How To Protect Yourself From the Flu

Intro: MemorialCare Health System, excellence in healthcare, presents Weekly Dose of Wellness. Here's your host, Deborah Howell.

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.

James Leo, MD: Thank you very much.

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

James Leo, MD: Influenza is a - an illness that is produced by a virus that is seasonal, occurs typically in the winter time, 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, and generalized discomfort.

Deborah Howell (Host): Has there ever been a summer case of flu?

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

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

James Leo, MD: So, you've already given the answer to the question. Vaccination, unquestionably, is the best way to protect oneself from developing the flu. The reason that 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 and then recover, a significant number of people die each year from the flu. Depending upon the season that we look at, looking from the mid-70s to the - to the recent years, the estimated number of deaths in the U.S. ranges from 3,000 a year to a high of about 49,000 people in the U.S. The majority of those are people 65 years of age and older, but about 10% are younger and sometimes completely healthy people until they get the flu. So this can be a dangerous and even fatal illness that is largely preventable by vaccination.

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

James Leo, MD: There are a 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 uh, need to be careful; there is an egg-free vaccine that they can get.

Deborah Howell (Host): Oh, there is?

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

Deborah Howell (Host): Okay. Well, that was uh, answering my next question, what are the options for people who are allergic to eggs?

James Leo, MD: 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 - in the vaccine is very, very small. It's only people who have a true anaphylactic, very severe type of reaction to eggs who need to avoid the standard vaccine. For those people, the physician should guide their getting the egg-free vaccine.

Deborah Howell (Host): Okay. So, there's the shot and then what else should people do to protect themselves from getting the flu?

James Leo, MD: 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 go into the air, and if you happen to pass by somebody who's 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 - handrails, tables, computer keyboards, etc. - and 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 to themselves. So during the flu season especially, December through March, careful and frequent hand washing and the use of alcohol-based hand degermers is an excellent way to help to prevent influenza.

Deborah Howell (Host): And don't forget those phone receivers that everybody uses. Make sure you wipe those down.

James Leo, MD: Absolutely.

Deborah Howell (Host): How do you respond to those people who avoid the flu shot like the plague because they believe it'll make them sick?

James Leo, MD: The influenza virus vaccine is made up of a 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, so 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. And so sometimes at worst people will feel a little ill for a day or two after the vaccination. That's actually uncommon. You cannot get the influenza from the influenza vaccine.

Deborah Howell (Host): How has MemorialCare been on the forefront of implementing influenza policies?

James Leo, MD: 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 over their nose and mouth throughout the flu season whenever they're in the hospital.

Deborah Howell (Host): Wow.

James Leo, MD: 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 Howell (Host): So, seriously, you can have the flu and not know that you have it?

James Leo, MD: A significant percentage of people have that exact situation. And so for healthcare providers, it's critically important - since we put safety of our patients first - that we are all either vaccinated or wearing a mask to prevent inadvertent transmission of influenza to our patients throughout the flu season.

Deborah Howell (Host): Incredible. I had never heard that. Is this a new development, or - or just something that we're realizing?

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

Deborah Howell (Host): So you can just feel maybe a little run down, not really know, you know, just like, "Oh boy, I'm just so tired. I feel beat. I feel like a truck ran over me," and really in fact you might possibly have the flu?

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

Deborah Howell (Host): What about diet?

James Leo, MD: 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 Howell (Host): Okay. What about feeding a cold and starving a fever and all that stuff?

James Leo, MD: (Laughs) It's a great old wives' tale, but there's not any scientific data to support that.

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

James Leo, MD: So you want to make sure first and foremost that you're really keeping up on your fluids. Uh, we tend to not eat and drink well when we're sick, and 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 into your hands, uh, and that you maintain good hydration. Use Tylenol or acetaminophen for any fevers that you may have, uh, and if you're running high fevers do contact your physician.

Deborah Howell (Host): What should you not do if you have the flu?

James Leo, MD: Uh, you should really avoid going out in public, you should avoid heavy physical activity, um, and you should do your best to try to avoid coughing or sneezing into the open air when there are people around you.

Deborah Howell (Host): Right. Certainly uh, cough and sneeze into your elbow if you have to.

James Leo, MD: Exactly.

Deborah Howell (Host): And don't go to the gym, right?

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

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

James Leo, MD: No, it's best - best to wait until the fevers are completely gone and you're well on the way to recovery.

Deborah Howell (Host): And 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?

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

Deborah Howell (Host): Okay. And what about when - when should you go to the doctor uh, if you suspect you have the flu?

James Leo, MD: I think contacting the physician if you have a 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, and the other symptoms of flu, there is medication that can be given that can shorten the duration of flu. So 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 illness.

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