SCIENCE FRIDAY: COMING BACK FROM FLU'

Coastal cheer. Taken by PKSenagore December 3, 2017. All rights reserved..

​INFLUENZA MAY PEAK BEFORE CHRISTMAS! DIAL DOWN COMEBACK EXPECTATIONS
A STATnews.com article by Helen Branswell, who obtained information from experts at the U.S. Centers for Disease Control and Prevention, indicates that the peak of the influenza season may come earlier than the usual January to February period; before Christmas, in fact!
 
The article also indicates that the strain of virus responsible for the early cases, “at the moment”, is Influenza A/H3N2, which is typically more severe than other strains and tends to hit older adults a bit harder. The North American pattern is following that of the recent severe Australian season that also showed a later peak of cases caused by influenza B, also tough on older adults.
 
What’s older? The article doesn’t say specifically, but this age is usually identified as 65 and above.   However, younger adults will feel the effects of an influenza infection as well, which includes fever and chills, cough, headache, bad sore throat, muscle aches, and fatigue.
 
Adding agony to the prediction of an early tough flu season is the finding that this year’s vaccine may be less protective than in previous years. A known weakness of the vaccination manufacturing process is that viruses grown in eggs may undergo mutations. In this vaccine, the virus underwent a change that decreased the body’s ability to mount a vigorous antibody response to it. As a result, the effectiveness of the H3 component of the vaccine may be as low as 10%, the article indicates.
 
I am thinking, What a difference a few weeks will make!”  Because being cold, over-tired, poorly nourished, and stressed can increase susceptibility to viral infection, the shift to an earlier circulation of influenza viruses within the population will be bad news for many in the pre-holiday rush.  It’s a set-up that can weaken natural defenses that fight the flu.
 
People of all ages will have more pressure to socialize, thus get less sleep, and possibly adopt less healthy eating and drinking habits in the upcoming weeks. To make matters worse we’ll be mingling in close quarters, shaking hands and giving friendly hugs. Spreading good cheer, and (ugh) possibly more.  Our exercise routines may be ‘busted’ by all the partying, hurried preparations, and travel. We’ll be feeling guilty about that, and possibly try unsuccessfully to maintain impossible exercise standards.
 
When influenza hits, runners and fitness enthusiasts will be among the fallen. And we may want to get up and out of bed as soon as possible to start working out again. There might be hopeful thoughts that if we continue working out per usual the infection can be exercised-away. It can’t.

If you do contract the illness* you won’t feel like running or completing tough training and exercise sessions while febrile and sick, and you shouldn’t! Afterward, resist the impulse to immediately return to vigorous exercise. An article by Pip Coates for executivestyle.com quotes an expert who recommends returning at a 60-75% level and limiting sessions to walking only or walk/run combination, only after several fever-free days.
 
Ultra-runner Joe Uhan wrote a cautionary article in 2014 about the pitflalls of making a training comeback too soon after a serious flu-like illness in “Down with the Sickness: Guidelines for Running During and After the Flu.” It’s long and scary, based on his personal experience.  He specifically refers to complications related to the H1N1 Influenza A virus, which circulated that year, like inflammation of the heart muscle (myocarditis) and skeletal muscle (myositis). 
 
Most will not know the specific strain with which we are infected, however, and should take general precautions. A search of the medical literature does not provide much guidance on this topic. Uhan’s article proposes a REASONABLE FORMULA: for every 1 day of fever (temperature above 100.4 degreesF, 38 degreesC), avoid hard exercise/running for 4-7 days. This means that if you have experienced 3 days of fever, you should be taking 12-21 days (~2-3 weeks) off, and then easing back into exercise.
 
Some who have recently been ill with fever from influenza won’t think this time-off is excessive, but other runners will mentally struggle with taking a long rest. Actually, the timing of this year’s flu season peak offers a perfect opportunity for recovery. The holiday crush prevents many from keeping to a normal schedule anyway. If you succumb to the flu, why not write off the rest of the month of December, enjoy the SEASON, and ease back into regular workouts after January 1.
 
Being laid low by a sickness is never convenient; the busy holiday season is the least “wonderful time of the year” for it. But use the opportunity to give yourself a physical and mental break in the name of rest and renewal.
 
RUN HAPPY!
https://www.statnews.com/2017/11/30/flu-season-update/

https://www.cdc.gov/flu/about/season/flu-season.htm
 
https://www.statnews.com/2017/11/07/flu-vaccine-egg-production/
 
https://www.webmd.com/cold-and-flu/cold-guide/flu-cold-symptoms
 
http://www.executivestyle.com.au/when-to-resume-training-after-illness-10dyr0
 
http://www.irunfar.com/2014/02/down-with-the-sickness-guidelines-for-running-during-and-after-the-flu.html
 
*Stay in bed and rest while you have a fever, minimize exposing others, and follow the usual recommendations to treat symptoms.  If at risk for developing more serious complication (older, pregnant, have other pre-existing diseases) seek medical help as soon as possible.
 
https://www.cdc.gov/flu/about disease/complications.htm /
https://www.cdc.gov/flu/treatment/index.html