Tag Archives: influenza


dreamstime_l_20046833The flu vaccine this year is a rather poor match for the current strain circulating in the U.S. this year, making the flu shot less effective.  The H3 strain of flu this year is different than the one in the vaccine provided for the 2014-2015 flu season.

If you have had the flu shot, then do be aware that if you develop the flu your shot will help reduce symptoms but probably it will not help ‘prevent’ the infection.  As a result, if you have severe symptoms of fever, aches, and cough, and have underlying health issues like diabetes, emphysema, or asthma, then you should call or come in to get the TAMIFLU pill.

Do not fret….most of us handle a flu infection without complications, but armed with knowledge we can make better decisions in getting treatment when we need.

Read more >>>>> HERE



virus puzzleThe flu vaccine has a long history of production in chicken eggs and as a result, patients who have reported egg allergies are told to avoid the influenza vaccine.

That issue has been resolved with the development of a genetically engineered flu vaccine that does not use eggs in it’s production.

FLUBLOK is that flu vaccine, but there are several things to know before you get this particular vaccine:

1.  It is approved for ages 18-49 only (although I presume it is safe in older age groups, there is no official approval and it has not been tested)

2.  It is difficult to find….  but there are locations for it and you can find them  >>>>>HERE.

3.  Despite the reported egg allergy, nearly all people can take the standard flu vaccine that contains eggs in it.  The Center for Disease Control has an algorithm for determining which flu shot to take….



IIThe figure above is a flow chart detailing recommendations regarding influenza vaccination of persons who report allergy to eggs in the United States for the 2014-15 influenza season. Persons with a history of egg allergy who have experienced only hives after exposure to egg should receive influenza vaccine. Because relatively few data are available for use of live attenuated influenza vaccine in this setting, inactivated influenza vaccines (IIV), or trivalent recombinant influenza vaccine (RIV3) should be used. RIV3 may be used for persons aged 18 through 49 years who have no other contraindications. However, IIV (egg- or cell-culture based) may also be used, with certain additional safety measures.



I read about new types of flu shots.  What do you recommend for me?



Dear Ivy;

It used to be simple to get the flu shot…there was only one type and everyone was to get the same one.  Now, there are multiple options and it’s a bit confusing, so I’d like to give some clarification.

There are a few options out there, but generally, you will get what is available at the office or pharmacy that you go to.  For instance, our office will have the trivalent low and high dose only.  We will not have any of the other special vaccines, for logistical reasons.

So….first….let me go through the options and availability.  I’ll start with the most important that….the ones that apply to most people in my practice:

Low Dose (standard…OK) vs. High Dose (recommended):  The higher dose flu shot has become available in the past few years and provides a stronger immune reaction.  It is thought this will provide better protection, but there is no definitive proof.

It has been proven as safe as the standard flu shot in two seasons of widespread use.

Trivalent (3 flu strains…standard….recommended) vs. Quadrivalent (4 flu strains):   All flu shots contain the same virus protection, as it is based on national recommendations from the government bodies in charge of this issue.  Trivalent contains 2 Type A flu strains + 1 Type B.  Quadrivalent contains 2 Type A flu straines + 2 Type B.

Since Type B is a minority of the flu we see, and since this is a new vaccine, I would recommend passing on this shot until it has been used for a few seasons and proven safe and effective.  Then I may change my mind.

Live vs. Inactivated/Dead virus (recommended):   The live virus (weakened) is available as a nose spray only and is for people 2-49 years old.  This does not apply, in general, to our patient base.  They are equally effective, although perhaps the nose spray is better for children…but that is unclear.

Egg based (recommended) vs. Non-Egg based:  If you do not have an egg allergy of note (and most people who claim to have an egg allergy do not) then there is no advantage to the non-egg based flu shots.  That said, these are a great advance in the technology of flu immunization production and may become more common in the future.  Again, they are new and I would like to see them available for a few seasons before generally considering them.  For egg allergic patients who want the flu shot, this is a great option that was not formerly available.

