Transcription:
Flu Season: Prevent, Protect and Know Where to Go

Bill Klaproth (Host):   The sneezing, blowing, fever, chills, muscle aches, coughs, congestion, yuck. You don’t want any of that. Since cold and flu season is upon us, what can you do to stay healthy? Let’s find out with Jessica Dixon, a registered nurse and infection prevention specialist at WakeMed Health and Hospitals. This is WakeMed voices, a podcast from WakeMed Health and Hospitals. I'm Bill Klaproth. Jessica, so let’s start with this. What is exactly the flu?

Jessica Dixon MHA, BSN, RN, CIC, FAPIC (Guest):   Absolutely. So flu is really a respiratory illness. A lot of people when they think of flu, they think of what they call “stomach flu”. So they think, “I'm nauseated. I have vomiting. I have diarrhea. I have stomach flu.” That’s really not flu. Flu is influenza, which is a specific family of viruses that cause respiratory illness. So flu symptoms are usually things like fever and cough. Those are the two main ones. Also you might have a headache. You may have a runny nose or a stuffy nose. You might have body aches, muscle aches, joint aches. You might be really tired, feel fatigued. It’s possible to have GI symptoms like vomiting and diarrhea with the flu, but it is usually seen only in children. It’s very rare for that to happen in adults.

Host:   Got it. Alright, so that’s good to know. So then the big question is knowing that, what can we do to stay healthy?

Jessica:   Well the greatest defense against spread of flu is really planning and prevention. So the first thing that we recommend from a prevention standpoint is getting your flu shot. Now, it is definitely the height of flu season right now and the flu shot does take about two weeks to reach full effectiveness. So the bad news is if you haven’t gotten it yet and you get it now, it’s still gonna be a couple of weeks before it can fully protect you. The good news is it’s not too late.

Host:   So it’s not too late to vaccinate.

Jessica:   Exactly.

Host:   So you're on a role. Hit us with some other prevention tips.

Jessica:   Well, my number one infection prevention tip for preventing all infections is keep your hands clean. So there's a couple of things that you can do. Alcohol hand gel, those little hand gels that you buy at the grocery store or you see at Bath and Body Works that have fancy smells to them, all of those things that have alcohol gel in them are really effective at killing the flu virus. So they are a good way to clean your hands, but also remember that washing your hands is something that you should do often and that you should do well. A lot of the stuff is spread by touching your face. So you want to make sure that you have clean hands as much of the time as you can. You want to try to keep your hands out of your mouth, nose, eyes so that you aren’t transmitting those germs to yourself.

Host:   So keeping your hands clean. Is there a right way we should be washing our hands?

Jessica:   Definitely, again when you're washing your hands, make sure you're washing them properly. My observation of people out in the community is that they tend to turn on the water, maybe put a little soap on them, rub them together really quickly, turn off the water and walk away. There really is a proper way to wash your hands. So making sure that when you're washing your hands you get your hands wet, put a good amount of soap on them. Then you really need to rub your hands together for at least 15 to 20 seconds. So what we teach for that is sing happy birthday to yourself twice. You don’t have to do it out loud, although you can if you want to. Then continue that scrubbing for that full 15 to 20 seconds. Make sure you're touching all of the surfaces of your hands because really the secret to hand washing is not the germ killing activity of the soap. It is the friction removing those germs from your hands so you can rinse them down the sink. So make sure you get the backs of your hands, your fingers, your fingernails, around your wrists and then rinse your hands.

We also, in my world, recommend that if you're especially in like a public bathroom or somewhere else that’s shared space turn off the water with a paper towel so that you don’t touch that dirty handle because you got whatever was on your hands on that handle when you turned the water on. So you don’t want to get that back on your hands when you turn the water off. So we recommend that you turn the water off with a paper towel and then dispose of that paper towel.

Host:   That is good advice.

