Posts Tagged ‘Flu’



Influenza is transmitted by direct and indirect contact via respiratory droplets from coughing, sneezing or from just shaking hands.  The incubation period is several days and contagiousness can last as long as a week after the symptoms begin.  The best way to limit its spread is by frequent hand washing with soap and water for 15 to 20 seconds and by limiting close face to face contact with others when symptoms are present.  It is very important to know the difference between the common winter cold and influenza.  As opposed to a common cold, influenza has these distinguishing characteristics:

  • Very sudden onset
  • Fever
  • Aches
  • Sore throat

At the onset of influenza symptoms people often say they feel as if they had been “run over by a truck.”

The treatment for influenza is mostly symptomatic care:  plenty of rest, Tylenol or Advil (ibuprofen) for fever and aches, and maintaining adequate liquid intake.  There are drugs such as Tamiflu, available from a doctor which if taken within the first 48 hours of influenza symptoms may shorten the course of the illness by several days.  These are recommended for the elderly or chronically ill patients with influenza symptoms.

Being immunized by a flu shot significantly lessens one’s chance of getting the flu.  But as with any treatment there is no guarantee of 100% success.  One can still get a bad viral upper respiratory infection during the winter months even after the flu vaccine. Most people who receive the flu shot have no bad reaction to it.  Some people may experience redness and swelling at the injection site lasting a few days.  One cannot get the flu from a flu shot because it is made from a deactivated dead virus.  The benefit of the flu shot far outweighs the minimal risks.  Although the ideal time for a flu shot is from mid-October through November, the flu season can extend through May.

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It’s time for me to make my annual plea for everyone to get their flu shot. In today’s column, I’d like to answer common questions I hear about influenza and the flu shot.

– Can’t I get the flu from the flu shot?

This is a very common myth and proven to be wrong. You cannot catch the flu from the flu vaccine. The flu vaccines that are given by needle are made with viruses that are killed (inactivated), and cannot cause an influenza infection.

– I’ve had the flu shot previously and I got the flu anyhow.

This is possible, but not likely, in that no vaccine is 100 percent effective.

– I’ve never had a flu shot and have never had the flu.

Consider yourself lucky, and as in most cases, one’s luck will usually wear out. Don’t take a chance, this could be the year.

– The flu is no big deal.

Tell that to those who have not survived a bout of influenza, or to the worker who misses a week or more of work, as well as the student missing time from school. Besides, having the flu can make you feel very miserable.

– I worry that it could be harmful to my baby/child to have yet another vaccination.Babies have a higher incidence of death due to influenza. There is no proof that the flu vaccine worsens or changes the effects of the other routine childhood vaccinations. The recommendation is that everyone from six months of age and older should receive the flu vaccine.

– I have already gave a chronic disease and I take lots of medications. Do I really need a flu shot too?

All the more reason to receive a flu shot since the flu is the most deadly for those with chronic medical conditions.

– I have a tremendous fear of getting a shot.

The flu vaccine is available as a nasal spray and is approved for those between the ages of 2 to 49 years of age. It has been proven to be more effective than the shot in children 2 to 8 years of age. The viruses used to develop the nasal spray flu vaccine are alive but weakened (attenuated).

– I’m pregnant, won’t a flu shot harm my baby?

Not only has the flu vaccine injection been proven to be safe during pregnancy, but is highly recommended for pregnant women in any trimester of pregnancy. Only the injection form of flu vaccine and not the nasal spray should be used in pregnancy.

– I’m 35 years old and healthy, do I really need a flu shot?

In 2009-10, the swine flu (H1N1 virus) took a particularly heavy toll on the age group 18 to 64 years of age. Better safe than sorry.

– Any reason I absolutely shouldn’t get a flu shot?

There are a few reasons, the most common being a prior allergic reaction to a flu shot or a severe allergy to eggs. The vaccine should be delayed if you have an illness with a fever.

– When should I get the shot?

The flu season typically begins as early as October and can last until late spring. Flu shots are currently available and I advise getting it sooner rather than later. It takes about two weeks after receiving the shot for it to become effective.

– Where can I get a flu shot?

Most major pharmacies such as Rite Aid, Walgreens and CVS, provide flu shots on a drop- in basis, as well as through most primary care doctor’s offices. Larger medical groups such as mine, the Palo Alto Medical Foundation, will have special drop in flu clinic days. For children, call your child’s primary care provider to find out how they are to receive a flu vaccination.

