Each year on average in America, more than 36,000 people die and 114,000 are hospitalized for complications related to the flu. The flu is a contagious viral illness that causes fever, cough, runny nose, sore throat, sweating, nausea, headache, body aches, fatigue and poor appetite. It usually does not cause severe vomiting or diarrhea.

The young, the elderly and people with certain underlying medical conditions are at high risk of developing serious illnesses and complications from the flu, with death sometimes resulting. These complications include dehydration, pneumonia and, rarely, Reye's syndrome. The latter condition is associated with aspirin use and results in failure of the liver, brain and, ultimately, the entire body. The flu in healthy individuals contributes to absences at work and school, increased physician visits and hospitalizations.

Who should receive the flu vaccine?
The Centers for Disease Control and Prevention and the World Health Organization recommend prevention by receiving the yearly flu vaccine. The traditional inactivated influenza vaccine (IIV) is given by injection for persons 6 months and older.

High-risk individuals who should receive the IIV include:

• People 50 years and older
• Infants 6 to 23 months
• Individuals 6 months to 18 years receiving long-term aspirin therapy
• Individuals 2 to 49 with chronic medical conditions
• Residents of nursing homes and chronic care facilities
• Pregnant women in the second and third trimester during flu season
• Healthcare workers and employees of hospitals, outpatient care facilities, nursing homes, and chronic care and assisted care facilities
• Out-of-home caretakers of infants from newborn to 23 months

The flu vaccine -- to spray or inject?
A recently approved nasal spray (live attenuated intranasal influenza vaccine, LAIIV) now is available for healthy persons ages 5 to 49 who are not at high risk for complications from influenza. Both the spray and injection contain strains of the influenza virus that are equivalent to the annually recommended strains: two influenza A and one influenza B virus. Both are grown in eggs. Therefore, people with allergies to eggs and certain other substances should not receive either vaccine.

Both can be given during minor illnesses such as mild cold or diarrhea, and both have been shown to be more than 90 percent effective in preventing influenza. People may have adverse reactions that include runny nose, stuffy nose, headache, fever and sore throat, but they will not get the flu from either vaccine. The injection is preferred over the spray if a person also is given other live viral vaccines. The spray should not be given until 48 hours after stopping antiviral medication, and antiviral medication cannot be given until at least two weeks after the spray is given. The spray also is more expensive than the vaccine in most locations.

The spray should not be given to people who are younger than 5 or older than 49, have chronic medical conditions, are on long-term aspirin therapy, are pregnant, have a history of Guillain-Barré syndrome or are allergic to eggs.

T.T. Nguyen, MD, is a pediatrician whose Healthy Kids & Teens Medical Practice is located in Suite 300, 2385 E. Prater Way, Sparks Medical Building (connected to Northern Nevada Medical Center). Dr. Nguyen has the nasal spray vaccine available for ages 5 to 49 for $55 per dose.

Northern Nevada Medical Center 2375 E. Prater Way, Sparks, NV 89434 775-331-7000