Winter flu doubles the risk of heart attacks and stroke

Scientists in Britain say a dose of winter infections such flu can double the risk of heart attacks and strokes.

An extensive study by scientists from the London School of Hygiene & Tropical Medicine's Medical Statistics Unit has revealed that the risk did not depend on age or gender and victims are twice as likely to be affected in the week after catching a respiratory infection.

For the comprehensive study the scientists examined two million patients registered with approximately 500 GPs and found the increased risks associated with flu were a 'substantial public health problem' that kills thousands of people every year.

The research has prompted renewed calls from experts and campaigners for all those with heart disease to have the flu jab in order to minimise their risk.

The GP database was used to identify all cases of a first-time diagnosis of MI or stroke and it was found of the 300,000 people who suffer heart attacks in Britain each year, 117,000 of them are fatal and more than 130,000 people in England and Wales suffer a stroke each year.

The scientists believe that infections such as flu dislodges fatty deposits that build up in the arteries, leaving them free to move around the body and clog up the brain or heart where they block the blood flow.

Around 23,000 more people die in winter than in summer and of the two million people whose GP records were studied, 11,000 had suffered a heart attack and were twice as likely to have been diagnosed with flu or a respiratory infection in the previous month.

The 9,000 who had suffered a stroke were twice as likely to have been diagnosed with a respiratory infection in the past three days.

The researchers say the risk of suffering a heart attack or stroke tailed off with time, and by three months after being diagnosed with flu there was only a 'slightly increased risk' of either complaint.

Professor Tom Meade and Dr. Tim Clayton, co-authors of the study, say heart attacks and strokes brought on by flu could account for several thousand of winter deaths and vaccinating against respiratory complaints could have a significant effect on lowering the numbers of victims.

The winter flu season usually begins in December or January and last for two months; free vaccinations are available for over-65s and patients with certain illnesses such as asthma.

Britain has not had a flu epidemic for a number of years and experts say one is due; they say influenza is a serious infection, particularly in patients with heart disease and they recommend anyone with heart disease have the flu jab.

The research was funded by the British Heart Foundation and is published in the journal Heart.

Influenza

By Kristy Haugen

Influenza is a respiratory tract infection involving the upper airways and lungs. Many refer to influenza as the “flu”. Influenza is highly contagious transmitted by saliva and airborne droplets expelled by coughing and sneezing. The incubation is very short ranging from one to three days. Common symptoms of influenza are fever, chills, muscle aches and pains, dry cough, nasal congestion, sore throat, headache, malaise, fatigue, sneezing, sweating, and irritated eyes.

The influenza virus is an RNA virus that belongs to the orthomyxoviridae family. Three genera of the influenza virus currently exist. Each influenza virus is identified by the antigenic differences in their nucleoprotein and matrix protein.

The influenza B and C viruses infect only humans. Populations tend to have more resistance to these two viruses. This is because influenza B and C only undergo a type of evolution referred to as antigenic drift. RNA replication in these viruses is frequently error prone and leads to many point mutations. These point mutations lead to very little change in the new viral strain. Influenza B and C viruses cause relatively mild and limited disease epidemics. The influenza A virus infects mammals and birds (avian influenza). This virus is more likely to cause a pandemic (world wide epidemic). Influenza A is a recombinant virus, meaning an interchange of gene segments if two different viruses infect the same cell. This type of evolution is referred to antigenic shift. Avian and human strains recombining in pigs in the Far East may permit the virulent human strains to evolve. Common antigenic variants include H1N1, and H3N2.

Influenza A can be further classified by the surface proteins. Sixteen subtypes of the viral surface protein hemagglutinin (HA or H) currently exist. Nine subtypes of the viral surface protein neuraminidase (NA or N) exist. These surface proteins are essential for the virus’ life cycle.

The flu season reaches a peak prevalence in winter. The Northern and Southern hemispheres have winter at different times, meaning that there is actually two flu seasons annually. Two different vaccinations are made for the different flu seasons each year. The Northern Hemisphere flu season peaks in January or February. The Southern Hemisphere flu season peaks in October.

Influenza vaccines are developed each based off the predominant strains in the Southern Hemisphere. The vaccine contains an inactivated (killed) virus. Protection provided by the vaccine depends on effectiveness of the strain used to make the vaccine.

