Winter Ills

It has been so many years since this island last suffered a major influenza epidemic that most people have long forgotten the…

It has been so many years since this island last suffered a major influenza epidemic that most people have long forgotten the nature and severity of the symptoms of the illness. It is a racing certainty that the vast majority of people calling in sick over Christmas and the New Year because, they say, of the flu were suffering from one or another of the customary seasonal colds or other infections that occur regularly at this time of the year. A few may have had isolated cases of "endemic" influenza (usually caused by the B strain of the virus), but there is no evidence of any epidemic here.

The adjacent island has certainly been affected by one of the epidemic A strains (the so-called Sydney flu) moving from Northern England down to the South East over the Christmas period but not significantly affecting Scotland or the West Country of England and nowhere amounting to an outbreak that could be described as being at epidemic levels.

Even if the British outbreak were to spread to Ireland, there should be little cause for serious concern here since both the Sydney influenza A (AH3N2) and the current endemic Beijing B-strain influenza are included in the influenza vaccines which have been administered in 1998 to those at risk from influenza this winter. These vaccines do not provide complete protection but can ameliorate the condition in those elderly or very young and those with chronic lung, heart or kidney disease or deficiencies in their immune system. Healthy young people and adults can easily get over an attack of either Sydney or Beijing influenza with bed-rest, warmth, plenty of fluids and mild pain-relievers such as aspirin or paracetamol.

That there will be a major and serious pandemic of influenza affecting this country and many others is almost inevitable one of these years. The greatest pandemics have occurred in 1918 (when some 20 million died world-wide from what was known as "black flu"), in 1958 and 1967. But there is a reasonable prospect that by the time the next pandemic hits (as a result of a mutational change in one of the unstable A strains of the virus), there may be a medicinal cure for the disease in the form of neuraminadase which some pharmaceutical companies are hoping to have on the market soon. Meanwhile, granny's old cures remain in place as the best means of ameliorating the symptoms of weakness, muscle pains, sore throat, headache, cold, fever and cough which influenza brings.

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But there is another ailment endemic in the community which tends to peak around this time of year and which doctors, schoolteachers and parents need to bear in mind. This is meningitis, and it should be emphasised that the great majority of meningitis cases recover completely. But a couple of bacterial forms of meningitis can be rapidly fatal without early intervention with antibiotics, so that the symptoms (even when they turn out to be a false alarm) need to be checked out by the doctor at the earliest opportunity.

While the earliest of these symptoms may mimic those of a cold or even influenza, the presence of headache, stiff neck, a dark red rash and inability to bear bright light will merit the most urgent medical examination.