AUAA… Episode 35 – The Flu – Penn State Medical Group-Elizabethtown

>>From Penn State Health, this is Ask Us
Anything About the Flu. I’m Scott Gilbert. Every year the flu is responsible for hundreds
of thousands of deaths across the world, so it’s not a mere nuisance, it’s something to
be taken seriously. Here today to talk with us more about the
flu, give us some good information about it, is Dr. Jay Zimmerman, he’s a family medicine
physician at Penn State Medical Group, Elizabethtown, which is where we are right now, so thanks
for having us here doctor. Let’s talk a little bit about this year’s
flu strain. Because, I mean, the flu is not the same every
single year, right? The flu is not just simply the flu but rather
there are various strains that are prevalent each year.>>Right, every year the flu strain that is
available around traveling changes, it has different forms, the different viruses you
may hear about, the different strains H3N2’s. This year’s one that seems to be going around
more right now and from the labs that they’re checking the different types.>>And so that’s referred to often as influenza
A, but yet like you say, that’s just one of several.>>Right. So when you go get your flu shot you get the
influenza A vaccine and usually has different strains in there. So whether it’s the H1N1 or the H3N2, and
then you also get an influenza B in there, depends on which flu vaccine you get.>>And I’ve heard that H3N2, that strain you’re
referring to, based on its previous performance in other years can lead to more severe disease,
is that a concern among providers this year?>>Yeah, it certainly is a concern when we
have something like that happen and we have a historic worsening of symptoms like when
the H1N1 came out, H1N1 hadn’t been seen for years. So a lot more people who were young and healthy
would get it and be really really sick, so.>>Yeah, the big swine flu scare several years
ago, as it was called.>>Correct, yeah.>>Alright, you’re watching Ask Us Anything
about the flu, from Penn State Heath Dr. Jay Zimmerman is here to answer your questions
and mine about the flu. So feel free to add them to the comment field
below this Facebook post and we’ll get you answers to those questions whether you ask
them live or if you ask them as you’re watching this video on playback, we’ll add those answers
as comments here. Let’s talk about the more severe complications
that can result from flu. We hear about some of those each year but
who’s most at risk, first of all, of developing those complications?>>Sure, when you think about that, the people
that are most at risk would be the people with preexisting problems like heart problems
or lung problems, folks with asthma, emphysema, COPD, or folks with congestive heart failure,
those are the people I’d be most worried about. Kids with cystic fibrosis, interestingly enough,
pregnant women are also really high risk too, so we always recommend that they get their
flu vaccine and them getting flu vaccine can help their babies from getting flu as well.>>And I know that you are recommending to
your patients that they absolutely get the flu vaccine if they’re able to. We do hear that there are subsets of people
who are not able to receive it. Who are they?>>So that’s a pretty small minority of people. It used to be that people with egg allergies
couldn’t get it and now we find that that is totally safe to do. If you have somebody who’s had some sort of
very rare neurologic problem; Guillain-Barre, or GBS, that’d be somebody who shouldn’t get
the flu vaccine. But otherwise it’s pretty widespread that
you can get it.>>And of course the effectiveness of that
vaccine varies widely from year to year, why is that?>>Yeah. So that’s a great question. And so part of the reason why it varies so
widely is that we never know exactly which strain is going to be around so we make the
best predictions and so we usually use the southern hemisphere so Australia and other
countries in the south to predict. And so this year the H3N2 in Australia was
really big and I think it was two years ago, about 90 thousand cases documented and this
year jumped up to about 150, 160 thousand cases. So that is a big increase and we’re seeing
the H3N2 in the United States here. Will it be as bad? We don’t know because we don’t know how everybody’s
going to respond to it, but the flu vaccines made the same so hopefully we’ll get a good
response for those folks that get the flu vaccine.>>And there are some early indications that
this year’s flu vaccine may not be effective in fully preventing the flu, is that right?>>Yeah, that’s right. So the data from Australia kind of says that
it wasn’t as effective for the Australians and assuming it’s pretty similar here, that’d
be the best guess.>>So a lot of people thinking then why should
I bother to get the vaccine. There’re actually several good answers for
that, aren’t there?>>Yeah, absolutely. So even if it’s not good, it’s still better
than nothing. So most people, they might get soreness at
the site of the shot, but otherwise they do really well with the flu vaccine and if it
helps prevent you from getting the flu or making it so it’s not nearly so bad, that’s