Vaccinations typically begin in October. Those that are susceptible to illness such as the elderly (65 years and older), young children (under 5 years of age), and immunocompromised patients are encouraged to be vaccinated. Young children are likely to get complications from the flu such as pneumonia, bronchitis, sinus and ear infections.

Anyone who has an allergy to eggs should not be vaccinated. Allergy to the vaccine is due to small amounts of egg protein that remain in the vaccine after purification. This is considered to be a rare side effect. Many complain of injection site soreness up to two days after vaccination. This is temporary and should go away. Typical side effects include fever, malaise, muscle aches occurring 6-12 hours after vaccination.

There are currently medications used to treat influenza. Amantadine and rimantadine are medications used to treat influenza A only. Neuraminidase inhibitors such as Tamiflu and Relenza block the normal function of the viral surface protein neuraminidase. These medications can be used to treat influenza A and B. Resistance to adamantine derivatives (amantadine, rimantadine) is seen in China, Hong Kong, Taiwan, and South Korea due to availability in over-the-counter remedies.

The avian flu naturally infects aquatic birds. However, pandemics occur when the avian adapted virus infects porcine (pigs). This virus will then recombine to form a genetically new virus. The genetically new virus infects humans that are in close contact with the infected porcine. The flu is then transmitted from person to person, beginning an epidemic.

In 1997 the avian flu (H5N1) originating from chickens in Hong Kong, killed 6 of 18 infected. This strain was not readily transmissible from human to human. However, this strain resurfaced in 2004 in Cambodia, Vietnam, and Thailand. This virus remains avian adapted and cannot be transmitted from person to person. A vaccine cannot be made until this virus has recombined into a human adapted form.

Elderberry extract is a trademarked over-the-counter remedy to shorten the duration of an influenza episode. This will not prevent the illness if taken before hand. Only vaccination can help to prevent influenza infections.

Influence is on the minds of many and rightfully so. The avian flu will pose a threat to the world's population if predictions are correct. Maintaining good health is essential during the flu season. One way to do that is take a good vitamin supplement.

Copyright 2005 Kristy Haugen

Kristy is a mother and experienced nurse. She has a Bachelor in Biology and Chemistry and writes to inform individuals interested in health information.

Flu Medications Comparison (II)

By Yury Bayarski

Dosage forms

Amantadine and Rimantadine are taken orally in pill form.
Tamiflu, the first neuraminidase inhibitor in pill form. It is also available as liquid suspension for children.
Zanamivir is administered by inhalation. Zanamivir can be inhaled using a device known as a Diskhaler.

Age

Zanamivir is used for people age 7 and older.
Oseltamivir is used to treat flu in people age 1 and older; to prevent flu in adults and children age 13 and older.
Amantadine is used in adults and in children older than age 1.
Rimantadine is used to prevent and treat type A influenza in adults and children age 1 and older.

Possible Side Effects

Side effects differ widely for each antiviral medication. The neuraminidase inhibitors generally cause fewer side effects than the older flu drugs.

Amantadine: The most common side effects associated with Amantadine relate to the nervous and gastrointestinal systems. Elderly people are especially sensitive to the effects of Amantadine. Amantadine may cause light-headedness, difficulty concentrating, dizziness, nervousness, insomnia, confusion, loss of balance, and seizures. Elderly patients often have reduced renal function and are better treated with Rimantadine, which is 75% metabolized by the liver.

Rimantadine: CNS effects like light-headedness, dizziness, headache, difficulty concentrating, nervousness, insomnia, loss of balance, and seizures. Side effects occur less often with Rimantadine than Amantadine.

Zanamivir: Some people who have asthma or chronic obstructive pulmonary disease (COPD) and use Zanamivir may experience reduced lung function and have difficulty breathing. Other side effects usually do not need medical attention, and may go away as your body adjusts to the medicine.

Oseltamivir: The most frequent side effects are nausea, vomiting, diarrhea. These symptoms are mostly mild to moderate and generally occurred within the first two days of administration of the drug.

None of these drugs is recommended for use during pregnancy or nursing. These drugs have not been evaluated in pregnant women.

Cost

Both drugs Amantadine and Rimantadine are available as generic. Oseltamivir and Zanamivir are new medications and are available only as brand name drugs. Therefore, of the four antiviral flu medications, Zanamivir and Oseltamivir are the most expensive.

