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January 11, 2013

Posted by Jim Macdonald at 02:17 PM * 225 comments

C: Cover your mouth when you cough or sneeze (inside of the elbow works fine)
O: Only use your own utensils and glasses
U: Use proper hand-washing technique
G: Get immunized
H: Stay Home if you’re feeling sick.

What’s in today’s news? Flu Prompts Boston to Declare Public Health Emergency. Yeah, the flu is hitting hard and hitting early.

How hard? It’s met the CDC’s threshold for an epidemic. It’s been reported at high levels in forty-one states. Flu leads to Texas teen’s death. Eighteen dead in Massachusetts. Five dead and a hundred and fifty in intensive care in Illinois…. From Pennsylvania to Oregon some hospitals are putting up “flu tents” outside the ER to handle the surge in cases.

Referring back to older Making Light posts:

The USA flu season usually peaks in late January. It takes about two weeks for the flu vaccination to bring you up to full immunity. (Note: Flu vaccines are approximate at best; they may not prevent 100% of the flu that’s going around, but they can make the cases less severe.) So, today isn’t too late to get the stick. Go do it. I’ll wait.

When to go to the ER:

You have difficulty breathing or have pain in your chest
Some of the things that cause shortness of breath and chest pain can kill you in the next five minutes. Don’t screw around.
You can’t keep fluids down because of nausea and vomiting
Dehydration kills.
Your fever or cough gets better, then gets worse
That means that you’ve picked up a bacterial infection of some kind, and it’s the secondary bacterial infections that most often result in deaths from flu. (Numbered in the tens of thousands every year.)
Comments on Cough:
#2 ::: Fade Manley ::: (view all by) ::: January 11, 2013, 02:30 PM:

I spent this morning sneezing my way through the grocery store. (As conscientiously as possible, I swear!) I'm increasingly glad I got my flu shot for this season already.

#3 ::: albatross ::: (view all by) ::: January 11, 2013, 02:43 PM:

Jim (and other biology/medicine types):

Is there any good information about how much benefit (or cost) you get from previous years' vaccinations? On one side, you'd think that having been vaccinated for similar strains year after year would boost immunity. On the other side, the idea of original antigenic sin came up from looking at responses to influenza strains, and it seems more-or-less plausible that it would apply here.

#4 ::: Stefan Jones ::: (view all by) ::: January 11, 2013, 03:01 PM:

I got a flu shot at the office a few months back. Between the discount that Costco offered, and a company subsidy, it was free!

Not sure if it was the flu, but I got hit with a 72 hour thunderbolt of an illness last week. Everything on the flu Bingo card but vomiting. After two days of couch flopping I felt much better.

I hope it was a minor case of the flu, and that I'm done with that for the year.

#5 ::: Samatha Cooper ::: (view all by) ::: January 11, 2013, 03:08 PM:

My doctor insisted in no uncertain terms I needed the flu vaccine way back in October, since I am a severe asthmatic which flips me into the high-risk grouping. I am so glad I listened to her; I haven't gotten the flu at all this year. Meanwhile, even my normally robust and healthy younger coworkers have had miserable times with it, and with subsequent bronchitis, pnuemonia, and other secondary infections.

Even if it only lessens the severity, I'm a real flu vaccine convert. I need to set a Google calendar annual reminder to keep getting it in October from now on.

#6 ::: Jim Macdonald ::: (view all by) ::: January 11, 2013, 03:09 PM:

Albatross, I have no idea. My opinion is that previous shots won't hurt and might help.

Stefan, that sounds like a case of the flu; the full-bore thing can put you down and out for up to two weeks.

#7 ::: Carrie V. ::: (view all by) ::: January 11, 2013, 03:09 PM:

Feeling especially virtuous for getting my flu shot this year.

I never got one at all until last year, with the impending addition of a baby to the family, which suddenly illustrated that the shot isn't just for me.

#8 ::: oldster ::: (view all by) ::: January 11, 2013, 03:12 PM:

JIm, on the "Flu Pre-pack" page, the link to "filling a much-needed void" is dead (which looks like it was the major kit-inventory).

#9 ::: albatross ::: (view all by) ::: January 11, 2013, 03:24 PM:

For some reason, our whole family managed to get our flu shots pretty early this year--our daughter was the last to get it, since she'd been running a fever the day her brothers got their flu shots, but she still got it about a month and a half ago. Normally, I go to my doctor's office, but the grocery store and discount store pharmacies are all offering flu shots now, so I wound up getting it while I was waiting for a prescription to get filled, pretty soon after it was available.

I get the flu shot every year, FWIW. (Which is why I wonder about the effects of previous years' shots.)

#10 ::: janetl ::: (view all by) ::: January 11, 2013, 03:30 PM:

I get a flu shot every year, and get it as soon as the "Get your flu shot!" signs show up in the pharmacies. I used to wait until November to get my vaccine, in the belief that it "wears off" and you don't want be left exposed towards the end of the flu season. The pharmacist assured me that it's fine to get it it early, and it will last until the spring.

A year or so ago, I got in the habit of washing my hands first thing when I arrive at work in the morning, and when I arrive home. Before the flu news broke, I was already upping the ante with hand gel during the day because there seems to more-than-the-usual levels of norovirus going around in Portland.

#11 ::: D. Potter ::: (view all by) ::: January 11, 2013, 03:48 PM:

Got the flu shot Monday (doctor appointment, offered, accepted).

I've had the flu twice in my life. Not pleasant. And now that I'm edging into 'elderly,' I'd really rather not have to deal with it a third time.

(I wash my hands frequently.)

#12 ::: Tom Whitmore ::: (view all by) ::: January 11, 2013, 03:55 PM:

As a massage therapist, I get classified as a health-care worker; and my high-deductible HMO gives me free flu shots. Which means I get them early in the cycle. And I wash my hands a lot when I'm working.

#13 ::: jnh ::: (view all by) ::: January 11, 2013, 03:59 PM:


One of the reasons that Norovirus is so contagious, is that it is relatively impervious to alcohol gel alone. Make sure you use a gel with benzalkonium chloride as an active ingredient.

#14 ::: joann ::: (view all by) ::: January 11, 2013, 04:15 PM:

Got my flu shot at the start of November (late for me). So what's been keeping me mostly down since just after New Year's is viral bronchitis in response to mountain cedar. I'm getting cabin fever, and it's a lot better, but swooping dizziness, even though mostly middle-of-the-night, makes me not want to go out without a spotter.

#15 ::: Jim Macdonald ::: (view all by) ::: January 11, 2013, 04:29 PM:

Oldster #8: The inventory was posted here.

#16 ::: LE ::: (view all by) ::: January 11, 2013, 04:45 PM:

Really wish I had gotten a flu shot this year (I missed the office health fair and just never got around to it). I got hit last week. Went from feeling fine the night before, the next morning exhausted, achy, and majorly feverish, followed by increasing sneezing/respiratory symptoms all of which lasted 4 days. Fever finally broke but now I've got the nagging irritated throat with wet cough, and going up the steps makes me blow like a freight train (and my temperature is hovering about a half a degree above normal - not high enough to be a fever, but enough to be uncomfortable).

Take home message: GET VACCINATED! Even if you can't avoid it completely if you can make it shorter and less severe it's definitely worth it.

#17 ::: Alison ::: (view all by) ::: January 11, 2013, 04:47 PM:

I wondered if what I had was cold or flu since I didn't get a vaccine, but based on Jim's checklist, it was definitely a cold. Albeit a nasty one that has left me fatigued for two weeks. I'm finally getting somewhat back to normal. I work at home and I'm crazy about hand washing, but it didn't help. I seem to get something like this once every six months or so. What am I doing wrong? Maybe it's doctor time.

#18 ::: Jim Macdonald ::: (view all by) ::: January 11, 2013, 05:01 PM:

Alison, if you're getting the set of cold symptoms regularly every six months, they're lasting longer than a typical cold, and they have an atypical symptom (the two-week fatigue) -- please consider seasonal allergies.

[Note: I am not a physician. I can neither diagnose nor prescribe. This is not intended as advice for your particular situation or condition. For genuine medical advice please consult a genuine health-care provider.]

#19 ::: thomas ::: (view all by) ::: January 11, 2013, 05:20 PM:

Couple of things.

1. One of the issues with vaccine effectivness in flu is that the developers have to guess which flu strains will be important. This year they got it right: the nasty H3N2 strain is in the vaccine.

2. The antibodies from flu vaccine do persist for at least two years (, but the strains keep changing. So, having been vaccinated for an H1N1 strain last year might give you good protection against that strain if it's still around, partial protection against a new H1N1 strain, but none against the H3N2 strain that's causing the problems. Long-term, there might well be some accumulated benefit from years and years of vaccination, but I don't know of any direct evidence.

It's hard to study the benefits of the flu vaccine, because of the very non-random subset of people who get vaccinated. People over 65 who are vaccinated are much less likely to die during the following year than those who aren't vaccinated, but hardly any of this benefit is really the vaccine. For example, the benefit is even greater during the period between vaccination and the start of the flu season than it is during the flu season.

#20 ::: thomas was gnomed ::: (view all by) ::: January 11, 2013, 05:21 PM:

The post really wasn't contagious.

#21 ::: thomas ::: (view all by) ::: January 11, 2013, 05:25 PM:

Also, on the 'Cold vs Flu' checklist, during the H1N1 pandemic there was a lot more viral culture testing than most years. That meant a lot more accurate data on who really had flu, and my medical colleagues were commenting that the traditional criteria were less reliable than they had been taught.

#22 ::: Lila ::: (view all by) ::: January 11, 2013, 05:37 PM:

The infection control officer at the hospital where my husband works says there are 4 prevalent strains of flu this year, and this year's flu vaccine covered 3 of them. She also said it is entirely possible to get ALL FOUR STRAINS if you're unvaccinated; having had one does not give you immunity to the other three. Ouch.

I've had flu twice (1981 and 2009). I get the flu shot every damn year. (I am also a health care worker, and many of my patients are elderly and/or frail.)

#23 ::: Jim Macdonald ::: (view all by) ::: January 11, 2013, 05:40 PM:

#19 : thomas People over 65 who are vaccinated are much less likely to die during the following year than those who aren't vaccinated....

Is it possible that people over 65 who get vaccinations are more likely to be getting regular health-care of all kinds?

#24 ::: thomas ::: (view all by) ::: January 11, 2013, 05:48 PM:


Yes, that's exactly the point. That's why it's almost impossible to estimate how much benefit there is from vaccination.

#25 ::: oldster ::: (view all by) ::: January 11, 2013, 05:55 PM:

Jim @#15--
thanks for the alternate link. it's a good list.

I see that you noted there that "I put it here because -- well, no on-line site is forever."

alas, poor Livejournal--I knew him!

#27 ::: nerdycellist ::: (view all by) ::: January 11, 2013, 07:22 PM:

My workplace provides free flu shots every fall, so I dutifully lined up for mine in October. In the beginning of December I got what I assumed was a severe cold (fever, coughing, chills, fatigue, dizziness, respiratory whatnot) that lasted three days. After those three days, I was pretty good, except for the coughing which has just now become manageable. Last time I had the actual, diagnosed flu I was laid up for a week with a couple of days that I was actually too dizzy to stand and walk anywhere further than the bathroom. I spent the better part of the month feeling kind of cruddy before I fully recovered.

I'm guessing what I thought was a cold last month was actually a mini-flu. I'll take a half day of feeling like someone's punched my arm and three days of abject misery over a week-and-a-half of being an invalid any time.

#28 ::: TexAnne ::: (view all by) ::: January 11, 2013, 07:48 PM:

The only year I failed to get a flu shot was the swine flu year, with the vaccine shortage...and I got the flu the week before the vaccine made it to my town. Took me about a year to recover fully. (Stupid asthmatic lungs.) This year I got a pneumonia shot, too! Thanks, science!

#29 ::: miz_geek ::: (view all by) ::: January 11, 2013, 07:52 PM:

The Visiting Nurse Association was at my polling place in November. Vax and Vote, they called it. What a great idea!

#30 ::: Lizzy L ::: (view all by) ::: January 11, 2013, 08:08 PM:

I was the caregiver for my elderly, immune system compromised mother from 1996 until the end of 2006. In order to keep her safe, I got a flu shot yearly. (She got one as well.) Neither of us got the flu during those years.

Since her death in December 2006, I have continued to get the flu shot as early as possible each year. I am careful during flu season to limit my exposure to crowds, and I wash my hands regularly. I have not had the flu.

#31 ::: Cynthia W. ::: (view all by) ::: January 11, 2013, 09:32 PM:

Got the flu last week for only the second time in my life, thanks to a choir member who came to rehearsal when she absolutely shouldn't have. Fortunately my boys and my husband had already had their shots, so I was the only one flattened. Not fun. Frankly, I'm mostly pissed at her, not because I got sick, I'm barely over 40 and very healthy, but because the choir has a lot of senior citizens, several of whom are extremely frail. Something that flattened me for most of a week could easily kill someone else in the choir. So far, it looks like we've been fortunate - the frailest ones have been religious about getting their vaccinations - but I'm still pretty upset at our patient zero.