something I certainly would recommend for all my patients.>>Why is the misconception out there that
the flu shot can actually cause the flu? I’m sure that’s something you hear.>>That’s a great question, that’s something
we hear all the time. Chances are they probably picked it up at
the same time, it just happened to get in and they feel like it’s linked to it. But I’ve certainly seen patients who are utterly
convinced and then I can’t convince them to get the flu shot, unfortunately. But you know I think just people kind of feel
bad and a little achy afterwards and that can make them feel like they have the flu
or they’re worried about it. And if you ever had the flu, you feel like
a train wreck, in the worst case you feel like you were run over and that’s not what
the flu shot gives you at all. You may feel a little bit sore and achy for
a day or two at most from what I’ve seen.>>That’s not a bad trade-off for what the
flu itself could cause, though.>>Correct. And all my patients who’s ever had the flu,
they will get the flu shot every year after that, every year. They say I would rather take my chance of
only 10% effectiveness if I can prevent that.>>Or even lessen the symptoms, right? Because as you mentioned it may not, even
if it doesn’t prevent the flu, it may help to mitigate the symptoms.>>Right, so your symptoms might be a little
more mild, you may not have the high fever or not as many aches, the headache might not
be so bad, absolutely.>>You’re watching Ask Us Anything About the
Flu from Penn State Health. Doctor Jay Zimmerman here welcomes your questions
as we come to you live from Penn State Medical Group Elizabethtown. We have a question from Pearl, she asks “once
you already have the flu do you need to have the flu shot?” I’m not sure if she means in a given year
or if once you’ve had the flu obviously like you just mentioned if you get it one year
you still should especially if you get the flu one year you should still get the shot
in subsequent years.>>Sure. So a lot of my patients come in and say they
had the flu already and I asked them what kind of symptoms they’re having and they talk
about the stomach flu. And I say well okay that’s very different
from the flu vaccine that we’re giving, the flu that we vaccinate for is respiratory,
so lungs, breathing, cough, headache, high feverish chills, not the stomach bug, stomach
flu. So a lot of people think those are the same
things but if you have the flu yes you should still get the flu vaccine because usually
flu A goes around first and then a couple months later flu B comes around and so you
can still get some protection from flu B then, if that’s the case. And we don’t know if your strain was the same
one that we’re vaccinating for or not and every time we get you the vaccination your
body is going to develop a response and then the next time the flu comes around it can
fight the flu better.>>And it goes back to the fact that there
are different strains out there and you should protect yourself against all of them. But the stomach flu is not a strain of influenza. It’s a virus but not a–>>That’s correct, a lot of times the stomach
flu is not influenza per se, there are many viruses in the US that cause that, but yeah.>>Well thank you for that question, Pearl. Our next question is from Christina. She says “how long does the flu shot last?” That’s an insightful question because I think
some people are afraid of having it too early, is there such a thing?>>Yeah, so I mean a lot of people are worried
about that so we do see a response in the body to the flu shot, your body starts making
a response to the flu and that does kind of increase pretty quickly in the first number
of weeks, four to six weeks. But it takes about two weeks for it to kick
in. So the problem is if the flu starts going
around and then you go get a flu shot and you get the flu the next day, it’s not going
to help you. So it takes two weeks for the flu shot to
start working a system. Then your body actually creates this types
of response that if it sees it again it should then be able to trigger a response anyway,
so there’s not such a thing as getting it too early.>>I have two small children at home, they
really miss the nasal flu mist. Remember, you know, just a couple years ago
but it was pretty much deemed to be highly ineffective last year and they haven’t really
figured out how to make it effective, right?>>Correct. So you know, I loved the flu mist vaccine,
I thought it was a very good thing when it first came out. The studies looked pretty good, it’s painless,
you might get a little runny nose and that sort of thing. And that’s what I was getting because I thought
it was the best and then found out that it doesn’t seems to be as effective as the injection. So because of that, the major body said that
we shouldn’t give it to anybody. And so now I think they’re not even making
it anymore.>>Some people may say well I don’t need to
get the flu shot because I’m relatively healthy. If I get the flu it’s probably not going to
be that severe of a case. But can you talk about the importance of getting
