Page 50 - Spring2013

Ask the Doctor

PREVENTING AND TREATING THE FLU
By Thomas S. Cowan, MD

Question: There is so much pressure on us to caused by the virus but by the body's response
get a flu vaccination. Is this wise, or are there to the virus.
better ways of preventing and treating the flu? In contrast, the humoral or Th2 immune
system targets extracellular (i.e., outside the
Answer: True influenza is an infectious disease, cell) infecting agents (such as worms) or foreign
transmitted through the air in infected secre- proteins and produces antibodies that call for a
tions (i.e., mucus), caused by an RNA virus in killing response before the offending agent gets
the Orthomyxovirus class of viruses. There are into our cells and makes us sick.
three subtypes of viruses in this class, called A, There are several important points to note
B and C with the subtype A associated with the here. First, with every naturally occurring infec-
most severe symptoms in humans. The global in- tion both immune systems respond, first the cell-
fluenza pandemic of 1918, which killed millions mediated to clear the virus, then the antibody or
of people all over the world, but especially in humoral system to make antibodies to remember
Europe, was supposedly a type A influenza virus. what happened so our cells don’t get infected with
There have been lesser outbreaks of other type A the same pathogen more than once. Second, the
viruses occurring from time to time since then. severity of any particular illness is a function of
It is important to note that not all cases of how many cells are infected and the strength of
sickness in the winter are the “flu” type, and our cell-mediated response. Finally, whether we
it is virtually impossible for a doctor to tell an get repeated sickness is related to whether we can
individual patient whether he is suffering from make an effective antibody response.
illness caused by the true influenza virus or some The influenza virus, being an RNA virus,
other variation of the common cold. Typically the can only replicate inside other mammalian cells;
distinguishing features of true influenza versus this is why it causes illness. If we haven’t encoun-
the usual cold are higher fever, body aches, sore tered a particular strain before it gets into our
throat and the tendency to get pneumonia. While cells and replicates, the cell-mediated response
these may occur in the common cold they are comes into play and leads to sickness.
more severe in classic influenza. The cell-mediated response usually lasts a
It is important in understanding influenza week to ten days; then the virus is cleared, we
to go over some basic principles of infectious make antibodies and are immune for life. This
Whether we disease and how our immune system functions. is what happens in the vast majority of cases.

get repeated We have two immune systems, the cell-mediated In the process of the cell-mediated response, a
kind of cellular house-cleaning takes place, in
or Th1 (thymus derived) immune system is re-
sickness is sponsible for eliminating intracellular (meaning which a lot of weakened and otherwise diseased
related to inside the cell) organisms. It primarily works cells are cleared from our tissue. This is why we
say after the flu that “we are better.” In fact, the
through the production of white blood cells that
whether we essentially digest and then excrete cells (for cell-mediated exercise is largely responsible for
can make example, in our throat or bronchial tubes) that immunity to cancer, auto-immune disease and
other chronic conditions. In other words, the
have been infected with a virus or bacteria. The
an effective consequences of a cell mediated response, that is, dictum “give me a fever [that is, the cell-mediated
antibody the digestion and excretion of dead and infected response] and I can cure any disease” speaks to
the power and efficacy of the cell-mediated im-
response. cells, are what we call sickness. In other words, mune system.
fever, rash, cough, mucus and so forth are not
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