Joey Wahler (Host): Each fall and winter, there's much talk about the flu and flu shots. So, we're discussing facts you should know for flu season.

This is Be Well with Skagit Regional Health. Thanks for listening. I'm Joey Wahler. Our guest, Jaya DeElena. She's a doctorally prepared family nurse practitioner with Skagit Regional Health. Jaya, thanks for joining us.

Jaya DeElena: Thank you for having me.

Joey Wahler (Host): So first, when exactly is flu season?

Jaya DeElena: So, flu season within the United States can span from October until late into spring or around April or May. However, the peak seasons for influenza tend to be between December and March, which is why we think about flu more often than not during the winter season.

Joey Wahler (Host): And how is flu different than the common cold?

Jaya DeElena: So, the influenza virus belongs to a specific viral family called the orthomyxoviridae family, and all influenza viruses belong to this family. And there are three types of flu. There's type A, type B, and type C. So, we see type A infecting humans and other mammals and warm-blooded species. And we also see type A in birds. And type B and C have only been isolated in humans. And we see these three types of strains differentiate or mutate or change over the flu season. So, this is different than the other colds and viruses that we see that cause colds. There are other viral families that cause us problems during cold and flu season, including the coronaviridae family that causes coronaviruses. The COVID-19 virus belongs to this virus family. There's also rhinoviruses that belong to another viral family called picornaviridae family. And corona and rhinoviruses are responsible for our common colds. And all of these viral families produce viruses that are capable of invading our cells in our body.

Joey Wahler (Host): So, people may think they know them, but what are the main symptoms of flu?

Jaya DeElena: Typical flu symptoms tend to have a sudden onset versus gradual. And a lot of people describe feeling like they got hit by a bus or a truck. We see symptoms including high fever, chills, which can literally become shaking chills, headaches, body aches, fatigue or feeling very tired, dry cough, sore throat, runny, clogged nose. However, painful muscle aches, headaches and high fevers set this apart from the common colds, we also see during this timeframe. And there's a specific kind of flu influenza virus people have heard of called the avian or bird flus, also known as H5N1. And that tends to be like the typical flu symptoms, but can also include diarrhea, abdominal pain, vomiting, lower respiratory tract symptoms like shortness of breath, a cough that is productive of mucus or sputum. And unlike our regular flu infections, we see the H5N1 influenza infection tends to lead to pneumonia, which we can see on chest x-rays. And oftentimes, patients are hospitalized with this particular flu, as we do see more acute respiratory distress, including low oxygen levels.

Joey Wahler (Host): We hear that some flu seasons are worse than others. So, how would you categorize this year's?

Jaya DeElena: I would say that this year's flu season is definitely a bad one compared to some other years. We are seeing an increased rate of flu. In fact, flu is one of the main offenders that is causing this triple threat of viruses. The increase in numbers of the flu cases this year are likely due to everyone getting back to gatherings, travel has increased, masking is not happening to the frequency that it was in the last two or three years. So, these factors combined inevitably will lead to increased transmission and thus increased rates of the flu, which is exactly what we're seeing this year.

Joey Wahler (Host): When we get a flu shot, Jaya, how well protected against flu does that typically make us? And who exactly should get one or shouldn't get one?

Jaya DeElena: The flu vaccine provides very, very good protection against the flu, depending on the flu strains that are circulating that year. So like all viruses, the flu virus likes to change and mutate to survive. So if there are mutations or changes within the genetic code, the virus can be more infectious, as the vaccine itself will not cover that particular strain. Therefore, the flu vaccine effectiveness can vary year to year, but they do work well. So depending on the flu year or the strains that we're seeing, the studies do show that the flu vaccine can reduce the risk of flu illness by between 40% and 60% among the overall population during the season when we see the flu circulating. However, again, mutations and changes within the flu strain itself can lead to higher infections. And then what the researchers do is they try to capture these changes for future flu vaccines, so they're covered.

However, the flu vaccine does protect. If you have the flu vaccine and you were to get the flu it does help reduce the severity of the illness itself as well as the duration of being sick. So, we see people who have been immunized with the flu tend to be in the hospital less, tend to have those severe secondary symptoms like pneumonias or another secondary bacterial infection, like ear infections, at a less frequent rate as those who have not been vaccinated.

Joey Wahler (Host): So, who should get a flu shot, and is there anyone that shouldn't get one?

Jaya DeElena: We advise everyone six months and older to get a flu vaccine each year. So, we do start recommending immunizations for babies as young as six months, and we recommend that everyone gets a flu vaccine as long as it has not been contraindicated or discussed with your primary care provider or another specialist that you should not get this vaccine.

Joey Wahler (Host): Gotcha. Now switching gears a little bit, what are some other ways that people can try to prevent the flu on their own just in everyday life?

Jaya DeElena: So, there are several ways we can prevent the flu. First and foremost is stay home when you're feeling sick. When you're sick. And if it is available to you to not go to work, you should stay home for seven to 10 days to allow the immune system to focus on recovery from the virus. Second strategy is to wear a mask if you can't stay at home. And you can wear an N95 mask, which will help reduce the spread of the viral particles to others. And wash your hands. Hand hygiene and washing the hands frequently will help reduce the spread. And as always, get a flu vaccine.

Joey Wahler (Host): So when could the flu become dangerous? And who would you say is most vulnerable there?

Jaya DeElena: The flu can be a very virulent or aggressive virus depending on the type of flu that we're talking about. So for instance, that H5N1 or avian or bird flu, that was a very virulent or aggressive form of the flu. So depending on the actual type of flu you have, it can be very dangerous and make people very sick. People who are vulnerable to complicated flu infections include those who are immunocompromised, either through medical conditions that compromise their immune systems, or if they are taking medications that compromise their immune system. Babies, toddlers, young kids are more vulnerable to severe flu infections because their immune systems are still learning to become competent and strong against these viruses that live among us. Additionally, the elderly are also susceptible to severe flu viruses. Because as we age, the ability of the immune system to respond to infectious diseases, including viral illnesses like the flu, decreases.

Joey Wahler (Host): And finally, if someone is getting a COVID shot or a COVID booster, how much time should they allow or wait between getting that and getting a flu shot?

Jaya DeElena: So at this point in time, you can get the flu shot with the COVID vaccines or COVID boosters. There's no need to wait in between vaccines to get either the flu or the COVID booster. When we are getting vaccines in general, we are eliciting an immune response. So when we get more than one vaccine at a time, sometimes we elicit a strong immune response. Therefore, it's not uncommon for people to feel like maybe they are sick, maybe they do have body aches, maybe they do have a low-grade fever. Maybe they do feel like they are getting sick. However, that's just the normal response of the immune system as it reacts to the vaccines and makes the antibodies, so the body is prepared to fight when they do see the actual viruses.

Joey Wahler (Host): All right. Well, valuable information, especially during flu season. Folks, we trust you are now more familiar with what to know during flu season. Jaya DeElena, thanks so much again.

Jaya DeElena: Thank you for having me.

Joey Wahler (Host): And for more information, please visit skagitregionalhealth.org. Again, that's skagitregionalhealth.org. Now, if you found this podcast helpful, please do share it on your social media. And thanks again for listening to Be Well with Skagit Regional Health. Hoping your health is good health. I'm Joey Wahler.