vaccinated to help protect those who are not able to get vaccinated?>>Right. So hear a lot of that, oh I’m never sick,
I’m always healthy, that’s fine that’s great for you, and may have mild symptoms and go
on and go to work and go to the store and that sort of stuff. And all the people around you who don’t have
that same immune response, they can’t protect themselves the same way. So with you with your kids, obviously if you
don’t get the flu or your flu’s more mild, you’re less likely to pass it on to them or
them pass it on to you. So yeah, certainly if you’re caring for somebody
who’s elderly or has one of those lung conditions or has young kids or is pregnant, then it’s
really a good idea for you to get the flu shot as well.>>We welcome your questions for Dr. Jay Zimmerman
as we broadcast live from Penn State Medical Group Elizabethtown. For Ask Us Anything About the Flu. Some really good information, very timely
too because we’re in December right now and we’re heading into the holidays. But when does flu season typically peak?>>So that varies year by year. So with the swine flu it was September once
the kids went back to school, but typically we usually see it, last few years it’s been
much more almost February and March, although I think we’re starting to see a big uptick
now in the States. Four different states I think have already
declared that it’s at full activity. And I’m not sure where Pennsylvania is on
that right now.>>Pearl has a follow-up question asking about
how early in the season should you get the flu shot. And she’s also asking when is it too late
to get one. So I know you mentioned it takes about two
weeks to take effect, is there such thing as too late in the flu season to get vaccinated?>>So I think usually when we look at it we
kind of see the peak of the flu come through and be gone, that’s usually with the flu A
and then flu B can come around up to a month afterwards. So the answer is I don’t know that’s really
too late if you’re seeing the flu season’s already come and gone it’s probably a little
on the late side. And no there’s not a too early, so I know
sometimes the local pharmacies will have a flu in stock in September and getting that
then is fine.>>We’re talking about vaccination as a great
way to prevent the flu, but there are some other methods too like hand hygiene.>>Absolutely, washing your hands, using the
hand sanitizer, those are the best things. Sneezing into the elbow of course can also
be helpful rather than covering with your hand. So those are all good things and of course
the hand hygiene is the biggest one.>>And so if those measure despite your best
attempts don’t work and you get the flu, people may wonder is this something I can treat at
home or what are some symptoms that maybe if they surface I should see a provider?>>Yeah so there are a lot of people that
can treat this at home. So things like the Tylenol, Motrin just for
the aches and pains and cough and cold medicines, that certainly is fine. If somebody’s starting to cough up something
that looks really bad, if they’re getting really short of breath, they feel like they’re
always winded, that’s a good reason to see a medical provider. Of course anybody with those underlying lung
conditions or congestive heart failure, who’s pregnant, really young kids, there is medicine. Tamiflu is one of those medicines, that antiviral
medicine. It’s not a great drug but it’s the only thing
we have out there that actually fights the flu. So it can help reduce the symptoms by some
degree. And so that’s something that if in the first
two days we start doing it can help.>>Very interesting, so there are antiviral
medications like that that are available. But like you say, it’s not going to cure it
instantly, it’s not going to go away in 24 hours necessarily.>>Right. I mean, the flu can last seven to ten days,
and like I said a lot of people feel like they’re hit by a Mack truck. Some people will get it much more mild, but
there’s people who just look like they’re dragged through the mud.>>A lot of things do get referred to as the
flu, I know you mentioned the stomach flu earlier. But what we’re talking about here, again,
it’s really something that affects the respiratory system more than anything else and that’s
not a system you want to mess with.>>Right, so I mean certainly shortness of
breath, I see people when they have the flu they can to me sound really wheezy when I
listen with the stethoscope. They’re going to cough, they’re going to have
typically bad headaches, muscle aches, and that sort of stuff, sweating, fevers, absolutely.>>Okay. Well this is Ask Us Anything About the Flu
from Penn State Health and we’ve been talking with Dr. Jay Zimmerman live here at Penn State
Medical Group Elizabethtown. We thank you very much for watching. Anything else to add as we bring things to
a close? Anything you want people to know? Other than get that shot.>>No, other than we’re still giving the flu
vaccine in clinic, that’s it.>>Alright so get vaccinated and we hope you
stay healthy this winter season and this flu season. Thanks again for watching Ask Us Anything
About the Flu from Penn State Health.

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