#32 ::: CaseyL ::: (view all by) ::: January 11, 2013, 10:13 PM:

It's odd: some persistent colds have been circulating at work, but no flu; and no one I know has come down with the flu. The first I heard about the epidemic was on the news.

I've had the real flu a couple times. Most recently in '99, when it laid me so flat the only way I could get out of bed and go downstairs was to actually drop onto the floor, then sort of slide along the walls to the stairs and then crawl backwards down them.

The cough got so bad I crawled out to the car - at 1:00 am, IIRC - and managed to drive to the hospital (fortunately, less than a mile away). They x-rayed me, gave me some magic cough pills (little round transparent things) and told me I was this!close to developing pneumonia and/or bronchitis.

I get flu shots every year now, you betcha.

#33 ::: Keith Edwards ::: (view all by) ::: January 11, 2013, 10:37 PM:

My wife is due to give birth sometime within the next 5 weeks. Any suggestions for flu prevention for newborns?

#34 ::: Rikibeth ::: (view all by) ::: January 11, 2013, 10:51 PM:

Keith: avoid crowds and keep sick visitors away. And plenty of handwashing for everybody who touches the baby.

That, and if your wife had the flu shot, and is breastfeeding, she'll pass some antibodies along in her milk. I don't know if it'll be full protection, but it can't hurt.

#35 ::: Paula Helm Murray ::: (view all by) ::: January 11, 2013, 10:59 PM:

I appear to have missed out at work, they have run out of vaccine. So tomorrow I'm going to Costco to get one.

This year the weather is weird and warm, and I'm having allergy symptoms, likely caused by molding vegetation. It is prior to peak so we don't have beaucoup random people at work yet and when they do come back, I'm going to be at a different job in a less populated part of the building.

I have had the flu shot every year since about 1990 and have never gotten it. I also got a pneumonia shot in November of '11. I am keeping clean and hoping to avoid the whole thing. I know it will take about two weeks before the shot takes hold but we don't get the influx of people at work until at least February.

#36 ::: Alan Hamilton ::: (view all by) ::: January 11, 2013, 11:59 PM:

If you have any sort of insurance at all, it's worth checking if vaccinations are covered. Even cheapo plans often cover flu shots because it's vastly cheaper than you ending up in the ER. I got mine back in December.

Last time I had the flu for real I was out of work for a week. (I never spent so much time watching Nick at Nite in my life.)

Google has Google Flu Trends which reflects the number of searches they're seeing related to the flu based on location. Although it may be inflated due to flu being in the news lately, the map does reflect the CDC map pretty well.

#37 ::: Anne Sheller ::: (view all by) ::: January 12, 2013, 12:41 AM:

I work nights, so my days off get pretty crowded with things to do. Haven't gotten the flu shot yet. I'll try to get over to CVS tomorrow for it.

#38 ::: CZEdwards ::: (view all by) ::: January 12, 2013, 12:45 AM:

Costco has been backordered on my variation of the vaccine for three weeks, and they're the only ones in the area carrying it. I have to take the nasal spray now, after having had severe reactions to the jab for the last six years. Until then, I am avoiding campus and crowds.

Learned my lesson in 2005, when I skipped it. A week down, then an ear infection that hung around.

#39 ::: Josh Berkus ::: (view all by) ::: January 12, 2013, 03:02 AM:

And, in "Popular Delusions and the Madness of Crowds" department this week, we have thousands of hospital workers refusing flu shots and getting fired in the USA:

Or, in Canada, not getting fired and making everyone sick instead:

Look, I can understand how some regular folks are weird about shots, but how can hospital workers, who daily force shots on other people, refuse to get them themselves? One of the fired women was an oncology nurse, who was giving people chemotherapy.

Personally, I think any health care worker who refuses vaccinations should not just be fired, they should be decertified.

#40 ::: GlendaP ::: (view all by) ::: January 12, 2013, 03:33 AM:

I had the flu once. In the span of three hours I went from perfectly fine to feeling like I'd been run over by a Mack truck. Three days later my fever was so high I was hallucinating. Three days after that I was hospitalized with pneumonia.

That was nearly forty years ago when I was a healthy twenty year old. I have no desire whatsoever to repeat it now. I get my flu shot in late September/early October every year.

#41 ::: Xopher Halftongue ::: (view all by) ::: January 12, 2013, 03:43 AM:

I got my flu shot in October or so, as soon as I could.

Still got sick while I was in California. As it usually does for me, it progressed to a bacterial infection which I call The Green Crud for reasons too disgusting to relate. Seven days of antibiotic later I was fine.

Coughing now and again all winter is the way I go through life. I've found a humidifier in the bedroom helps a lot.

#42 ::: Lila ::: (view all by) ::: January 12, 2013, 07:52 AM:

My insurance allegedly covers the flu shot, except (1) only if I get it from my doctor, which (2) incurs a $20 copay, and (3) my doctor gets very limited supplies of the vaccine and always runs out early.

So I end up paying out-of-pocket at the local pharmacy ($35). They have big signs everywhere that says "flu shot covered by most insurance".

#43 ::: beth meacham ::: (view all by) ::: January 12, 2013, 09:47 AM:

I'm feeling really glad we got flu immunizations in November. I must speak in favor of our sometimes difficult health insurance plan: it covered the flu shot 100% at Walgreens. So if you have a pharmacy benefit on your insurance, check to see if they'll cover the shot.

I've had the flu twice in my life, and that was more than enough.

One thing I've been noticing in the sudden media blitz about the budding epidemic -- the descriptions of how people are dying are very reminiscent of the Spanish Flu epidemic after WWI. Young people get very ill, then seem to recover, only to relapse and die very suddenly. Doctors are saying now that what's killing them are opportunistic bacterial infections hitting weakened immune systems.

I'll be carrying hand sanitizer with me on my travels next month, for sure. Maybe face masks.

#44 ::: Dave Harmon ::: (view all by) ::: January 12, 2013, 09:48 AM:

Josh Berkus #39: What I see in that article is thousands of HC worker refusing flu shots... and eight of them getting fired, apparently because they couldn't convince the government they warranted a religious exemption. Leaving aside the problems with that last bit, this is not a safe situation. And in Canada... how the hell does the U.S. get to be more sensible than Canada?

#45 ::: P J Evans ::: (view all by) ::: January 12, 2013, 10:49 AM:

There are a few of those in the US, too. What part of 'health care' they aren't understanding, I don't know.

#46 ::: Caroline ::: (view all by) ::: January 12, 2013, 01:25 PM:

Last time I had the flu, it was H1N1. I got it in early June of 2009, before the vaccine was available IIRC. I went to Target one afternoon feeling fine; while in the store I was suddenly hit by intense exhaustion, then intense body aches. I'm not completely sure how I drove myself home, but I then collapsed on the couch whimpering.

I ended up in the ER later that night because of the spiking fever (102.9°) and body aches so bad I couldn't quit hyperventilating. I've had ovarian cysts and ovarian torsion; these body aches were that level of pain, but everywhere in my body. It was miserable. I was literally crying, and I don't usually cry from pain. (The nurses struggled to place an IV -- unusually for my veins. Probably it was inflammation, and maybe dehydration?)

Two days of that, then sore throat from hell, then nausea and vomiting for a day. Then I got a whomping sinus infection for two weeks, and felt like warmed-over shit for another two.

I realize not every case of flu is that bad. But some are, and I don't want anybody I care about to go through that. And for sure, I don't want to go through that again! So I have become a huge flu shot stickler.

I even got the shot in the fall of 2009, even though I'd already had H1N1, because I didn't want another strain. (Also, strictly speaking I'm not certain I had H1N1. They did not test me until after my fever broke, when I began vomiting and had to go to urgent care. The test was negative for everything, but I later read that it is much less accurate when given after the patient no longer has a fever. The timing and symptoms matched up well with H1N1 -- severe flu symptoms in midsummer that included vomiting -- so I'm still pretty convinced it's what I had. But on the off-chance it wasn't, I got vaccinated against it in the fall.)

This year, I got the shot in October. One day in November I was hit with a sudden, intense wave of fatigue. It felt like the fatigue that had heralded my 2009 flu -- but I had no fever and didn't feel sick in any way. Just bone-tired such that I could hardly move. I went to bed early and was fine in the morning. I wonder if that was my immune system fighting off the flu. No way to tell, of course; might have just been fatigue from some other cause. But it's satisfying to think that it was. Take that, influenza virus.

#47 ::: Fragano Ledgister ::: (view all by) ::: January 12, 2013, 01:40 PM:

I got my regular flu shot last October (plus a couple of other immunisations). Still came down with a bad cold in late December.

I've had the flu several times. Including once a few months after having had a flu shot (in that case, on 6 February 2009, it was exacerbated by stress since we had a massive layoff at work that day and going home from work the symptoms manifested themselves).

I get very annoyed at the anti-vaxers who say "just build up your immune system". What do they think immunisation/vaccination does?

#48 ::: OtterB ::: (view all by) ::: January 12, 2013, 02:00 PM:

My office was closed for 10 days over Christmas/New Year's and several of my colleagues spent pretty much the whole time sick. I was lethargic and had some mild cold/asthma symptoms. Might just have been a cold, might have been me fighting off the flue with the assistance of last fall's shot.

My older daughter was working the day the rest of us got flu shots in October. With all the stuff on the news, her dad and I finally nagged her into getting one a day or two ago. The first two pharmacies she visited had no vaccine available, but third time ws the charm.

#49 ::: ACW ::: (view all by) ::: January 12, 2013, 02:20 PM:

If anybody knows a pharmacy in west suburban Boston that hasn't run out of vaccine, let me know. Belmont, Cambridge, Watertown, Waltham, Lexington, that sort of area.

The place we went had a sign up, saying they were all out, but inviting us to call an information number that would give us information about vaccine availability. The number ran us through a phone tree, which provided the usual phone tree fun, but had no information on which pharmacies had vaccine and which had run out.

#50 ::: Adel ::: (view all by) ::: January 12, 2013, 02:30 PM:

I was incredibly lucky to get my (first!) flu shot this year. One of the groups we cater to on the weekends is our local Special Olympics, run in part by a wonderful nurse who brings in vaccines for the staff at our center. For free! Sure, it probably helps her - if we don't get the flu, we don't run the risk of passing it on to her possibly-immunity-compromised kids - but it was incredibly gracious nonetheless.

I haven't had my yearly crud this year, while just about everyone else at my center has been laid up at one time or another, so I think I'm a convert.

#51 ::: OtterB ::: (view all by) ::: January 12, 2013, 02:46 PM:

me @48 fighting off the flue
Bah. There are problems with the chimney on our house, which is 75 years old, but none of them require active self-defense.

#52 ::: Cygnet ::: (view all by) ::: January 12, 2013, 04:26 PM:

I'm asthmatic, and have some heart issues too. (Heart issues not diagnosed until adulthood, but it's pretty clear that I've had problems since childhood. The heart meds work MUCH better than albuterol ever did for treating exercise induced shortness of breath ...!)

I had influenza when I was twelve or thirteen, and it put me in the hospital with viral pneumonia. I thought I was going to die. I'd had a flu shot, but got sick the next day, before immunity would have kicked in.

I get the flu shot every year. I've had influenza one other time, when I was twenty. I had pneumonia that time (fortunately not as bad) and was sick for weeks. It was the same scenario -- I got the vaccine but got sick immediately afterwards, before the immunity could kick in.

If you're getting a flu shot, by the way, it's not a bad idea to ask your doctor if you're due for a pertussis booster. Speaking from experience, it's pretty unpleasant, and the vaccines you may have gotten as a child do wear off. I missed three weeks of work.

#53 ::: Teresa Nielsen Hayden ::: (view all by) ::: January 13, 2013, 12:47 AM:

Until I started getting flu shots, I got the flu every time it came through. I don't recall any times when I escaped secondary bacterial infections. My immune system has never been up to spec.

Vaccinations! They're brilliant! I want all of them that apply.

#54 ::: Ursula L ::: (view all by) ::: January 13, 2013, 01:10 AM:

Looking at your flu pre-pack list, you have several medications listed. Something for fever and pain, a decongestant, an expectorant, and a cough suppressant.

I've found that if I have Alive, 12-hour time release Sudafed, and 12 hour Muconex DM around, then taking one table of each, every 12 hours, provides medication for all cold/flu symptoms.

And because they are all 12 hour medications, you only have to remember to take your medicine twice a day, and you don't have to keep track of the different duration of different medications, which can get confusing, particularly if you are not feeling well. It is also easier to explain what you've taken, and when, should you need to see a doctor.

This cuts down on the risk of accidental overdose, and of forgetting a medication so that a symptom gets out of control.

And if your cough gets bad enough that you're prescribed an acetaminophen/codeine type cough syrup, it doesn't duplicate any of the OTC stuff you've taken.

#55 ::: Mary Aileen ::: (view all by) ::: January 13, 2013, 12:26 PM:

Ursula L (54): I'm not familiar with a drug called Alive. Do you mean Aleve?

#56 ::: Keith Edwards ::: (view all by) ::: January 13, 2013, 02:06 PM:


Thanks! We took a birthing class yesterday and they said the same thing. I should be getting my flu shot soon and my wife already has had hers.

