2017-2018 Seasonal Flu

Flu season is here. The best guard against the flu is to educate yourself about it, how to prevent it, and if you get it, how to take care of yourself, and most importantly get the flu vaccine every season. The flu is caused by a virus that strikes the respiratory system. This is not the same stomach flu (Gastroenteritis), which causes nausea, vomiting, and diarrhea. There are several types and sub types of flu. We often hear most about type A and B. Type A is the flu recognized during the winter months when flu is expected to be most active. Widespread flus occur about every 10 years, and people tend to get sicker than when the usual annual flu comes around.

Transmission is through direct contact from one person to another through coughing, sneezing, or touching someone (handshake) or an object like a tissue used to blow their nose or cough into. You are contagious from the day before you start having symptoms up to 7 days after they develop. Symptoms often develop 1-4 days after your exposure. The flu should pass in 5-7 days, but you may feel tired for several weeks.

Risk factors include those who are very young, elderly, live in nursing homes, those whose immune system is compromised, such as HIV, and cancer patients, those who have respiratory problems already, such as, asthmatics, and COPD, heart problems, pregnant women, and those who are overweight.

Diagnosis of flu is now often made using a rapid test, but it is not 100% accurate, and is usually diagnosed by the provider based on symptoms, exposure history, and community alerts to outbreak by the local department of health.

Symptoms include fever, body muscle aches, runny nose, chills, sweating, headache, cough, fatigue, weakness, nasal congestion, and sore throat. Sometimes vomiting can be seen in children. Smoking worsens symptoms. Complications include Pneumonia, sinus infections, dehydration, Bronchitis, Asthma flare-ups, ear infections, and heart failure for those with heart problems.

Antiviral medication early in illness can shorten the flu, reduce severity, and prevent complications. The antiviral may not work though. The medication must be taken within 48 hours of the first symptom, and does not mean you should not get the flu vaccine. Two medications used are Oseltamivir (Tamiflu), and Zanamivir (Relenza). Antibiotics, Vitamin C, and Echinacea cannot prevent or treat the flu. Other treatments include plenty of rest, and increased fluid intake. Treat aches and pain with Tylenol or Ibuprofen. Cough medicine and nasal decongestants may help those symptoms.

Seek immediate medical care if you have trouble breathing, have a severe headache with a stiff neck, feel confused, or you cannot stay awake. You should see your doctor if you have very high fever that lasts more than 3 days, if your child is less than a year old and has a fever, pain to ears, chest, throat, sinuses, or wheezing.

Prevention includes vaccine against the flu every year, frequent hand washing, cough and sneeze in a tissue and then dispose of the tissue in a garbage container, and avoiding crowded areas. The CDC currently recommends vaccination for children over 6 months of age. Higher dose vaccination is available for those over 65 years of age. There are different types of flu vaccines. Ask your doctor which one is best for you. The most common are made with or without eggs, and have no preservative. Make sure to notify your provider if you are allergic to eggs, have a history of Gillian Beret, or feel sick the day of your vaccination. Wearing a surgical mask is a good idea for caregivers. Sanitizers that contain alcohol may help with cleaning surfaces, such as door knobs, remote controls, and cell phones. Bleach is also effective, but may not be appropriate for cleaning some objects as it may cause damage.

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Acute vs Chronic Bronchitis

Acute bronchitis is more common during cold and flu season. Acute inflammation is caused by a virus or bacterial infection and usually resolves on its own except for people with:
1. Respiratory irritants such as cigarette smoke, pollutants, chemicals
2. Lowered immune system- such as children, elderly, pregnancy, cancer,
diabetes, HIV
3. Heartburn- GERD
4. Respiratory conditions- Asthma, Chronic Obstructive Pulmonary Disease
(COPD)
Symptoms usually began with upper respiratory set the symptoms such as sore throat stuffy nose and cough. The cough starts as a dry hacking nonproductive and usually interrupts sleep. After a few days mucus production begins. Chest X rays may be normal or show inflammation. Scattered wheezing may be noted, and fever may be present. Respiratory infections can last up to 3 weeks. Symptoms include cough with little to no sputum, low grade fever or chills, sore throat, body aches, tightness or pressure of the chest. Sputum tests look for type of respiratory infection such as pertussis.

Chronic bronchitis involves excessive mucus production. There is a relationship between the amount and duration of cigarette smoking and severity of bronchitis. But in advanced stages of chronic bronchitis, emphysema can develop as well as heart failure, increased airway obstruction, and Polycythemia which can result in pulmonary embolism. Diagnosis occurs when the cough and increased mucus production occurs three months each year for two years. Advanced stages of chronic bronchitis can resemble emphysema. Over time chest xray results would show hyperinflation of the lungs. Pulmonary function tests show airway obstruction.

Seek medical care if:
1. Cough lasts more than 3 weeks
2. Prevents you from sleeping
3. Fever of more than 100.4
4. Yellow/green/dark colored mucus or having streaks of blood
5. Having wheezing or SOB

Treatment includes bed rest, and increase of fluid intake as well as:
1. An antibiotic if infection is bacterial
2. Cough medicine- to help expectorate mucus. Cough suppressant only at
bedtime allows for better sleep
3. Inhalers to reduce inflammation and open narrowed passages in your lungs
4. Wear mask if your exposed to respiratory irritants at work
5. Use humidifier
6. Vaccines- flu, and pneumonia
7. Hand washing to prevent spread of viral infections.
8. Use hand sanitizers