(Our Time editor interviews Dr. Edwin M. Fortuno, MD, President of the Philippine College of Geriatric Medicine, a component society of the Philippine College of Physicians and a specialty society of the Philippine Academy of Family Physicians)
What should senior citizens need to know about the flu, including symptoms?
Dr. Edwin M. Fortuno: Senior citizens are defined as Filipinos who are 60 years old or more and this is mandated by our country’s senior citizens’ law. Flu is one of the diseases that without doubt causes a lot of problems to the senior citizens. This disease can lead to grave disability or even cause them to die.
The condition frequently starts off as fever that may be as high as 38 degree-Centigrade and muscle aches. Joint pains are felt by the patient. Anorexia or a lack of appetite is a symptom that may not be as common to the general adult population but may be seen more often among elderly patients. Other symptoms would be sore throat, nasal congestion, headache, dry and persistent cough.
By and large, the patient can mistake it for a cold or rhinitis. However, the course of influenza is more sudden and the patient will feel much worse to the point of being too weak to ambulate and perform daily activities.
How serious is the flu to the elderly, and what are the complications?
Dr. Fortuno: Flu is graver to the elderly patient because this may not be the only disease the elderly is stricken with. The disease may complicate long standing pulmonary disorders such as COPD and asthma or may even lead to myocardial infarction to those who already have heart disease.
The anorexia that the elderly oftentimes experiences can cause their immune status to precipitously decline because of the nutritional deficiency due to the anorexia.
Can you give some prevention tips/advice?
Dr. Fortuno: Simple handwashing, cessation of smoking and alcohol intake are the easiest steps toward a healthy lifestyle. This also includes having regular exercise and consuming a well-balanced diet. Regular exercise for the elderly means engaging in an exercise program, such as walking, biking or swimming for 30 minutes or more, three to five times a week.
Must all elderly citizens have the flu vaccine?
Dr. Fortuno: Influenza vaccination in our country does not have to start at the age of 60. It is highly recommended that persons age 50 or more be given the vaccine.
When should senior citizens get the flu vaccine?
Dr. Fortuno: Vaccination has to be done annually since the virus changes its morphology every year. Physicians should inform their patients by the month of April because this marks the start of the flu season in our tropical country. Patient should also be reminded that the influenza vaccination has to be done annually.
Some senior citizens don’t want to get flu vaccinations fearing side effects. Are there vaccine side effects?
Dr. Fortuno: Education on the part of the physician is very important since it is the doctor’s responsibility to convey correct information to the patient.
The foremost side effect that may be felt by the patient would be hypersensitivity to the vaccine. Other than that, there are no known major contraindications. Minor occurrences may be pain at the injection site, redness and fever albeit unusual.
On top of vaccination, are there other ways to protect the elderly against the flu?
Dr. Fortuno: Vaccination is still the best form of prevention. Other ways are building up the elderly patient’s immune status through proper nutrition and maintaining an acceptable body weight.
If senior citizens have the flu, are they contagious? If so, how long are they contagious?
Dr. Fortuno: Flu is spread through the respiratory route and is highly contagious. A family member in one household has the potential to spread the disease easily. The persons in the family who are highly vulnerable would be those who have the weakest immune mechanisms, namely the very young and the very old.
The patient is no longer contagious once the fever and the other symptoms initially felt by the patient disappear with a noticeable improvement in his well-being.
Is the flu a serious problem among senior citizens in the country?
Dr. Fortuno: Yes, it absolutely is. Aside from the lost productivity hours, this can also be a cause of mortality to the elderly patient who has had other diseases prior to the start of the illness. Moribund elderly patients are most at risk of dying from influenza.
What advice can you give to our senior citizens to protect themselves not only from flu but also from other diseases?
Dr. Fortuno: There are three preventable diseases that commonly have dire consequences among the elderly population. These are flu, invasive pneumococcal disease (IPD) and tetanus. Fortunately, there are already vaccines that have been developed to avert these diseases. It should be emphasized, however, that vaccination will not ensure full protection from the disease. Vaccines are capable of shortening the hospital stays of the sick elderly patient or prevent the patient from dying from the disease or through its complications.