I Don’t Need a Flu Shot!

1. I Don’t Need a Flu Shot! Bill Rogers Ball State University

2. Ryan was having a bad day. On top of waking up nauseated, his computer was giving him problems. “It’s probably all these junk emails,” he complained to his girlfriend Ashley. “Look at this one. It’s from the campus health education office. Something about free flu shots. Well it’s too late now; I just got done with the stomach flu. And besides, shots hurt!” Ashley just rolled her eyes. “What a wimp,” she thought.

3. Ashley is a biology major who is also completing a minor in public health administration. “Go get your flu shot soon,” she instructed Ryan. “I don’t want to be your personal nurse when you get the real flu!” “I told you, I just got over the flu. I don’t need a shot! And besides, it’s not like I am going to die from the flu or anything!” responded Ryan. Ashley retorted, “Sit down and let me tell you a thing or two Ryan. You are, well, how should I put this nicely, woefully uninformed.” Ryan just sighed.

4. “Look, Ryan. An average of 36,000 people in the United States die each year as a result of influenza-related complications. So getting the flu bug can be deadly!” Source: Centers for Disease Control and Prevention

5. “Maybe so,” responded Ryan. “But the flu only kills old and weak people, not a physical masterpiece like myself.” “Now I feel nauseous,” Ashley whispered under her breath. “You did NOT have influenza. Ryan, it was probably something you ate. You ARE going to learn some things about the flu. If nothing else, maybe it will help you pass your next biology exam. I really doubt you will do well on the test if you don’t know the difference between the stomach flu, the 24-hour flu, and real influenza!”

6. Influenza is caused by an influenza virus.

8. Stomach Flu or 24-Hour Flu • The “stomach flu,” sometimes referred to as the 24-hour flu, is gastroenteritis, not influenza. • Gastroenteritis is an irritation of the stomach and intestines. It often is caused by bacteria, other kinds of viruses, or parasites. Poor hygiene or contaminated food or water are likely sources. • While the symptoms of gastroenteritis may resemble influenza symptoms, gastroenteritis usually only lasts for a day or two.

9. “All right, all right, you made your point,” groaned Ryan. “But if I get the flu, I’ll just ask the doctor for some penicillin. I still don’t need a shot!” “Ryan, Ryan, Ryan. Antibiotics don’t work against a virus! You’ll feel so bad you won’t even think of, well you know, being romantic for maybe several weeks!” responded Ashley. Ryan suddenly seemed more interested. “Typical male,” Ashley thought to herself.

10. CQ#1: Which of the following is true? • If Ryan’s illness was caused by a virus, he should begin taking antibiotics. • If Ryan has gastroenteritis, he should feel better in one or two days. • Ryan’s stomach flu was probably caused by an influenza virus. • The stomach flu kills around 36,000 people in the United States every year.

11. “One more thing!” mentioned Ryan. “My brother Bryan got a flu shot last year and it actually gave him the flu!” “No, no, no. He didn’t get the flu from the flu vaccine. In rare cases, a person may have a mild reaction to the shot that resembles the flu, but even that is definitely not influenza,” explained Ashley.

12. CQ#2: A flu shot may actually cause a person to get sick with influenza. A. True B. False

13. “Okay, you win,” exclaimed Ryan. “I’ll just get the shot over with. But is this like a tetanus shot where I’ll have to get another one in 10 years or can I just get one and be done with it?” “Um. Sorry. In fact, I’m afraid you’ll have to get one every year,” replied Ashley. “What! Why? Must not be much of a vaccine!” yelled Ryan. Ashley explained, “Some viruses change or undergo mutations. Influenza viruses mutate constantly, so a vaccine that is effective one year may be limited the next.”

14. Flu viruses may change slightly from year to year. This type of a mutation is called “antigenic drift.” A person may have little immunity to this mutated form of the virus. Antigens

15. CQ#3: New flu vaccines are made every year because: • The current flu vaccines are not safe. • Flu viruses mutate. • The number of people who get the flu each year is increasing, so stronger vaccines are needed. • People develop resistance to the previous vaccines. • Vaccine manufacturers need to make money.

16. “Well, what about this Swine Flu that’s been in the news? I saw on the news last night that health officials fear it is something called a pandemic.” Ashley explained that a pandemic is sometimes described as a worldwide epidemic.