#57 ::: Cynthia W. ::: (view all by) ::: January 13, 2013, 02:11 PM:

Persephone from the other thread - the up-the-nose variant of the flu vaccine is available in a lot of places these days, more so in kids' venues than adults, IME. I.e. our pediatrician's office always has the nasal version, our adult PCP, not so much. It's a liquid that they shoot up your nose while you inhale, and then you have to avoid blowing your nose for an hour or so. Seems to have 30 minutes or so of mild post-nasal drip as the main unpleasantness.

(Going by my eldest son here, who is needle-phobic and thereby gets the spray. The rest of us just get needled.)It seems to work just fine. Neither kid has caught the flu this year, despite having it all over the house as the parents went down.

#58 ::: The_L ::: (view all by) ::: January 13, 2013, 02:55 PM:

As a person with a ridiculously strong immune system, I never really paid attention to flu shots, because I never really get sick at all.

I guess if it's reached epidemic status this year, though, that I should actually get the flu shot this year so I don't turn into a Typhoid Mary. :/ Getting my students sick would not be a good idea!

#59 ::: janetl ::: (view all by) ::: January 13, 2013, 04:37 PM:

Question: What is the point of an expectorant? I completely understand taking a cough suppressant to enable falling asleep, but on the coughing side of things, it's always seemed like my body was managing just fine without assistance.

#60 ::: greening ::: (view all by) ::: January 13, 2013, 05:31 PM:

janetl@59: An expectorant makes the mucus more watery so it's easier to cough out. This is referred to as the cough being more productive, which always sounds to me like it's discovered better organizational skills.

#61 ::: Nancy Lebovitz ::: (view all by) ::: January 13, 2013, 07:14 PM:

Are other infectious diseases tracked? It seems like I know a lot of people who have or recently had laryngitis.

#62 ::: Tom Whitmore ::: (view all by) ::: January 13, 2013, 07:55 PM:

Nancy Lebovitz @61 -- you might want to check out the CDC's Morbidity and Mortality Weekly Report, or MMWR. It's the best source of tracking info on current diseases in the US.

#63 ::: Tom Whitmore ::: (view all by) ::: January 13, 2013, 08:06 PM:

With further checking -- it's not obviously there, so it's probably not being tracked. It's more often diagnosed by individuals than MDs in my experience, so that may be part of the problem.

#64 ::: Persephone ::: (view all by) ::: January 13, 2013, 08:13 PM:

CZEdwards @38 mentioned a nasal spray version. I'm terrified of needles and have been telling people I'd rather just have the flu than get the shot. If there's a nasal spray available, though, I'd take it in a heartbeat. Can anyone give details on how well it works and/or where to get it?

#65 ::: Persephone ::: (view all by) ::: January 13, 2013, 08:16 PM:

Cynthia W. @57, thanks! Maybe my PCP will be able to point me in the right direction to get it.

(Cynthia's comment is showing above my actual question in the thread because I got the "too many comments" error and got distracted for a few hours before I hit the post button again here.)

#66 ::: Lila ::: (view all by) ::: January 13, 2013, 08:29 PM:

Laryngitis is a symptom, not a disease; it just means inflammation of the larynx. This can be caused by any number of organisms, or by allergies, or by chemical irritants, or by (for example) yelling for a long time at a football game.

#67 ::: David Wald ::: (view all by) ::: January 13, 2013, 10:23 PM:

On the nasal spray vaccine: here is the CDC Q&A page about the nasal spray vaccine in the US, and here is their two-page info handout. It doesn't say where to get it, but it does give general information about what it is and how it differs from the flu shots.

#68 ::: Jim Macdonald ::: (view all by) ::: January 13, 2013, 10:33 PM:

When our ambulance squad was giving free flu shots to the public we had both nasal and injectable forms on hand.

The nasal form was preferred for kids.

They're equally effective, I'm told, in granting immunity to flu.

#69 ::: --E ::: (view all by) ::: January 13, 2013, 10:59 PM:

In addition to the flu, there's been a bad novovirus and other colds going around. Starts as a scratchy throat, escalates into a head cold, and if you're me, it turns into a sinus infection. (I get sinus infections super easily, so YMMV on that score.)

I've had the flu twice as an adult. Both times I spent the better part of a week not knowing which end to point at the toilet. (Sitting on the toilet with a bowl in one's lap is so demoralizing.) The second time I ended up lying in bed with a zillion blankets on while still shivering madly because I couldn't get warm despite running a 104° temperature.

Even after it was done, I was weak as a kitten for days. I couldn't go to work because I didn't have the strength to walk two blocks to the bus.

Yeah, that was when I understood how this thing could kill someone. I was a healthy 30-something and it almost killed me. After that I vowed to always get a flu shot. Being sick like that was far, far worse than any minor risks from the vaccine.

#70 ::: Rob Rusick ::: (view all by) ::: January 13, 2013, 11:10 PM:

A couple of years ago I was told the nasal spray vaccine was not an option for the 50 year old and up.

Not that it might not have been effective; just that it had not been tested on that population and was not approved.

Might be different now.

#71 ::: thomas ::: (view all by) ::: January 14, 2013, 12:20 AM:


Flumist is still only approved for people aged 2-49, with the expansion to little kids being relatively recent.

Doctors might well be willing to prescribe it off-label, but insurance companies would be unlikely to pay for it.

#72 ::: Bill Stewart ::: (view all by) ::: January 14, 2013, 02:19 AM:

When the FluMist nasal vaccine came out, it was approved for people 10-50. It was one of the flu vaccine shortage years, and they were saying to leave the flu shots for the more vulnerable old people and kids. But since the nasal vaccine wasn't approved for them, so taking it wasn't an ethical problem, and I was still under 50 so I tried it. I felt kind of blah for a couple of days, which I don't usually get from the injected flu vaccine, but I didn't get the flu that year.

#73 ::: The_L ::: (view all by) ::: January 14, 2013, 07:18 AM:

Reading everyone else's flu stories, I'm beginning to suspect that either what I had the other year wasn't really the flu, or I just don't react to it the same as everybody else.

I remember feeling puny for 2-3 days, being so congested it was hard to even breathe, and having to take a day off for the first time in years. Basically, it felt like strep, only with more fatigue and less fever.

Colds, on the other hand, always seem like such a minor annoyance that I usually don't bother to take anything for them. I just get a bit congested and maybe a little sore/inflamed.

So...did I even get the flu 3 years ago when I thought I got it?

#74 ::: ACW ::: (view all by) ::: January 14, 2013, 11:40 AM:

In case anybody else in my area is still looking, I finally found a flu shot this morning. It was at the Mt. Auburn Star Market in Cambridge.

#75 ::: charming quark ::: (view all by) ::: January 14, 2013, 04:20 PM:

I and my asthmatic son both had our flu shots in early October.

However, we were both sick over Christmas with RSV (respiratory syncytial virus), sometimes known as bronchiolitis, and I'm only just getting over it.

If you are in California/the LA area, the seasonal flu hasn't really even hit here yet, but RSV has been hitting the area pretty hard. Everyone tends to think they have the flu, because RSV hits you a lot harder than a cold, and a lot of people tend to assume anything that's worse than a mild cold is the "flu".

The_L, what you had might have been RSV.

Symptoms start with a mild sore throat for a day or two, then your sinuses close up completely (the amount of sinus pressure makes some people think they have a sinus infection), and you will spend the next 2-4 weeks with a severe cough and blowing your nose constantly while you try to clear your lungs and head of a seemingly never-ending stream of yellow phlegm. Add in constant severe fatigue, and you will be SIIIIICKKKKK.

The NIH page for RSV describes it as having "mild cold-like" symptoms, but that's bull. I've been through eight boxes of kleenex so far with this bout - my personal record was seventeen.

Strep throat has also been making the rounds out here, but that's usually pretty easy to tell apart.

#76 ::: Mary Aileen ::: (view all by) ::: January 14, 2013, 04:28 PM:

charming quark (75): From what my former ENT* told me, yellow (or green) mucus/phlegm means that it is in fact a sinus infection. Or some other flavor of bacterial respiratory infection, I suppose.

*ear-nose-throat doctor

#77 ::: The_L ::: (view all by) ::: January 14, 2013, 04:33 PM:

@charming quark: That does sound familiar, except mine only lasted 2-3 days. Then I was coughing and congested a wee bit for another couple days after that.

I guess part of the problem is that, because I don't seem to get anything as severely as most folks (except hay fever, which is about the worst thing to have in southern Florida where everything's constantly growing and blooming), I have no idea whether I should see a doctor unless there's extreme physical pain involved. I didn't realize I had a certain hormonal issue until it had me literally doubled over in pain!

#78 ::: Jennifer Baughman ::: (view all by) ::: January 14, 2013, 05:51 PM:

When I was a teenager, twice a year I'd get something that laid me out completely for at least a week; exhaustion, chills, sinuses completely blocked, and coughing up stuff in colors that really don't belong in the respiratory tract. (Note: the parental units didn't ever bother to take me to the doctor for this, so it generally lingered for a good three-four weeks after the first hammer-blow. And I'd get grilled about why I wasn't back in school yet after a week.)

It got a lot better after I got out of an environment where I couldn't escape the secondhand smoke, and improved again when I started getting yearly flu shots (and after I got the 5-year pneumonia shot). Now I only get something like that once every couple years, and I know the signs that say "get thee to the doctor for antibiotics".

#79 ::: shayne ::: (view all by) ::: January 14, 2013, 06:19 PM:

My mother believes in pharmaceuticals; I believe in apple cider vinegar and cayenne pepper, the ability of the body to resist infection through proper ph balance. Neither of us has had the flu in more than 10 years. When I feel some ick pushing at me, it's ACV, organic maple syrup, a good dose of cayenne, and lemon water, 2ce a day. Ick recedes and disappears.

I have no health insurance. I take common-sense safety precautions when I'm out and about. I also exercise, pay attention to my diet, and nap when I need to.

I find it interesting that many of the people on this thread who religiously get flu shots, get sick anyway with something cruddy.

#80 ::: Xopher Halftongue ::: (view all by) ::: January 14, 2013, 06:32 PM:

--E 69: IIUC the barfing sickness isn't flu. The chest congestion is. And you feel cold when you have a fever because shivering is part of your body's mechanism for driving up your temperature. Then (maybe) you feel hot (sweating brings down the temperature).

shayne 79: How about because some of us get sick with something cruddy that might well have turned fatal had we not had a flu shot? And flu shots aren't 100% effective (I think I heard someone on the radio say this year's is about 60% effective and that that's excellent for a flu vaccine).

I'm going to assume that you weren't intending to be smug about your not getting the flu, or derisive of the effect of getting a flu shot.

#81 ::: Lila ::: (view all by) ::: January 14, 2013, 06:54 PM:

"Reality is that which, when you stop believing in it, doesn't go away." --Philip K. Dick

#82 ::: Lee ::: (view all by) ::: January 14, 2013, 07:00 PM:

We got our flu shots because we were heading out to a con, where the risk of exposure to a lot of things is much higher than normal for us. CVS is now off the list of places we will ever go for a flu shot again. The sign said "Walk-In Flu Shots"; what it didn't say is that if you're not a regular customer, it takes them OVER AN HOUR to "process the paperwork". We should have gone to CostCo.

Shayne, #79: When (not if) you get the flu, your body won't give a shit what you believe in; luck and coincidence isn't a substitute for proper health care. And while you're at it, stay the fuck away from me, everyone I care about, any children or parents of children, and anyone with a compromised immune system. You're a walking menace.

#83 ::: Xopher Halftongue ::: (view all by) ::: January 14, 2013, 08:10 PM:

Lee, that's an incompetent CVS. I got my flu shot at a CVS and had nowhere near that much trouble, even the first time. These days it's a five-minute process.

#84 ::: Dave Harmon ::: (view all by) ::: January 14, 2013, 08:16 PM:

I just checked, and I got my flu vaccine in September. Now, however, I'm having trouble laying hands on my dog's vaccination certificates (I've got the rabies one, but that's it), and she's going to stay at a kennel next weekend....

#85 ::: P J Evans ::: (view all by) ::: January 14, 2013, 08:19 PM:

Xopher, they usually want a consent form;if they're competent, you can do that with an on-line form and print a copy to take with you. Then it's just a matter how many people are in front of you (for any reason).
I tend to avoid CVS anyway; they seem to get snippy if you don't have a discount card.

#86 ::: Melissa Mead ::: (view all by) ::: January 14, 2013, 08:30 PM:

Thanks for the info on RSV. I've been assuming I have a rotten cold, but it could be that. (The symptoms are just like the list in the old Nyquil ads, with the fever being brief + mild. The rest of it, not so mild.)

#87 ::: Lizzy L ::: (view all by) ::: January 14, 2013, 08:32 PM:

shayne at #79: you have no health insurance? So when that drunk driver plows into you as you're waiting at some intersection to cross the street, breaking ribs, leg, etc., or some sick person with drug-resistant TB coughs in your face on the grocery store line, you won't mind that bill for thousands and thousands of dollars that the hospital will hand you once you're well and home again.

If you can't afford health insurance, I hold my fire. But sounds like you've simply decided you don't need it, because bad things just don't happen to you. Right.

Good Lord.

#88 ::: Ursula L ::: (view all by) ::: January 14, 2013, 08:41 PM:

Mary Aileen @55:

Yes, I meant Aleve. 12 hour NSAID, helps with both pain and fever. AKA naproxen.

