(Lower photo by Rob Bye)
During the 2017-18 flu season, flu-related deaths were at epidemic levels for 16 consecutive weeks.
By Paul Culp, MA (Oxon.), CFT
We are only a few weeks away from the 100th anniversary of the armistice that ended the fighting in World War I, by far the deadliest armed conflict in history up to that time. We have also reached the centenary of a scourge that killed more people than the World Wars and the Holocaust combined.
The final year of World War I and the year after were marked by a worldwide influenza pandemic that took the lives of approximately 50 million. Ten times that many were incapacitated while suffering from the virus.
One of the oddities of the pandemic was that young adults were the group most affected, a phenomenon not accounted for by the unusually large number of young men then in the military–considering that more than a quarter of the U.S. population became ill.
“We’re not known as being the cleanliest of people.”
Young adults: It makes you think–especially if you consider young adults brought together from all points of the compass and living at close quarters with each other. As a nurse at a large state university told USA Today, “Many college students have irregular schedules, don’t get enough sleep or eat properly, so they are more vulnerable to disease. They go to class together, socialize together, eat together and sleep together…Any type of disease can go through a population like that very quickly.”
One must admire the candor if not the syntax of the undergraduate serving as a research assistant on a study of how flu spreads on a college campus:
“We’re not known as being the cleanliest of people.”
The college years may not be the best time for us to think of ourselves as immortal, and last year’s especially virulent flu outbreak should be enough to raise extraordinary concerns.
The Centers for Disease Control and Prevention report that the 2017-18 flu season, which began in November and continued through March, saw the number of flu-related deaths remain above the epidemic threshold for 16 consecutive weeks. Vox reported in February of 2018 that flu was “everywhere” in the U.S., with 10 percent of all reported deaths during the previous week being flu-related. School districts closed. At least one state declared an emergency.
Overall hospitalizations for all age groups were the highest since the CDC developed its current monitoring system 15 years ago. As of this writing, statistical analyses of the effectiveness of 2017-18 flu vaccines are not yet available–they’re expected any time now–but the CDC estimates that in 2016-17 “flu vaccine prevented an estimated 5.3 million illnesses, 2.6 million medical visits, and 85,000 hospitalizations associated with influenza.”
Meanwhile, the vaccination rate on college campuses remains notably low. The National Foundation of Infectious Diseases reported in 2016 that even the campuses with the most conscientious vaccine-getters are in the 39 percent range–and that the low end is 8 percent.
“On college campuses, influenza viruses are known to circulate rapidly, through constant exposure in close quarters like common living spaces, classrooms, shared restrooms, and through social activities. On average, college students who get the flu experience up to eight or more days of illness along with increased rates of health care use, school absenteeism, and impaired academic performance.”
Oh, and flu can kill you or cause permanent damage to your vital organs.
“It won’t happen to me.”
One health services director at a college in New York State told NBC that 95 percent of students with flu had not been vaccinated. “Students don’t see themselves as vulnerable to much,” she said. “Parents can encourage them, but they have that bubble of invulnerability.”
The NFID laments the difficulty involved in driving home the vaccination gospel with college students. Students tend to believe that “it won’t happen to me,” and many of them are also not accustomed to coordinating their own health care, having had parents or guardians looking out for them before. Students display “varying levels of awareness/attitudes toward the flu vaccine, side effects, and overall effectiveness,” and “busy schedules and competing priorities make it difficult to capture student attention,” so students may be “desensitized to health communication materials or awareness efforts that seemingly have little relevance to their daily routine.”
Not surprisingly, many students are also confused about what preventive measures are covered by their health insurance plans. (And who said college doesn’t prepare you for real life?)
Some people simply abhor needles. For them, a nasal spray alternative is available. Other people are opposed to vaccination for philosophical reasons or because they believe vaccination is dangerous. It is worth noting that last year’s high mortality and hospitalization numbers were caused in part by an unexpectedly high incidence of a particular strain of flu that is especially resistant to vaccination. In any case, basic precautions and preventive measures make sense for everyone, not that even a high level of vigilance is any guarantee of avoiding flu.
Good etiquette might not be enough.
In addition to the hazards posed by contact with saliva or mucus, sneezing or coughing exerts an aerosol effect. As Johns Hopkins virologist Andrew Pekosz puts it, “This could mean that just having good cough-and-sneeze etiquette — sneezing or coughing into tissues — may not be enough to limit the spread of influenza. Just sitting in your office and breathing could fill the air with infectious influenza.”
Still, good cough-and-sneeze etiquette can go some distance toward limiting the transmission of the flu virus. The CDC also recommends fundamentals like avoiding people who are sick; washing the hands often and thoroughly; cleaning and disinfecting frequently washed objects and surfaces; getting sufficient sleep; eating properly; not touching your eyes, nose, and mouth; and just staying home–though if your home is a dormitory, it might not be much of a refuge.
If you do experience significant flu-like symptoms–some combination of fever, cough, stuffy or runny nose, body aches, sore throat, headaches, fatigue, and vomiting or diarrhea–seek medical attention promptly. Flu tends to move quickly after the onset of infection, and victims who delay treatment may become very seriously ill, perhaps lethally so, before intervention occurs. The CDC warns of flu-induced pneumonia, a common cause of flu-related deaths; inflammation of the heart, muscle, or brain; respiratory or kidney failure; and sepsis. People with diabetes, chronic heart disorders, asthma, and kidney disease are especially at risk, as are pregnant women.
Adults who experience “difficulty breathing or shortness of breath, pain or pressure in the chest or abdomen, sudden dizziness, confusion, severe or persistent vomiting,” or “flu-like symptoms that improve but then return with fever and worse cough” should declare an emergency and seek medical attention accordingly.
We don’t wish to alarm anyone unduly, and we grant that the pandemic of 1918 and 1919 involved an exotic and unfamiliar strain of flu in combination with less advanced medicine than we have today, but the unexpected could occur again. As so many people discovered in 2017-18, even the familiar can be debilitating and possibly deadly. We can hope and pray that the centennial of the 1918-19 outbreak will be decidedly nontraditional.
College students are especially vulnerable to influenza. Flu is serious. Act accordingly.
Paul Culp writes about college admissions, college costs, financial aid, and college life in general for The Coaching Educator team. A former journalist and corporate ghostwriter, he has taught academic writing and research methods at the university level and an assortment of humanities courses at the secondary level. He has degrees from Oxford University, Jacksonville State University, and Samford University, and also is certified as a fitness trainer.