While senior citizens and children younger than five are at greatest risk, anybody can get the flu. Symptom severity is what differentiates the flu from the common cold. Both can cause a sore throat and runny nose, but the flu puts you to bed with a fever, chills, muscle aches, and even “the shakes.”
In this podcast, Alexander Evens, a Doctor of Osteopathic Medicine and an infectious disease specialist at MarinHealth Medical Center, offers tips on how to protect your self and your loved ones during flu season. He also debunks some misconceptions about the flu shot and offers recommendations to hasten your recovery if you do get the flu.
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How to Keep the Flu From Finding You
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Alexander Evens, DO
Alexander Evens, DO is committed to serving challenging patients in the area of infectious diseases, HIV medicine and infection control. His goal is to provide the highest standard of care with evidence-based medicine and to perform the clinical research needed to advance the broader public health needs.Learn more about Alexander Evens, DO
Transcription:
How to Keep the Flu From Finding You
Bill Klaproth (Host): Fever, chills, body aches, fatigue, sore throat, cough, headache, runny or stuffy nose, nausea, vomiting, hmm; sounds like the flu. And I got to tell you, the flu is no fun. Here to talk flu season safety with us is Alexander Evens, a Doctor of Osteopathic Medicine and an infectious disease specialist at Marin General Hospital. Dr. Evens, thank you so much for your time today. So, let’s start with this. Who is the most vulnerable to catch the flu?
Alexander Evens, DO (Guest): That’s a fantastic question. But I like to tell people that every person is vulnerable to catching the flu; even the young and healthy. But particularly, certain age groups are at highest of risk and those include the extremes of age. What I mean by that, are children particularly in the ages of 5, especially newborns as well as older individuals particularly over the ages of 65. These groups are most at risk.
Bill: So even a healthy person that comes in contact with someone who has the flu, a coworker, you are on a bus and somebody is coughing or sneezing, you are still at risk then, right?
Dr. Evens: Very dangerous, because those people tend to be stronger. They tend to still go to work despite being sick and they are even more likely to spread it.
Bill: So, then what are the symptoms we need to look out for. I listed several of them in the open, but what is it really, we need to watch out for to go oh, oh, this might be the flu?
Dr. Evens: Well the flu puts you in bed. I mean so the flu is different from the common cold primarily due to the severity of the symptoms. It can start feeling like a cold but much more than a cold it puts you into bed. A very common symptom would be a high fever but also symptoms such as sore throat, sometimes without a runny nose per se, as well as muscle aches, and sometimes people start to shake. They call those rigors. All these symptoms combined, especially right in the middle of flu season; the person probably has flu.
Bill: So, generally watch out then for that fever because a general common cold, you don’t normally get a fever, is that right?
Dr. Evens: No, yeah, not as high, not as high. It’s possible. I mean it depends on the patient. I mean there are rare patients who have flu and don’t have a fever, but typically fever is a very common sign and it can be high, but it is these aches, it’s this feeling of just being very, very weakened and patients oftentimes have to lay down and go to bed and that’s fairly classic for flu.
Bill: So, like you said, the flu puts you in bed. Now when should someone see a doctor? A lot of people are probably saying to themselves I’m just going to ride this out. When do you not ride this out? When should someone come see you?
Dr. Evens: Those persons at the extreme of age should see the doctor because they are the ones that are at most risk of having complications of the flu and being hospitalized. Patients who have certain underlying diseases such as lung disease, diabetes, kidney disease, should definitely see a doctor. Because they are more likely to have prolonged symptoms and these patient populations may benefit most from taking therapy which can treat the flu. Other people like myself, since I work in the hospital, if I develop even subtle symptoms, it probably is best for me to check myself for the flu because I could spread it to other people, potentially patients. So, it’s important to do that depending on your type of job.
Bill: And you mentioned therapy, how do you generally treat the flu?
Dr. Evens: Well therapy is primarily supportive in the grand majority of people. What I mean by that is that you try to control the fever with pain medication, Tylenol, being a brand name drug for that otherwise known as acetaminophen or you take ibuprofen, you can take other therapies to soothe the sore throat or cough but there is antiviral therapy that’s proven to be effective, especially in outpatients if they get it in their bodies soon enough, if they start on therapy within the first 48 hours, there’s a brand name there, it’s called Tamiflu, but the generic name is oseltamivir. This therapy has been shown to reduce the duration of symptoms and possibly reduce the amount of shedding of the virus later on, therefore the patient may be less likely to spread it to their loved ones.