17. “Pandemic flu is virulent human flu that causes a global outbreak, or pandemic, of serious illness. Because there is little natural immunity, the disease can spread easily from person to person.” • Source: http://www.pandemicflu.gov

18. “I saw a video clip about a flu pandemic in one of my classes. Let me see if I can find it on the web,” said Ashley. PanFlu Storybook: Beth Hines http://www.pandemicflu.gov/storybook/stories/1957/hines/index.html

19. “We also learned about the Great Flu Pandemic of 1918, often also called the “Spanish Flu,” added Ashley. Posted in Chicago, IL. 1918

20. “About 30 - 50 million people died worldwide during the 1918 flu pandemic including 675,000 Americans. An unusually high proportion of casualties was found among young adults, ages 20-40.” Source: http:1918.pandemicflu.gov

21. Storyteller Gloria GambalePennsylvania "My grandfather, Nicola "Nick" Maffeo, and my grandmother Constance Maffeo came to America from Italy. Constance had a separate room curtained off when seven of their children got sick with the pandemic flu. When she entered the room she wore gauze over her nose and mouth. Of the seven children who got sick, four of them died. They were Frank, Nick and Rosa, and Dominic. Nick and Rosa were twins. One of the three surviving children, my aunt May Ann Maffeo, said that she knew when one of them was not going to live because Constance would sit with the dying child in the family's rocking chair and sing to him/her. The rocking chair would creak and when it stopped, she knew they were gone."

22. CQ#4: Form a hypothesis: Which of the following best explains why Constance Maffeo “never got the virus”? • She may have been one of those people who just never seem to get sick. • She may have received a flu shot. • She may have developed immunity without showing symptoms. • She wore gauze over her nose and mouth.

23. “During the 1918 flu pandemic, mortality rates were high among healthy adults as well as the usual high-risk groups. The attack rate and mortality was especially high among young adults.” Source: http:1918.pandemicflu.gov

24. CQ#5: During the flu pandemic of 1918: • Elderly people were especially at risk. • The mortality rate was high, second only to the Asian flu. • Over 600,000 Americans were killed. • It was the last major flu pandemic until today.

25. “See Ryan, even a physical masterpiece like yourself can be at high risk!” teased Ashley. Ryan responded “Yeah? Well, that was over 90 years ago. Something like that won’t happen again!”

26. “Let’s hope not!” Ashley commented. “But there have been two other flu pandemics since then!” Asian Flu (1957) 2 million deaths worldwide, 70,000 in the United States Hong Kong Flu (1968) 700,000 deaths worldwide, 34,000 in the United States “And new strains of influenza appeared in 1977, 1997, 1999, 2002, 2003, 2004, and 2009!” Source: National Institute of Allergy and Infectious Disease (NIH)

27. Source: http://www.pandemicflu.gov/

28. Ryan replied “Yeah, I heard about the 2009 strain, weren’t they calling it the swine flu for awhile? But I’m not too worried. It’s not like I’m planning on kissing a pig!” “Lucky for the pig!” thought Ashley.

29. Various strains of flu viruses are are found in different hosts.

30. A common host may become infected with different strains of flu viruses.

31. Different strains of flu viruses may combine to create a new strain of flu. This is called “antigenic shift.”

32. The new strain may be able to be transmitted between species as in the case of the “swine flu.” The new strain may also be able to jump from person to person.

33. CQ#6: The Swine Flu: • Is most common in rural areas. • Can be caught by eating undercooked pork. • Is especially dangerous since pigs show different symptoms than humans. • Is a result of genetically different flu viruses combining together in pigs.

34. “Okay, let’s go. I’m ready for my flu shot. But it better work against the most current strains of the flu!” muttered Ryan. “Flu shots can be very effective, but making one against a new strain takes time,” said Ashley. “Huh? You mean you great scientists can’t even keep up with a stupid little virus?”

35. Annual Influenza Production Timeline Source: Sanofi Pasteur, Inc.

36. CQ#7: Which of the following is true about a flu vaccine? • The vaccine will protect you from all strains of influenza. • If a new flu strain is identified, a vaccine can be mass-produced very quickly, which will limit the severity of an outbreak. • It has been demonstrated that flu vaccines have caused influenza in some instances. • Mutations in flu viruses may reduce a vaccine’s effectiveness. • One flu vaccination will last for several flu seasons.

37. “Fine, fine, but what am I supposed to do in the meantime?” asked Ryan. “Read this,” Ashley replied as she handed him a pamphlet. “And good luck on your next biology test.” “After all, with your attitude, you’ll need some luck!” Ashley thought.

38. Get a flu vaccine • Take everyday preventative measures • Ask your doctor about antiviral drugs Free flu resources are available at:http://www.cdc.gov/flu/freeresources/index.htm

39. CQ#8: All of the following are true about flu pandemics EXCEPT: • Pandemics are likely to be due to a new strain of the flu. • The flu spreads quickly from person to person. • People have little natural immunity toward the viruses responsible for the pandemic. • Pandemics involve large numbers of people in localized areas.

40. CQ#9: Which of the following situations would be the most likely to contribute to a new flu pandemic? • A year where very few people are immunized. • An environment where flu viruses common to different species are present. • A year when a single strain of the flu virus mutates. • A year when people from all over the world gather together (such as the Olympics).

41. Ryan Not too surprisingly, Ryan, Ashley’s former boyfriend, did not do well on his biology exam. He didn’t feel too good the day of the exam, which he blamed on the stomach flu.