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Autumn ushers in season of falling under the weather with flu

A bronze bench and statue near the America Building at Walter Reed National Military Medical Center in Bethesda, Maryland, memorializes military dependent Trevor Lin. The 7-year-old's death in the fall of 2009 was attributed to influenza.  (Photo courtesy of Walter Reed-Bethesda) A bronze bench and statue near the America Building at Walter Reed National Military Medical Center in Bethesda, Maryland, memorializes military dependent Trevor Lin. The 7-year-old's death in the fall of 2009 was attributed to influenza. (Photo courtesy of Walter Reed-Bethesda)

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With autumn comes seasonal influenza, a contagious viral infection that may cause fever, cough, headache, sore throat, muscle and body aches, and fatigue. The flu virus is common; approximately 49 million Americans came down with it during the 2017-18 season, according to the Centers for Disease Control and Prevention.

Flu infections usually happen during the fall and winter, according to the CDC, with peak activity occurring between December and February. Most flu sufferers can count on feeling bad anywhere from a few days to up to two weeks, but they will recover.

Some people, however, develop complications that can become life-threatening. The CDC estimates that for the 2017-18 flu season, 960,000 hospitalizations and 79,000 deaths were linked to influenza.

"Certain groups are at high risk of flu-related complications," said Dr. Jay Montgomery, medical director of the Defense Health Agency's North Atlantic Region Vaccine Safety Hub, Immunization Healthcare Division. At-risk individuals include children ages 6 months to almost 5 years, adults 50 and older, people with chronic medical conditions, and pregnant women, Montgomery said, citing statistics from the CDC.

So health care experts recommend that everyone 6 months and older – including the elderly, chronically ill people, and expectant mothers -- receive the flu vaccine as soon as it becomes available. It's particularly important not only for individuals in the at-risk groups, but also for people who live with or care for them. The benefits of the vaccine far outweigh the risks of contracting the virus, health care experts say.

"The sooner sufficient herd immunity is achieved – which decreases the spread of the virus – the better," Montgomery said.

TRICARE covers the flu vaccine at military hospitals and clinics, participating network pharmacies, and TRICARE-authorized providers.

The flu vaccine is administered as an injection or nasal spray. The spray is not advised for pregnant women, people over 50, and those with specific medical conditions. The CDC says the flu shot is safe for pregnant women in any trimester and offers additional information on pregnancy and the flu vaccine.

Whether it's a shot or nasal spray, the vaccine appears to be effective for at least six months, Montgomery said. That's typically enough time to ensure protection for the duration of the flu season.

The composition of U.S. flu vaccines is reviewed and updated as needed annually, the CDC said, to match whatever flu viruses are in circulation. Flu vaccines usually protect against the viruses that are likely to be the most common.

Depending on the viruses in circulation, the level of protection of a particular season’s vaccine may be less than optimal, Montgomery said. However, he added, immunization is still an important tool in influenza infection control.

Active-duty, National Guard, and Reserve members are required to get the vaccine annually, Montgomery notes. Flu vaccination is also a requirement for Department of Defense civilian health care personnel, said Tara Reavey, chief of policy and program management for DHA's Immunization Healthcare Division.

The CDC notes that pandemic flu is caused by a strain of influenza that's easily able to infect people and effectively spread from person to person -- which is different from seasonal flu. Pandemic flu may lead to life-threatening complications in people regardless of their age and health. Flu pandemics have occurred four times in the past 100 years, the CDC said, with the most recent one in 2009-10. The CDC estimates that from April 2009 through January 2010, about 57 million people were infected with the H1N1 virus, also known as swine flu.

About 257,000 people were hospitalized during this time period and 12,000 died, including 7-year-old Trevor Lin. His father, retired Navy Capt. Henry Lin, says Trevor was an otherwise healthy and active boy before he got sick.

"I knew flu could be fatal, but I thought it happened only to people who had co-morbidities," or other chronic health conditions, said Lin, a bariatric surgeon in Maine.

Lin was on active duty as a general surgeon at Walter Reed National Military Medical Center in Bethesda, Maryland, when Trevor came down with the flu. Lin's then-11-year-old daughter, Ashley, also got the flu and recovered. Lin's then 9-year-old son, Ryan, received an anti-viral prophylaxis after his younger brother died.

Lin said his children had received flu vaccines in previous years, but they had not been immunized yet that year because of a vaccine shortage. His children’s flu diagnoses came after Trevor died.

Since then, Lin has worked to strengthen the details of evaluating children with influenza by health care practitioners, and to improve the criteria for hospitalizations, particularly during medical crises and flu epidemics.

He also spearheaded the establishment of a bronze bench with a statue of Trevor near the America Building at Walter Reed-Bethesda. The memorial is inscribed with the words "Families Fighting Flu."

Lin said his fervent hope is that knowledge of his family's tragedy will prevent another family from enduring the same kind of loss.

"I want people to never forget there are ways we can prevent illness or death of our children," Lin said. "I want to make sure parents of otherwise healthy kids know about the importance of the flu vaccine."

The CDC offers more information for preventing and treating flu.

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