When Larry Sharpe and his wife Ronnie went on a family reunion to Maui, they never expected that Larry might not make it home.
The North Delta, B.C., couple, along with their children and five grandchildren, had been looking forward to this past March break in Hawaii, where they had planned two weeks of swimming, surfing, touring and spending quality time together.
But only four days into the trip, Larry, 74, began to feel unwell. What began as a sore back soon became cold-like symptoms, which then turned into debilitating fatigue. Over-the-counter cold medication wasn’t working. After three days of worsening symptoms, Larry’s daughter urged Ronnie to take Larry to the clinic, saying that he looked “terrible.”
Larry remembers stumbling as he entered the clinic, and the physician taking his blood pressure and calling an ambulance immediately. The rest of the day was a blur. His blood pressure was extremely low and doctors later marvelled that he had been able to walk into the clinic on his own.
After a battery of tests, it was confirmed that Larry had influenza along with pneumonia — an extremely serious condition, especially for senior citizens. (Those over 65 accounted for up to 70 per cent of flu-related hospitalizations and up to 91 per cent of flu-related deaths between 2013 and 2018, according to Public Health Agency of Canada).
Larry was admitted to an isolation ward, where to his shock he was asked whether he had his affairs in order and if he wanted to see a chaplain.
His wife, Ronnie, said at that point they began to grasp that Larry was very ill. “I don’t know if people realize just how devastating the flu can be,” she said.
“He was very close to saying goodbye to us.”
Larry did not have a chronic illness such as diabetes or heart disease, but many seniors who get very ill with influenza can have pre-existing conditions that make it much worse.
“Influenza can be devastating especially to those over age 65 and the presence of concurrent illness makes things even worse,” said Dr. Ronald Grossman, a respiratory specialist.
For example, Dr. Grossman says if a senior had chronic obstructive lung disease and developed the flu, it would take “weeks to months to get back to their baseline.”
Larry spent four nights in the isolation room in the hospital, and his wife wasn’t even allowed to see him because she had also developed influenza A.
He recovered enough to leave the hospital by day five — albeit with a lowered blood oxygen level that he says still hasn’t completely resolved in the months since. The couple found a flight back to Vancouver, but Larry needed a wheelchair and a cane to get through the airport.
“His balance was off. He looked like he had aged about 20 years,” said Ronnie. Loss of mobility can happen to seniors who have influenza, along with numerous other possible complications, according to Dr. Grossman.
“Flu is among the leading causes of catastrophic disability and dramatic losses of activities of daily living in the elderly,” said Dr. Grossman.
There are many other potential respiratory complications of influenza, he added, including:
- influenza pneumonia
- bacterial pneumonia
- fungal infection
- cryptogenic organizing pneumonia (a form of lung injury)
- exacerbations of COPD and asthma
- exacerbation of cystic fibrosis
And seniors in nursing homes can have an even tougher time recovering, said Dr. Grossman.
“Assuming they survive the acute illness, there is increasing data to suggest an increased risk of cardiovascular events in the weeks to months following the acute illness.”
The road to recovery has been very long, said Ronnie. Larry was off work for two months and has just recently returned full time. Although some seniors who experience devastating effects from influenza already have pre-existing illnesses, the Sharpes were perfectly healthy before getting the flu (being avid cyclists, they had just done a Netherlands bike tour the year before and spend time walking, camping and travelling), and they have always ensured they ate a well-balanced diet. In fact, says Ronnie, they don’t think they had ever had the flu before.
It took the couple about four months to get back on track physically, mostly by resting and taking in fluids. The Sharpes have just recently started biking again.
As well, the Sharpes didn’t believe they were at risk — because they had been getting the standard flu shot for 15 years. Although it’s recommended that seniors 65 and over get the influenza vaccine, along with those in nursing homes and nursing home staff, there is evidence to show that the high-dose vaccine is 24 per cent more effective in protecting seniors from seasonal influenza compared with the standard dose vaccine.
“There is good evidence to suggest that, in the elderly, the high-dose influenza vaccine is preferred over the standard-dose vaccine,” says Dr. Grossman. “As individuals age, their immune system weakens, a process known as immunosenescence. The elderly have a less vigorous immune response to the standard influenza vaccine but respond better to the high-dose variant.”
The high-dose vaccine has been available in Canada since 2018. In some provinces, such as Ontario, the cost of the high-dose vaccine is covered. If possible, those over 65 should urge their health care provider to offer it, says Dr. Grossman, because of its improved efficacy.
The Sharpes, meanwhile, are now training for a 52-kilometre bike ride and are doing much better.
But the effects of what happened linger in their minds.
If you are over 65, getting the seasonal flu can change your life forever. To find out whether the high-dose vaccine is covered in your province, visit fluzone.ca.
Vaccination does not provide 100% protection and does not treat influenza and / or its complications.