Flu Vaccine Shortage May Result in Higher Incidence of Bacterial Infections, Expert Says

PITTSBURGH  - Sinusitis and bronchitis take a significant toll on a persons ability to participate in everyday life and have a sizable economic impact, accounting for more than 30 million missed workdays each year, according to survey results released by Berrylin J. Ferguson, MD, FACS, FAAOA, associate professor of otolaryngology at the University of Pittsburgh School of Medicine. Both of these bacterial infections occur most frequently during the cold and flu season -- November through January.

In a random survey of 606 self-identified recurrent chronic sinusitis or bronchitis sufferers, roughly one quarter (24.9 percent) reported missing three or more days of work and another 23 percent missed one to two days of work. Sinusitis and bronchitis sufferers were more likely to miss leisure activities (58 percent) than work as a result of their illness. Parents reported missing additional time from work to stay home with children who developed sinusitis or bronchitis. About 21 percent of parents missed one to two days of work to care for their children and an additional 20 percent missed three or more days.

This cold and flu season, we should be particularly vigilant of our health as the flu vaccine is in short supply, said Ferguson. Increased prevalence of influenza may translate into an increase in bacterial infections, including sinusitis and bronchitis.

Ferguson said a person should see a doctor if he or she experiences symptoms of bacterial sinusitis, such as nasal congestion or yellow nasal discharge, with facial pain or pressure that worsen after four days or persist beyond seven days. Symptoms experienced for fewer days are more likely due to a viral illness such as a cold. Bronchitis symptoms to be aware of include shortness of breath, chest pain and chronic cough accompanied by phlegm or mucus 24 to 48 hours following the cough. A persistent phlegm-producing cough that lasts more than three months may be chronic bronchitis.

While viruses and colds usually run their course, bacterial infections, such as sinusitis and bronchitis, may require treatment with an antibiotic in order to get better. Appropriate use of antibiotics may also help people get better faster.

According to the survey, 69 percent of sinusitis and bronchitis sufferers said they felt better more quickly when they took antibiotics versus over-the-counter medicines, with 53 percent experiencing improvement one to two days more quickly with an antibiotic.

Sinusitis and bronchitis may be caused by viruses or bacteria, with indistinguishable symptoms regardless of the cause. Bacteria usually cause more severe symptoms that persist for a longer period of time, and often follow a viral illness. Survey respondents associated the following symptoms most frequently with sinusitis: nasal congestion (61 percent), headache (53 percent), facial pressure and pain (37 percent), and sore throat (22 percent). Just 21 percent reported discolored or thickened mucus as a symptom they associate with sinusitis.

While 85 percent of survey respondents said they had been afflicted with a sinus infection in the past 12 months, this survey suggests people may not be as familiar with the primary symptoms of sinusitis. While the other symptoms in combination may signal sinusitis, yellow or discolored drainage is the most specific sign of a sinus infection, said Ferguson.

In bronchitis, bacteria attack the lining of the bronchial tubes, which carry air to the lungs, causing swelling and mucus. The symptoms respondents most frequently associated with bronchitis included coughing and coughing up phlegm with chest pain (60 percent) and shortness of breath (37 percent). Bronchitis may accompany or follow influenza.

The random survey of 606 sinusitis and bronchitis sufferers was conducted in September and October 2004. The study was supported by an unrestricted educational grant from Abbott.

Source: University of Pittsburgh Medical Center