Bill: Well, that’s really good to know and Dr. Evens, we hear about getting a flu shot every year, but I still have people in my life that say to me I’m not going to get a flu shot because the flu shot gives you the flu and I always put the time out sign together and I say to them, no it doesn’t and they say, yes it does. So, can you explain this to us one more time, the flu shot doesn’t cause the flu and why it’s such a good idea to get a flu shot every year?
Dr. Evens: Well the flu shot is very smart to get and the data that we get every year shows that there’s benefit. Now the flu shot is not 100% effective and that’s the one downfall. But it has efficacy even this year’s flu shot which had some notoriety going into the season that it was not going to be too effective did show some benefit particularly in certain age groups. So, the flu shot doesn’t cause the flu. At most the person may feel a tiny bit sick, may feel a little sore in that arm, but whatever they feel for that half an hour or hour or four hours or maybe that next day; is not consistent with the flu. The person probably doesn’t even know what the flu is if they think that’s the flu and how they feel sick. It’s much worse and I have heard this and it’s a difficult preconceived notion to force someone to not think this anymore. However, the flu shot has efficacy even when it’s about 20% effective, it has efficacy because it’s better than having zero percent effect. I mean if you get nothing you have no protection, something is better than nothing. Now they are trying to develop better flu shots, that’s true. The flu shot itself is not – they are not giving you the flu, what they are giving you is essentially a premade antibody against strains of flu that have been grown in eggs and so they give this to the human and they develop immunity. It’s not a perfect science. And they are trying to make this better. There is one flu shot that they actually discontinued, a nasal shot which would actually give a patient a virus, it’s a weakened virus, but that’s no longer even approved, it’s no longer given. It used to be a shot, not a shot but a nasal vaccine that we used to give to kids. It is actually shown to be less effective and they pulled that from the market.
Bill: So, like you say, even at 20% that can lessen the severity if you get the flu, so even at 20% that helps.
Dr. Evens: Yeah, well it’s been shown that even when you get the flu shot, it tends to be less intense. They have shown that patients who are admitted to the hospital are less likely to go to the ICU so those are the sicker patients, if they had gotten the flu shot versus ones who didn’t get the flu shot. So, even some partial protection is beneficial. And people don’t die from the flu. So, when you get admitted from the flu and we see patients every single season admitted from the flu; they don’t die from it. They die from complications. So, the flu weakens a person and then they potentially die from bacterial pneumonia which is completely separate from the flu or they die of heart attack or a stroke or something where their body is weakened and then something else takes over.
Bill: So, you are compromising other areas of the body then. So, even partial protection is good for you and Dr. Evens, what about staying home? I know people get sick and they still want to go to work. Tell us why people should just stay home and get better.
Dr. Evens: Yeah, it’s tough because when we live in a society where we want to work through things, we want to make money, we want to do our job, but what we don’t realize is that sometimes than can hurt us and sometimes staying at home and recovering is the best therapy because working through it, a lot of times makes you worse. You really need to rest. You really need to hydrate. You stay home, you are more likely to recuperate from this, you are more likely to rest, and perhaps even go to the doctor and get therapy for this. If you go to work, you are more likely to exacerbate your symptoms perhaps talking more, causing more sore throat, you name it. I’ve done this, maybe not with flu but with other illnesses when you have no other choice and you have to go to work, however, you can also spread it to other people and that’s really the dangerous thing and sometimes you don’t even mean to do it. You have to be very cautious to make sure you cough into your shoulder and not into your hand or when you are around work, that you wear a mask at all times, a simple face mask will probably do best. But that sometimes can be just completely not thought of.
Bill: Dr. Evens also, can you quickly just share with us some general tips for not getting the flu? Now you mentioned coughing into the crook of your elbow if you have a cough but what about washing hands and other tips?
Dr. Evens: Well hand hygiene is key. It prevents not only flu but other illnesses in the hospital setting. So appropriately washing your hands for 20-30 seconds when possible, especially if you have that cold or you have a flu, those are very contagious people get colds probably about two to four a year and flu is so common in the general population, they estimate up to 20% of all people get the flu in a given season. So, it’s really common and so to frequently wash your hands, especially if you have caught yourself coughing into it, really, really will help not only yourself out but spreading it to others.