A 12 hour time release of any other medications for pain and fever would work as well.

My point is that if you can get things to control all symptoms on the same, 12 hour, time-release schedule, taking medication to control your symptoms is easier to keep track of, and therefore more likely to be managed without mistakes, either accidental overdose or missing a medication for a particular symptom.

If one medicine is every 4-6 hours, another every 6-8 hours, and a third every 12 hours, you're going to have to be quite alert to take everything on the right schedule to avoid both overdose and a gap in symptom control. Which is tough when you're sick and not thinking at your best, at least for me. And even if you are careful to take the 4-6 and 6-8 hour medicines every 6 hours, that still means that you can't get a full night's uninterrupted sleep.

Sorry about the spelling mistake.

#89 ::: Dave Harmon ::: (view all by) ::: January 14, 2013, 09:00 PM:

Ursula L #88: I recall from a prior discussion here, that for ibuprofen at least, that 6-hour span assumes you are not waking up to take it during the night, and if you do so, the amount in your blood may rise to dangerous levels. I suspect this applies to other OTC meds as well.

#90 ::: Ursula L ::: (view all by) ::: January 14, 2013, 09:11 PM:

Dave Harmon @89:

That could well be true. Which only adds to the complication - you're probably pushing your levels up higher than needed during the day, going closer to 6 hours, and then dropping lower and loosing the benefits of full levels overnight.

For me, three tablets in the morning and three tablets at night is both easy to keep track of and cheap, since two of the medications (Aleve and Sudafed) are available as generics, and the third (Muconex DM) isn't too expensive in the brand name.

#91 ::: shayne ::: (view all by) ::: January 14, 2013, 09:41 PM:

Lizzy @87,

I cannot afford health insurance. That is the fact of it. I can afford to go to the grocery, maintain a clear mind, be attentive to self-care, and care for others with respect and calmness.

I only speak from my own conviction and experience. If others can see possibility for changing their own habits, so be it. If they see confusion, so be it.

#92 ::: Dee ::: (view all by) ::: January 14, 2013, 09:48 PM:

Free gift with purchase of influenza: I managed to catch the flu in October before I was able to grab the vaccine, and had two lovely weeks of misery followed by many more weeks of exhaustion and sinus pain. What I did not realize, however, is that the flu did quite a number on my depression. It took me a couple of months to muster the energy to see my doctors and even that was only after some very bad thoughts. I can try to find some links (I haven't found particularly good sources yet) but it seems to involve serotonin re-uptake. I'm doing much better now, but I'd encourage anyone who has had trouble getting their mood and energy back after having had the flu to talk to a doctor, especially if you are already dealing with depression or any other mood disorder.

#93 ::: Lee ::: (view all by) ::: January 14, 2013, 09:52 PM:

shayne, #91: We can't afford health insurance either. I paid for our flu shots out of my own pocket; there are plenty of places offering them cheaply enough for most people to afford.

What I am not doing is going around telling other people that "conviction" and SNAKE OIL are a substitute for health care. You are. That makes you not "confused", but despicable.

#94 ::: Xopher Halftongue ::: (view all by) ::: January 14, 2013, 10:10 PM:

My CVS, if you don't have a discount card, swipes one they have behind the counter and offers you a form for a discount card.

#95 ::: Lizzy L ::: (view all by) ::: January 14, 2013, 11:11 PM:

I heard on the news this morning that the flu vaccine has been distributed to about 50% of the US population (that includes people who REALLY ought to have it, like people with compromised immune systems and folks over 65.) 50% is pretty low.

#96 ::: Ursula L ::: (view all by) ::: January 15, 2013, 12:44 AM:

For those without the good luck of having access to health insurance, if you are in Wegmans territory, I know that they have a fairly long list of generic medications that they sell at $4 for a 30 day supply or $10 for a 90 day supply.

List here:

This obviously doesn't help with finding someplace affordable to get your prescriptions written. And it doesn't help if you have an uncommon condition that isn't covered by something on the list, or if you have specific reasons for needing a different course of treatment. But if you do have a way to see someone who can write prescriptions, then it may be useful to bring the list along and see if a treatment plan can be worked out from what is available.

When I didn't have health insurance, there were a couple of times when I had to pay a ridiculous amount out of pocket at an urgent care clinic to see someone (for bronchitis), but by having the list handy, I was able to show it to the nurse practitioner who saw me, and she re-wrote her initial prescription, for an expensive new single-dose antibiotic, to be for an older antibiotic where I had to take multiple pills a day, but which saved me over $50. I've never had a problem with a doctor when I asked them to check the list to see if there was something that was suitable to try at a good price, when I explained I was willing and able to follow through with multiple pills a day, I knew about the dangers of antibiotic resistance if I didn't finish the course of medication, etc. Sometimes the answer was "sorry, nothing there is suitable" but more often, they would see something that was likely to work a worth trying.

I'd guess that there are probably other pharmacies in other regions with similar plans. I mention Wegmans as an example I'm familiar with.

#97 ::: Lisa Padol ::: (view all by) ::: January 15, 2013, 01:40 AM:

Josh got his shot at work. I dropped the ball, and tried to get it from my GP in December, only to find the GP was fresh out. I'm going to see if I can get it from GP or drug store this week, as we're going to Arisia, and I'd rather not get or give it.

I gather October's the time to do it? If so, I'll put a note on my calender now for October 1 to try to prevent a repeat of this.

#98 ::: SamChevre ::: (view all by) ::: January 15, 2013, 08:28 AM:

For those without the good luck of having access to health insurance, if you are in Wegmans territory, I know that they have a fairly long list of generic medications that they sell at $4 for a 30 day supply or $10 for a 90 day supply.

Other pharmacies that have the same pricing scheme: Target, Wal-Mart, Sams Club, CostCo. (And yes, it's a godsend when you pay for prescriptions out of pocket, and we've found doctors to be very willing to prescribe generics when asked.)

#99 ::: Janet K ::: (view all by) ::: January 15, 2013, 08:54 AM:

I got my flu shot in October. I've been getting the shot every year, I think, for at least the past 25 years and I've never had the flu.

My heathcare provider Kaiser is awfully insistant about its members getting the shot and it's free.

Kaiser recently emailed me about the flu. Nothing new but a summary might be useful here so I'll pass on what they say:

Just because people around you are sick, you don't have to get sick, too. You can keep yourself healthy by practicing a little proactive prevention. And if you do catch a cold or flu, be mindful to help protect others.

Handy tips for staying healthy

1. Wash your hands often. Frequent hand washing helps protect you from whatever bug is going around. Plain soap works just as well as antibacterial soap.

2. Use hand sanitizer. The alcohol in sanitizer gels and wipes helps kill cold and flu viruses you pick up from any surface you touch.

3. Keep your face hands-free. Try not to rub your eyes, nose, or mouth. Germs can enter your body this way, or be spread from your hands to others.

4. Get your flu vaccine.

If you get sick, be kind to yourself and others

1. Stay home and rest. Limit your exposure to others. Children, seniors, pregnant women, and those with weakened immune systems are at higher risk of getting sick.

2. Drink lots of fluids. Hot herbal tea, warm water, and chicken soup are especially good for congestion (runny or stuffy nose).

3. Treat your aches and fever. Acetaminophen or ibuprofen can help provide relief. Be sure to follow the instructions on the label, especially for children. Stay home for at least 24 hours after your fever is gone without using fever-reducing medicine.

4. Cover your sneeze or cough. Cough or sneeze into a tissue or your sleeve to trap the germs. If you cough into your hands, wash them as soon as you can. Use disposable tissues and throw them away immediately after each use.

Viruses--not bacteria--cause colds, flu, and chest colds. Antibiotics don't kill viruses, so they don't work for colds or flu.

#100 ::: Janet K is gnomed ::: (view all by) ::: January 15, 2013, 08:59 AM:

I suppose for those wicked three spaces again. I don't now how to avoid them--how does one format a post with paragraphs without causing the problem?

[One doesn't. Multiple spaces are stripped out anyway in the display so there's no purpose. Note your post just above; the spaces are still there: They don't show. You get blank lines with the return key. -- JDM]

#101 ::: SamChevre ::: (view all by) ::: January 15, 2013, 09:26 AM:

Thanks for the encouragement to get a flu vaccination; I'd gotten mine at my employer, but this was sufficient motivation for my wife and the three older children to get their vaccinations yesterday.

#102 ::: Lori Coulson ::: (view all by) ::: January 15, 2013, 11:17 AM:

"Drink lots of fluids"

Actually you want to force fluids (8 ounces every hour) if you can keep them down. If you are vomiting, try to drink a little water after each episode.

If you cannot keep even water down, this is the time to call your doctor. At this point, hydration by IV may be necessary.

The last time I had an episode like this, my doctor was able to prescribe a medication that ended the nausea. He told my partner that if that didn't work to bring me in for an IV.

I was very glad the medication did the job. I HATE needles...

#103 ::: Inquisitive Raven ::: (view all by) ::: January 15, 2013, 03:47 PM:

@Shayne: The problem with relying on a healthy immune system to protect you from the the flu, is that with novel flus, your immune system can kill you.

#104 ::: shayne ::: (view all by) ::: January 15, 2013, 08:13 PM:

Inquisitive Raven @ 103, thank you, it's a very interesting subject. I Googled "Cytokine storm/foods" and got about 260K results, many of which go into great detail about the foods and herbs that can either tame down a cytokine storm, or make it worse.

Potential vaccine and medicine shortages are always hyped up during flu season, especially when a novelty rears its head. Understanding how home remedies are used, having the herbs on hand, and some experience in using them on oneself, could prevent panic and hysteria among friends and neighbors. This statement has not been evaluated by the FDA.

"Let food be thy medicine, and medicine thy food." - Hippocrates

(... and since medicine got its start in food, my personal hunch is that all that closely observed data is still true ...)

#105 ::: charming quark ::: (view all by) ::: January 15, 2013, 10:09 PM:

Mary Aileen – it’s my understanding that green mucus is more likely to be the sinus infection, yellow tends more toward viral, but everyone’s mileage and coloration may differ!

Melissa Mead – Yes! I forgot to mention mild fever, which usually only lasts for about 2-3 days.

Shayne – I get crud despite having had my flu shot because I have a 4 year old in preschool, otherwise known as the human petri dish.

Others – I don’t think apple cider vinegar and cayenne pepper is a cure-all either, but Shayne is also talking about practicing good self-care – getting exercise, eating well, getting enough sleep – which is always useful and good for the immune system. I feel for Shayne not having any health insurance. I’ve kept jobs I HATED to stay on the insurance.

#106 ::: Paul A. ::: (view all by) ::: January 16, 2013, 04:37 AM:

shayne @ #104:

My personal hunch is that, after 25 centuries of medical research, we maybe know a few things about medicine that Hippocrates didn't.

Just saying.

#107 ::: abi ::: (view all by) ::: January 16, 2013, 05:55 AM:

Modern medicine saved my mother's life when she had an ectopic pregnancy. It means that my insulin-dependent sister in law did not die at the age of 40 like my diabetic great grandfather did. It means that I (Rhesus negative) bore two Rhesus positive children, and all three of us are alive and healthy.

Modern medicine permits the founder of this blog to function on a day to day basis—I know of no herbal remedy that has much traction against narcolepsy. Medications also saved her life, saved the lives of two of our community members, and prolonged the life of a front pager we all still miss. Many of the people commenting here are only alive and functional because of medication.

I'm glad that there are people healthy enough to require very little beyond good diet and self-care to remain healthy. Indeed, childbirth issues and light therapy aside, I'm one of them.

But I've just listed nine people who would have been in an early grave or a long-term sickbed in Hippocrates' time. I'm glad none of us, nor the people who love us, lived then and under those conditions.

#108 ::: Jim Macdonald ::: (view all by) ::: January 16, 2013, 09:57 AM:

I really do need to write that post on the history of death. (Up to about a century and a half ago, doctors freely admitted that they couldn't be certain if their patients were alive or dead. The medical journals and private patrons offered substantial cash prizes for an infallible test.)

#109 ::: Mary Aileen ::: (view all by) ::: January 16, 2013, 10:21 AM:

charming quark (105): That ENT told me that green and yellow mucus are bacterial, it's the thick white stuff that's viral. But in my experience, sometimes it's hard to tell the difference between the yellow and the white, so there's definitely some room for variation.

#110 ::: --E ::: (view all by) ::: January 16, 2013, 10:30 AM:

Xopher@80: Nope, it was flu. Those two episodes were the years when the flu was the extra-vicious kind and the vaccine was not a good match. (Not that I had gotten the vaccine those years. But the herd immunity was poor as well.) It ripped through my office like the plague (almost literally).

(When I read that bit in Nine Princes in Amber where Corwin describes living through the plague, I think, "Oh, buddy, I know exactly what that feels like." I didn't think it was possible to be that ill and not die. I was probably very foolish not to go to the hospital.)

Nowadays I have a compromised immune system, so I never fail to get vaccinated. My regular checkup is usually Octoberish, so the timing is very good.

