Transcription:
How To Protect Yourself From the Flu.

Deborah Howell (Host): Hello and welcome to the show. You're listening to Weekly Dose of Wellness, brought to you by MemorialCare Health System. I'm Deborah Howell, and today's guest is Dr. James Leo. Dr. Leo is the Medical Director of Best Practice and Clinical Outcomes for MemorialCare Health System, and Associate Chief Medical Officer and Medical Director for Clinical Quality at Long Beach Memorial. He is board certified in internal medicine, critical care medicine, emergency medicine and has practiced at Long Beach Memorial for 26 years. Welcome, Dr. Leo.

Dr. James Leo (Guest): Thank you very much.

Deborah: Today we're going to talk a bit about how you protect yourself from getting the dreaded flu. First of all, what is a flu, and what are the symptoms?

Dr. Leo: Influenza is an illness that is produced by a virus that is seasonal, occurs typically in the wintertime, sometimes lapsing into early spring as well. Common symptoms are chills, fever, runny nose, sore throat, muscle aches, headache—oftentimes severe—associated with coughing, with weakness or fatigue, generalized discomfort.

Deborah: Has there even been a summer case of flu?

Dr. Leo: It's extremely rare. It can occur, but it's very rare.

Deborah: Interesting. How can people protect themselves from the flu, and why is it so very important to get the vaccine every single year?

Dr. Leo: You've already given the answer to the question. Vaccination unquestionably is the best way to protect oneself from developing flu. The reason influenza vaccination is so important is that while most people who get the flu suffer through it, feel miserable for a few days to a week then recover, a significant number of people die each year from the flu. Depending upon the season we look at, looking from the mid '70s, to the recent years, the estimated number of deaths in the US ranges from 3,000 a year to a high of about [49,000] people in the US. The majority of those are people 65 years of age and over, but about 10 percent are younger and sometimes completely healthy people until they got the flu. So this can be a dangerous and eve fatal illness that is largely prevented by vaccination.

Deborah: Is there somebody who should not get the flu shot, or should just everybody get the flu shot?

Dr. Leo: There are few groups of people for whom influenza vaccination is contraindicated. First, children less than six months of age should not be vaccinated at all. In general, the vaccine is approved for six months and older. People who have had severe allergic reactions to influenza vaccination in the past should not get the vaccination. People who have severe egg allergies need to be careful. There is an egg-free vaccine that they can get.

Deborah: Oh, there is?

Dr. Leo: Yes, there is. That needs to be done clearly under the supervision of a physician.

Deborah: Okay. Well, that was answering my next question now. What are the options for people who are allergic to eggs?

Dr. Leo: It turns out that most people who report an allergy to egg actually do fine even with the standard flu vaccine, because the amount of egg protein in the vaccine is very, very small. Only people who have true anaphylactic, very severe type of reaction to eggs will need to avoid the standard vaccine. For those people, the physician should guide their getting egg-free vaccine.

Deborah: Okay. So there's this shot. What else should people do to protect themselves from getting the flu?

Dr. Leo: Careful and frequent hand washing is probably the best thing that people can do. Influenza is transmitted predominantly by aerosol—that is, coughing or sneezing, the virus particles going to the air, and if you happen to pass by somebody who has just coughed or sneezed, you can breathe it in. Hand washing doesn't help with that, but what it does help with is that people will often cough or sneeze or get their secretions onto surfaces, hand rails, tables, computer keyboards, et cetera. The virus can live in that circumstance for enough time for somebody else to come along, pick it up on their fingertips, and then transmit it themselves. During the flu season, especially December through March, careful and frequent hand washing and use of alcohol-based hand de-germers is an excellent way to help to prevent influenza.

Deborah: Don't forget those phone receivers that everybody uses. Make sure you whip those down.

Dr. Leo: Absolutely.

Deborah: Yep. How do you respond to those people who avoid the flu shot like the plague, because they believe it will make them sick?

Dr. Leo: The influenza virus vaccine is made up of virus that has been inactivated. It doesn't multiply in the body. It cannot cause you to get the flu. What people sometimes experience after they get the vaccination is their immune system responding to the vaccine. They may feel a little achy. Sometimes you'll even see some low-grade temperatures. But that doesn't represent your getting the flu. That represents your immune system doing what it's supposed to do. Sometimes, at worse, people will feel a little ill for a day or two after the vaccination. That's actually uncommon. You can't get the influenza from the influenza vaccine.
Deborah: How has MemorialCare been on the forefront of implementing influenza policies?