Conclusions

Amantadine and Rimantadine are of limited use today due to side effects and the rapid appearance of resistant virus that can be spread to close contacts. Furthermore, Amantadine is associated with several drug interactions (with antihistamines or other medications that stimulate the central nervous system) that may increase the risk of side effects such as insomnia, anxiety, and seizures. Also they are only effective against influenza A, a less dangerous form of flu than influenza B.

Oseltamivir and Zanamivir have fewer side effects and may be used as a treatment and post-exposure prophylaxis of both A and B influenza. Additionally, they are better structured to treat and prevent mutating virus strains. Oseltamivir, that has recently become famous as an effective treatment for bird flu, is an orally administered drug and is more convenient to use than the inhaled administrated Zanamivir.

Although influenza viruses A and B have not developed resistance to Zanamivir or Oseltamivir at this time, resistance is possible with increased use of these medications.

Yury Bayarski is the author of Price-RX.com - a prescription drug price comparison website. Please follow this link if you would like to read more about flu prescription drugs

Important Facts About The Flu

by Ethan Miller

The flu is a respiratory infection, despite the fact that it causes full body pain, digestive upsets, and headaches. The flu can sweep through entire communities in a matter of days, moving through schools, work places, and shopping centers.
The Centers for Disease Control and Prevention (CDC) estimates 5 to 20 percent of Americans are infected with the flu during each flu season, typically from November to March. Children are two to three times more likely than adults to become ill.

The CDC estimates that 200,000 people are hospitalized each year and about 36,000 people die from the flu and its complication.

The danger of the flu is that it spreads to epidemic proportions within days, and it mutates, making it difficult to prevent. Each strain of flu reacts differently in the body, making it impossible to predict how the next epidemic will hit society.

The government is now encouraging people to cough into their upper arm, or sleeve, if they do not have a tissue. They should also wipe their hands after they cough. This prevents the spread of the disease between people working in close proximity of each other.

Hand washing needs to be done with a soap based, or alcohol based hand cleaner. The new bacterial cleaners may not work unless they are alcohol based.

The elderly, newborn babies, and people with certain chronic illnesses, however, the flu and its complications can be life-threatening. The danger caused by an out-break dependsd on the virus strain.

Flu is caused by a variety of influenza viruses. Researchers identified the first strains in the 1930s. They classify influenza viruses into types A, B, and C.

* Type A is the most common and causes the serious epidemics. * Type B outbreaks can cause epidemics, but the symptoms are milder than those in type A. * Type C viruses, has never been connected with an epidemic.

There is no cure for the flu. The only plan of action is plenty of bed rest, drinking fluids, and taking medications that alleviate the symptoms.

This is followed by careful attention to symptoms. The flu can turn into a bacterial infection, resulting in pneumonia, within hours. It is important to remember that complications can appear after the patient starts to feel better.

Complications include a high fever, shaking, chills, chest pains, and may include vomiting and diarrhea. A doctor should be consulted if coughing produces a yellow-green mucus, especially if it is expectorated from the body. This means, that it is coughed hard from the body with force, sending it several feet away - if the patient did not have a tissue.

It is important to remember that influenza A virus is resistant to Rimantadine and amantadine. The CDC recommends that you not take these medicines to treat the flu. Avoid giving aspirin to children and adolescents with the flu, and do not take antibiotics.

IF a pandemic breaks out, visit http://www.pandemicflu.gov/ to learn the news, and learn what you can do to protect yourself and your family. This site tracks the all forms of the flu, and has tutorials to help people protect themselves in case of a flu pandemic.

About the Author
Ethan Miller advises on health issues from his web site at http://asthmaroom.com He invites you to receive his FREE health information guide here http://www.lowcarbrescue.com

Flu Medications Comparison (I)

By Yury Bayarski

At present time four drugs in the United States are approved by the FDA for the treatment and prevention of flu:

Neuraminidase inhibitors: Oseltamivir (brand name: Tamiflu) and Zanamivir (brand name: Relenza)
Adamantane derivatives: Amantadine (brand name: Symmetrel) and Rimantadine (brand name: Flumadine)

The U.S. Food and Drug Administration (FDA) approved two drugs to both treat and prevent influenza type A - Amantadine in 1976 and Rimantadine in 1993. In 1999, FDA approved two new antiviral medications to fight the flu: Zanamivir (Relenza), the first neuraminidase inhibitor, and Oseltamivir (Tamiflu), the first of a new class of antiviral drugs called neuraminidase inhibitors. The antiviral drugs approved for influenza in the United States all are prescription drugs.