Eh, I figure since I rolled really high on the INT, STR, and DEX scores, having a 7 CON is the price I pay. ;-)

#111 ::: Cally Soukup ::: (view all by) ::: January 16, 2013, 01:34 PM:

Shayne @104

Herbal and home remedies might "prevent panic", but preventing panic is not the same thing as preventing the flu.

Are herbal and home remedies the reason you're no longer in danger of dying from smallpox or polio, or do you think there might be some other reason?

#112 ::: shayne ::: (view all by) ::: January 16, 2013, 01:40 PM:

Why is it, when I offer an example of what has worked for me personally, in one instance, and take care to mark my comments as being my own personal experiences and decisions, a crowd assumes I'm preaching that everybody else doing things a mite differently are a bunch of sinners and idiots?

Why is that?

#113 ::: Carrie S. ::: (view all by) ::: January 16, 2013, 01:53 PM:

shayne: Several reasons, most of them from your first post.

Because you presented your belief if "pH balance" as opposed to your mother's in pharmaceuticals; because you took pains to point out that the flu vaccine is not always effective; because you implied that getting sick is something that could be prevented through diet, exercise, and "common sense"; because you implied that getting sick is something that could be prevented through "conviction".

Shall I go on?

#114 ::: Xopher Halftongue ::: (view all by) ::: January 16, 2013, 01:57 PM:

shayne, it did sound that way. That's why I said I was going to assume otherwise, to give you a chance to say that you didn't mean it that way. But your comments since then have sounded more preachy, not less.

#115 ::: Lisa Padol ::: (view all by) ::: January 16, 2013, 02:02 PM:

Meanwhile, every place that supposedly has flu shots that I'm checking (via, generally drug store check, GP's office, und so weiter) is out. I'll keep checking, but I may have to rely on herd immunity.

#116 ::: Jim Macdonald ::: (view all by) ::: January 16, 2013, 02:24 PM:

You can get further with diet, exercise, rest, fluids, and a flu shot than you can with diet, exercise, rest, and fluids alone.

#117 ::: Carol Kimball ::: (view all by) ::: January 16, 2013, 02:52 PM:

Shayne, I understand your doing your best to research and follow through keeping yourself healthy.

I have catastrophic health insurance with a catastrophically high deductible (nothing short of a major event covered, and it still takes about 1/3 of my month's income). Were I in a severe accident and not fortunate enough to die right away, my 88 year-old mother would be stuck. As long as I can scrape by, I'll pay into that.

Nonetheless, even if it means a skimpier lifestyle every fall, I hie me to Walgreen's/Costco and keep my vaccines current. I can't afford the down time, and I owe it to my community.

We all have to make our own choices, and this is where I've landed.

#118 ::: shayne ::: (view all by) ::: January 16, 2013, 04:22 PM:

*gives up*

As you wish.

#119 ::: Xopher Halftongue ::: (view all by) ::: January 16, 2013, 04:41 PM:

shayne, that wasn't trying to get you to give up. It was trying to get you to clarify your position. You say "why is it taken as" but don't say you didn't mean it that way; we cited some things that seemed to imply the meaning we read, by way of answering your question.

Please explain what you did mean. I'm still interested.

#120 ::: Lee ::: (view all by) ::: January 16, 2013, 05:21 PM:

shayne, if you don't want people to think you're an anti-vaxxer, stop using anti-vaxxer arguments. It really is that simple. We've heard them all before, and are Not Impressed.

#121 ::: shayne ::: (view all by) ::: January 16, 2013, 06:03 PM:

Xopher @ 119: Thank you for your gentle reply. My intention was simply to illuminate that my Mom and I have made opposite choices in response to flu season, and *neither of us gets sick.* Totes. That's it.

It's fine to question the overall effectiveness of natural remedies. My point is, there is no magic bullet for staying healthy, just *practice.*

But it seems people here want to defend the amount of money *they* spend on health insurance and health care, even though I never made a specific challenge to anyone about it.

Take the following for what you will. I offer it as another bit of light on the subject of how we make our health care choices, when in fact there is the *luxury* of a choice.

Flu shots are not a magic bullet, either. According to what I was reading in this thread, and what I've seen in the people around me, flu shots are NOT 100% effective in preventing a case of the flu. I'm also keely aware of how pharma marketing hypes up the perception of risk, so -- based on my personal (that's P-E-R-S-O-N-A-L, as in, nobody else has to do what I'm doing) choice to create my own health via diet and exercise -- I'm not one to go running out for a vaccine just because of a press release.

Just a few minutes ago (Facebook, ocean of coincidence) a friend posted a pic from the "Informed Aussies" FB page, a shot of the white paper packed with "Fluaval," a flu vaccine. The fine print states: "There have been no controlled trials adequately demonstrating a decrease in influenza disease after vaccination with FLULAVAL."

So the manufacturer admits that there's no proof that the vaccine works - yet they're out raking in money from people demanding a flu shot.

A second friend, who is a veteran medical writer and editor of such white papers, chimed in on the Facebook thread: "… Flu shots are in the public consciousness as an effective, preventive measure, but that's theoretical and comes from marketing; that's not evidence. Evidence comes from clinical trials with strong, clear outcomes. Flu shots WOULD BE awesome if they were proven safe and effective. But when you create the widespread perception that flu shots have been proven to be an important, effective, preventive measure, then who needs evidence and clinical trial data, right?"

I have no problem with anyone wanting to go get a flu shot. I do think that what is more important to prevention and/or mitigation of catching the crud is the commonsense set of actions that Jim McDonald lists in the original post ... and (from my own experience) paying attention to what goes into your body.

Addendum: in two to five years I am due to come into a modest inheritance. One of the first purchases is going to be long-term health insurance ... at last.

#122 ::: Dave Harmon ::: (view all by) ::: January 16, 2013, 06:35 PM:

shayne #121: Like Lee said, we've heard those arguments before. In particular:
1) The claim that flu shots are not proven safe and effective is flatly an anti-vaxxer lie.
1a) Yes, there are a few people who should not take them, and any doctor will tell you so. Most people are not in that category.
1b) No, they are not a magic shield that will guarantee you can't possibly get the flu... but they will both decrease the odds, and if you do get the flu, they are likely to make the illness much milder.

2) That health insurance won't be a magic shield either. In particular, being "insured" doesn't mean you won't get sick, just that you can afford a doctor when you do. If it's a particularly nasty strain of flu and you weren't vaccinated, that doctor:
2a) may not be able to save you, and
2b) may well curse your name, because at that point you'll have endangered him, your fellow patients, and the other people around you. Especially the people who couldn't get vaccinated.

#123 ::: Cally Soukup ::: (view all by) ::: January 16, 2013, 06:58 PM:

Shayne, if you want to increase your odds of being one of the thousands of people (yes, including healthy young people like teenage athlete Austin Booth) who die each year of the flu, that's your right. The thing is, in exercising that right, you're also increasing the odds of people like my friend who's got an egg allergy and can't have the flu shot dying of the flu.

I'm not "defensive" because I paid money for a flu shot; in fact, my flu shot was free. I'm upset because people who can have flu shots but choose not to get them decrease herd immunity. They're herd immunity freeriders. And if enough choose not to get the shot, then there is no herd immunity, and not just they, but also lots more infants, elderly people, and other people who medically cannot have the flu shot are put at risk.

And I still wonder if you'll address why we don't have to worry about smallpox any more.

#124 ::: oldster ::: (view all by) ::: January 16, 2013, 07:22 PM:

Shayne, why are you spreading falsehoods from anonymous facebook pages, when you could collect some facts from Wikipedia?

"A 2011 meta-study published in the journal The Lancet, "Efficacy and Effectiveness of Influenza Vaccines," analyzed 31 prior studies on the effectiveness of influenza vaccination trials conducted between 1967 and 2011. The analysis found that flu shots were efficacious 67 percent of the time..."

"...multiple clinical trials of both live and inactivated influenza vaccines against seasonal influenza have been performed and their results pooled and analyzed in several 2012 meta-analyses [cites].... The meta-analyses examined the efficacy and effectiveness of inactivated vaccines against seasonal influenza in adults,[40] children,[46] and the elderly.[47][48] In adults, vaccines show a three-quarters reduction in risk of contracting influenza (4% influenza rate among the unvaccinated versus 1% among vaccinated persons)...."

all from:

There are more caveats, details, and citations there. If you want to read the original research, follow the links you find there.

Meanwhile, would you please stop saying that "there is no proof the vaccine works" when in fact there is ample proof that the vaccine works? How far down the denialist black-hole do you want to go?

#125 ::: Tom Whitmore ::: (view all by) ::: January 16, 2013, 07:48 PM:

The vaccine works statistically; there's no proof that it will work in any given case.

Rather like gravity. Or, to be less facetious -- like any other form of insurance.

#126 ::: P J Evans ::: (view all by) ::: January 16, 2013, 08:00 PM:

Actually, shayne sounds like hse's getting hir information from Michael Savage.

#127 ::: shayne ::: (view all by) ::: January 16, 2013, 08:02 PM:

See why I 'gave up,' Xtopher? I stand outside the local herd belief system.

Namaste, y'all.

#128 ::: Dave Harmon ::: (view all by) ::: January 16, 2013, 08:17 PM:

shayne #127: Should you get the flu, have fun disbelieving that you could have done something to avoid it.

#129 ::: Cally Soukup ::: (view all by) ::: January 16, 2013, 08:32 PM:

That's right, we're all just a herd of sheep in our belief that modern, peer-reviewed medical studies and large-scale tests are more accurate than some random guy's gut feeling.


#130 ::: Lisa Padol ::: (view all by) ::: January 16, 2013, 08:52 PM:

Flu shot received! I found a Duane Reed that had one bottle in. This means I don't need to go back to the place I called that said it had it, but which, upon my arrival, lacked someone able to administer it.

So, assuming I don't already have the flu and don't know it, this should work over the next weeks as I understand it.

#131 ::: Nicole J. LeBoeuf-Little ::: (view all by) ::: January 16, 2013, 09:07 PM:

Well, jeez, shayne, if you present "facts" which most people at the party know to be wrong, their correcting your statements doesn't exactly make you a martyr to the sheeple. No one here can do anything about how you choose to perpetuate your status as flu virus carrier; don't be surprised if folks here at least do what we can to keep you from spreading contagious misinformation.

(And I'm speaking as someone who's bustled in here blurting stuff I thought was true and got corrected from five simultaneous directions. I hope I remember correctly that I didn't go off into a snit about sheeple and herd mentality, but instead said "thank you" for the lesson, and came away better educated.)


As far as I can tell, the flu vaccine is in good supply here in Boulder. I got jabbed at the downtown Pharmaca when I went in to pick up some meds for Uno.

Most years I get the vaccine as a sort of way of spitting in the eye of my needle phobia, though I've gotten less punctual about it since quitting the job that got me jabbed for free. So when I asked, "So, when are your flu vaccine hours?" and the pharmacist said, "Oh, we can give it to you right now. Got a minute?" my tummy went all butterflies and my brain went all You had to open your big mouth, didn't you? Which is par for the course. I had a minute. I got jabbed.

Turns out, though, that they'd just run out of the intramuscular variety, so I got to experience the intradermal shot for the first time. The needle was tiny, like TB test tiny, and it involved a lot less serum, resulting in a shorter duration of "Urgh! Weird painful pressure in my arm! Panic!"

Then my arm itched for the rest of the afternoon and a little of the next morning. Ta-da.

The sign's still up at the Pharmaca saying "We have the flu shot!" so I suspect they aren't out of it yet.

#132 ::: Jim Macdonald ::: (view all by) ::: January 16, 2013, 09:17 PM:

I feel I really must address one of the recent comments here:

Just a few minutes ago (Facebook, ocean of coincidence) a friend posted a pic from the "Informed Aussies" FB page, a shot of the white paper packed with "Fluaval," a flu vaccine. The fine print states: "There have been no controlled trials adequately demonstrating a decrease in influenza disease after vaccination with FLULAVAL."

So the manufacturer admits that there's no proof that the vaccine works - yet they're out raking in money from people demanding a flu shot.

No, the manufacturer did not "admit that there's no proof that the vaccine works." They stated that there have been no controlled trials. That is because conducting such "controlled trials" on human subjects would be vastly unethical.

Controlled trials would require withholding a known effective treatment from a control group.

As I'm sure you know, in the case of controlled trials involving treatments of unknown efficacy, if one of the treatments proves to be effective, medical researchers are required to stop the trial and give the effective treatment to all participants. (There have been some notable lapses in this: Do we really want to recreate the Tuskegee Syphilis Experiment?)

While there have been no controlled trials of particular influenza vaccines, there have been hundreds of observational studies of vaccinated versus unvaccinated people. And those studies show that the flu vaccine is, generally, around 66% effective in preventing the flu.

Few if any medical interventions are as effective as vaccines -- and we know this from observation and statistics dating back well over a century, to the days of Louis Pasteur and Robert Koch. (Heck, we have data back to the days of Edward Jenner. It was observation and statistics that led him to the conclusion that exposure to cow pox granted immunity to small pox. And, as a result, smallpox is now extinct in the world.)

The entire "there have been no controlled trials!" line is a standard anti-vaxxer argument. That's right, there have been none. And there won't be, either, so they can keep trotting it out year after year.

I will note, in passing, that there have been no controlled trials proving the efficacy of parachutes when jumping out of airplanes.