– How much will a flu shot cost me?

For most people it is free, either because they have a government insurance plan such as MediCare or MediCruz, or they have private insurance. For those who have no such coverage, the out-of-pocket cost of flu vaccine is between $30 to $50 depending on which vaccine is given.

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Winter Resp

The winter respiratory, cold and flu season is upon us. I have seen quite a spike in visits to urgent care by people suffering from coughs, nasal and sinus congestion, sore throats and generalized achiness.

I believe that people, now more than ever, realize that there is no cure for the common upper-respiratory infection, also known as URI or head and chest cold.

I am sympathetic to anyone who feels ill, and I understand the desire to feel well as soon as possible, but there just is no quick fix to the common upper-respiratory infections, including bronchitis.

Unless one’s symptoms last longer than expected, as I will describe below, antibiotics will do no good and may even cause unwanted side effects and help create germs that are resistant to antibiotics.

Here are some situations in which someone with upper-respiratory symptoms should be seen by a doctor:

– You have a fever of 103 degrees Fahrenheit or higher.

– You have any fever lasting more than three days.

– Your cough is associated with wheezing, chest pain or shortness of breath.

– You are elderly or have a compromised immune system due to chronic disease or chemotherapy.

– You have vomiting for more than one day and cannot keep down any liquids, or you have profuse diarrhea.

– You are basically well, except that you have a cough for two to three weeks.

– Your sinus congestion with green mucus doesn’t improve after seven to 10 days.

Most coughs, even with yellow or green mucus, are considered bronchitis and are caused by viruses that cannot be cured with antibiotics. A recent large study concluded that bronchitis can last as long as 3 weeks. If your cough lasts longer, you should see a doctor.

Another reason to see a doctor is if you have a cough associated with fever, shortness of breath and feeling as if you’ve been run over by a Mack truck — you might have pneumonia or influenza. Treatment is available for many who have these illnesses.

Regarding sinusitis: Almost all sinus infections, even with green mucus production, begin as a common viral infection and will improve without antibiotics. If symptoms last more than seven to 10 days, then an antibiotic may be indicated.

When you do see your doctor, let him or her evaluate you by listening to what you have to say, examining you and then determining what type of treatment is necessary to make you feel better.

PS: It’s not too late for the flu shot. Influenza cases are just beginning in our area, and as is happening in other parts of the country, this disease may spread among us quickly. Better safe than sorry.

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It’s getting to be the time of year when respiratory illnesses, such as colds, coughs and the flu, begin to make more of us ill.

I’m frequently asked by patients whether they can return to work or school or resume exercising when feeling sick. I’d like to offer some guidelines to help make such decisions.

I know missing work or school can mean falling behind on one’s workload, but going to work or school while ill can not only prolong an illness, but also spread it to others.

It seems employers and educators are becoming more tolerant of excused absences due to illness. They realize that not only will workers or students who are sick be less productive, but they may cause others to become ill and affect the entire office or classroom.

In fact, it has been reported that more than two-thirds of all health-related productivity losses are the result of sick employees who show up and perform poorly — not those who miss work to recover.

As a rule, stay home when ill:

– If you have a fever (100 degrees or higher).

– If you experience frequent coughing or sneezing.

– If you are taking medication that may make you dizzy, lightheaded or unable to concentrate.

– If you have vomiting or diarrhea.

Consider returning to work or school when the above symptoms have cleared up.

Meanwhile, you can take several precautions — whether at home, at work or at school — to help keep from spreading illness to others.

Wash your hands frequently with soap and water or with a hand sanitizer, and keep your hands away from your face.

Cover your face when sneezing or coughing, using tissue paper or the sleeve on your arm.

Try to stay several feet from face-to-face contact with those around you.

I can’t emphasize enough the importance of keeping distance between those who are sick and others who are not. Germs are spread through respiratory droplets from our noses and mouths. In normal conversation and breathing, those droplets from the mouth may extend out one or two feet from you, but a sneeze or cough can spread them an estimated six to eight feet.

Those who are healthy need to act defensively when in the presence of someone who is showing symptoms of an illness.

Mild to moderate physical activity is usually OK if you have a common cold and no fever. Don’t exercise if you have a fever, fatigue or widespread muscle aches.

