Flu fighters

Pharmacist vaccinator Nigel Campbell gives assistant Nannette Wilkinson a flu shot at Pharmacy 53.

INFLUENZA can be a killer. According to the National Influenza Specialist Group, more than 200,000 people in New Zealand get influenza every year, and of these, an estimated 400 will die directly or indirectly as a result of the illness.

Such grim statistics have prompted some District Health Boards (DHB) to improve or increase access to the influenza vaccine.

After a scheme was trialled by the Waikato DHB last winter whereby specially trained pharmacist vaccinators were approved to administer influenza vaccines, the programme has this year been taken up by Hauora Tairawhiti.

Pharmacist vaccinators at Pharmacy 53 and Bramwells Pharmacy are now authorised to carry out influenza and three other vaccinations — pertussis, shingles and meningitis.

Pharmacist Nigel Campbell at Pharmacy 53 says his team completed the comprehensive training which is the same for nurses, doctors and pharmacists last year. The training is provided by the Immunisation Advisory Centre and involves about 20 hours of study of the immune system, vaccines, injection technique and an advanced resuscitation course.

“Some vaccines have ingredients which can cause allergic reactions but careful pre-screening allows us to identify such patients and refer them on,” says Nigel.

“People now have a choice — going to their GPs or one of the two approved pharmacies. The advantage of going to a pharmacy is that no appointment is necessary and there is usually no waiting time.

“It’s easy for people because they can just pop in as they are passing by. People are asked to wait in the pharmacy for 20 minutes after the injection just in case any problems or reactions occur.”

Pharmacist vaccinators administered more than 800 funded vaccinations to over-65-year-olds in the Waikato last year and Nigel says since the same funding pilot went live here late last month, the uptake has been “really good so far”.

“Since the funding for over 65s was approved by Hauora Tairawhiti, we have given more than 20 flu vaccinations and we expect the uptake to grow quickly” he says.

“We also vaccinate people under 65 and over the age of 13 but they have to pay for the vaccine. We have done a similar number of injections so far. Hauora Tairawhiti is to be congratulated for improving access and availability."

The rationale for widening access to the flu vaccine is to reduce already high pressure on the health system during peak times over the winter and hopefully improve health outcomes all round. GPs are informed of all vaccinations carried out at pharmacies.

There is still widespread confusion between influenza and the common cold.

“Many people visiting the pharmacy complain of having the flu when they actually have a cold. A cold starts mildly with a sore throat, runny nose and raspy voice progressing to a cough and nasal congestion about 24 hours later. There can be associated body aches but these are generally minor.

Hit by a bus“The onset of influenza, on the other hand, is more rapid and within a few hours you feel as though you have been hit by a bus.

“Muscle aches and pains are a very common characteristic of the illness, and people suffer nasal congestion, a runny nose, hacking cough, high fever and headaches. Flu typically lasts up to 14 days whereas a cold lasts less than a week.

“When you have the flu, keep away from non-infected people especially the elderly and very young. Be fastidious about hand-washing and avoid touching eyes, nose and mouth without a tissue.

“The treatment regime is mainly common sense. There’s an increased need for hydration to offset the effects of fever so take plenty of fluids and lots of rest.

“Take pain relief such as paracetamol and ibuprofen, nasal decongestants to aid breathing and an antihistamine to dry up the runny nose.”

Nigel recommends day and night-type medications which include all three ingredients. Tamiflu is an antiviral that can reduce the duration of flu if used in the early stages of the illness.

“If there is no improvement, no response to medication or a major deterioration, see your GP, particularly if the patient suffers from respiratory illnesses like asthma or emphysema or has other conditions like heart disease.

“The threshold for referral to a doctor is much lower in young children where dehydration and reduced fluid intake can be a problem.

Err on the sde of caution“Always err on the side of caution if the child is sensitive to light, has a rash or a high or prolonged fever as these can be signs of meningitis.”

In 2009, Medsafe banned 12 well-known cough suppressants and decongestants for children under six because side-effects such as drowsiness and shallow breathing outweighed the benefits.

“However we have found that honey is as good or better than a cough suppressant for children over 12 months. And it’s easy to make — a teaspoon of honey and a dash of lemon in a glass of warm water.

“For those under 12 months, a dose of paracetamol and some saline nasal drops to help clear mucus from the nose, warmth and hydration are the most important factors.

“Many products have arrived on the market with honey or honey by-products and they can be useful.”

Taking a holistic approach to staying healthy over the winter, Nigel recommends regular exercise and getting enough sunshine to keep your Vitamin D levels up.

“This can be very important for the elderly in rest homes who may not get much exposure to the sun in the winter. Regular exercise will help you sleep better, and healthy eating with an adequate intake of fresh fruit and vegetables in a variety of colours (red, green and orange) provide the best source of essential vitamins and antioxidants.

“If you are a smoker, now is the time to consider tackling the habit,” says Nigel.

“Smokers are more at risk of complications of respiratory illness so the start of winter is definitely the time to consider giving up. Pharmacies, GPs and Quitline all provide funded options for helping you give up smoking.”

As for alternative remedies for staying well over the winter, Nigel recommends products where there is evidence of quality and efficacy.

“If you have any queries about staying healthy this winter, call into a pharmacy to discuss the many options now open to you — we will be only too pleased to help."