I often hear both health professionals and the general public saying “why bother having the flu jab?” Let’s face it the most recent pandemic back in 2009 (H1N1) was a bit of a damp squib compared to the 21 million who died in the legendary 1918 flu pandemic. Flu or Influenza virus just doesn’t seem to be as severe nowadays, who’s heard of anyone staying in bed for 2 weeks anymore? Really...nobody should fear getting flu...should they?!? Well...1 in 1000 cases of Influenza ends in death. That’s quite high, isn’t it? Still putting off that flu jab, should you prescribe Zanamivir or Oseltamivir/Tamiflu to your patients and would you recognise the complications that lead to that high mortality rate? Flu isn’t just the cough, fever and aches.
It’s Saturday morning and a patient is admitted with a fever, shortness of breath and a cough. Not an uncommon scenario in the middle of the winter in the UK but in this case the patient also has a history of infection with the Human Immunodeficiency Virus (HIV). The clinical team could find no past results for the patient on the hospital computer system and there were no past medical notes. The team started treatment for severe community acquired pneumonia with IV Amoxicillin and Clarithromycin, then added in Septrin for possible Pneumocystis pneumonia (PCP). They called the oncall Microbiologist as they were considering starting quadruple therapy for tuberculosis and Ganciclovir for cytomegalovirus. “Crikey what a mess!” said the Microbiologist “...do you really want your patient on eight different antimicrobials!?!”
Okay I sound a bit like a two-year old (and probably sometimes behave like one as well!) but the question “why?” is often a much more important question than “what?” in microbiology and medicine. Let me explain…
It’s a normal Wednesday afternoon in clinic when a young woman enters looking extremely anxious. She says she came back from her holidays in Rio de Janeiro 2 weeks ago, is 16 weeks pregnant and covered in mosquito bites. She was watching the news last night and is worried she might have Zika virus. What would you do? What would you tell her?
Anyone watching the news at the moment would think that Zika virus has just been discovered and is about to cause widespread panic in the way that Ebola did in 2014. However Zika virus is not new, it was first discovered in the Zika forest in Uganda in 1947; apparently Zika means “overgrown” in the local Luganda language. However the Spice Girls seem to coin the term in “Wannabe”...I can’t get that tune out of my head since every sound-bite is on Zika virus!