Bill: Dr. Evens, thank you so much for your time today. Great information on the flu and for more information visit www.maringeneral.org that’s www.maringeneral.org . This is the Healing podcast brought to you by Marin General Hospital. I’m Bill Klaproth. Thanks for listening.
How to Keep the Flu From Finding You
Bill Klaproth (Host): Fever, chills, body aches, fatigue, sore throat, cough, headache, runny or stuffy nose, nausea, vomiting, hmm; sounds like the flu. And I got to tell you, the flu is no fun. Here to talk flu season safety with us is Alexander Evens, a Doctor of Osteopathic Medicine and an infectious disease specialist at Marin General Hospital. Dr. Evens, thank you so much for your time today. So, let’s start with this. Who is the most vulnerable to catch the flu?
Alexander Evens, DO (Guest): That’s a fantastic question. But I like to tell people that every person is vulnerable to catching the flu; even the young and healthy. But particularly, certain age groups are at highest of risk and those include the extremes of age. What I mean by that, are children particularly in the ages of 5, especially newborns as well as older individuals particularly over the ages of 65. These groups are most at risk.
Bill: So even a healthy person that comes in contact with someone who has the flu, a coworker, you are on a bus and somebody is coughing or sneezing, you are still at risk then, right?
Dr. Evens: Very dangerous, because those people tend to be stronger. They tend to still go to work despite being sick and they are even more likely to spread it.
Bill: So, then what are the symptoms we need to look out for. I listed several of them in the open, but what is it really, we need to watch out for to go oh, oh, this might be the flu?
Dr. Evens: Well the flu puts you in bed. I mean so the flu is different from the common cold primarily due to the severity of the symptoms. It can start feeling like a cold but much more than a cold it puts you into bed. A very common symptom would be a high fever but also symptoms such as sore throat, sometimes without a runny nose per se, as well as muscle aches, and sometimes people start to shake. They call those rigors. All these symptoms combined, especially right in the middle of flu season; the person probably has flu.
Bill: So, generally watch out then for that fever because a general common cold, you don’t normally get a fever, is that right?
Dr. Evens: No, yeah, not as high, not as high. It’s possible. I mean it depends on the patient. I mean there are rare patients who have flu and don’t have a fever, but typically fever is a very common sign and it can be high, but it is these aches, it’s this feeling of just being very, very weakened and patients oftentimes have to lay down and go to bed and that’s fairly classic for flu.
Bill: So, like you said, the flu puts you in bed. Now when should someone see a doctor? A lot of people are probably saying to themselves I’m just going to ride this out. When do you not ride this out? When should someone come see you?
Dr. Evens: Those persons at the extreme of age should see the doctor because they are the ones that are at most risk of having complications of the flu and being hospitalized. Patients who have certain underlying diseases such as lung disease, diabetes, kidney disease, should definitely see a doctor. Because they are more likely to have prolonged symptoms and these patient populations may benefit most from taking therapy which can treat the flu. Other people like myself, since I work in the hospital, if I develop even subtle symptoms, it probably is best for me to check myself for the flu because I could spread it to other people, potentially patients. So, it’s important to do that depending on your type of job.
Bill: And you mentioned therapy, how do you generally treat the flu?
Dr. Evens: Well therapy is primarily supportive in the grand majority of people. What I mean by that is that you try to control the fever with pain medication, Tylenol, being a brand name drug for that otherwise known as acetaminophen or you take ibuprofen, you can take other therapies to soothe the sore throat or cough but there is antiviral therapy that’s proven to be effective, especially in outpatients if they get it in their bodies soon enough, if they start on therapy within the first 48 hours, there’s a brand name there, it’s called Tamiflu, but the generic name is oseltamivir. This therapy has been shown to reduce the duration of symptoms and possibly reduce the amount of shedding of the virus later on, therefore the patient may be less likely to spread it to their loved ones.
Bill: Well, that’s really good to know and Dr. Evens, we hear about getting a flu shot every year, but I still have people in my life that say to me I’m not going to get a flu shot because the flu shot gives you the flu and I always put the time out sign together and I say to them, no it doesn’t and they say, yes it does. So, can you explain this to us one more time, the flu shot doesn’t cause the flu and why it’s such a good idea to get a flu shot every year?
