Search for tag: "flu"

Interviewer: Should you get tested for COVID-19? It's an ongoing question that many people have. Dr. Richard Orlandi is the Chief Medical Officer of Ambulatory Care at University of Utah Health and he says, as a general rule, if you are experiencing the following symptoms, you might want to consider getting a test.

Dr. Orlandi: If you have symptoms of fever, plus a cough, shortness of breath, malaise, that feeling of feeling sick, like you have the flu, we're saying go ahead and let's get you in and let's get tested. It doesn't matter where you've traveled. It doesn't matter if you've been exposed to someone. Let's just get you in and get tested.

Interviewer: Dr. Orlandi goes on to say, before you go, you should make a phone call first.

Dr. Orlandi: A lot of times, we can discuss your symptoms over the phone or through a virtual visit and get you to where you don't need to go to the test. We could say, "You know, we've talked about it. Based on what we're seeing and hearing from you, testing is not really necessary for you right now."

Interviewer: And if you're concerned whether or not you could possibly get COVID-19 at the testing site, Dr. Orlandi says you don't need to worry about that.

Dr. Orlandi: The good news is not a concern. We have done everything we can in working with our epidemiologists and our infectious disease experts to make that as safe as possible. So in between each test, our staff are wiping off any surface that could have come in contact with the patient, changing out their gloves, and doing everything necessary to make that as safe as possible for each one of our patients.

Interviewer: To find the telephone number to call about testing, or to find out the latest testing criteria and other COVID-19 information, go to uofuhealth.org/coronavirus.

This information was accurate at the time of publication. Due to the changing nature of the COVID-19 pandemic, some information may have changed since the original publication date.

Dr. Gellner: Every winter, we see a lot of kids with coughs, runny nose, sore throat, fevers, diarrhea, and we all immediately think it's the flu. But is it? I'll talk about influenza versus adenovirus on today's Scope. I'm Dr. Cindy Gellner.

Announcer: Keep your kids healthy and happy. You are now entering "The Healthy Kid Zone" with Dr. Cindy Gellner on The Scope.

Dr. Gellner: Wintertime is the worst for parents. It seems our kids are constantly sick. Everyone has runny noses, coughs, sore throats, fevers, vomiting, diarrhea, the list goes on. And the flu can definitely cause all of these symptoms. But there is another virus that loves to make us miserable too. It's a virus we pediatricians often call the mimicker virus, because it can mimic the symptoms of the flu or pinkeye or the stomach virus and even appendicitis. It's called adenovirus, and it's a nasty virus that's around all year, not just in winter.

There are over 60 types of adenoviruses, and they can all cause different symptoms. With adenovirus, most symptoms last about 10 days. And most symptoms are easily treated with nasal saline for congestion, fever reducers, and rest. This is in contrast to influenza where symptoms can be so bad that kids get dehydrated, have problems breathing, and can be so truly lethargic that it's scary to watch.

Both viruses are spread by direct contact with someone who is coughing or sneezing or contact with door handles and light switches that someone who had these viruses touches. Adenovirus can live on surfaces for weeks. Unlike influenza, which can cause outbreaks, adenovirus is usually sporadic, a case here, a case there, and they're usually not deadly.

While doctors do test for influenza, they usually don't test the child for adenovirus, unless the child is being admitted to the hospital. So sometimes it's hard to determine if that's what a child has or not. Regardless of if the virus is influenza, adenovirus or any of the other viruses that makes our kids miserable, the best way to keep your child virus-free is to teach them to wash their hands frequently and avoid touching their faces.

Kids like to put their fingers in their noses and their mouths, and that is exactly how the viruses get into their bodies and start making them sick. As a pediatrician, I know how frustrating it is to tell parents, "I'm sorry, it's a virus," because there isn't much we can do for your child in terms of medications. But I do tell parents viruses can be anything but benign, and they can make your child seem more ill than if they had a bacterial infection.

If you ever have any concerns about viruses, be sure to talk to your child and take your child to see their pediatrician. And definitely take their viral illnesses seriously.

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Interviewer: Dr. Scott Youngquist is an emergency room physician. First of all, let's just talk about, I'm out in the heat, what are the symptoms that I might have started to get heat stroke?

Dr. Youngquist: Well, mild symptoms may feel like a mild flu-like illness. All the way up to severe symptoms, such as confusion, trouble breathing, chest pain, abdominal pain.

Interviewer: All right. So it's degrees, not just a singular condition?

Dr. Youngquist: Exactly.

Interviewer: All right. And the kind of . . . I'm trying to recall when I thought maybe I might have had heat stroke. I remember feeling a little nauseous, I think, a little light headed, really tired and fatigued. And then after about a half hour, 45 minutes, that kind of went away after I got out of the sun. Is that pretty normal?

Dr. Youngquist: Yeah, that would describe someone with a mild heat related illness, I would say, and not severe hyperthermia or heat stroke.