Dr. Leo: Several years ago, we were one of the first health systems in the state of California to require our hospital-based staff either to get a vaccination, or if they declined vaccination, to wear a mask with their nose and mouth throughout the flu season whenever they're in the hospital. Our rationale behind that is that up to half of people who get the flu don't get significant symptoms with it. They may feel a minor illness or may not experience anything at all, and yet they still transmit the virus during the course of the influenza illness. What that means as a healthcare provider is that you may unknowingly pass on influenza to your patients if you have not been vaccinated.

Deborah: So seriously, you can have the flu and not know that you have it?

Dr. Leo: A significant percentage of people have that situation. So, for healthcare providers, it's critically important, since we put the safety of our patients first, that we are all either vaccinated or are wearing a mask to prevent inadvertent transmission of influenza to our patient in the flu season.

Deborah: Incredible. I've not ever heard that. Is this a new development or just something that we're realizing?

Dr. Leo: Actually, people who study influenza have known this for a while. It's not a commonly known fact amongst the lay population, but it has been observed for years.

Deborah: So you can just feel maybe a little run-down, not really knowing, just like, "Oh, boy. I'm just so tired. I feel beat. I feel like a truck run over me." And really, in fact, you might possibly have the flu.

Dr. Leo: Exactly. Some people will pass it off as if it's a minor cold, or I'm just feeling a little run-down.

Deborah: What about diet?

Dr. Leo: There's no great evidence that diet makes a significant difference, either in your susceptibility to influenza or in how long the illness lasts.
Deborah: Okay. What about feeding a cold and starving a fever, those stuff?

Dr. Leo: It's a great old wives' tale, but there's not any scientific data to support that.

Deborah: So really, if you have the flu, what is the best thing to do?

Dr. Leo: You want to make sure, first and foremost, that you're really keeping up on your fluids. We tend to not eat and drink well when we're sick. It's very important to maintain good hydration. If you have the flu, most important, do not go to work, because if you do, you're going to pass it on to your coworkers. So you want to stay home. You want to make sure that you're washing your own hands anytime you cough or sneeze with your hands, and that you maintain good hydration. Use Tylenol, of course, Acetaminophen for any fevers that you may have. And if you're running high fevers, do contact your physician.

Deborah: What should you not do if you have the flu?

Dr. Leo: You should really avoid going out in public. You should avoid heavy physical activity. You should do your best to try to avoid coughing or sneezing into the open air when there are people around you.

Deborah: Right, certainly, cough and sneezing to your elbow, if you have to.

Dr. Leo: Exactly.

Deborah: And don't go to the gym, right?

Dr. Leo: Correct. All you're going to do is make yourself feel worse and pass on the flu to all the people around you.

Deborah: Because, you know, us gym rats, we want to be there every day doing our thing, and it's just not a good idea when you have the flu or symptoms of the flu.

Dr. Leo: No. It's best to wait until the fevers are completely gone and you're well on the way to recovery.

Deborah: What about bed rest? Do we really need to be in bed just resting when we have the flu, or can we take gentle walks?

Dr. Leo: As long as you're not having shortness of breath, gentle walks are reasonable. I think it's good to listen to what your body tells you when you're down with a flu.

Deborah: Okay. When should you go to the doctor if you suspect you have the flu?

Dr. Leo: I think contacting the physician if you have fever of over 101 degrees, at least, to discuss what's going on. Physicians know to ask questions that will help to sort out if there's a potential for bacterial infection or something that might require antibiotics. If you come down with flu symptoms during the flu season, within the first 48 hours of onset of fever, severe muscle aches, any other symptoms of flu, medication can be given that can shorten the duration of flus. It's a reasonable idea to contact your physician oftentimes without necessarily needing to see the patient. If the physician feels that influenza is likely, they can prescribe this medication to help shorten the duration of the illness.

Deborah: Thank you so much, Dr. Leo. To listen to our podcast and more information, please visit memorialcare.org. I'm Deborah Howell. Have a wonderful day. Thanks to all.