Ebola and RA: Should You Worry?

Well, sure.

Both are unpleasant, both can make you feel awful, and both are potentially deadly. But rheumatoid arthritis is a chronic autoimmune disease and Ebola is a virus, a relative of the bug that causes the common cold.

But how about this: if you have rheumatoid arthritis, should you be more

Ebola virus

The Ebola Virus

concerned about catching the Ebola virus? Are you more susceptible to it? Should you be scared?

No, maybe, and no.

Unless you’re a health care provider working directly with an Ebola patient, or you’ve recently visited the African countries Liberia, Sierra Leone, Guinea, or you’ve come into direct contact with the bodily fluids of an Ebola patient, your chances of actually catching Ebola are about the same as your chances of traveling to the moon tomorrow morning. You shouldn’t be in the least concerned, not even if you’re taking disease modifying anti-rheumatic drugs (DMARDs) that suppress the immune system. They might make it harder for your body to fight the virus off if you’re exposed, but (see above) you probably won’t be.

Want to know what you should be scared of? The flu.

That’s right. Influenza. It’s also a virus, just like the common cold (rhinovirus) and Ebola. Unlike Ebola, though, the flu virus is everywhere. It’s all over the world, and it’s seasonal—it thrives and passes easily from person to person in cool and cold weather. In the Western Hemisphere, autumn is well underway—and flu season has arrived. It’ll be with us until spring.

Between April and October of this year, Ebola killed 4,555 people, the vast majority of them living in the three African countries mentioned above.

The Flu Virus

The Flu Virus

In the last 10 years, the flu killed an average of 32,743 people each year in the U.S. alone. Some years more people died, some less. It depends on several factors: which flu strain is dominant (some are more deadly than others), the weather, the efficacy of the flu vaccine in any given year, and whether people actually take the vaccine.

And that’s the thing. There is no vaccine (yet) for Ebola. But there is for influenza. Every year, medical science makes an informed, educated guess about which strains of flu will dominate in the coming year and develop a vaccine against it. And every fall, the vaccine is available to anyone who wants to get it.

To clear up a silly myth: You can’t get the flu from the flu vaccine. Although the virus in the vaccine is dead, it still stimulates your body to create antibodies to attack the live virus, should you contract it. Those antibodies will seek it out and destroy the bug, and you won’t get sick. Some people might get some flu-like symptoms after receiving the vaccine, but they’ll be mild and will go away within a day or two. Others might develop redness, tenderness, or swelling at the vaccine site, but that will go away within a couple of days, too.

Another myth: getting the flu shot will make your RA flare. Um, no. It won’t. There are a million different reasons your RA might flare up—stress, weather changes, fatigue, you’re wearing blue today—but getting a flu shot isn’t one of them.

Once you’ve taken the vaccine, your body needs about two weeks to build up a strong immunity to the flu strains the vaccine fights. During that time you can still catch the flu. And you can still catch any other strains of flu that aren’t in the vaccine at any time during the season.

If you have rheumatoid arthritis, should you get a flu shot?

Oh, absolutely. RA affects the immune system, making it harder for you to fight off any type of infection, including from the flu. And if you take chemical or especially biologic DMARDs—disease modifying anti-rheumatic drugs—to control the progression of your RA and its symptoms, your immune system is

The Flu Shot

The Flu Shot

even further compromised. You’re more susceptible to the flu, may get a more severe case of it, and may be more susceptible to further complications, such as pneumonia.

If you have RA or other forms of inflammatory arthritis, getting the flu vaccine is one of the smartest things you can do every year.

The Centers for Disease Control and Prevention recommends that everyone 6 months old and older get the seasonal flu vaccine that’s injected into the muscle of the upper arm.

The flu vaccine is also available as a nasal mist. People with RA or other types of inflammatory arthritis should not take the vaccine in this form.

Getting the flu shot doesn’t mean you can’t pass the flu on to others. Flu is transmitted by person-to-person contact. If you touch something that someone who’s contagious with the flu has touched, you can easily pick up the virus and pass it on to someone else. Avoid this by:

  • Washing your hands frequently with soap and water. If they’re not available, use an alcohol-based hand-rub.
  • Avoid contact with people who have the flu if you can.

Flu symptoms include:

  • Fever/Chills
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Body aches
  • Headache
  • Fatigue

If you feel like you might have the flu, contact your doctor immediately. He or she will decide if you need to take an antiviral medication or stop taking your RA medication.

The fear-mongering media has whipped up a fear-and-loathing frenzy over Ebola, a deadly virus that has almost no chance of becoming epidemic in the U.S. or any other developed nations. We really have nothing to fear from it.

