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Seniors and Asthma
Preventing respiratory infections November and December mark the height of the holiday season in the United States. Most people look forward to visiting with family and friends to enjoy and share the spirit of the season. November and December also mark the time of year when many seniors suffer from respiratory illnesses. The rate of illness actually increases as people travel far and wide during the holidays. There is no prevention of, nor cure for the common cold; however, there are vaccine-preventable diseases that seniors, especially seniors with asthma and other chronic diseases need to know about. The two respiratory illnesses that every senior needs to know about are influenza (flu) and Pnuemococcal pneumonia. Influenza typically occurs during the winter months. The virus is spread from person to person through coughing and sneezing. If someone with influenza coughs on you, you generally will develop symptoms within one to four days of the exposure. Unfortunately, people are infectious one day before they develop symptoms and continue to be able to spread the disease for five days. Someone who has a routine case of the flu will have:
These symptoms will resolve after a limited number of days for most individuals. Some, however, may have cough that can persist for weeks. For senior citizens, especially those with asthma and other chronic diseases like diabetes and kidney disease, a case of influenza can be anything but routine. An average of 114,000 influenza-related hospitalizations occur each year. Fifty-seven percent of these occur in patients over the age of 65. Influenza-related deaths could result from pneumonia or complications that develop as a result of previously existing medical problems. In the epidemic that occurred in 1994-1995, more than 20,000 deaths occurred; greater than 90% of deaths were in older adults. Each fall, flu shots designed for the protection against influenza are offered across the country. Vaccination is the most effective way of preventing the spread of influenza and its potential devastating consequences. In 1999, the vaccination rate among those older than 65 was 66%. Vaccination rates among African American and Hispanic seniors were only 50% and 55% respectively. We can do better than this, and we must do better than this. Vaccination against influenza is also recommended for all persons aged 50-64 because this group of people has an increased prevalence of high-risk medical conditions. Vaccination is also recommended for all physicians, nurses and other personnel, such as emergency care response workers, employees of nursing homes and assisted living homes, as well as household members of persons in high-risk groups. In 2000, only 38% of health care workers received a vaccination. So, when your physician reminds you about your flu shot, remind him or her of the importance of vaccinating their entire office staff. All healthy children age six months to 5 years should get the flu vaccine. Like seniors, they are more likely to develop illness that leads to hospitalization. The best time to get your flu shot is in October and November. It generally takes two weeks to develop immunity. Theoretically, as long as you get vaccinated two weeks before the outbreak in your community you should be covered. The vaccine is 70-90% effective in preventing the disease. You can still get the flu after receiving the vaccine but it is generally less severe. Contrary to popular belief, you do not get the flu from the flu shot. If you fell sick with a flu-like illness after the shot, you had the bad luck of simultaneously catching another respiratory virus. The influenza vaccine and the Pneumovax (see below) can be administered on the same day at different sites so there is no need for two visits to your health care provider. Persons who are allergic to egg should not receive the influenza vaccine. Pnemococcal pneumonia can be life threatening to seniors. This is a bacterial illness that causes high fever, cough and stabbing chest pains. It can become blood borne (bacteremia) and cause meningitis. The pnuemococcal bacterium is one of the most common causes of death in the United States that is preventable with a vaccine. Each year 40,000 people die. Half of these deaths could be prevented by vaccination. Anyone who is older than 65 should be vaccinated. Anyone with a serious long-term health problem such as heart disease, alcoholism, diabetes or chronic lung disease, or if your immune system is compromised because of cancer should be immunized. All patients with emphysema, COPD and severe steroid dependent asthma should be vaccinated. Asthma has not been associated with an increased risk for pnuemococcal disease, unless it occurs with chronic bronchitis, emphysema, or long-term use of systemic corticosteroids. If your asthma is mild or moderate, you and your doctor will need to make a decision. At this point, patients with mild-moderate asthma are not considered at high enough risk to recommend vaccination. Pnuemococcal vaccine is safe and effective. The side effects are minimal (local swelling and tenderness and in some low grade fever). In general the recommendation is that everyone should receive the shot at age 65. If you received your first dose of Pneumovax before age 65, you will need a booster shot five years later. Although the protective effect of the vaccine tends to decrease with time, at this time, booster shots are not routinely recommended. As part of the national childhood immunization program all children receive a similar vaccination call Prevnar. Make immunization against influenza and pneumococcus a priority during this holiday season and have a happy, productive and healthy 2003 and many years to come. Kathleen A. Sheerin, MD, is a Fellow of the American Academy of Allergy, Asthma and Immunology (AAAAI) and a practicing allergist/immunologist in Atlanta, GA. |
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© 1996-2008 · All Rights Reserved · American Academy of Allergy Asthma & Immunology |
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