Adieu to the Flu

If you’re 65 or older, a serious bout of the flu can compromise your entire immune system and put you at risk for major complications. This year, don’t let influenza influence your health! For boomers hitting their stride, it may come as a surprise to realize they are in the category of folks at greater risk for serious complications from the flu. Typically beginning in October, the flu remains active through February, though sporadic cases can continue as late as May. So even if you feel 25, learn why it’s time to take preventive measures.

Age & Risk

Adults 65 and older are disproportionately more likely to get the flu and far more likely to be hospitalized for it. One of the reasons for this is the gradual deterioration of the immune system due to aging, known as immunosenescence. For those with pre-existing health concerns – like frailty or low physical activity – the threat is especially real. Flu-related deaths are estimated to be six times higher in adults 65 and older than in all other age groups combined.

According to Dr. Alycia Cleinman, a geriatrician with CHI Memorial Center for Healthy Aging, “Common flu symptoms include fever, cough, generalized muscle aches, and malaise.” While adults over 65 may have some of the symptoms, they may also experience exhaustion and gastrointestinal problems like pain, nausea and vomiting, or diarrhea. (Of course, since those symptoms can mimic food poisoning or a stomach virus, it’s best to seek medical advice to confirm it’s the flu.) Phillip Smith, a pharmacist with Access Pharmacy explains, “Flu is very contagious and is characterized by a very rapid onset of symptoms – one minute you are fine and the next you aren’t.”

Flu Complications

Typically, flu symptoms should be gone within two weeks, unless complications arise. Dr. Cleinman shares, “People 65 and older have a higher risk of flu-related complications due to immunosenescence, any immunosuppressant medications (drugs used to make the body less likely to reject a transplanted organ), secondary infections, or any underlying chronic lung disease they have, like COPD or emphysema.”

Pneumonia is one of the most common complications for older adults, and it can be especially dangerous. More common in adults with chronic lung disease, it can lead to fluid buildup and a reduced oxygen supply that might require a hospital stay.

The increased risk of cardiovascular problems is another complication to look out for. Even months after recovering from traditional flu symptoms, vascular inflammation can linger and lead to blood clots. In fact, the risk of heart attack rises 3-5 times in the first few weeks after infection, and the risk of stroke rises 2-3 times in the same period.

It’s also important to be on the lookout for symptoms of dehydration – like dizziness, weakness, dry mouth, and poor skin elasticity – throughout the duration of the flu. If left untreated, dehydration can severely affect an individual’s health.

Getting Vaccinated

The Centers for Disease Control and Prevention recommends getting a new flu shot each year, since a person’s immune protection from a vaccination can decline over time and the strains it protects against change. So, if you haven’t had your flu shot yet, get it. Medicare covers the cost for everyone over 65 as long as the provider accepts Medicare assignment.

While it is possible for you to get the flu even if you have had the vaccine (the vaccines don’t protect against every strain, just the ones expected to be the most widespread that year), your symptoms will be milder and the duration shorter. It’s the best prevention method available.

Two types are designed especially for seniors to amp up the body’s ability to create antibodies: high dose and adjuvanted. “Fluzone is the high-dose vaccine,” Smith explains. “It has four times the amount of flu antigen compared to the standard flu shot.” A two-year trial of older adults receiving it showed 24.2% lower risk of confirmed flu symptoms.

The second type, sold under the name Fluad, is an adjuvanted flu vaccine that prompts a higher antibody response than standard doses. While this vaccine was just introduced in the U.S. during the 2016-2017 season, it has been used successfully in other countries for decades.

Both improved vaccine types tend to cause more injection site reactions versus standard doses, such as redness, mild pain, swelling, or headache and muscle pain, but the risk versus reward ratio is definitive.

Further Protections

Make sure you’re up-to-date on a pneumococcal vaccine, too, which will protect you against pneumonia, meningitis, and bloodstream infections. “Stay away from sick people, cover your mouth when you cough or sneeze, and limit how many times you touch your face, eyes, nose, and mouth. Wash your hands with soap and water if possible, and use alcohol hand sanitizers if you don’t have access to soap and water,” Smith adds. And if you start to notice flu-like symptoms, visit the doctor immediately. Antiviral drugs can be used to reduce the threat of complications, but they need to be administered within the first two days for greatest effect.

Finally, do what your mother told you: eat right, get plenty of rest, manage stress, and let things go. It’s a busy season, so practice healthy habits. Regular exercise – even a simple walk around the block every day – will make you feel better and keep your heart healthy. As an older adult, you need to protect yourself as much as possible. It’s never too late to get vaccinated for flu season!

Picture of Dr. Alycia Cleinman

Dr. Alycia Cleinman

Chi Memorial Center for Healthy Aging

Picture of Phillip Smith

Phillip Smith

Pharmacist, Access Pharmacy

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