October 18, 2018
I was 12 or 13 years old when I first heard about the flu. My social studies teacher took my class on a field trip to the Regina Cemetery as part of a history lesson. A section of the cemetery is called Potter’s Field, and this is where many Spanish flu victims were buried in unmarked graves. Ten per cent of the city’s population of 30,000 became sick with influenza, and nearly 300 died in 1918, while across Saskatchewan 3,906 died from the flu.
This time of year always reminds me of that field trip as I start to think about how to do my part to keep me, my family, and my patients and co-workers as healthy as possible during flu season. This year, I googled “Regina Spanish Flu” because I wanted to check my memories, and I found this fascinating
website, which provides an amazing timeline of the epidemic through archival documents and photos.
What struck me was, despite 100 years of remarkable advancements in medical care, much has stayed the same. Read through the website and you will see the foundations of our current approach to preventing and treating seasonal influenza: a strong public and population health strategy, Medical Health Officers providing leadership and direction, a coordinated community response with civic leaders, churches, schools and businesses working together to take care of the sick, contain the epidemic and protect the community, in addition to data, surveillance and reporting that guides the system response.
Interestingly, back in 1918 there were only 50 vaccine doses available for the entire city of Regina. Due to the shortage, the decision made was to inoculate nurses and doctors.
Exactly 100 years later,
influenza remains one of the top 10 causes of death in Canada.
It may be easy for some to disconnect from how deadly influenza can be. Not for me. My work in the ICU puts me directly in contact with people every fall and winter who become critically ill, facing death and sometimes succumbing to influenza. These patients are young and old, some are pregnant. While many are chronically ill, some are remarkably well prior to illness. The effects of this illness can be devastating for the patient and the family, and lead to sadness and strain on our staff.
I remember most of the patients who were young, previously well and needed emergency life and organ support such as dialysis and ECMO (Extracorporeal membrane oxygenation) – not benign treatments. And sadly, the ones I remember the most are the ones who died.
Influenza is sneaky. Asymptomatic carriage of the virus ranges from 5.2 per cent to 35.5 per cent, while subclinical cases (not meeting criteria for flu-like illness)
range from 25.4 per cent to 61.8 per cent.
This means you can be completely well, or only mildly ill, while spreading influenza to those much more vulnerable than you.
I got my first flu shot in 1995, which was also my first year as an anesthesiology resident. My attending pediatrician gave me firmly-worded advice to go and get immunized during my pediatrics rotation. This doctor went on to tell me about how he got the flu while he was a resident. If I remember correctly, he missed two weeks of work and it took six more weeks before he returned to his baseline. We reviewed the literature and he assigned me some reading. I had yet to see a case of influenza in my medical training, but his story made it very easy for me to know what I needed to do.
Get your flu shot. For you, for your patients and for your family. The best thing you can do to protect yourself and your loved ones is to get yourself immunized as soon as you can.
The 2018 flu shot will be available for free across our province starting on October 22. I’m planning on getting mine from our Saskatchewan Health Authority Occupational Health and Safety staff as soon as I can. Some of this is selfish – I frankly do not have time for the flu. But mostly I must do whatever I can to protect my patients and my family. We are all capable of transmitting the flu to those we care for, whether at home or at work.
www.4flu.ca for all the information you will need to find a flu clinic near you. And keep your eyes and ears open for information from your local Occupational Health and Safety teams for vaccine programs in our facilities for staff, patients and long-term care residents.
Dr. Susan ShawChief Medical Officersusan.firstname.lastname@example.org