If anyone was raising this argument through ignorance, well, that person should now be enlightened.

#133 ::: Lee ::: (view all by) ::: January 16, 2013, 10:55 PM:

Shorter shayne: "Why won't you people just LISTEN to me?"

Where "listen to" is used as code for "agree with me and thank me for enlightening you". Unfortunately, the light has already been shone on the anti-vaxxer movement -- and what it reveals is ugly.

#134 ::: Xopher Halftongue ::: (view all by) ::: January 17, 2013, 01:52 AM:

Jim said most of this, but no given year's flu vaccine has gone through controlled clinical trials by the time it's being administered, in part because by the time those trials were done, any given vaccine would be obsolete. You'd have to do the trials for an entire flu season!

That's what enables the people who lied to shayne to say that about the clinical trials. The specific medicine (a given vaccine) really didn't go through the trials.

Cally 123: And if enough choose not to get the shot, then there is no herd immunity, and not just they, but also lots more infants, elderly people, and other people who medically cannot have the flu shot are put at risk.

Not to mention people who get it but are not protected by it. The fact that it isn't 100% effective is part of why we need maximum coverage.

shayne 127: I see why you gave up, but not why you're not citing more credible sources on your side. And I know you were making a joke about herd immunity, but you wound up being kind of insulting.

#135 ::: dcb ::: (view all by) ::: January 17, 2013, 03:36 AM:

Jim Macdonald @132: There is, however, a wonderful paper regarding the lack of controlled trials on the use of parachutes: Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials. BMJ 2003;327:1459 (Published 18 December 2003) I've read it, and it's really funny. Here's the abstract:

"Objectives To determine whether parachutes are effective in preventing major trauma related to gravitational challenge.

Design Systematic review of randomised controlled trials.

Data sources: Medline, Web of Science, Embase, and the Cochrane Library databases; appropriate internet sites and citation lists.

Study selection: Studies showing the effects of using a parachute during free fall.

Main outcome measure Death or major trauma, defined as an injury severity score > 15.

Results We were unable to identify any randomised controlled trials of parachute intervention.

Conclusions As with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomised controlled trials. Advocates of evidence based medicine have criticised the adoption of interventions evaluated by using only observational data. We think that everyone might benefit if the most radical protagonists of evidence based medicine organised and participated in a double blind, randomised, placebo controlled, crossover trial of the parachute."

#136 ::: thomas ::: (view all by) ::: January 17, 2013, 04:00 AM:

Jim Macdonald #132:

There have been randomized trials of the inhaled vaccine, eg, this one in 1999

There have also been trials of the strategy of recommending vaccination, such as this one in 2006.

You won't be surprised that both found a benefit.

#137 ::: thomas was gnomed ::: (view all by) ::: January 17, 2013, 04:00 AM:

Cough, splutter, wave for help from Duty Gnome

#138 ::: Dave Harmon ::: (view all by) ::: January 17, 2013, 06:39 AM:

Xopher Halftongue #134: Actually, his "joke" is a better analogy than he might realize. After all, he's been trying to infect us with a potentially-deadly memetic virus, only to find that we're immune.

#139 ::: shayne ::: (view all by) ::: January 17, 2013, 02:38 PM:

xtopher @134 -- I apologize for using the word "herd." It was an unnecessary dig.

I thought of many more honorable words later upon reflection, but at this point anything I say will be taken as an insult.

Odd Duck Out.

#140 ::: abi ::: (view all by) ::: January 17, 2013, 03:08 PM:

shayne @139:
at this point anything I say will be taken as an insult.

I beg to differ. Respectful, non-preachy and genuine engagement in the conversation would not be taken as an insult. You should try it.

Of course, then you would have to pay attention to the other posters, including the ones who have posted rebuttals of your assertions. And you could listen to what they have to say and learn from it, rather than coming in and assuming you already know better than everyone else.

(And don't even pretend that statements like this @91 aren't preaching: I only speak from my own conviction and experience. If others can see possibility for changing their own habits, so be it. If they see confusion, so be it. Asking in 112 Why is it, when I offer an example of what has worked for me personally, in one instance, and take care to mark my comments as being my own personal experiences and decisions, a crowd assumes I'm preaching that everybody else doing things a mite differently are a bunch of sinners and idiots? is so many kinds of disingenuous that I'm embarrassed on your behalf.)

#141 ::: charming quark ::: (view all by) ::: January 17, 2013, 06:16 PM:

Mary Aileen @ 109: Maybe it's so. The stuff I was blowing out of my nose about 3 weeks ago was the color of lemon curd - bright neon yellow, sure I'm pretty sure about the color at least!

#142 ::: charming quark ::: (view all by) ::: January 17, 2013, 06:23 PM:

Shayne - I'm sorry, but you've kept digging yourself further into the hole on this one. Jim and Abi completely have the right of it here.

#143 ::: charming quark ::: (view all by) ::: January 17, 2013, 06:25 PM:

And Jim McD - your medical posts are the awesome! I wish you'd put them all in a book - you know, the old-fashioned paper kind.

#144 ::: Xopher Halftongue ::: (view all by) ::: January 17, 2013, 07:38 PM:

shayne, abi isn't being rhetorical, I don't think. If you now engage as she has recommended, it will work. And people will (I'd hope) refrain from piling on anything you say in the new mode.

#145 ::: shayne ::: (view all by) ::: January 17, 2013, 07:48 PM:

Abi @ 140 – thank you for the thoughtful note. I enjoy your posts most of all on Making Light. In fact, I make daily visits to this site because I enjoy the topics -- I share a lot of the posts and point recipients to the comment threads for favorite quotes.

I intended no harm. I intended no overt disrespect – only to clearly, briefly and in the most neutral terms to state what it was I wanted to offer to the discussion. I intended to allow everyone the space to have whatever reaction they would have. “So be it.” I take none of it personally.

If such intention and calm language are not things you feel you can trust, where do we go?

My response was to exit the room. I should not have used the word “herd” as I did, even though I was escaping a stampede.

There is no way to hold a conversation with a stampede.

I peeked back in a few hours later, and was amazed by two things. First, the spectacular variety of emotions on display, and second, that I still took none of it personally.

How could I take it all personally? Everyone commenting had their own interpretations of my words and intentions – a score of phantom “shaynes” that for each was their very own to abuse and educate. Bits and shards of real information flew past, collided with each other and changed; I gathered up what felt useful, thank you.

The anthropologist in me was dazzled. This was truly a tribal moment – the war chants, dance moves, arias, keening, flaring intellectual plumage, the spontaneous debates and fact-checking, secret jokes and handshakes – it had a life of its own, and I was a spectator.

If I am not to be a spectator – and do I feel safe, now, not being a spectator? Just barely – I ask only one question of each of you: Who were you fighting?

I am an electronic ghost. There is the human sitting at the laptop, typing, but each of you had an Enemy in mind. Who was that? What person waybackwhen put you in fight-or-flight passion about this topic – so that a trigger word could put you in a frenzy of righteousness?

That’s all the energy I want to invest in this. The rest of it is yours – as the Making Light household is yours, and I was a Visiting Odd Duck. Thank you for your time.

#147 ::: Dave Harmon ::: (view all by) ::: January 17, 2013, 08:16 PM:

Electronic ghost, my ass. And you're no anthropologist, either -- for at least half a century, real anthropologists have known that there's no understanding a culture without actually joining in, and learning what they have to teach.

We are a community of people who care about each other, and about the other people around us. If you're not willing to engage with us other than as a voyeur, if you think our responses mere "tribal displays" -- that's because you don't care, and because you're just here to taunt and mock. Begone, hollow one -- come back when you find your heart, and you will find this a very different place.

#148 ::: albatross ::: (view all by) ::: January 17, 2013, 08:34 PM:

The right to speak your piece implies the right of other people to both think badly of you because of what you said, and to respond with their own contradictory views. Further, your words stick around forever, and the antidote to bad information is good information.

As far as the effectiveness of the flu vaccine, that is a question of fact. As the old saying goes, everyone is entitled to their own opinion, but not their own facts. A number of people have done their best to look into the effectiveness question, and found pretty good evidence it offers some protection, albeit not as much as you'd like. Now, there are ways they could all be wrong, ranging from fraud to error to bad luck. But that's not the way to bet. Similarly, it's possible there is some subtle health problem caused by the flu vaccine, something hard enough to see that it hasn't shown up in any studies and hasn't been noticed by doctors. But again, that is not the way to bet.

There is also a moral issue wrt most kinds of vaccination, which only makes sense to consider if you think the vaccine actually is at least somewhat effective. There are people who think it's probably somewhat effective, but don't think it's worth the cost--whether that's measured in dollars or hassle or facing a needle. If you think the flu vaccine is probably somewhat effective, then along with the likely benefit to yourself, you should also consider the potential benefit to others. That's obviously a much bigger deal for, say, a nurse (likely to be exposed and to expose others) than for a hermit living in a cabin in the woods (not too likely to be exposed or to expose anyone). But it is something to consider. If lots of people get the flu shot, then even though it's only somewhat effective, the flu just won't spread as effectively, and many people who would have gotten the flu will avoid it. Some subset of those people will die, and many more will just spend several days being really miserable.

That moral issue doesn't apply to vaccines for stuff that doesn't transmit among people (say, tetanus or rabies). And it has little practical importance in situations where almost everyone is immune. Part of the angry reaction to the anti-vaccination movement is the potential to convince a big fraction of the population to stop getting vaccinated, at which point you can get (and this has happened) diseases that had more or less disappeared coming back and making people sick again.

#149 ::: Jim Macdonald ::: (view all by) ::: January 17, 2013, 08:37 PM:

Antivaxxers are, in my opinion, somewhere on the scale from flat-earthers to creationists -- only more dangerous, because they don't merely keep themselves ignorant, or harm only themselves. They seek to harm others. Not only that, they have lately succeeded in harming others: See the recent resurgences in, among others, whooping cough and measles.

Some may parrot the antivaxxer line through ignorance. Those who continue to do so, after being informed of their error, have gone over to the side of evil. They actively seek to increase pain, suffering, disease, and death.

(BTW, "Why are you all so defensive?/overly invested in [topic]," "I don't understand what I've done to earn this hostility," "It's just electrons; don't take it seriously," "It's like you all have something to prove," and "I'm just trying to understand what people here think," are squares on a Bingo card.)

#150 ::: P J Evans ::: (view all by) ::: January 17, 2013, 09:27 PM:

Diseases where this has actually happened in the very recent past: whooping cough (pertussis), measles (rubeola), chickenpox (varicella) and, ISTR, polio.

#151 ::: oldster ::: (view all by) ::: January 17, 2013, 09:43 PM:

I don't know, I think #145 is pretty much a masterpiece of passive aggressive styling. It's a gem! It's got it all!

It's got yer fake apologies, it's got yer not-so-veiled insults, it's got yer more-in-sorrow-than-in-anger tone. It levels charges of irrationality and over-emotionalism at everyone in the room, and then pantomimes incomprehension that anyone could take offense. It takes disingenuity to new heights of ingenuity.

Okay, some may complain that it doesn't make any genuinely *new* moves in the genre of whiny internet martyrdom. Sure, we've seen it all before--each of the pieces, at any rate. But isn't there something novel in their arrangement, or at least in the relentlessness of their deployment? Shouldn't he get points for delivery, at least?

Don't worry, pal. Maybe everyone else here is picking on you like horrible meanies. But you're okay with me, kid: bei mir, bist du shayne.

#152 ::: P J Evans ::: (view all by) ::: January 17, 2013, 09:45 PM:

Another study on flu vaccine safety reported here, showing that the vaccine is much safer for pregnant women than actually getting the flu. For one thing, flu doubles the chance of miscarriage.

#153 ::: Allan Beatty ::: (view all by) ::: January 17, 2013, 11:04 PM:

More or less on topic: I heard a story on NPR about giving children several vaccines at once. They quoted a parent who was against this practice, who said something like, "This recommendation is based on only forty studies. That's not nearly enough science to protect our children."

#154 ::: Lee ::: (view all by) ::: January 17, 2013, 11:23 PM:

Lots of links about the resurgence of preventable diseases over on the Why We Immunize thread, especially down toward the end. Notice that one of the common factors in these articles is the rise in the percentage of people who are NOT vaccinated.

People who can take advantage of immunization and don't bother are a public health menace and should be locked up for everyone else's safety. The more so if they "don't believe in it". You don't get to create your own reality, about this or anything else.

#155 ::: abi ::: (view all by) ::: January 18, 2013, 04:14 AM:

shayne @145:

Bruce Baugh, a regular here, once remarked that the internet is phenomenological. If you do a letter-perfect imitation of, for instance, a troll, it doesn't really matter how pure your heart is. You've trolled the conversation. It's kind of the flipside of no one knowing you're a dog.

I don't know what your intentions were. I know what your effects were, and they are all too familiar. (I know what you're doing now, and I recognize it, too.)

We take what you give us. If so linguistically acute a community as this takes it "wrong", then the chances are very good that you gave it to us wrong.

I can tell you where the first canary died for me, if that would help. It was the word "pharmaceuticals", way up there @79. That word, used the way you did, has all the live-and-let-live neutrality of a mother holding her teenaged son's month-old unwashed underwear.