Jessica:   There are certainly lots of other things that you can do to keep from getting the flu. I jokingly say avoid people. However, that is hard to do, especially this time of year. It’s getting cooler outside depending on where are. It’s not very cool here right now. That’s part of the reason that we see so much spread of flu around this time of year is because everybody’s inside, they're all together, they're close together. Flu is spread through infected droplets. So basically somebody has to cough or sneeze it out close enough to you that it then goes into your eyes, nose, or mouth in order for you to get the flu from someone. So if you see someone who’s coughing or sneezing, keep yourself six feet or more away. That will help. Now, that can be difficult especially if the sick person is your child and you're a parent or your spouse or someone else that you're going to be in close contact with.

For example, I find this ironic since I'm doing this today, but my husband woke this morning with 102 fever, body aches, a headache, little tickle in his throat, and a stuffy nose. So he probably has the flu. So I immediately said, “Stay in the bedroom. Only use this one bathroom right here. Don’t touch anything else in the house and go to the doctor as soon as they open.” So we have a nine year old. So I've said, “Don’t go near her. I love you, but don’t come near me. We’ll see you in a week.”

Host:   Right.

Jessica:   Definitely isolation of yourself from sick people if you know you're going to be around sick people and of yourself from others if you are sick. I think a lot of people get the flu, they take some ibuprofen, or they take some acetaminophen, and they feel better when their fever goes down. So they're like, “Great. I'm feeling perky. I'm going to the grocery store.” Or they medicate their kid and say, “Great, you don’t have a fever anymore. You're going to school.” Flu is really contagious for up to about a week from when your symptoms begin. So if you have flu symptoms and we think you have the flu, you really need t stay away from other people for a good week.

Host:   Alright. That is really good advice. Then I would imagine just general proper good nutrition, hydration. Those types of things help.

Jessica:   Absolutely. One of the things germs need in order to make you sick is what we call a susceptible host. So if you can keep yourself healthy, you will reduce your risk of being infected if you come into contact with the flu. So that does mean getting rest, reducing your stress as much as possible, exercise, eating well, drinking lots of water. All of those kind of general things that you would do to take care of yourself will help you to resist the flu should you be exposed to it. There's also some evidence that you can do a few other things that may help reduce your risk. Interestingly there's some recent studies that say that dry air can make you more vulnerable to respiratory illnesses like the flu because basically the membranes inside your nose and mouth are just more easily infected when they're dry. So if you can use a humidifier in your home, your office, your environment that you're in, that may reduce your risk of getting the flu if you're exposed to it. There are also things like elderberry syrup. There is pretty good evidence that elderberry syrup is effective at reducing the duration of symptoms and the severity of your symptoms if you do get the flu. There's also some limited evidence that it could be used as a preventative measure for flu as well.

Host:   Well, I have elderberry at home. So I'm glad to hear you say that.

Jessica:   Oh perfect.

Host:   So let me ask you this. You were just talking about your husband. If you are symptomatic for flu and you kind of knew it, should you treat yourself for the flu?

Jessica:   You should. You should take care of yourself as if you have the flu. It’s really hard sometimes to tell, but adults don’t usually get high fevers with other respiratory illnesses. So especially if you're an adult and you wake up and have a 101/102 fever like my husband did this morning especially this time or year really start thinking flu. Certainly treat yourself that way from the standpoint of avoiding contact with other people. So don’t go to work, school, the grocery store, the movies. If your child has it and you're like, “Oh my gosh, we just came off of holiday break. I can't have you in the house for another week. Let’s go to the playground.” Please don’t go to the playground. Try to do what you can to stay away from other people. It can be really hard. People have busy schedules. You have commitments, you have classes that you’ve paid for your child to take. You have work that you have to get to. Germs that even aren’t making you that sick can make someone else really sick depending on that person’s underlying health status. So it’s not just a matter of saying, “Oh, well I don’t feel that bad. So this must not be a very bad flu that I have.” That same influenza germ if you give it to someone else could have some really serious consequences for other people.

Host:   Good point about thinking about others. They may have a compromised immune system and the flu would be really bad for that person. So if I took notes properly Jessica, this is what I have on how to stay healthy. Make sure you get a flu shot, properly wash your hands, avoid people who are sick, get proper rest, pay attention to good nutrition and hydration, consider using a humidifier. If you are symptomatic for flu, treat yourself for the flu. Make sure you stay home so you don’t spread your illness. Is that about right?

