Silent battles
Flu season, and the fight to stay on your feet is well underway. Gazbeya El-Hamamsy offers precautions against the cold
"I've been in bed four days on end with the flu," Ola Hassan, the vice president of Intrag, recounts. "I haven't had such a bad flu for a very long time. One night I had a slight soar throat -- that's how it started -- and within hours an ongoing high fever set in, accompanied by a bad cough. I feel so unwell I can't even walk," she complains. "It's been horrible." Nor is Hassan the only prey to this insidiously virulent virus, alas: the flu has been back in the air for a few weeks now and its symptoms are hitting hard this year -- a peculiarly resilient fever, and a feeling of being terribly, irredeemably unwell.
The flu season, medical experts state, begins in October, continuing all the way through March. Low temperature and rain vitalise the virus, physician Mostapha Orkhan, director of the National Influenza Centre, explains. "In Egypt we have the advantage of sunny weather for most of the year, but as soon as it gets cooler," he points out, "the virus begins to spread." Sherif Albert, general practitioner at the Anglo- American Hospital, adds that sometimes a strain that is more potent than others comes into being. "It's too early in the season to tell, though undoubtedly the flu is highly contagious this year," he warns.
Both physicians explain that, notwithstanding natural ultraviolet radiation, which acts as an effective defense against the flu, Egyptians remain vulnerable to infection due to high levels of pollution, exacerbated further by living in closed spaces. Pollution not only accentuates the symptoms, it makes the virus last longer in the atmosphere -- and in the patients' bodies. Pollution reduces immunity, exacerbating nasal congestion and irritating the mucus membranes. The by now notorious annual "black cloud," a concentration of smog that besets the country in October, contributes to respiratory inflammation and makes people more vulnerable to the flu's complications. "More pollution equals more transmission," Albert elucidates, "and this year, the rate of transmission seems to be quite high."
According to doctors, the fastest way to catch the flu is to be in the vicinity of someone who has it. Avoiding such contact can be difficult in closed office spaces, on buses or the underground and in the classroom. Where there is a lack of ventilation the risk is especially high, and however difficult it is to avoid such day- to-day interactions, it is well to remember that an infection can leave you bedridden for days.
The flu shot is an alternative precaution, to be taken, ideally, before the advent of the season in question; yet it can still be helpful long after the flu has arrived, doctors insist, especially since the vast majority of infections occur from late December to early March. "A vaccine is manufactured each year that protects against the three most potent strains," Orkhan explains, "which provides immunity. The vaccine takes one to two weeks to start acting," he adds, "so the sooner it is taken the better." The procedure consists of a single injection, he says, which reduces susceptibility to the virus by 60 to 90 per cent.
In the US, where four children died of the flu this season, the Health and Human Services Department and other public organisations are urging people to be vaccinated. The vaccine is no guarantee of immunity, however. There remains a chance of contracting the flu even after having the injection, though symptoms tend to be milder then. "It will bolster up the body's immunity against the virus," Dina Mahmoud, a pharmacist, points out, "so people will have at least some protection, which is already far better than being without any immunity at all." According to doctors it is schoolchildren aged three to 10, and older people with lower immunity levels, who need the vaccine the most. The latter may have naturally low immunity, or their immunity may be compromised by lack of activity or the intake of certain kinds of medication.
With a yearly demand of 250,000 injections, Orkhan states, only a tiny portion of the constituency evidently takes the vaccine. According to Mamdouh, who owns a pharmacy in Zamalek, it is most popular among people who suffer from complications of the flu -- out of fear of contracting the virus during that time of year. The vaccine is relatively costly -- LE30 to LE45 per injection -- yet, as the medical establishment points out, ending up bedridden for five days to a week is likely to have a worse effect on finances than the cost of the injection.
Nor should general preventative measures -- a rigorous hygienic discipline and vitamin C, for example -- be taken lightly. This is especially true in the light of the fact that antibiotics will only go so far. Preventing complications like pneumonia, apses and serious allergies, they might also bring the fever down and reduce respiratory irritations. But the virus still has to take its course in the body.
One seemingly far-fetched alternative is homeopathy. "It doesn't prevent the flu as such," Magda Sirry, oculist, practising homeopath and Cairo University professor, admits. "But it does raise a person's energy levels and improve immunity. It works on the whole system, especially the immune system, allowing the body to help itself by itself. It gets rid of the flu in a shorter time, with no side effects to deal with." This way, homeopathy promises a cure tailored to the patient's symptoms rather than the standardised, temporary solutions of modern medicine. "But since people are still not used to the concept of homeopathy," Sirry goes on to say, "flu shots are the next best thing for those with very low levels of immunity. They're better than nothing, though they're not for anyone, all the time. Over time, the artificial chemicals in the vaccine can actually act to weaken rather than fortify the immune system."
"This summer I had the beginnings of a flu," Hassan, for one frequent patient, testifies. "I had the same soar throat and I was feeling generally unwell, so I went and tried a homeopathic remedy. In a single day I was well again, it worked with me. I should have done the same thing this time, but by the time I realised what was happening my flu was already full-blown. I should have spotted it earlier."