But people misspeak. Canaries die for many reasons (though not one falls that we are not aware of it here).

The next canary left its perch here:
I find it interesting that many of the people on this thread who religiously get flu shots, get sick anyway with something cruddy.

Note the word "interesting". Alongside a veiled "you people", it's often either a distancing term—setting the speaker apart from (and implicitly above) the audience—or an outright accusation of hypocrisy.

OK, but sometimes things just don't come out right.

Preachifying in 91 didn't help. But sometimes people have tin ears.

By 104, I was getting a strong whiff of someone who's not only above it all, but also a habitual contrarian. Let me bold the telling phrasings in this single paragraph:

Potential vaccine and medicine shortages are always hyped up during flu season, especially when a novelty rears its head. Understanding how home remedies are used, having the herbs on hand, and some experience in using them on oneself, could prevent panic and hysteria among friends and neighbors. This statement has not been evaluated by the FDA.

At this point, I'm pretty clear on whether you're engaging with the community or merely performing your special superior-contrarian fan-dance for our admiration.

Comment 112 is a lapidary example of the "Noble Martyr For Truth" theme, which had previously been more implicit than explicit. Despite being ornamented with the appropriate punctuation, it's not a true question (identifying a default of information and requesting assistance supplying it). But it is a nice addition to the performance.

Likewise 118, with its delicate foreshadowing of the Martyred Flounce yet to come.

After that graceful caesura comes the second act. 121 continues and escalates a motif implicit in your choice of addressees in Act 1: the attempt to split the community into the Bad and the Good but Misguided. I'm not sure your choice of Xopher as the Strayed Lamb Being Led To Safety was wise. Also, misspelling his name in 127 shatters the illusion.

But I am ahead of myself.

Comment 121 is also the climax of the performance, the moment when you reveal the true blinding glory of your position and shatter our foolish illusions. (Yes, I know this is all just you describing your P-E-R-S-O-N-A-L choice. That's is why you have to parade it before us all, over and over, when we don't agree.) Unfortunately, you picked the wrong audience, and the thunderous applause and standing ovations do not follow.

And then, I am sad to say, your performance falls apart. A halfhearted thematic riff on sheeple is all you can muster to bridge the awkward moment.

You do pull it all together reasonably well for the finale at 145. Another attempt to separate the sheep from the goats (I'm delighted that you like what I do here, thank you, but that doesn't mean it's reciprocal); a cute but (probably unintentionally) ironic attempt to paint your interlocutors as savages and yourself as a scientist; a reassertion of the detachment that doomed your entire enterprise here; a flounce.

You know what? I hope you really are as detached from the self projected here as you say. Because that way you won't feel quite as embarrassed at your stunning failure to be a productive part of this conversation.

If you would like to come back to Making Light as a participant, not a performer, you are still welcome. It might be prudent to admit some sheepish (no pun intended) awareness of how badly this conversation went, and it's strongly advised that you consider what you say with more care. But the door is not closed, even now.

#156 ::: Cadbury Moose ::: (view all by) ::: January 18, 2013, 07:10 AM:

Abi @ #155


(This moose wonders if "shayne" thinks someone's dropped a 155 on his bridge.)

#157 ::: Serge Broom ::: (view all by) ::: January 18, 2013, 09:52 AM:

Abi... What Cadbury said.

#158 ::: Ginger ::: (view all by) ::: January 18, 2013, 10:29 AM:

oldster @ 151: I see what you did there. Gives a whole nu meaning to the phrase, it does.

Your internet is hereby awarded, in Yiddish, nu?

#159 ::: Serge Broom ::: (view all by) ::: January 18, 2013, 10:34 AM:

I got my first-ever flu shot back in November at the nearby clinic.
In their gynecological dept.

#160 ::: Ginger ::: (view all by) ::: January 18, 2013, 10:42 AM:

Pardon me, Serge; I'm still reeling from the thorough dissection and analysis from the Master known simply as Abi, at 155.

When I grow up, I want to be just like her.

#161 ::: SamChevre ::: (view all by) ::: January 18, 2013, 11:04 AM:

An actual question about the flu vaccine.

For some reason, I have the impression that it mostly affects severity (you get less sick) rather than frequency (you get sick less). This is plenty enough reason to get it for me[1]. But it would mean that it isn't protective of others in the way that measles or pertussis vaccines are.

Can anyone confirm/contradict that notion?

1) The most miserably sick I can remember being was when I had the flu in my late teens. It was a particularly virulent flu--nearly everyone in the community had it, and it had a particularly high and long-lasting fever. We were dairy farmers. There is nothing quite like doing physically-challenging work for 3-4 hours twice a day, in the cold and rain, while aching all over and unable to think straight.

#162 ::: Ginger ::: (view all by) ::: January 18, 2013, 11:19 AM:

SamChevre @161: The main difference between influenza and other viral illnesses is that influenza mutates very easily. There's two paths of change, and in summary, they create essentially "new" viruses each season. This is why you don't get full protection guaranteed; there's no way to predict which of the many versions of influenza will be circulating next season, and how they'll mutate from this season. Our best approach is to generate vaccines against the most prevalent serotypes, hoping to capture the ones that do become important, and thus induce antibody responses in the population that will protect against the greatest degree of viral variations.

Now, given that the influenzas mutate and have a wide selection to choose from even without mutating, we're lucky that there's some overlap in some of the cases. This is what gives us partial immunity even when we don't choose the correct versions for the vaccines.

All a vaccine is intended to do is stimulate your immune system into generating the neutralizing antibodies, and then hold them in reserve in case you do actually meet the infectious particles. A pre-stimulated immune system is faster in responding to illness, resulting in shorter duration of said illness, or in reduced severity, or both. Sometimes you get lucky enough to fight off the illness altogether.

#163 ::: Lori Coulson ::: (view all by) ::: January 18, 2013, 11:27 AM:

SamChevre @161:

Actually it does both, if the flu in your area is one of the strains that was in the shot, and it's more than two weeks after you've had the shot, you should not get that variety of the flu.

However, if it is one of the strains but it has mutated since it was picked for the shot, you may get the flu, but with less violent symptoms, and for shorter duration.

If you get one of the strains that isn't in the shot, you're going to be miserable. Oh, and if you got the shot but the virus arrives before your immune system has developed a full suite of antibodies -- you can catch it. Not sure if having had the injection will moderate the symptoms in this case.

#164 ::: OtterB ::: (view all by) ::: January 18, 2013, 11:56 AM:

Responding to SamChevre @161 on the question of the flu shot protecting others if it's making you less sick instead of keeping you well altogether, my understanding is that means that you would have fewer and/or weaker viruses in your system that you could pass on, plus if it doesn't last as long, then that's less time you are contagious. So I would guess it still helps reduce the spread. But I am neither a medical professional nor an epidemiologist.

#165 ::: Lori Coulson ::: (view all by) ::: January 18, 2013, 01:12 PM:

Wow -- just saw the headlines, Pediatric death toll from this year's flu has increased to 29.

Looks like Tennessee and Hawai'i have the least cases at the moment.

#166 ::: Tom Whitmore ::: (view all by) ::: January 18, 2013, 01:32 PM:

Not a professional epidemiologist either, OtterB, but there are definitely complicating factors: if one is less sick, one is more likely to go out in public. But if one is less sick, one is less likely to cough or sneeze. So it's not clear how these competing factors would play out in terms of the spread of the flu. Lori Coulson put out the basic argument really well; one small addition would be to say that increased (appropriate) immune response does slow the spreading, all other factors being equal (which they never are).

#167 ::: nerdycellist ::: (view all by) ::: January 18, 2013, 02:55 PM:

Well, it makes a huge difference - having to take one day off work rather than eight - when you have a limited number of sick days and an unlimited amount of work that no one but you can seem to do. I will repeat: having a vastly shortened flu is far preferable to the alternative. The only downside I can see to the vaccine is the feeling that my arm had been punched hard. I really don't get the argument (also showing up with the new gNu ctrl discussions) that if it's not 100% perfect, you should just forget about it.

#168 ::: Cally Soukup ::: (view all by) ::: January 18, 2013, 03:48 PM:

nerdycellist @167

You remind me of the time I was debating a staunch anti-contraceptives advocate. She kept saying that condoms were only 98 percent effective, and therefore should never be used. The fact that lack-of-condoms is vastly less effective than that never seemed to get through to her.

If you're going to have sex, and don't want to get pregnant (and aren't on any other sort of birth control) you should use a condom. Even though they're not 100% effective.

If you don't want to get the flu, and there's any chance at all that you might come in contact with a flu carrier (and you're not medically contraindicated from getting a flu shot) you should get the flu shot. Even though it's not 100% effective.

Shayne wonders why we're so intent on giving him the facts about flu? In my case it's simple. My grandfather almost died of the flu when he was a young man. He was so sick he was triaged out of a hospital bed (which they needed for someone who they thought would live) and on to the hallway floor. He got really lucky: he lived. But being a young, healthy farm boy didn't prevent him from getting and nearly dying of the flu.

Flu kills. Even today. Even with hospitals. Take it seriously.

#169 ::: OtterB ::: (view all by) ::: January 18, 2013, 03:52 PM:

Tom Whitmore @166, good point about being out and about more with a weakened version.

nerdycellist @167, I don't think SamChevre @161 was arguing that it wasn't worthwhile; he said (as you did, and I agree) that it's clearly worthwhile just to be less ill for a shorter period. I think the other discussion is more curiosity than anything else - an imperfect flu vaccine is good for effect A; what is its impact on effect B, if any?

#170 ::: David Harmon ::: (view all by) ::: January 18, 2013, 03:54 PM:

I really don't get the argument that if it's not 100% perfect, you should just forget about it.

That's called "making the perfect the enemy of the good". It's almost never a genuine argument, instead it's meant to undercut any actually effective measure.

#171 ::: charming quark ::: (view all by) ::: January 18, 2013, 05:00 PM:

Serge Broom @159 - If no one else is going to ask, I just have to. If you had your flu shot in the gynecological dept., where did they give you the shot? :-)

#172 ::: Serge Broom ::: (view all by) ::: January 18, 2013, 05:07 PM:

charming quark @ 171... Thankfully, only in the traditional location.

#173 ::: Lee ::: (view all by) ::: January 18, 2013, 05:31 PM:

nerdycellist, #167: This is a combination of (1) the well-known fallacy of "the perfect is the enemy of the good" and (2) stalling / stonewalling. By refusing to accept anything but an absolutely-dead-perfect solution, they can prevent any solution at all from being attempted.

#174 ::: Xopher Halftongue ::: (view all by) ::: January 18, 2013, 06:18 PM:

abi 151: *cheers*

#175 ::: Xopher Halftongue gnomed ::: (view all by) ::: January 18, 2013, 06:19 PM:

Shortest comment I've ever had gnomed. Maybe too short?

#176 ::: abi ::: (view all by) ::: January 18, 2013, 06:35 PM:

Too enthusiastic.

#177 ::: Cadbury Moose ::: (view all by) ::: January 19, 2013, 05:28 AM:

Xopher @ #174

Wrong number, too: abi's post was 155 (one round of which has probably dropped shayne's bridge into the bottom of the gorge).

If the gnomes are scoring enthusiasm, they may be running INTERCAL (in which case we should all run away, very quickly).

#178 ::: Rob Rusick ::: (view all by) ::: January 19, 2013, 06:47 AM:

Only tangentially on topic, but I'd always assumed 'herd immunity' was why computer anti-virus vendors like AVG and Avast have free versions of their software available. Their paid clients are better protected by widespread use of anti-virus software (even if the majority of the users were 'freeloaders') than would be the case if the vendors insisted everyone pay full price.

#179 ::: Rob Rusick ::: (view all by) ::: January 19, 2013, 06:51 AM:

Re 178: For 'paid clients' read 'paying clients'.

#180 ::: Jim Macdonald ::: (view all by) ::: January 19, 2013, 08:37 AM:

The wide-dissemination of free anti-virus software also gets them info on newly-developed viruses that much sooner, too.

The same was true with Duotrope, I think: The large number of free users uploading reply-time information made their reply-time stats more reliable.

Since they've gone to pay-only (as of the first of January), I believe that their stats, which were a major selling point, will no longer be reliable, since they won't have anywhere near as large a base from which to draw their data.

#181 ::: Xopher Halftongue ::: (view all by) ::: January 19, 2013, 01:01 PM:

Cadbury, you're right that I tagged it wrong (unless several other things were un-gnomed after I posted), but I really doubt that was why it was gnomed!

#182 ::: Lee ::: (view all by) ::: January 19, 2013, 02:26 PM:

abi, #155, quoting shayne: I find it interesting that many of the people on this thread who religiously get flu shots, get sick anyway with something cruddy.

Something I missed the first time thru. Yes, people who get the flu shots may very well still get sick with "something cruddy" -- but "something cruddy" and "the flu" are not synonyms! That was an attempt to palm a card by asserting that flu shots are worthless because they don't protect you from everything ELSE you might catch during flu season.

#183 ::: Cally Soukup ::: (view all by) ::: January 19, 2013, 03:31 PM:

Lee @182

Indeed. "These gloves are useless! I wore them out in the snowstorm and my feet still got cold!"

