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When other offices lose winter man-hours to a shared flu bug, Dr. Raoult Ratard and his coworkers get busy. As Louisiana State Epidemiologist, Ratard makes it his job to know who's getting sick, where and how. This time of year that means tracking a lot of influenza. Spread person-to-person via droplets of infected fluids (think of that sickly spray from coughing or sneezing), flu viruses are most common in winter months. Ratard explains why that is and what you can do to avoid it.


Q: How's flu season shaping up so far this year?

A: This year looks like it will be an average year. This year it's going well.


Q: How do you know?

A: Not every case of the flu is counted. People are going to stay at home and not go anywhere. Some go to doctors. We do a surveillance program with about 40 different physicians in different areas and several emergency rooms, nursing homes and schools. We see how many people coming in (to surveillance centers) have flu. Because not every case of flu gets a diagnosis, we follow that percentage. This year our percentages are fairly low.


Q: What counts as "fairly low"?

A: Maybe one out of 10 gets the flu—which means about 450,000 in Louisiana. In a serious season, it's about one third of the people.


Q: How is a flu diagnosis at a surveillance center different from a diagnosis made at a regular doctor's office?

A: Those 40 physicians, they collect some samples and we forward them to the CDC (Centers for Disease Control) so they can check on the strains. You are accumulating different strains that are circulating around the world and that is used for the vaccine next year. It's really complicated and it takes a lot of time. This is only for research purposes.


Q: At any given time, how many strains are circulating?

A: There are maybe, circulating throughout the year, five or six major strains in the world. Every so often you have a pandemic. Everybody has to have a plan for what they would do if there was a serious pandemic.


Q: What kinds of plans?

A: There are different aspects. You have to plan for the distribution of a vaccine if you get a pandemic. If it happens, it will take six months to get the vaccine. There are some drugs, antivirals, that can improve the survival. You have to plan for distribution of those. Pandemic flu would affect everything in society.


Q: What would happen if avian flu showed up in this area?

A: For avian flu, there is an entire surveillance system. The local department and U.S. Department of Agriculture are working with the poultry industry. They test to see if the strain of avian flu is coming into Canada or North America. Whenever they see a suspicious strain, they investigate. If we have a human strain in an area with wildlife, there would be a big investigation. For the humans, you would start collecting a lot more samples and laboratory data. We would do an investigation to see who was exposed to that strain. It would be a very big investigation.


Q: When exactly is flu season in Louisiana?

A: No two flu seasons are alike. Some start in October, some start in December. Sometimes they end in February, sometimes May. ... It's never too late to get a vaccine.


Q: How effective is the flu vaccine?

A: The flu vaccine is a very useful vaccine. From year to year you have to change it, minor changes. The vaccine gives you fairly good protection, not 100 percent, but 85 percent or more.


Q: How does it work?

A: The vaccine will look a little bit like the virus, but of course it's harmless. Your body identifies the vaccine in your blood stream and produces antibodies. When you come across the real virus, these antibodies will latch onto the virus and destroy them.


Q: Who should get a flu shot?

A: The elderly, 65 and older. Even 50 and older, it's recommended they take the vaccine. Adults with pulmonary vascular disease. Children who have chronic illness. Adults who have chronic illness. Pregnant women.


Q: Is there anyone who shouldn't get it?

A: If you are allergic to some of the components of the vaccine, but there are very few people who are.


Q: Beyond the vaccine, what else can you do to ward off the flu?

A: Usually if you're going to be sick, it's not a good idea to go to the office coughing and sneezing and getting everybody sick. Washing hands and using hand sanitizers is very important.


Q: Are there other diseases with seasons?

A: There are many, many infectious diseases that have seasons. You have a lot of respiratory diseases in the winter. Enteric diseases — diseases that cause diarrhea — some are more common in the summer.


Q: Why is that?

A: People are going out. They're eating out at picnics. If you're outside at a picnic, fairly often you're not going to take the same precautions.


Q: So if winter is a season for respiratory infections, how do you know when it's not just a cold and it's time to go to the doctor?

A: If you have a high fever or difficulty breathing, you don't want to wait to go to the doctor.

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