By Judie Donaldson

A couple of readers told me once that they enjoyed my writing. . .when I was humorous. I appreciate that, but darn. That doesn’t happen very often, and it certainly isn’t the case today. Today, I’m talking about illness, about ­­­older adults and the flu.
I know. You’ve heard that this year’s flu season is worse than usual. It got started early and it’s been more severe. Add to this, it’s been dominated by a flu strain called H3N2 that is described as the “problem child of seasonal flu.” It’s a renegade. The vaccine that most of us received provides only minimal immunity to H3N2. This means, of course, that many who were inoculated against the flu came down with it.  But, I want to focus on something else­––why the flu is often missed in older adults, and why this can result in a far more serious illness.
We all undoubtedly know that women and men 65 and older are among those who are at a higher risk of falling very ill, and have the highest death rates, from the flu. It seems unimaginable, then, that influenza could be undiagnosed. But, it happens, and it occurs for two reasons. First, older adults and their families don’t identify the condition as the flu and, second, health professionals, believe it or not, don’t always conduct an influenza test.
A primary reason for this is that older adults don’t develop typical influenza symptoms, and the outcome is that their treatment is delayed, or not prescribed at all. This is problematic because anti-influenza drugs are most likely to work when they are given within 48 hours of a person falling ill from influenza, with earlier being better. In particular, it’s critical that older adults who have chronic illnesses (especially those affecting the heart or lungs) are treated with an anti-influenza drug as early as possible. It’s this lack of early treatment that can lead to a serious escalation of the illness.
So, how can flu systems of older adults be recognized? How do they differ from those of a younger population? First, the Center for Disease Control identifies the following symptoms for the general population: fever, meaning a temperature of 100°F (37.8°C) or greater; cough and/or sore throat; and no other known cause for the symptoms. At times, individuals can also suffer from nasal congestion and body aches.
Now for older adults. Let me first clarify that some older adults do develop the typical flu symptoms (described in the previous paragraph). But it’s also common for them to have the flu and not have a fever, cough or sore throat. Instead, older adults with the flu more commonly exhibit: weakness, dizziness, loss of appetite, confusion or worse-than-usual mental function (possibly delirium), and malaise (feeling “blah” or unwell).
In addition, older adults with chronic heart or lung conditions typically experience a worsening of their condition. Their symptoms can include: increased shortness of breath, wheezing and/or increased sputum production, an episode of worsening heart failure (which often means shortness of breath and/or increased leg swelling), and/or worsening of asthma symptoms.
So, what can we do? Leslie Kernisan, MD, a geriatrician in San Francisco, recommends being quick to suspect that an older adult who is sick may have the flu, even though he or she doesn’t exhibit the typical symptoms. In fact, feeling weak or confused, for example, could be the only symptoms present at all. Contact the appropriate medical provider immediately, request an evaluation, be proactive in asking for influenza testing and, if appropriate, an anti-influenza drug. By acting quickly, we can make a difference for ourselves and for our friends and family members.
Carquinez Village is based on the concept of neighbors helping neighbors and of a caring community where no one is isolated or alone. Without being intrusive, let’s all stay attuned to our neighbors. And Carquinez Village members, if you know of other Village members who are ill, please call us at 707-297-2472.  We’d like to know and, if possible, provide some support.
I know that reading about the flu is hardly fun or inspiring. I’d much rather write those kinds of columns. But, I think that this information is important for all of us. Next time I’ll try for inspiring. Humor is more of a challenge, but I’ll work on it.

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