Influenza antiviral medications are drugs that suppress the ability of influenza viruses to reproduce. When used correctly, they can reduce the duration of symptoms and some complications from influenza virus infection. When used for treatment within the first 2 days of illness, all 4 antiviral medications are similarly effective in reducing by 1 or 2 days the duration of illness caused by influenza A viruses, and make you less contagious to others. Only Oseltamivir and Zanamivir are effective against influenza B viruses, though they do not cure influenza outright.

Oseltamivir and Zanamivir are preferred for treatment in part because influenza viruses are more likely to develop resistance to Amantadine and Rimantadine. The 4 influenza antiviral drugs are effective only against influenza viruses. They will not help reduce symptoms associated with the common cold.

All of the antiviral drugs are different in terms of who can take them, approved uses, approved ages, how they are given, any dosing changes based on age or medical conditions, side effects and costs.

Mechanism of Action

The surfaces of influenza viruses are dotted with neuraminidase proteins. Neuraminidase inhibitors block the enzyme's activity and prevent new virus particles from being released, thereby limiting the spread of infection. Zanamivir is inhaled through a device called a Diskhaler. This inhaler device delivers the medicine to the lungs, where the influenza virus multiplies. Oseltamivir is taken as a pill. Zanamivir and Oseltamivir help prevent influenza A and influenza B viruses from multiplying in the body by interfering with the production and release of virus from cells that line the respiratory tract. This may slow the spread of the infection within the airways and lungs.

Amantadine and Rimantadine: inhibit entry and uncoating of influenza A virus. These drugs block penetration and uncoating of the virus by preventing acidification of the endosome and thus the pH-dependent activation of the fusion activity of the virus hemagglutinin by interfering with the function of the M2 protein of Influenza A virus. Both agents are active against some influenza A virus strains (H1N1, H2N2, H3N2), but are inactive against influenza B (influenza B does not possess a M2 protein).

Medical Uses

To treat flu: Symmetrel (Amantadine), Flumadine (Rimantadine), Tamiflu (Oseltamivir), Relenza (Zanamivir).

To prevent flu: Symmetrel (Amantadine), Flumadine (Rimantadine), Tamiflu (Oseltamivir). Zanamivir is not currently approved for preventive use.

Used against influenza type A: Symmetrel (Amantadine), Flumadine (Rimantadine), Tamiflu (Oseltamivir), Relenza (Zanamivir).

Used against influenza type B: Tamiflu (Oseltamivir), Relenza (Zanamivir).

Respiratory Infections in Winter Associated With High Heart Attack Risk

Researchers at London School of Hygiene have revealed that respiratory infections can double the risk of heart attacks and strokes in winters

It has been found that there is a sturdy increase in the number of deaths from coronary heart disease (CHD) and stroke during the winter months.

The study led by Tim Clayton and Tom Meade of the London School of Hygiene & Tropical Medicine's Medical Statistics Unit suggests that the benefit of reducing respiratory infection, either through ensuring high immunisation rates or by treating and preventing infection, may be substantial.

Clayton said that the data provides a strong evidence for a linking the infection with heart problems.

"These data add to the growing body of evidence linking respiratory infection with subsequent risk of cardiovascular events. However, the absolute risk of such an event to an individual with respiratory infection remains low," said Clayton.

Dr. Mike Knapton, Director of Prevention and Care at the British Heart Foundation who funded the research also said that influenza could cause heart attacks.

"We recommend that anyone with heart disease has the flu jab. Influenza is a serious infection, particularly in patients with heart disease such as heart failure, and it could even trigger a heart attack," said Knapton.

"Flu is a potential killer and heart patients are offered the flu jab for free, no matter what their age."

"We strongly recommend they take up the offer to give themselves protection against the flu," he added.

The research is published in the online edition of the European Heart Journal.