If you do choose to exercise when you’re sick, reduce the intensity and length of your workout. Exercising at your normal intensity when you have more than a simple cold puts you at risk for a more serious illness.

Let your body be your guide. If you have a cold and feel miserable, take a break. Scaling back or taking a few days off from exercise when you’re sick shouldn’t affect your performance. Resume your normal workout routine gradually as you begin to feel better.

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I would like to make my annual plea for everyone to get a flu shot.

According to the Centers for Disease Control and Prevention, there is a good supply of the vaccine available this year, enough for 135 million doses.

Influenza, commonly called the flu, is unpredictable. During the 2009-10 season the “swine flu” was a pandemic, causing thousands of hospitalizations and many deaths worldwide.

It is estimated that during an average flu season, 250,000 to 500,000 people die worldwide from complications of the flu. Although last year’s flu season was relatively mild, there were still numerous deaths, including 35 children who died of influenza in the U.S.

This year’s vaccine contains two new strains, plus the same H1N1 as last year. Children 6 months and older and almost all adults should be vaccinated, starting now. The vaccine’s effectiveness should last all season. Children 8 years and younger need two doses only in the first year they are vaccinated.

Flu shots are safe at any stage of pregnancy and are especially important for expectant mothers, as they are much more likely to have a serious illness resulting from the flu and could thus be more likely to miscarry or have a premature delivery. A pregnant woman’s flu shot stimulates her immune system, creating antibodies that cross the placenta into the fetus. That protects her baby during the first six months after birth, before the infant is old enough to be vaccinated.

There’s no need to delay receiving the flu shot because of a mild illness, but don’t get a shot if you have a fever. Waiting until the fever is gone or until you’re feeling better after a more moderate or severe illness is the rule.

Many people worry that a flu shot might give them the flu. That is just not true. The viruses found in the flu shots have been inactivated (killed), and dead germs cannot cause illness. They do, however, stimulate the immune system to create antibodies to help prevent the flu.

The only people who should not get a flu shot are those who:

– Are allergic to egg products.

– Have already had a bad reaction to influenza vaccine (extremely rare).

– Have had an episode of a neurological disease called Guillain-Barre syndrome.

A few minor side effects may briefly occur from the flu shot, such as a mild ache and redness at the injection site, a low-grade fever and mild body aches.

I look at it this way: Why not get a vaccination that has minimal side effects and has a good chance at preventing an illness that could make you feel terrible for a week and also make you miss work? It’s a cheap form of health insurance.

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It’s that time of year again to start making preparations for the flu season, which can begin as early as October and last as late as May.

Influenza, the name of the virus for which the “flu” season is named, causes a highly contagious respiratory infection that often starts very quickly and may cause the following symptoms:

– Fever, headache and extreme fatigue

– Cough, sore throat and runny or stuffy nose

– Body aches and sometimes vomiting and diarrhea

The flu can cause mild to severe illness and occasionally can lead to death. Most healthy people who contract the flu recover without complications. However, some people, especially the elderly and the very young, as well as those with chronic medical conditions such as diabetes, heart disease, and asthma, are at a high risk for serious complications of the flu. One of the most deadly side effects of the flu is pneumonia, which is a very serious lung infection.

The flu usually spreads from person to person via respiratory droplets when someone who is ill coughs or sneezes. It also often spreads when a person touches some object that has the influenza virus on it and then touches the mouth, nose or eyes.

A person coming down with the flu is contagious from one day before any symptoms appear and remains contagious for up to five days after the symptoms begin.

The best way to prevent getting influenza is to get a flu vaccination. The vaccine is approved for use in people older than 6 months of age. Almost everyone can benefit from the flu shot, but it is highly recommended for the following groups:

– Pregnant women and children younger than 5 years

– People 50 years of age and older and those with chronic medical conditions

– Those who live in nursing homes or other long-term care facilities

– People who work or live with those at high risk for complications of the flu

The flu shot contains a dead virus which, when injected via a needle in the arm, will cause a person’s immune system to create antibodies to help prevent one from getting infected. This vaccine cannot give anyone the flu, but it can cause side effects of soreness, redness or swelling at the injection site, low-grade fever and aches. These side effects are usually very mild and last only a few days. In extremely rare instances, a severe reaction may occur, as is possible with any vaccination or medical procedure. Don’t get vaccinated if you have a severe allergy to chicken eggs, have ever had a bad reaction to a flu shot or are ill with a fever.