#184 ::: Mary Aileen ::: (view all by) ::: January 19, 2013, 04:45 PM:

Lee (182)/Cally (183): I suspect that the thought behind that statement was something like, "If you* get the flu shot, you'll probably just catch something else instead, so why bother getting vaccinated?" Of course, this misses the fact that unvaccinated you might well come down with flu in addition to the other thing, not to mention that flu is potentially much worse than the other cruddy things going around. (The four-month bronchitis I had last winter was No Fun, but still better than the flu. And I shudder to think how sick I would have been if I'd had the flu, as well.)

*generic 'you'

#185 ::: P J Evans ::: (view all by) ::: January 19, 2013, 06:31 PM:

I got a cold on top of bronchitis once. I'd rather have the flu than get that combination again.

#186 ::: Vicki ::: (view all by) ::: January 19, 2013, 08:43 PM:

Mary Aileen: And I've found that flu makes me more likely to get bronchitis (which isn't a specific infection, it's a description of symptoms).

#187 ::: Mary Aileen ::: (view all by) ::: January 19, 2013, 09:24 PM:

185/186: Last January's local version of the winter nasties* gave a lot of people a lingering cough. In my case, it interacted badly with my cough-variant asthma; bronchitis was the result. Flu on top of that would not have been good.

*not a cold, not the flu, but some other viral infection, one which went straight for the lungs and set up housekeeping

#188 ::: Mary Aileen ::: (view all by) ::: January 19, 2013, 09:26 PM:

I've caught myself being inconsistent with my terminology, so now I'm curious:

What do you say someone is sick with, 'flu' or 'the flu'?

#189 ::: David DeLaney ::: (view all by) ::: January 19, 2013, 09:45 PM:

SamChevre @98: Also, in this area, the pharmacy at Food City, with store card. Kroger's also BUT one of my meds slipped off their Generics list into hundreds-of-dollars-a-month territory, so I packed everything over to Food City (where I had had one).

Serge @172: I didn't know you HAD a traditional gynecological-department location!


#190 ::: Cassy B. ::: (view all by) ::: January 19, 2013, 10:45 PM:

Mary Aileen @188, in my dialect (Chicago) it's "the flu". Oddly, it's an indefinite article for a mere cold. I guess perhaps it's an indication of severity? "I caught the flu" as opposed to "I came down with a cold"?

#191 ::: Mary Aileen ::: (view all by) ::: January 19, 2013, 10:50 PM:

Cassy B. (190): Yes, colds always take the indefinite article. Odd, that.

#192 ::: David Goldfarb ::: (view all by) ::: January 19, 2013, 10:54 PM:

I'm a California boy, and for me as well it's "a cold" and "the flu". Other diseases generally take no article at all.

#193 ::: Tom Whitmore ::: (view all by) ::: January 20, 2013, 12:32 AM:

Colds are kind of non-specific diseases -- nobody's found a single virus that causes them.

Flu is caused by the influenza virus, of which there are a lot of variants but only one basic bug.

That's why I say "a cold" and "the flu".

#194 ::: albatross ::: (view all by) ::: January 20, 2013, 01:13 AM:

a cold
a stomach bug
the flu
the measles
chicken pox

I'm not sure why it works out this way....

#195 ::: albatross ::: (view all by) ::: January 20, 2013, 01:18 AM:


I think there are lots of different known viruses that cause colds--rhinoviruses, coronaviruses, and adenoviruses, and surely a bunch of others. Apparently one problem with antivirals for colds is that by the time you have symptoms, the viral infection is nearly over, so even if you get the right virus type for your antiviral, it doesnt help much. If I understand things right, the immune reponse to the virus is what drives nearly all your cold symptoms.

#196 ::: thomas ::: (view all by) ::: January 20, 2013, 01:34 AM:

Tom Whitmore: I think it's probably more complicated than that. It typically is for use/non-use of an article.

Some examples: including a few that expand beyond infections, because until recently 'infection' wasn't a natural category of medical conditions.

the: flu, mumps, measles, ?plague, sniffles, runs, pox, clap, dreaded lurgy, blues
a(n): cold, stomach bug, virus, stroke, heart attack, boil, ?apoplexy, ulcer

no article: hysteria, salmonella, leprosy, TB, HIV, AIDS, syphilis, smallpox, food poisoning, gastroenteritis, ?plague, ?apoplexy

The only really consistent pattern I see is that articles are fading over time: 19th century usage would have an apoplexy, the cholera, the plague, the clap. I think nowadays apoplexy and cholera would usually not have articles, and plague and clap would be allowable without them.

That's also tending to happen with country names. Sudan, Gambia, Libya all have lost their definite article, and Vatican City's is weakly attached.

#197 ::: thomas was gnomed ::: (view all by) ::: January 20, 2013, 01:35 AM:

Probably because of suspicious punctuation.

#198 ::: Xopher Halftongue ::: (view all by) ::: January 20, 2013, 02:11 AM:

There are many colds. Colds are caused by a maze of twisty little viruses, all different.

There are a couple of flu variants each year, with one dominating in any given area (usually). I don't know why this is, but it explains why flu gets the definite article and colds get the indefinite.

#199 ::: Xopher Halftongue ::: (view all by) ::: January 20, 2013, 02:14 AM:

...but thomas' list makes me rethink. Ongoing process at the moment.

#200 ::: David Goldfarb ::: (view all by) ::: January 20, 2013, 03:36 AM:

I don't have an article on measles, mumps, or sniffles. And in general I think that the default for a disease or medical condition is no article. I'll agree with the rest of thomas's lists, though.

We might mention Ukraine as well, which lost its article when it became an independent country.

#201 ::: Tom Whitmore ::: (view all by) ::: January 20, 2013, 03:45 AM:

thomas @196 -- yes, it's a bit more complicated, and you hit a couple of exceptions: except the majority of your examples follow the same basic rule. Where it's long been believed that there's a single cause: the definite article. Exceptions here: sniffles and runs. It's hard to argue against those. But the blues -- that's a humour thing, and was initially called melancholia (black bile, I think, for the specific humour). For the indefinites, ulcers have recently become thought to have a single cause, where before they didn't. The others all have multiple causes, in popular thought. And cancer is an interesting example: I can see people saying they have a cancer of the XXX, though they would generally say they have cancer if they're not trying to be specific. They wouldn't say they have the cancer of the XXX, though.

And yes, things change over time.

albatross, we agree, and I didn't state as clearly as I might: no single virus has been discovered that causes all colds (because they've found several).

#202 ::: David Goldfarb ::: (view all by) ::: January 20, 2013, 04:19 AM:

Incidentally, anyone have any news on testing (and production?) of DRACO? I heard about that here, a little while ago: a treatment that induces cells infected with viruses to undergo apoptosis, while sparing ones that aren't. By interfering with the cycle of viral replication, it thus effectively cures all viral infections. As I recall someone saying at the time: if this is safe and effective and inexpensive, it's the biggest thing since penicillin.

#203 ::: TomB ::: (view all by) ::: January 20, 2013, 06:57 AM:

I believe we say "the flu" because it is not one thing.

#204 ::: P J Evans ::: (view all by) ::: January 20, 2013, 10:31 AM:

The swoles (but not a swole). (If you read Pogo.)

#205 ::: joann ::: (view all by) ::: January 20, 2013, 11:27 AM:

In my experience/lexicon: "The flu" for what's currently going round, but it seems to lose the article if you're talking about it generally. "Influenza" for some reason does not seem to take an article, even though it's the same virus(es). In an older usage, "grippe" always gets preceded by "the", perhaps because it's taken from the French, where it's "la grippe".

#206 ::: Mary Aileen ::: (view all by) ::: January 20, 2013, 11:39 AM:

joann (205): In my experience/lexicon: "The flu" for what's currently going round, but it seems to lose the article if you're talking about it generally. "Influenza" for some reason does not seem to take an article, even though it's the same virus(es).

That fits. In fact, I think it's exactly what I'm doing.

#207 ::: janetl ::: (view all by) ::: January 20, 2013, 11:56 AM:

I don't think 97.6% of English speakers have ever given any thought to the variation in any particular type of disease, and so a logical explanation for the article, or lack of same, is a snare and a delusion. Any "rule" in English has at least a dozen exceptions. My heartfelt sympathy, and congratulations, to everyone who learns to speak it fluently as a second (or nth) language!

#208 ::: Lila ::: (view all by) ::: January 20, 2013, 12:15 PM:

I don't know if this is cause, effect, or an unrelated epiphenomenon, but to me the definite article suggests personification. The Flu, The Clap and The Runs could be characters in a mystery play, in a way that A Cold or Cancer might not. (The Measles and The Mumps are sort of an edge case, but maybe it's because they're plural and we don't have a plural indefinite article?)

(Obviously I am completely unqualified to touch this question; this is merest speculation.)

#209 ::: praisegod barebones ::: (view all by) ::: January 20, 2013, 12:40 PM:

Xopher @ 198, 199

I think 'the lurgi' - if that's an expression in your version of English - is also a counte-example to this suggestion.

#210 ::: dcb ::: (view all by) ::: January 20, 2013, 02:05 PM:

Lee @182 / Cally @183 / Mary Aileen @184: I think shayne was trying to imply that the fact people went down with something else shows that, lacking the "proper pH balance" due to insuficiant apple cider vinegar and cayenne pepper, everyone else's immune systems are rubbish - while of course shayne's immune system is proof against every microbe going, because of having taken these things.

#211 ::: praisegod barebones ::: (view all by) ::: January 20, 2013, 02:53 PM:

Lila @208: over on Facebook, a schoolfriend has made the related suggestion that the definite article is a mark of respect, analogous to 'The Shadow' and 'Winnie-ther-Pooh'.

#212 ::: thomas ::: (view all by) ::: January 20, 2013, 03:56 PM:

David Goldfarb #202

There's still nothing on the PubMed database apart from the first article in 2011, and nothing in Web of Science or Google Scholar.

The initial article is really only about prophylactic use, not treatment, and that has been a difficult step in the past. You may remember interferons, which were going to be the next big thing in the 1980s (and which have a related mechanism)

#213 ::: Xopher Halftongue ::: (view all by) ::: January 20, 2013, 04:33 PM:

pgbb: Unless you're referring to the Goon Show script, I have no idea what you're talking about.

#214 ::: P J Evans ::: (view all by) ::: January 20, 2013, 04:42 PM:

I associate the cider vinegar thing with ads on the back of Sunday newspaper magazines (but not the glossy-paper magazines). Or with supermarket tabloids.
IOW, it's a claim that immediately raises my level of skepticism.

#215 ::: Lee ::: (view all by) ::: January 20, 2013, 07:25 PM:

#210/214: If somebody wants to drink cider vinegar and cayenne pepper, I'm certainly not going to tell them not to. It neither breaks my leg nor picks my pocket, it won't hurt them, and ghod knows I've heard of folks eating and drinking weirder stuff!

But if that same somebody turns around and tries to tell me that I got sick because I didn't drink their worthless snake-oil concoction, the gloves come OFF.

#216 ::: Stefan Jones ::: (view all by) ::: January 20, 2013, 08:16 PM:

I think we should start calling the malady in question The Influence!

Italicized, with enthusiasm.

"Bob? Poor guy . . . he's home with The Influence!

#217 ::: Naomi Parkhurst ::: (view all by) ::: January 20, 2013, 10:07 PM:

Another definite/indefinite article thingy: when our son was small, he used to get the croup. Except that as we were exposed to more medical professionals, (or more incidents of the symptom in question, and it is indeed a symptom, not a disease), we stopped calling it the croup and started calling it croup with no article at all.

#218 ::: Dave Harmon ::: (view all by) ::: January 20, 2013, 11:10 PM:

Random thought about disease articles, or lack of them: Most diseases would be naturally be uncountable nouns, which in English don't take articles. But... could the articles have snuck in from other languages?

#219 ::: David DeLaney ::: (view all by) ::: January 21, 2013, 01:37 AM:

Dave @218: As James Nicoll reminds us, it's probably not a matter of "snuck" so much as "GET OVER HERE!!" a la Mortal Kombat. We are large, we contain multitudes, we have room for country AND western!


#220 ::: Tamlyn ::: (view all by) ::: January 21, 2013, 03:02 AM:

Stefan Jones @216 I like that!

My boss was handing out consent forms for our flu shots today (for later in March). They occur on a day I don't normally work, but she told me I was quite welcome to pop in just for the shot.

I'll have to cancel my normal morning activities, but I think it's worth it. I can make a day trip of it. There are so many things I want to do in the city (need to do some research at the state library, finish the NGA, etc), but going all the way into the city not for work is normally too much effort.

#221 ::: Dave Harmon ::: (view all by) ::: January 21, 2013, 08:43 AM:

Stefan Jones #216: Coming soon to cable TV!

David DeLaney #219: Yeah, but the $65,536 question is, are the particular terms that do or formerly did this, the ones that we took from other languages?

#222 ::: Tom Whitmore ::: (view all by) ::: January 21, 2013, 12:33 PM:

Dave Harmon @221 -- what are the previous 15 questions?

#225 ::: P J Evans ::: (view all by) ::: April 01, 2013, 04:12 PM:

The good news is, H7N9 doesn't seem to be transmissible between humans. Yet.

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