- The Washington Times - Sunday, November 4, 2001

Anthrax may be claiming all the headlines but a potentially deadlier disease is knocking at the door as the weather cools down: influenza.
The flu, as it is commonly known, claims more than 20,000 lives every year in the United States, said Keiji Fukuda, chief of epidemiology at the Centers for Disease Control and Prevention. Local health authorities note that complications arising from the flu claim thousands of lives every year.
While most of these casualties are among the elderly and people with heart and lung disorders, diabetes and weakened immune systems, the young and the healthy are also at risk if they ignore symptoms.
"The flu is something we need to be mindful of every year," said Greg Reed, program manager for the Maryland Center for Immunization.
While people who die or are hospitalized due to complications arising from the flu are usually over 65 or have chronic health problems, "there are always people that you wouldn't expect to get sick who are hospitalized every year," he said.
Health workers say the illness is not to be taken lightly.
"The flu has always been a very serious illness. It is a respiratory illness that can lead to severe diseases like pneumonia if left unattended," said Marie Serafin, director of community health programs for Medstar Health Visiting Nurse Association, a Hyattsville-based group that organizes flu vaccine drives in the Washington area.
In the District alone, between 1,000 and 1,500 people die every year of complications arising from flu, such as pneumonia and other respiratory diseases, according to Dr. Michael Richardson, deputy director of public health for the city.
The numbers are an estimate because flu is not a reportable disease in the District, he said.
In Maryland, 2,895 persons died of complications due to the flu in 1998, the latest year for which numbers were available, while in Virginia the number was 1,597 in 1999, according to health department records.
About half of the deaths could be prevented by taking the vaccine on time, Dr. Richardson said. The vaccine is believed to prevent illness in 70 percent to 90 percent of healthy people who take it.
The peak months for flu, according to the CDC, are December through March. However, people can catch the flu as early as October and the right time to get the flu vaccine is in October and November, Dr. Richardson said.
The most common symptoms of flu are fever, lack of energy and muscle aches. Other symptoms include headache, a dry cough, sore throat, and possibly a runny nose. The fever and body aches can last for three to five days, but the cough and fatigue can last for two or more weeks, according to the CDC.
While it is still early to say whether this year's anthrax scare has made a difference to people's reaction to flu, "anecdotally we hear of people taking the flu more seriously and hope this will translate into more people taking the flu vaccine," Dr. Richardson said.
Some health experts, however, warn that the rush to get flu shots could create a problem because of a delay in the shipment of vaccine and stress the need to prioritize the vaccine for those most at risk.
Montgomery County Executive Douglas M. Duncan has said he has asked Secretary of Health and Human Sevices Tommy G. Thompson to make sure that Montgomery and other jurisdictions close to the District get the earliest shipments of flu vaccine so that doctors and hospitals are not overwhelmed by people who fear they have something more life-threatening, such as anthrax. In the District, the health department is prioritizing the vaccine for the high-risk population, Dr. Richardson said.
The CDC says 79.1 million doses of the vaccine will be made available this year, of which 56 percent will be distributed by the end of October, an additional 31 percent in November, and the final 13 percent in December.
Unlike other vaccines, the flu vaccine must be created fresh and administered every year because the virus mutates and changes, said Jim Farrell, director of the Department of Immunization in Virginia.
"Early every year we identify viruses occurring in other parts of the world, like Australia, and then develop a vaccine to address those viruses," he said.
In addition to the vaccine, there were some other steps people could take to prevent getting the flu, Dr. Reed said.
"Make sure you wash your hands, and don't be in the same room with a sick person for more than an hour. Don't spend a lot of time around people who are sneezing or coughing," he said.
It is difficult to tell the difference between flu symptoms and inhalation anthrax in the initial stages, but so far, symptoms like a runny nose found in flu victims were not found in those who had contracted anthrax, Dr. Fukuda said.
People who lived in parts of the country where there had been no instances of anthrax also could also assume their symptoms were more likely to be the flu, he said.
"The bottom line is, it is going to be difficult to tell the difference. But if we apply common sense, there is a good chance of distinguishing flulike viruses from anthrax," he said.
Margie Hyslop contributed to this report

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