Intramuscular (recommended) vs. Intradermal:  There are flu shots that can be given with a very tiny needle, like a bee stinger, just under the skin.  These flu shots are just as good as the standard one with the longer needle and will soon become standard, but they are not currently generally available.  In the next few years these will be the flu shot of choice.

So, rather than confuse the issue, this year I am recommending for those over 65 the HIGH DOSE, TRIVALENT VACCINE, but we do have the STANDARD DOSE, TRIVALENT VACCINE as well.  Either is fine.

As for the specialty vaccines, I would ask your local pharmacy if they have them available for special circumstances that may apply to you.



I recommend for all adults over 65:



Swine flu is just ‘flu’ in pigs. It is important because it can transfer from pigs to humans….and if that occurs, there can be lots of trouble. Why? Well….if the humans then transfer that from person to person…..we have a massive epidemic.
Three years ago, H1N1 influenza (a swine subtype) had an enormous outbreak, so much so that it has now become the predominant flu stray in the U.S. in just three years. Fortunately, it was not very virulent…it did not cause severe reactions generally, but anytime there is a change in the flu type, we can see a stronger and more severe reaction.
With the confirmed outbreak of 158 cases of H3N2 swine flu in Indiana & Ohio, new concerns are raised of a possible pandemic.
It’s not time to ‘raise the alarms’ yet….but if you are travelling to Indiana and Ohio it is important to be aware of this issue.
Prevention remains the cornerstone. Avoiding handshakes and close contact with ‘everyone’ you meet. Washing hands is always important.
Treatment would consist of Tamiflu or Relenza…the two influenza treatments generally available.
Keep tuned into this topic…it may be come increasingly important over the next two weeks…or it may just burn out (let’s hope so.)

Read more at:



The CDC issued it’s final analysis for the flu season in the past week and they confirmed the mildest flu season in recent history. This is based on very complete data that they have been collecting since 1997.
Probably, this occurred as a result of the new strain of Influenza Virus (the swine flu or H1N1 strain) that changed in the 2009-2010 season. That new flu strain was very active and caused a high degree of infection. The next year (last year) showed significant flu as well, as the group without exposure in the previous year now was getting infected. This year, the last few people who had missed the previous two years were the final ones to get infection and this left a very limited number of people susceptible.
Yet…..there is still some flu here in Arizona. This is very late in the season and quite unusual. There were 88 cases in AZ last week, so to be aware that despite the mild season, we are having a trailing-off of cases that will inger for a few more weeks through the summer.


Well….the initial statistics suggested a peak, and then decline in the flu reports in Arizona, but the latest data shows that the decline is a false hope. The flu remains in the state and is hovering at an elevated level. It is showing no sign of resolving itself quite yet.
So…if your home is filled with cough, fever, and sore throat…it’s probably the flu and you should call in to try some flu medication if you can catch it early.


Flu season is in full swing in Arizona currently. Although fewer cases than in past years, and milder disease, it is still all around us right now.
If two people in the same house have cough, fever, and sore throat….you are probably dealing with the flu.
Give us a call or stop in if your symptoms are severe or getting worse and worse. Tamiflu pills and Relenza inhaler work well to reduce symptoms and end the flu earlier.
Keep updated on my Twitter Feed, with automatic updates on the flu for Arizona and Scottsdale.


Flu season remains strong in Arizona, but we may be peaking this week and are on the wane. The state data suggests we are reaching our zenith and if that is the case we’ll be seeing a marked decline in cases in the next week or two. Next weeks data will tell the tale, so stay tuned and check us out beginning of April.
For now, be careful with travel and the bugs are out there. Wash hands, avoid excessive hand-shaking and ‘pecks’ on the cheek. Now is the time to be a bit more cautious, just for the next few weeks.


Flu is on the upswing, slowly, in Arizona. That said, I have not documented a single case yet in our office. All suspected cases have tested negative.
This is looking to be among the mildest of flu seasons over the past several years, but do be cautious in public and attending to washing/cleansing hands and avoiding excessive casual contact with people during the next four weeks if you have the potential for infection due to a compromised immunity (diabetes, COPD, Heart Failure)….better to be safe over the coming few weeks.