsps honey and a tot of whiskey ( if you are so inclined). Honey has antimicrobial properties, the lemon is an antioxidant and the whisky , well, that helps you to sleep ( and hopefully nukes any bugs too).
For the irritating nasal congestion sprays like Iliadin and Drixine are useful- although I suggest that you try to reserve them for night-time (when you really need to be able to breathe) and rather let the mucus drain freely during the day. It's also important that you limit their use to 3 days otherwise the congestion may worsen.
During the day, use a tea tree oil nasal spray or salt water nose spray (like Salex) to help.
Headache and body aches generally respond well to the anti inflammatories, but if you need a bit more kick, then codeine based pain killers are the next step (can be taken with the anti inflammatories) such as Sinutab, Lenadol, Syndol, AdcoDol.
The specific antivirals (a medication that specifically targets the flu virus) that are useful for the flu include Amantadine,Rimantadine, Oseltamivir and Zanamivir. However, they should really be started within 48 hours of the flu starting and should be reserved for severe flu cases. In the case of HIV, the lower your CD4 count or the worse your overall health, the more important it is for you to start the antiviral agent as early as possible. In general, if 10 people get ill, 7 will have a mild illness ( a 'cold'), 3 will have the 'flu' and 2 will require antivirals.
There is no value to be had from antibiotics (medication that targets bacterial infections) as the flu is a viral illness and will not respond to antibiotics.
Other approaches that may help are to take mega doses of Vitamin C (1000mg three times daily ), increased echinacea dosing, steam inhalation, Karvol capsule inhalation, ACC-200 effervescent tablets (to decrease mucus production).
You will notice that I have not mentioned cough mixtures. This is deliberate, because they simply do not work. You will probably get more benefit from a hot toddy or plain honey than the many cough mixtures on the market. The only exception I make is if you have a painful, hacking cough that is keeping you awake (or your child). In that case I would recommend a codeine based medication such as Pholtex syrup (or Pholtex Junior).
Finally, most people will not need to see their doctor with the following exceptions: if you have a CD4 less than 200 or any other serious illness (like TB), or are pregnant then you are at higher risk for complicationsand I would recommend that you see your doctor as early as possible.
For more information on the South African seasonal flu statistics see here
Cheers, Gail
So, if you are HIV positive how are you going to prepare for this season? i advise a 3 step approach:
1) Maximise your health to protect against the flu
2) Get your flu vaccination in the next 8 weeks
3) Be armed and ready to treat the flu if it hits you.
1) So, this is the proverbial healthy lifestyle that all experts advise but so few of us really embrace. It's all about stocking your body with vitamins and antioxidants (the good guys that soak up and neutralise toxins in the body). Get lots of veggies and fruits - variety will give you a range of vitamins.
Excellent vitamins to boost are Vitamin C 1000mg, D 400 IU and E . These are important in the immune system to fight infection. Echinacea and garlic are also useful to add but doses are variable and not standardised.
It is also a good idea to take a probiotic ( a tablet containing beneficial gut bacteria that will help to protect the gut from invading organisms) although there is no evidence that it will prevent the flu but it seems to shorten the severity and duration of it.
Anyone who does Yoga or is familiar with Ayurvedic medicine may be aware of the Neti pot which looks a little bit like Aladdin's lamp. It is used to pour water through the one nostril while tilting the head and the water then flows out the other nostril. Interestingly, this is effective to cleanse the nasal passages and assist in preventing colds, flu and sinus problems. For those of you not so adventurous, a simple saline nasal spray is also good. A couple of bursts of this a day will help to cleanse the nasal passages which are the main port of entry of viruses.
Finally, good hygiene and handwashing practices will also help to spread viruses (especially important if you have kids).
2) Flu Vaccination. For some reason the topic of vaccination always seems to get people hot under the collar. If you are nervous about vaccinations or have heard stories about vaccines causing other illnesses then your first stop should be here MMR-autism link myth.
