If you don't want to get the flu, go to Mars

EACH year millions around the world are made miserable, thousands are flattened", and some people even die from it. But there is no known cause or cure for influenza.

It has been sweeping Ireland for almost two months. It is bad, but it could be a lot worse, that's the word from doctors about the current bout. Despite the seemingly huge numbers who have been "flattened" by this bug, doctors say it is not of epidemic proportions. Looking back at the history of flu they point to the 1918 epidemic, which killed more people than the first World War.

In a real epidemic entire households fall victim, workplaces are forced to close or operate on a skeleton staff, and mortality rates rise.

This particular strain of flu is similar to those which have been around for some time, meaning many of us have built up some immunity, and the flu vaccine given is the correct strain protecting the elderly and others who are susceptible to the virus.

"From the beginning I knew that it was not going to be an epidemic," said a spokesman from the Virus Reference Laboratory in UCD. "The strain is too similar to last year."

While a number of people are walking around with coughs, sniffles and sneezing they are not suffering from the "real" flu. "The real thing comes on very suddenly with an abrupt onset of headache, fever, muscle pain, chills and simply feeling flattened. Usually it is so severe people have no choice but to go to bed," said Dr Michael Coughlan, chairman of the Irish College of General Practitioners.

In most cases the influenza virus begins in the Far Fast, which is why the different kinds of flu have names such as Shandong, Singapore and Beijing. It crosses to the Northern Hemisphere and on to Europe and North America. "It moves very quickly, like a tidal wave, usually in a fairly regular pattern," said Dr Howard Johnson, a specialist in public health medicine with the Eastern Health Board. It also, tends to move with the seasons.

It said it is not known why it originates in the Far East. "We think it may be to do with close, dense populations, different wildlife, other variants. It comes out of there and spreads. Despite all the modern technology it has never really been understood."

INTERESTINGLY, according to Dr Johnson, even in the days before air travel a familiar flu virus would appear simultaneously in Europe and the US.

Dr Johnson operates a "bugwatch" surveillance system. A number of EHB family doctors send in samples from people who have flu symptoms and these are analysed. "It means we can confirm the exact cause of the outbreak. We know that there is influenza in Dublin for the past month. This is important because previously when we had flu like outbreaks we did not know what we were specifically dealing with or how it should be treated."

The illnesses caused by influenza viruses generally peaks between late December and early March. Epidemics of flu are caused by influenza type A and type B. They usually last four to eight weeks in a community.

Irish GPs began seeing people suffering from flu in November. They had an exceedingly busy Christmas and New Year period. "It's hitting people that I usually never see including a lot of young fit and active people," said Dublin doctor Michael Doyle, who has a practice on the South Circular Road. It is devastating and can knock people out for about 10 days.

A west Cork GP, Matt Murphy, said the current virus is hitting people of all shapes and sizes. But it is not an epidemic. It is hitting one and two in a house but not entire families, as you would have had in the past. Those that do get it have to go to bed and stay there. Those who had the jab appear to be escaping," said Dr Murphy.

Ireland is not the only country hit by the current bout. This week influenza activity reached a peak in the Czech Republic, southern France and Britain. In a number of other European countries it increased during December, according to reports from national influenza centres to the World Health Organisation.

In Britain an outbreak occurred in a boarding school in the south in October, affecting about 200 of the 500 pupils. In Germany employers were distributing vitamin pills to staff in an attempt to halt the spread of a particularly severe flu.

AS in Ireland, influenza A continues to predominate; it has been the most common type diagnosed in Canada. Poland. Switzerland and parts of France.

Since the start of October last year cases of influenza A and/or B have been reported all over the world including Africa, the US, Canada, Chile, Iran, Israel, Belgium, Australia, New Zealand, Finland, Romania, Spain, Sweden and Switzerland.

It is spread from person to person by direct contact, through the air and by particles recently contaminated with secretions from the nose and throat of an infected person. People with the flu are contagious for the 24 hours before they become sick, and until their symptoms begin to resolve. The incubation period (time from exposure until symptoms of the illness begin is one to three days.

Typical flu illness is characterised by sudden onset of fever, often associated with chills, muscle aches, sore throat and a dry cough. In some cases complications such as bronchitis and pneumonia may occur.

At least three flu type viruses, as well as the actual influenza A are now circulating. Since the end of November the Virus Reference Laboratory has tested almost 150 samples of either throat washings or blood for either a virus or significant antibodies. Influenza A was diagnosed in 52 patients. Last year only a few cases were diagnosed.

The other viruses identified were the respiratory syncytial virus, which is an annual visitor and mainly strikes children, mycoplasmal pneumonia, which is always with us, the adeno virus and para influenza. All of these produce symptoms which people associate with flu. But there is as vet no vaccine for them and because they are viruses, antibiotics are useless.

The spokesman pointed out that while the laboratory has diagnosed that 52 people have influenza A. double that number tested positive for respiratory syncytial virus, which causes serious illness. "Almost all of those would have been children who would have been hospitalised. They would generally be under one year of age and be acutely ill. The interesting thing is that we saw this much earlier than usual this year."

But the spokesman for the Virus Reference Laboratory said that because doctors only test a portion of their patients, the 52 cases are simply the "tip of the iceberg".

Getting the flu shot each year before the season begins is the most effective way to reduce the impact and the incidence of the illness. A percentage of people who receive it may still develop flu but the effects may be milder and victims may be protected from developing pneumonia and other complications.

Current influenza vaccines are produced in chicken embryos.

Influenza vaccine should be given in October and yearly immunisation is recommended.

The Department of Health strongly recommends that only those who fall into the at risk categories be immunised. The jab is free for those with a medical card but costs about £30 privately.

According to medical experts, if you have not had the jab, there is nothing you can do to avoid the flu. "You could hide away at home but it could still get you," said Dr Howard Johnson. "Apart from a flight to Mars there is nothing really you can do."