A Case Study Involving Influenza and the Influenza Vaccine

31 May A Case Study Involving Influenza and the Influenza Vaccine

Karen and Mary work at a grocery store. Mary is a nursing student and works part time to pay for her living expenses. Karen has worked at the grocery for nearly “# years, since she was $$. %e two of them are talking when Karen points to one of the tabloids by the check-out with a headline suggesting that aliens created the bird ßu. As their conversation progresses, Mary suggests that Karen should get a shot when the nurses come in next week selling inßuenza vaccine.

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Karen: No way am I going to waste !’ bucks on another ßu shot. I got one last year and I still got sick. Do you remember that horrible sinus infection I had? I was so sick that I missed the PackerÕs game at Lambeau Field. I had to watch the game at TomÕs house because he was having a party. I could barely breathe!

Mary: I remember that you were sick last year, but that wasnÕt inßuenza. %e inßuenza virus causes fever, aches and malaise.

Karen: WhatÕs malaise?

Mary: %atÕs when you feel sick.

Karen: Well duh, I already told you I was sick.

Mary: But you went to the party to watch the game.

Karen: I was sick, I wasnÕt dead.

Mary: Look, if you had had inßuenza you wouldnÕt have gone out to a party. In fact, you probably wouldnÕt even have cared to watch the game on at home. Malaise is the very sick and weak feeling that comes with having inßuenza, and it takes all of your energy away and leaves you with no desire to do anything but lie still. %atÕs inßuenza!

Karen: Well, anyway, Tom also got the ßu shot and he still got the stomach ßu real bad a couple weeks later. You canÕt tell me that the ßu shot did him any good.

Mary: I canÕt argue with that. YouÕre right. %e inßuenza vaccine didnÕt protect him from the stomach ßu.

Karen: %ere! So you admit it!

Mary: I donÕt admit anything. What you call the stomach ßu has nothing to do with the ßu shot. %e shot is a vaccination that protects against inßuenza, not vomiting and diarrhea. Some people do get

ÒA Case Study Involving Inßuenza and the Inßuenza VaccineÓ by John Bennett Page !

those symptoms, but inßuenza is the fever and aches. %e stomach ßu is caused by other viruses like rotavirus and Norwalk virus; sometimes theyÕre called noroviruses. %e inßuenza vaccine doesnÕt do anything about those.

Karen: If it doesnÕt stop you from getting the stomach ßu, then what good is the vaccine? And another of my friends says that there are a lot of side e?ects from getting the ßu shot, like allergic reactions, seizures, even autism.

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Ò!at ought to do it,Ó Karen thought to herself. She wasnÕt about to lose this argument to a kid of MaryÕs age.

Questions

!. What are the main symptoms of inßuenza?

$. Would you expect a ßu shot to protect against the Òstomach ßuÓ? Why or why not?

“. Identify some of the various causative agents of Òstomach ßuÓ and compare them to the inßuenza virus.

+. Explain how a vaccine provides immunity against infection. Are there any side e?ects to the inßuenza vaccine? Should Karen or Mary worry about developing autism?

‘. Karen described the upper respiratory infection ( ) that she su?ered last year and thinks that her well being is a matter of fate. How many infectious agents cause ? How can these infections be prevented? How can they be treated?

Part IIÑShift and Drift

Mary didnÕt take the bait; instead of countering KarenÕs worries about side e?ects, she chose a di?erent approach. &

Mary: Inßuenza can wipe you out for a week. You wonÕt have the strength to come to work and you would have to take vacation time. Who would take care of your mother at the retirement home if you were sick for a week?

Karen: Oh, come on. A week!?

Mary: %e virus can make a person so tired, that once the fever is gone they still wonÕt have the strength and energy to do anything productive for nearly a week. YouÕd even have di?culty Þnding the strength to visit your mother for another week.

Karen: Oh my gosh. %at would be bad. I guess I remember being that sick about seven or eight years ago. Back then, my mother came over to help me. She wouldnÕt be able to do that any more.

Mary: So, now do you think you want to get the shot?

Karen: Not so fast; if I got the shot last year, wonÕt I be immune this year?

Mary: %e virus changes all the time. %e vaccine might protect against the strain of virus that is circulating in the area, but then again, it might not. %e new version of the inßuenza vaccine is designed to protect against the most frequently recognized strains of inßuenza.

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Karen was starting to realize that inßuenza might really be a di?erent kind of infection than she had thought.

Questions

!. Is it a reasonable gamble for Karen to skip the inßuenza vaccine this year?

$. What is antigenic drift (or genetic drift)? What is antigenic shift (or genetic shift)?

Part IIIÑViral vs. Bacterial Infection

Karen was still unconvinced, however Mary had brought up a lot of good points. But even if inßuenza was a lot more serious than she had thought, a vaccination wasnÕt a guarantee against illness.

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Karen: So, are you telling me that I could get the shot again and still not be protected, because I got sick from some other strain? %en why bother?

Mary: Sure, but the vaccine protects against the most likely viruses. You could still get inßuenza, but the chances are smaller. You could get the stomach ßu, you could get another sinus infection. But by getting the inßuenza vaccine, you are greatly decreasing your chance of getting very sick this winter.

Karen: Last year when I got sick, I ended up going to the doctor and he gave me some antibiotics. I got better the next day. I could just do that. %at way, I only take medicine when I am sick instead of every winter.

Mary: Sorry, but thereÕs a big di?erence between viral and bacterial infections. %e antibiotics helped you feel better because your sinus infection was caused by a bacteria. Antibiotics donÕt help at all for viral infections. And inßuenza is a viral infection. Even if the doctor gives you antibiotics, they wonÕt do any good.

&

Questions

!. Can Karen rely on antibiotics if she gets inßuenza this year? Why or why not?

$. Compare the e?ectiveness of vaccines to antibiotics (or other antimicrobials) prior to infection. Compare the e?ectiveness of vaccines to antibiotics (or other antimicrobials) after the start of symptoms.

“. When are antibiotics e?ective?

Part IVÑWho Should Get Vaccinated?

Karen was still tempted to take the risk; she was generally healthy.

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Mary: Besides, if you get the shot, and protect yourself from infection, you wonÕt spread the virus to other people. Consider this; if you became infected, you could spread the virus to your mother and her friends at the retirement home.

Karen: Oh, I would hate to see that happen.

Mary: Did you know that approximately “1,### people die each year in this country from inßuenza? %at means inßuenza causes more deaths than breast cancer, and most of the people who die of inßuenza are elderly.

Karen (sobered by the possibility): So, if I get the shot, I probably wonÕt get sick, but more importantly, I am less likely to pass the infection on to my mom?

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If that were the case, then Karen thought it might be worth doing, despite her lingering doubts. On the other hand, she was deathly afraid of needles. If only there was another way to get a ßu vaccine É.

Questions

!. Should KarenÕs mother get an inßuenza shot, or is she too old?

$. What about KarenÕs sister who works in a daycare center or MaryÕs six month old niece?