Ebola Versus Influenza: Both Can Kill, But One Has a Vaccine
Airborne Infectious Diseases Are Difficult to Prevent
Fortunately, the way Ebola is transmitted from one person to another has been relatively stable since discovery in 1979. By this I mean that it still takes direct contact with an infected symptomatic person or their body fluids. Some diseases don’t need direct contact. They can be spread more quickly to many people just by being in the same general area as an infected person. These diseases are the airborne diseases.
An example of airborne disease is tuberculosis. Tuberculosis at one time was the leading cause of death in the United States. It is transmitted directly from the lungs of an infected individual through breathing or coughing and into the lungs of a new person. It is still around.
Currently it is estimated that approximately one third of the world's population has been exposed to tuberculosis, particularly in developing countries. We don’t hear as much about tuberculosis because of vaccination programs for children in developing countries and better treatments for active disease.
Sinister Aspects of Influenza Virus
At this point you are probably wondering what this infectious disease discussion has to do with heart disease. I want to talk about another sinister virus called influenza. Influenza is also an airborne disease and is transmitted when infected people sneeze, cough, or talk in the area of another person. The little infected airborne droplets can also land on surfaces and objects and when a person comes in contact with these objects with his hand and then touches his nose, mouth, or face he can become infected as well. Most of the time, symptoms of flu include a fever, cough, headache, body aches, sore throat, and a runny nose. But just like Ebola, influenza can be a wicked virus and cause multi-organ failure and death.
I have never cared for a person with Ebola, but I have cared for numerous people with influenza in the critical care units, on ventilators, and in some cases these patients have died. Now that we recognized how difficult it is to prevent Ebola that is spread by contact, you can imagine how difficult it is to truly prevent the spread of an airborne disease like influenza. Complicating the challenges with influenza is that the virus often mutates and future strains may be more powerful and lethal than any we have experienced or can imagine. That is an ominous thought when you consider influenza’s past.
- The Russian flu in 1890 killed approximately 1 million people.
- The Spanish flu in 1918 killed up to 100 million people.
- More recently in 2009, the H1N1 flu killed nearly 300,000 people.
Preventing Severity of Flu With Influenza Vaccine
If you have read my prior columns you will know that I believe the best way to tackle any disease is to prevent it, if possible. Each year we have the opportunity to receive an influenza vaccination. We need these each year because influenza tends to mutate into new strains. Sometimes the new mutations are beyond the available vaccination, but most of the time the vaccination works very well.
Here are facts reported by the U.S. Centers for Disease Control and Prevention (CDC) about the influenza vaccine.
- Children who were vaccinated have a 74 percent reduction in risk of being admitted to a pediatric intensive care unit for treatment of the illness.
- In adults, vaccination is associated with a 71 percent reduction in flu-related hospitalization.
- In pregnant women, vaccination reduces the risk of flu hospitalization to their infant by 91 percent.
Although these numbers are not 100 percent, they do demonstrate that the vaccination actually works as a means to prevent disease.
As a heart doctor, I find it particularly important to share with you that the virus can invade the heart itself. This can cause heart injury that can be progressive and fatal. Also, if you have had a heart attack, heart failure, or have other heart diseases you are often more susceptible to complications with influenza.
What Do We Know About Influenza and the Heart?
Can We Prevent Heart Problems With an Influenza Vaccine?
The truth is we don’t know this answer completely. A meta-analysis gave us some insight. The study looked at 39 previously reported studies and the authors found that the flu vaccination was effective in lowering adverse cardiac events and death by approximately 49 percent.
An additional study looked at 31,546 patients in 40 countries to further understand if vaccination reduced heart disease. The authors found that the influenza vaccination lowered risk of major adverse heart events such as stroke, heart attack, and heart-related death by 35 percent during the flu season. The authors did find that the heart-related benefit was dependent on how well the vaccination matched the seasonal flu virus strains.
Right now the best way we know to prevent influenza is to receive the vaccination. Don’t rely on others including the health care industry to minimize risk of disease transfer or reduce your risk of exposure. With airborne diseases, it is almost impossible. If you are concerned about safety of the influenza vaccination, please review the CDC website.
Most people do very well with the vaccination and experience no or mild symptoms. Some people should not receive a vaccination, mainly those with a known allergy and those with an egg allergy. Fortunately, I have never cared for a patient with a severe reaction to the vaccination. Unfortunately, I have cared for numerous patients with influenza who were not vaccinated.
So as a cardiologist, for your heart health, I highly recommend you get yourself and your family vaccinated.
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