Jessica:   It’s perfect? You're a quick learner.

Host:   See that, I'm a quick learner. Alright. So even though some of us may be quick learners and you were just talking about your husband. When it comes to flu season, illness can't always be avoided. So if you have flu like symptoms, how do you know whether to go to primary care, urgent care, or the emergency department. So let’s start with primary care.

Jessica:   Sure. That’s a great question. So your primary care provider can help you protect yourself and your family during cold and flu season. Most of them have room in their schedule for sick visits from their regular patients. So you probably can't call at 4:00 and get seen that same day, but if you call first thing in the morning they should be able to get you in. So if you have flu like symptoms, that’s where you should really start is with your primary care provider. This is especially true if you're in a high risk group. So if you're talking about a very young person, a child, anyone elderly, pregnant women, people who have a BMI of greater than 40, or people with underlying chronic health conditions like asthma or COPD, all those people should go ahead and contact their primary care provider if they think they have the flu. If you are a high risk individual, you probably do need to be seen in the office if that’s what you think you do have.

Host:   Okay, very good. Then how about urgent care and virtual urgent care?

Jessica:   So if it’s after hours or a weekend of if your primary care physician is just so slammed with flu patients right now that they don’t have any appointments left available, it’s definitely appropriate to visit an urgent care office. WakeMed has urgent care locations in Cary, Raleigh, Forestville Crossing, Fuquay-Varina, Garner, and Morrisville that all offer a wide range of adult and pediatric services. You can also seek care through a virtual urgent care. This is perfect for people like my child who is part of the YouTube generation. So WakeMed has a virtual urgent care. It’s a low cost alternative to going physically to an urgent care for after hours care. Non-emergent illnesses, non-emergent injuries. So this is something that you can have access to 24 hours a day 7 days a week everyday of the year from a mobile device or computer through the WakeMed All Access app.

Host:   That’s a very useful app to have. Then how about emergency care?

Jessica:   Certainly. Anytime there is a medical emergency, you should seek care at an emergency department. If it’s something that you think is life threatening, please call 911 or go directly to the nearest hospital emergency room. If your flu symptoms get more severe than those things we initially talked about—you feel bad, you have a headache, your nose is stuffy—then it may be time to go to the emergency room. So if you start to experience difficulty breathing, chest pain or abdominal pain, dizziness, confusion, severe vomiting where you really can't keep anything down and can't stay hydrated or if you have a high fever that isn’t brought down by fever reducing medications, that is certainly a time to go to the emergency room.

Host:   Again, really good advice. Last question Jessica. This has been very informative. Some symptoms of a cold are the same as the flu, right? Runny nose, you're stuffy, you're tired, your fatigued. You just gave us a great list of symptoms of when it’s time to go to emergency care. What’s the biggest differentiator for people like this is a cold or this is the flu? How do we know which is which?

Jessica:   I think the biggest differentiator tends to be the presence of the fever, especially a high fever. Unfortunately despite what I do for a living and be very attentive to infection prevention measures and being vaccinated, I have managed to have the flu not once, not twice, but three times in the past four years. So either I'm really bad at what I do, or I have exceptionally bad luck. You definitely feel different. So the high fever—Because, again, in adults especially we don’t usually have fevers 101/102 above that unless there's something serious wrong. So flu is always a good bet there. The other thing is that fatigue and body aches—Now when I have a cold, I will be tired, but it is not the bone sucking I can't get out of my bed fatigue and that achiness that I felt when I had the flu. So with a cold, you will see some of that same symptoms like a headache and a stuffy or runny nose, maybe a cough. Really fever is the big differentiator for flu. Then, again, that kind of achiness malaise, kind of just general I feel like a truck ran over me.

Host:   So those are really important symptoms to remember and especially fever. So remember that. Jessica, this has been really informative and thank you so much for your time today.

Jessica:   Absolutely. Thanks for having me.

Host:   That’s Jessica Dickson with WakeMed Health and Hospitals. To learn more about WakeMed’s services and locations, please visit wakemed.org. If you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. I'm Bill Klaproth with WakeMed Voices brought to you by WakeMed Health and Hospitals in Raleigh, North Carolina. Thanks for listening.