Dr. Evens: Well the flu shot is very smart to get and the data that we get every year shows that there’s benefit. Now the flu shot is not 100% effective and that’s the one downfall. But it has efficacy even this year’s flu shot which had some notoriety going into the season that it was not going to be too effective did show some benefit particularly in certain age groups. So, the flu shot doesn’t cause the flu. At most the person may feel a tiny bit sick, may feel a little sore in that arm, but whatever they feel for that half an hour or hour or four hours or maybe that next day; is not consistent with the flu. The person probably doesn’t even know what the flu is if they think that’s the flu and how they feel sick. It’s much worse and I have heard this and it’s a difficult preconceived notion to force someone to not think this anymore. However, the flu shot has efficacy even when it’s about 20% effective, it has efficacy because it’s better than having zero percent effect. I mean if you get nothing you have no protection, something is better than nothing. Now they are trying to develop better flu shots, that’s true. The flu shot itself is not – they are not giving you the flu, what they are giving you is essentially a premade antibody against strains of flu that have been grown in eggs and so they give this to the human and they develop immunity. It’s not a perfect science. And they are trying to make this better. There is one flu shot that they actually discontinued, a nasal shot which would actually give a patient a virus, it’s a weakened virus, but that’s no longer even approved, it’s no longer given. It used to be a shot, not a shot but a nasal vaccine that we used to give to kids. It is actually shown to be less effective and they pulled that from the market.
Bill: So, like you say, even at 20% that can lessen the severity if you get the flu, so even at 20% that helps.
Dr. Evens: Yeah, well it’s been shown that even when you get the flu shot, it tends to be less intense. They have shown that patients who are admitted to the hospital are less likely to go to the ICU so those are the sicker patients, if they had gotten the flu shot versus ones who didn’t get the flu shot. So, even some partial protection is beneficial. And people don’t die from the flu. So, when you get admitted from the flu and we see patients every single season admitted from the flu; they don’t die from it. They die from complications. So, the flu weakens a person and then they potentially die from bacterial pneumonia which is completely separate from the flu or they die of heart attack or a stroke or something where their body is weakened and then something else takes over.
Bill: So, you are compromising other areas of the body then. So, even partial protection is good for you and Dr. Evens, what about staying home? I know people get sick and they still want to go to work. Tell us why people should just stay home and get better.
Dr. Evens: Yeah, it’s tough because when we live in a society where we want to work through things, we want to make money, we want to do our job, but what we don’t realize is that sometimes than can hurt us and sometimes staying at home and recovering is the best therapy because working through it, a lot of times makes you worse. You really need to rest. You really need to hydrate. You stay home, you are more likely to recuperate from this, you are more likely to rest, and perhaps even go to the doctor and get therapy for this. If you go to work, you are more likely to exacerbate your symptoms perhaps talking more, causing more sore throat, you name it. I’ve done this, maybe not with flu but with other illnesses when you have no other choice and you have to go to work, however, you can also spread it to other people and that’s really the dangerous thing and sometimes you don’t even mean to do it. You have to be very cautious to make sure you cough into your shoulder and not into your hand or when you are around work, that you wear a mask at all times, a simple face mask will probably do best. But that sometimes can be just completely not thought of.
Bill: Dr. Evens also, can you quickly just share with us some general tips for not getting the flu? Now you mentioned coughing into the crook of your elbow if you have a cough but what about washing hands and other tips?
Dr. Evens: Well hand hygiene is key. It prevents not only flu but other illnesses in the hospital setting. So appropriately washing your hands for 20-30 seconds when possible, especially if you have that cold or you have a flu, those are very contagious people get colds probably about two to four a year and flu is so common in the general population, they estimate up to 20% of all people get the flu in a given season. So, it’s really common and so to frequently wash your hands, especially if you have caught yourself coughing into it, really, really will help not only yourself out but spreading it to others.
Bill: Dr. Evens, thank you so much for your time today. Great information on the flu and for more information visit www.maringeneral.org that’s www.maringeneral.org . This is the Healing podcast brought to you by Marin General Hospital. I’m Bill Klaproth. Thanks for listening.