The flu, on the other hand, can and will kill tens of thousands of Americans this year—but somehow, that’s not as exciting or sexy as Ebola, so it doesn’t get much mention. Thank goodness we can protect ourselves from the flu with a vaccine.

Maybe someday they’ll have one for Ebola, too, so that no one—anywhere in the world—can suffer terrible illness and death from it ever again.


9 thoughts on “Ebola and RA: Should You Worry?

  1. You know last year at this time I would have said yes and yes and yes to all of this. All this splendid information about the flu and the vaccine. I still do. I would carry a poster around town urging people to get the vaccine. I still would. I mean: DO GET THE FLU VACCINE!
    But last year, three days after the vaccine, I got ill and it was a flare (I don’t have RA, I have Wegener’s aka Autoimmune vasculitis) and when my doctors saw me, they all tuttutted and said, um, yes, there is that slight possibility.
    So my verdict is that for the next two years, I must not get it but stay home when people at my work place are poorly or someone is out sick with actual flu. After two years, I can and should and will try again because the vaccine is different each year, based on the virus structure of the previous year.
    Also, there is an option to get the vaccine not in a shot but via a nasal spray. This is only available for infants here right now, but should be ready for adults eventually and that is apparently a much safer way to prevent that icky teensy tiny minute risk to people with autoimmune disorders.


    • Guten Tag, Sabine!
      It’s so good to hear from you! That said, I can absolutely understand why you can’t get the flu vaccine for a couple of years–having that bad flare when you did may just have been a coincidence, but it’s always better to err on the side of caution.
      Speaking of caution: be very wary of getting the nasal mist vaccine. It contains the live virus, which can be dangerous to those of us with compromised immune systems. The shingles vaccine is another to stay away from, for the same reason. In the meantime, my fingers are crossed that you’ll be able to avoid the flu while you wait. That’s got to be frightening and frustrating.
      Wishing you the best, as always. I love reading your blog–your writing is gorgeous. 🙂


      • Thanks for this info. I have been told to wait for 1-2 years with the nasal vaccine as apparently a version not based on the live virus is being developed.
        I would also urge people with autoimmune diseases to get the pneumococcal vaccine. It is safe and lasts for six years. In fact it is protocol here for patients on immune suppressing drugs.


    • Thanks, Nan. I’ve also gotten a flu shot almost every year since forever. I’ve never once felt ill after taking it or had any sort of reaction. I haven’t gotten mine yet, but I plan to next week when I see my primary care doctor. My rheumatologist says I should also get the pneumonia shot again, and the vaccine against whooping cough, now I’m taking Humira. Sigh… pincushion time! 😉


  2. Great post, Wren. My hubby and I both got the flu one year, and both of us ended up with pneumonia. That’s the year I got RA. Now we do flu shots, but I sure wish I’d known long ago how serious flu can be. I got my flu shot in September, but still haven’t gotten my husband in for his this year. It’s always a challenge to get him in for the shot before someone in his workplace gives everyone the flu.

    Sabine: the nasal spray is a live virus. If you’re on DMARDS, you shouldn’t do the nasal spray and neither should anyone who lives with you.


    • Socks! Hi!
      Thanks for the kind words. I didn’t realize that the flu killed so many people each year, either. I always thought of it simply as being a miserable experience, a sudden, brief illness that could force you to stay home from work and use up all your sick days for the year all at once–which was all the reason I needed to get the vaccine every season. Staying home wouldn’t even be fun!
      Thanks for adding a warning about the nasal vaccine. For people who are phobic about needles, it will be a godsend, but those of us with compromised immune systems need to be very, very careful.


  3. Hi Wren: As you know, I live in Ebola central — Dallas. The hospital in question is my “home hospital” and if my husband’s recent health scare had been a few days later, we would have been in the emergency room at the same time as Patient Zero. At any rate, great post on the flu vaccine. A couple of other points. First, there is now a “super” vaccine recommended for people 65+. And second, I was proud of myself for getting my flu shot early (in September) when they first came available. Then I learned that the shot wears off and, if you take it too early, you may not be fully protected in the high flu season of late January and February. For those of us on drugs that suppress our immune systems, I think it’s especially important to get all the protection we can get! Thanks for the timely and compelling reminder!


    • Hi, Carla!
      I’m very glad that you and your husband weren’t in that ER while poor Mr. Duncan was. I haven’t heard if the hospital has tried to contact those who were in there at the same time as him or not, but I hope they have. Truly a frightening thought.
      So I guess in your case, your chances are a teensy bit higher for getting the Ebola virus–maybe in the neighborhood of your chances of fielding a huge reward from that Nigerian prince for giving him a little financial help so he can access his riches. You know, the prince who emails everyone now and then… 😉
      I hope the new biologic is starting to work for you, Carla. You’ve been through the wringer with your RA this year! Be well, friend.


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