DeborahOrtegaCarr-300x267By Dr. Ortega-Carr

We know that viruses are the culprits behind colds and the flu and can cause exacerbations of allergic rhinosinusitis and asthma. Though people with asthma are not more likely to get the flu, influenza (flu) can be more serious for people with asthma, even if their asthma is mild or their symptoms are well-controlled by medication. This is because people with asthma have swollen and sensitive airways, and influenza can cause further inflammation of the airways and lungs. Influenza infection in the lungs can trigger asthma attacks and a worsening of asthma symptoms. It can also lead to pneumonia and other acute respiratory diseases. In fact, adults and children with asthma are more likely to develop pneumonia after getting sick with the flu than people who do not have asthma. Asthma is the most common medical condition among adults and kids hospitalized with the flu.


Researchers have long studied the effects of viruses on allergic and asthmatic patients to understand why viruses cause  such problems. Cells which make up the lung structure and lining called pulmonary epithelial cells help the immune system fight viruses by releasing a chemical messenger, interferon.   In asthmatic patients this response is defective which results less virus-fighting capability.   So asthma patients catch the flu like everyone else, but they have a harder time getting rid of the virus and are more likely to get complications.


Patients often ask how they can “boost their immunity” with supplements or other natural agents.  Natural immunity boosters with the best supporting data include getting at least 7 hours of sleep a night. Probiotics may prove helpful in the future for other viruses but they have not been studied with the influenza virus specifically.   The other most reliable way to boost your immunity to viruses is to get vaccinated with the flu shot or nasal spray vaccine. The flu shot has inactivated vaccine and the nasal spray vaccine has weakened live virus.  Flu vaccines are designed to protect against the influenza viruses that experts predict will be the most common during the upcoming season. The three kinds of influenza included are Influenza A (H1N1) viruses, Influenza A(H3N2 )viruses, and Influenza B viruses.  This is the most widely administered vaccine and the vaccine used by Midwest Allergy.


There are additional immunizations available that contain 4 strains (2 influenza A virus and 2  influenza B viruses) and a high dose trivalent shot, approved for patients 65 and older.  This vaccine is approriate in long term care residents.  The increased dose of influenza vaccine stimulates a greater immune response than the standard dose in long-term care residents older than 65 years, according to a new study  “The superiority of high-dose influenza vaccine was demonstrated for all

influenza strains except A/H1N1 in 2012-2013,” said Richard Zimmerman, MD, from the University of Pittsburgh.  As researchers continue to study the various flu vaccines, they are able to determine which vaccines are best for a particular population.


Several studies on egg allergic patients all point to the same conclusion:  its is safe to give to the flu shot to egg-allergic patients, even those with severe egg allergy.  The current recommendations are to observe the egg-allergic patient for thirty minutes after a flu shot. However, in a large number of research studies  thousands of egg allergic children, including those with severe life threatening allergy to egg have received injectible influenza  vaccine as a single dose without reaction.  The AAAAI/ ACAAI joint task force recommends that special precautions for egg allergic patients should be removed from influenza vaccine guidelines and product labeling


If you do get sick with the flu there are antiviral drugs that are available that can shorten the time you are ill by 1-2 days.  These drugs are more important for people with moderate to severe asthma, COPD, Diabetes and chronic heart disease.  Tamiflu comes as a pill or liquid and Relenza is an inhaled powder.  Relenza is not used in people with breathing problems such as asthma or COPD.  Having a plan of action for a viral exacerbation of asthma, especially the flu virus, can be very helpful for patients  and may help to prevent compilcations.


Recent research also shows that Vitamin D helps switch off  T cells (specialized immune cells) post infection so that the immune system fighting the virus will calm down and not cause additional  problems.  Vitamin D is found in fortified dairy products and fatty fish.  It is also made when you are exposed to sunlight  so getting out for a few minutes of daylight while you are recovering from the flu may be beneficial in several ways.


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