About Common Cold and Influenza - What is the Difference (I)

By Knut Holt

Both common cold and flu give symptoms from the ear, nose and throat, fever and symptoms from the rest of the body, and the symptoms of both diseases can vary between mild and very bad. By common cold, the symptoms from the windpipe come first and remain as the main symptoms.

By flu fever, pain in the rest of the body, nausea, feeling of weakness and other general symptoms are predominant. Symptoms from the windpipe are usually milder, but can gradually get somewhat worse. The symptoms from the windpipe may sometimes nearly lack.

THE CAUSES AND SYMPTOMS OF COMMON COLD

The common cold is caused by a large variety of viruses, which mutate quite frequently during reproduction, resulting in constantly changing virus strains.

Common cold is generally transmitted when drops coming out when a person sneezes or coughs get airborne and then are inhaled by another person. Transmission by direct contact with a sick person is also frequent. Between one-third and one-half of all people exposed to cold viruses become infected and develop symptoms after 1–2 days.

The symptoms from the windpipe are the strongest by common cold:
- The throat feels sore, and a sore throat is often the starting symptom.
- There will then be increased secretions of mucus form the nose, resulting in running nose and dryer secretions building up in the nose.
- The throat will also secrete more mucus, resulting in a wheezing sound, and possibly building up of dryer secretions also here.
- There will be swelling in the nose and throat.
- Cough and sneezing are important symptoms of common cold. These reactions are stimulated by the building up of secretions and of the swelling in the windpipe.

There may also be mild symptoms from the rest of the body.
- Mild to severe headache is common.
- A mild fever may occur.
- Some persons experience a little neck stiffness and pain in the neck when trying to flex it, but this symptom must not be great. If this symptom is great, it can be a sign of meningitis, a very serious disease.

THE PREVENTION AND TREATMENT OF COMMON COLD

Staying away from people being sick and strict washing habits can prevent the transmission of common cold, but it is difficult to carry through a strict enough regime of this sort in a populated society.

Because of the frequent variations of viruses causing common cold, successful immunization has not been developed.

The immune system of the body usually manages to beat down the infection within some days. By common cold one shall hold an activity level that is felt comfortable. It is not necessary to strictly restrict the daily activities level.

High doses of vitamin C have been proven to help prevent cold and get rid of the cold faster, but the doses that must be used are impractically high if vitamin C is used alone. However, a combination of lower doses of vitamin C with other natural substances may be useful.

Common treatments of cold have the aim of relieving symptoms and of strengthening the immune system so that it can beat the infection better. Pain killers such as aspirin and paracetamol relieve the pain by common cold effectively, and are the most common treatment for this disease. However, both drugs can give adverse reactions if they are used in greater amounts than recommended and even recommended doses can sometimes give dangerous effects.

Aspirin can cause internal bleeding and both aspirin and paracetamol can cause liver damage. For children and teens it is advised to use paracetamol, because the liver damage caused when young people take aspirin can be very severe. The drugs should therefore be used with caution and not in a too long period.

Drugs to loosen mucus, to decrease swelling, to decrease mucus production or to suppress the cough reflex can be effective to relieve symptoms. These drugs are often made to mainly loose mucus or mainly suppress exaggerated cough, but these two effects can be blended in the same drug. These drugs may be liquid, be prepared as nasal spray or as tablets to suck on. To choose the right drug for your child or yourself, you must examine to find out what are the main symptoms: Mucus production, whether the mucus is loose or hard, swelling or exaggerated cough.

Steam inhaling is a traditional treatment long used in many countries. The treatment can help loose the mucus so that the windpipe more easily is cleared by cough. The treatment may also to some extend destroy the virus.

The drug Pleconaril is ment to attack the viruses causing the majority of common colds, picornaviruses. The drug has been developed by ViroPharma Incorporated and Schering. The drug is available in oral form and inter-nasal formulations are being developed, but the efficacy of the drug is not clearly established and the drug is not yet approved for general use.

Interferons are used nasally in Eastern Europe to treat common cold. Interfeons are natural proteins than regulate the function of the immune system.

There exist herbal and mineral supplements on the marked that may strengthen the immune system and thus prevent cold from occurring, ameliorate the cold if it still occurs, and help the body to fight down the disease faster. These supplements often contain extracts of Echinacea Angustifolia. Treatment with this herb should not exceed two weeks.