Flu shots are already available at many doctors’ offices and also are being conveniently provided by the local pharmacies CVS, Walgreens and Rite Aid for about $30 cash, with Medicare and some private insurance accepted.

I think of the flu shot as being a form of cheap health insurance. I’ve already gotten mine and hope that you will, too.

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Every parent of a sick child wants to do whatever possible to make the child feel better. But most cold- and flu-like illnesses in children are caused by viruses, which will be cured by the child’s own immune system.

Many over-the-counter cold medications for children have been withdrawn for safety reasons. The Federal Drug Administration now warns against giving children younger than 4 years any over-the-counter medications, other than pain and fever relievers.

Here are my suggestions for symptomatic relief of your child’s cold- or flu-like illness:

Encourage the child to drink plenty of fluids to prevent dehydration and to help thin out mucus. Contrary to popular opinion, milk has not been proven to increase mucus.

Fever or pain can be controlled using either acetaminophen (Tylenol) or ibuprofen (Advil). Accurate, consistent doses should be given every six hours.

Saline irrigations can help with drippy noses. For infants, use rubber bulb suction with saline nose drops to remove mucus. Older children can use a saline nose spray.

Place a cool-mist humidifier or vaporizer in the child’s room. To prevent contamination, the water should be replaced daily and the machine cleansed regularly according to the manufacturer’s recommendations. Keep indoor relative humidity at about 40 to 50 percent.

If a medication such as Tylenol or Advil is given, I do not advise the use of household silverware spoons for dose measurement. Teaspoons found in our kitchens can vary in size and should be used only for eating, not for measuring liquid medication. Proper measuring devices using units of milliliters usually come with the medicine or can be obtained from a pharmacist.

Honey can relieve a cough by increasing saliva, which coats the throat and relieves irritation. Suggested doses are half a teaspoon for children between 1 and 5 years, 1 teaspoon for children 6 through 11 years and 2 teaspoons for children age 12 and older. Do not give honey to a child younger than 1 year of age.

See your health care provider immediately for:

** An infant not yet two months of age with any fever

** A child younger than 2 years with a fever that lasts longer than two to three days

** A child who complains of an earache or a severe sore throat

** A child who has thick green nasal discharge for more than one week

** Mild symptoms that do not improve in 10 to 14 days

** Any child who seems very ill to you

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The 2010 influenza season officially begins in October, but cases of flu in some areas of the country have already been reported to the Centers for Disease Control and Prevention. The infection usually peaks in January, February and March and usually ends by May. It is impossible to predict ahead of time how bad the flu season might be, but as we learned with the H1N1 (swine flu) last year, it’s best to be prepared.

Fortunately the H1N1 bug never became the nightmare that it could have been. But it was bad enough, killing almost 13,000 people and sickening more than 60 million in the U.S. alone.

This year’s flu shot will provide protection against the three strains of flu expected to be most prevalent: H1N1, a new strain called H3N2 and influenza B. The swine flu virus will most likely affect the young, as it did this past year, and H3N2 will cause illness among the elderly. Those who had either the seasonal or the swine flu vaccine last year are recommended to get this year’s flu shot as well. There is no anticipated shortage of flu vaccine this year, as there was last year.

The new 2010 vaccine is now becoming available to the public. I recommend that people get immunized as soon as it is available, as there is no good reason to delay it. After being immunized, it takes about two weeks to become effective and it will last all through the flu season.

Although I recommend that everyone be immunized, these following groups are the most at risk:

* Pregnant women.

* Children younger than 5, but especially children younger than 2 years old.

* People 50 years of age or older.

* Those with chronic medical conditions or who live in nursing homes.

* Those who work in the health care industry

* Those who live with persons with chronic disease who are at high risk for the flu

* Those who live with or take care of infants younger than 6 months old (these children are too young to be vaccinated).

The viruses used in the flu shot are killed (inactivated), so you cannot get the flu from the flu shot. However, some minor side effects can occur, including soreness, redness or swelling at the site of the injection; a low-grade fever; and generalized aches

If these side effects occur, they usually show up soon after the shot and last 1 to 2 days.

Some people should not be vaccinated. They are the following:

* People who have a severe allergy to chicken eggs

* Those who have had a severe reaction to an influenza vaccination in the past

* Infants younger than 6 months of age

Also, those who are sick with a fever should wait until they recover to be vaccinated.

