THE VIRGINIAN-PILOT
Copyright (c) 1996, Landmark Communications, Inc.
DATE: Tuesday, October 29, 1996 TAG: 9610290277
SECTION: LOCAL PAGE: B1 EDITION: NORTH CAROLINA
SOURCE: BY DEBRA GORDON, STAFF WRITER
LENGTH: 85 lines
Ninety-year-old John J. Buchanan knows no one gets out of this world alive. But when he goes, he's determined that it won't be from the flu.
So last week, the Norfolk man rolled up his sleeve for his annual influenza vaccine.
It's an exercise public health officials wish more elderly people would follow.
Not because older adults are more likely to get the flu. In fact, the elderly are less likely to get the flu because they have built up a lifetime of immunity to most strains of the virus.
But if older adults do get the flu, they may wind up in the hospital. Those 65 and older make up 90 percent of the 20,000 deaths nationally each year resulting from influenza.
``If they're infected, an older adult has a very hard time clearing the virus,'' said Dr. Douglas C. Powers, a geriatrician at Eastern Virginia Medical School's Glennan Center for Geriatrics. That means a bout with the flu often becomes serious in the elderly, turning into pneumonia or other severe respiratory infections.
Powers researches influenza in the elderly, with particular attention to the effect of vaccines.
In Virginia, 13,000 elderly were admitted to hospitals with flu or flu-related illnesses like pneumonia in 1994, the latest year for which figures are available. About 1,500 of them died - 90 percent of the 1,740 deaths from flu that year.
Yet less than half of those 65 and older in Virginia get vaccinated, according to Medicare figures. The figures are even worse for African Americans - only 26 percent of blacks 65 and older got their vaccine last year.
The reason is two-fold, said Dr. Sallie Cook, medical director for the Virginia Health Quality Center, which works with health providers to improve the care that Medicare patients receive. One is awareness of the need for the vaccine; the other is accessiblity to places where the vaccine is available.
Vaccines are free to Medicare beneficiaries, and local health departments also offer free vaccines. Although flu season doesn't usually hit Virginia until December or later, residents should get vaccinated now.
Predicting the severity of this year's flu season is a bit like predicting next month's weather, although some experts are cautiously warning that this year's flu strain could be more severe than in past years.
In Hawaii, more than 100 cases of influenza have already been reported, most of which is Type A-Wuhan. This flu, named after the Chinese city where it was discovered, typically has a higher mortality rate than other strains of flu expected this year, and could kill up to 40,000 people in the United States.
In the coming years, older people in Hampton Roads will be able to help test new types of vaccines as part of the research Powers and other researchers at the Glennan Center are bringing to the area.
Most research on flu vaccines focuses on their ability to stimulate the production of antibodies, proteins in the blood created when a person is exposed to a virus, which provides immunity against future exposure to that virus.
But Powers studies vaccines from another angle: the way they work at the cellular level to help older people quickly get rid of the virus.
At his former job at St. Louis University School of Medicine, Powers ran several clinical trials to test new vaccines.
One was made by by cloning the genes of the virus, using recombinant DNA techniques. Typically, vaccines are made by growing flu viruses in eggs, then killing them.
That's why people with egg allergies shouldn't have the vaccine.
But the new type of vaccine gets around that problem, Powers said, and also is shown to produce less pain at the injection site. This vaccine also can be made in about half the time as the egg vaccine - enabling drug companies to develop vaccines closer to flu season, thus more accurately pinpointing the flu strain expected.
Recently, researchers have touted the benefits of a children's nasal-spray vaccine that uses live forms of the virus.
Such a vaccine is not as effective in older people, Powers said, unless given in combination with the shot. ILLUSTRATION: FREE VACCINATIONS
The Pasquotank County Senior Center and the Pasquotank County Health
Department will hold a clinic to provide influenza and pneumonia
vaccinations for older residents Sunday from noon to 6 p.m. at
Albemarle Hospital.
Arrangements have been made with Medicare officials so there will be
no out-of-pocket costs to adults 65 or older. For more information,
call 338-4400. by CNB