By David Work

Guest columnist

Most of us have had a bout with "the flu" at one time or another, and some have had more than one encounter with this disease. It usually consists of a spiking high fever and a general achy feeling with occasional chills. Many cases run their course in a few days. So why all the publicity about the swine flu, which is medically known as the H1N1 Influenza virus?

Well, not all cases are quickly resolved, and some can be life-threatening such, as the one described by reporter Beth Velliquette ("H1N1 a nightmare for local family," The Chapel Hill Herald, Oct. 21, Page 1). A 4-year-old boy in Chapel Hill went quickly from a high fever to the hospital Emergency Department to Intensive Care, where the critical care pediatrician said he was "very, very sick, on death's door." The boy spent 10 days in Intensive Care and was then moved to a regular hospital room. They needed to use "extreme measures," including a breathing tube, to keep him alive.

Any parent would have empathy with the ordeal this family endured. The boy returned to school after recovering at home for three weeks. The stark reality here is that a case of the flu can turn bad in a hurry. Situations like this are what Public Health authorities have in mind when they issue warnings about H1N1 influenza.

Vaccines are the most effective medicines because they prevent disease. It is not a matter of treatment or cure but complete prevention that makes them so essential to Public Health! Problems can arise with any drug, of course, but the primary concern with flu immunization is usually due to allergy to chicken egg albumin used to cultivate the product.

Pregnant women, young children and health care workers should have priority to receive the vaccine. Patients with lung problems such as asthma or other conditions including obesity that inhibits breathing need to be especially vigilant for complications if they get the flu.

A group of parents of autistic children have alleged that thimerosal, a preservative found in some vaccines, caused autism in their children. In February of this year this claim was discredited in a federal court decision. For parents concerned about this issue there is a limited supply of vaccine that does not contain thimerosal.

When regular consumers hear about the flu or influenza they often think of a short-term sickness that nearly everyone gets in their life at one time or another. The fact that most people recover quickly leads to a false sense of security that is unwarranted. When doctors, nurses or pharmacists think of the flu they recall in the back of their memory the stories of the 1918 flu epidemic that caused havoc all over the United States, Europe and the world. More people died in that flu epidemic than in the four years of Bubonic Plague from 1347 to 1351.

Public officials, who cannot predict the severity of such an outbreak ahead of time, are aware of this and want to take the most prudent course with ample warning to the population. Nobody in the Public Health field wants patients to be surprised in case the flu is more virulent than normal.

At one time not so long ago the public accepted recommendations to get flu immunizations, but times apparently have changed. Even some hospital workers, who should know better, are balking at a requirement to get vaccinated or lose their jobs.

With talk radio and some cable television channels churning out material for a 24-hour news cycle, it seems that there must be at least two sides to every story, even those that are apparently virtuous. A program that provides food to starving children, for example, is criticized as being wasteful for providing only temporary relief without a plan for them to grow their own food.

I recommend that everyone get a flu shot unless they have an allergy to chicken eggs.

David Work is executive director emeritus of the N.C. Board of Pharmacy. E-mail him at dwork@nc.rr.com.