So, should you get a flu vaccine this year? All I can say that as I look back over my past 37 years of medical practice, the vast majority of patients whom I have treated for symptoms of influenza have been people who were not immunized.

Read more:Press-Banner – Your Health Consider vaccination as flu season approaches

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Flu activity seems to have quieted down recently, for which we can all be thankful. But the flu season is not over yet. Influenza is still out there.

Many states are reporting flu activity, which still remains a threat. Seasonal influenza usually peaks in February and March and can continue as late as May. So increased activity from the seasonal influenza, the H1N1 flu or both is still possible.

We need to remember the 1957-58 pandemic, when flu activity decreased in December and January. Thinking the worst was over, officials relaxed their push to get people vaccinated. When flu activity significantly returned in February and March, many were hospitalized, and deaths increased, as well. This could be a good lesson for us today.

So far during this flu season, most activity has been attributed to the H1N1 virus, which first appeared in April.

By the middle of November, the United States had reported roughly 47 million H1N1 flu cases. This resulted in well over 200,000 hospitalizations and caused nearly 10,000 deaths. About a thousand of those deaths were in children younger than 18, a number of whom were healthy before they caught the flu. That is why it is important not to take this disease lightly.

Although I think everyone would benefit from the flu vaccine, it is especially important for certain groups. You should be vaccinated if you:

• Have a chronic illness such as asthma, heart disease, or diabetes.

• Are pregnant.

• Are 65 years or older, and therefore are at increased risk of complications.

• Care for or live with a baby less than 6 months of age, as these infants are too young to be vaccinated for influenza.

Children who are 9 years old or younger need two doses of vaccine about a month apart; however, waiting more than a month between doses does not seem to decrease the effectiveness of the vaccine. Adults need only one dose.

HSN1 Virus Under a Microscope

Regarding popular worries about side effects of the H1N1 vaccine, data from the established surveillance systems would indicate that H1N1 has a safety profile similar to that of the seasonal flu vaccine. No significant pattern of adverse health events have been seen with either of the vaccines.

The bottom line is that although flu activity has died down this past month, the season is not over. It is still important to get vaccinated and be prepared for a possible increase in flu activity, which could occur between now and May. At this time, there appears to be enough vaccine for anyone who wants it.

I would like to thank the Palo Alto Medical Foundation’s Santa Cruz Incident Command Committee for supplying some of the information for this article.

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Health officials are concerned about the possibility of a surge in swine flu cases appearing soon after students return to school this fall.

The symptoms of H1N1 infection, called swine flu, include fever, cough, sore throat, body aches, headache and, sometimes, vomiting and diarrhea.

To help prevent an epidemic of this illness, we must all do our part. If you become sick with these symptoms, you will probably be ill for at least one week. You should stay at home and avoid close contact with others as much as possible.

Avoid most of your usual activities, such as school, work, shopping, social events and public gatherings. Do not resume any of these activities until at least 24 hours after your fever is gone. This period of isolation is of utmost importance to help prevent the spread of swine flu.

Schools will send sick students home. When an ill child is identified, there may be isolation rooms where students will wait until they can be picked up and taken home.

At all times during your illness, you need to cover your cough or sneeze with a tissue and wash your hands frequently with soap and water for 15 to 20 seconds, or use one of the many available alcohol-based hand sanitizers.

Avoid face-to-face contact with others by keeping a distance of at least 3 or 4 feet between you. If you have to leave home to seek medical care or for some other necessity, wear a mask.

In case of a severe swine flu epidemic, many of us may need to be confined to our homes for a period of time. I recommended having the following supplies on hand to get through a period of home confinement:

  • A one- to two-week supply of food and water.
  • Medication for treating fever, aches and pains, such as Tylenol (acetaminophen) or Advil (ibuprofen).
  • Cough medication, such as Robitussin DM, Vicks 44 or honey/menthol lozenges.
  • Throat lozenges, such as Sucrets Complete (with dyclonine and menthol).
  • Electrolyte drinks, such as Gatorade or Powerade.
  • Alcohol-based hand sanitizer, such as Purell.
  • Surgical masks, obtainable from most pharmacies.
  • In the event of a major swine flu epidemic, being able to see a doctor and receiving treatment may be difficult. That is why I recommend the above list of supplies and home remedies.

    No one knows how the swine flu season will unfold. I hope it will be no worse than any other flu year. But we have to be prepared, just in case.

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