Each year a flu vaccine is produced and offered to the public. If you are HIV+ this is an extremely good idea to be vaccinated yearly. However, the lower your CD4 count, the less effective the vaccine may be but still worth doing.
What does the flu vaccine do? Well, it vaccinates you against the 3 strains of flu that have caused the most severe illness around the world. The vaccine will stimulate your immune system to develop protection against these 3 strains specifically. So, in answer to your next question (How come I get the flu even though I had the vaccination?) - the flu vaccine does not stop you from getting the flu at all, but will protect you from the most serious forms of flu. This is why it is still possible to get the flu even though you have had the vaccine.
You need to get your flu vaccine every year because it is a newly developed vaccine that has the most recent viral strains included. Now is the right time to get vaccinated so that you have a few weeks to build up your immune response before the season hits in full strength. Check out the NICD page for swine flu and flu updates South Africa
3) If you are unfortunate to get the cold or flu this season, then don't panic. Remember the old wisdom: 'treat the flu with drugs and it will be gone in a week, treat it at home and it will be gone in seven days'. Most people will develop a fairly mild illness that affects the upper airways (the nose/sinuses/throat/voicebox) which may be uncomfortable but not a serious illness. Some will however, develop the 'real' flu which will consist of all the former symptoms as well as general body aches, fever, fatigue and possible nausea and vomiting. The flu really packs a mean punch and can result in a week off work - so, best to have a plan of attack if you are struck by it.
I recommend that you keep some useful over the counter medications at home for these occasions (because the flu always seems to strike after the shops have closed). Personally, I advocate symptomatic relief for pain and fever with anti inflammatories like : MedLemon, Nurofen, Compral.
A good old fashioned hot toddy works wonders and even has an evidence basis to it: take a cup of boiled water, add 2 tsps lemon juice and 2 tsps honey and a tot of whiskey ( if you are so inclined). Honey has antimicrobial properties, the lemon is an antioxidant and the whisky , well, that helps you to sleep ( and hopefully nukes any bugs too).
For the irritating nasal congestion sprays like Iliadin and Drixine are useful- although I suggest that you try to reserve them for night-time (when you really need to be able to breathe) and rather let the mucus drain freely during the day. It's also important that you limit their use to 3 days otherwise the congestion may worsen.
During the day, use a tea tree oil nasal spray or salt water nose spray (like Salex) to help.
Headache and body aches generally respond well to the anti inflammatories, but if you need a bit more kick, then codeine based pain killers are the next step (can be taken with the anti inflammatories) such as Sinutab, Lenadol, Syndol, AdcoDol.
The specific antivirals (a medication that specifically targets the flu virus) that are useful for the flu include Amantadine,Rimantadine, Oseltamivir and Zanamivir. However, they should really be started within 48 hours of the flu starting and should be reserved for severe flu cases. In the case of HIV, the lower your CD4 count or the worse your overall health, the more important it is for you to start the antiviral agent as early as possible. In general, if 10 people get ill, 7 will have a mild illness ( a 'cold'), 3 will have the 'flu' and 2 will require antivirals.
There is no value to be had from antibiotics (medication that targets bacterial infections) as the flu is a viral illness and will not respond to antibiotics.
Other approaches that may help are to take mega doses of Vitamin C (1000mg three times daily ), increased echinacea dosing, steam inhalation, Karvol capsule inhalation, ACC-200 effervescent tablets (to decrease mucus production).
You will notice that I have not mentioned cough mixtures. This is deliberate, because they simply do not work. You will probably get more benefit from a hot toddy or plain honey than the many cough mixtures on the market. The only exception I make is if you have a painful, hacking cough that is keeping you awake (or your child). In that case I would recommend a codeine based medication such as Pholtex syrup (or Pholtex Junior).
Finally, most people will not need to see their doctor with the following exceptions: if you have a CD4 less than 200 or any other serious illness (like TB), or are pregnant then you are at higher risk for complicationsand I would recommend that you see your doctor as early as possible.
For more information on the South African seasonal flu statistics see here
Cheers, Gail
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