Interviewer: All right. And did I do the right thing just by getting out of the sun? Should there have been other things that I did at that point?

Dr. Youngquist: No, you did exactly the right thing. You want to stop any exertional activity that generates metabolic heat, such as running, jogging, forceful exertion. Get out of the heat and get to a cool environment. And then replenish any fluid losses through sweating or from the heat alone by drinking water or an electrolyte solution.

Interviewer: And I imagined once you start feeling those light symptoms, you should really take that as a warning so it doesn't get more severe. Explain what could potentially happen if you didn't?

Dr. Youngquist: Absolutely. There are all sorts of problems that can arise from heat related illness if it's not treated early. And those include things like liver failure, shock, hemodynamic collapse, things that cause you to go ultimately into cardiac arrest and death.

Interviewer: So it's something to take very seriously. If it's a mild case and I get better after about a half hour, I'm good, how long should I wait, though, before maybe, even in that mild case if the symptoms aren't going away before, maybe, I consider seeing a doctor?

Dr. Youngquist: Well, I think in your case, you know, if it's 30 to 45 minutes after you've treated the mild symptoms, if they're resolving or they've resolved completely, you don't need to go see a doctor for that.

Interviewer: All right. And if you do go see a doctor, what types of treatments would you give me then at that point?

Dr. Youngquist: Well, you'll get a careful history and physical examination. And then the treatment from there will depend on the severity of the case, but may include intravenous fluids, it may include passive or active cooling measures, and investigation into evidence of end organ damage.

updated: June 15, 2021
originally published: June 26, 2019

Interviewer: Flu season 2016-2017 update. That's next on The Scope.

Announcer: This is "From the Frontlines," with emergency room physician Dr. Troy Madsen, on The Scope.

Interviewer: Dr. Troy Madsen's an emergency room physician at University of Utah Health Care. And a lot of times, he's going to see things happening in the community before the rest of us really even hear about it. And from what I understand, it's a pretty bad year for the flu this year.

Dr. Madsen: It sure is, and, again, I'm speaking from my perspective in the ER where we see the sickest of the sick. But I have seen some incredibly sick people who have had the flu. These are people who have come in. I've seen them. I assume they some sort of just severe pneumonia, some sort of sepsis, where the infection from a bacteria has spread through their body. I'm not finding any source besides the flu. And these are individuals where I ask them afterward, I say to them, "Well, did you get the flu shot this year?" And they say, "Absolutely, I did."

So we're seeing a resistant strain out there. We're definitely seeing people who are getting very, very sick with this who we're admitting to the hospital and I'm seeing quite a few people. And as I talk to other ER doctors, as I talk to our pharmacists in the emergency department, they say that's been pretty much reflective of what we're seeing across the board right now.

Interviewer: All right. So the flu season, you just never quite know when it's going to hit, but you're saying it's hit.

Dr. Madsen: It has absolutely hit.

Interviewer: And if you got the flu shot, you're going to want to take some other precautions as well because it could be a strain that wasn't vaccinated for.

Dr. Madsen: That's exactly right. And I don't have all the data to note how many of these strains that we're seeing now are going to be prevented by the flu shot versus how many of these are not. Again, I'm seeing a lot of cases of people who had their flu shot who are getting very sick from the flu.

But don't assume because you had the flu shot you can just walk around anyone who's sick and walk away just fine. You've got to wash your hands. You've got to try and avoid contact with people who are sick, if you can, certainly if they're family members, just practice basic health hygiene. Try to stay well, but know that you may have the flu, even if you had the flu shot and you get sick.

Interviewer: So as an emergency room physician, how do you not get the flu then? Because, I mean, you're around all these really sick people with the flu.

Dr. Madsen: Yeah, it's a challenging thing. If people come to the ER with flu-like illnesses, in the triage area, they automatically put a mask on them because it's spread by droplets when they're coughing and sneezing. That's one thing you can certainly do at home. We wear masks in the room as well. Certainly hand washing, making sure we're doing that frequently. You know, it's basic hand washing and basic sanitation practices you'd do at home as well.

Interviewer: All right. And probably can't predict this. Do you think it's going to get worse?

Dr. Madsen: I do. I mean, given the increase that we've seen just in the last couple of weeks, I expect we're going to see this get worse over the next month And it could be a pretty significant flu season for us.

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Dr. Gellner: No more flu mist means another shot for your child. How can you help your child prepare for this and other vaccines? I've got some advice today on The Scope. I'm Dr. Cindy Gellner.

Announcer: Keep your kids healthy and happy. You are now entering the Healthy Kids Zone with Dr. Cindy Gellner on The Scope.

Dr. Gellner: You've probably heard that the Centers for Disease Control and Prevention is dumping FluMist. I know, my kids are disappointed too. But a CDC advisory panel found that the spray is so ineffective at protecting from the flu that it shouldn't be used anymore. Vaccine experts aren't sure why the mist isn't working but none of that really matters to parents who are now wondering how to prepare their children to face the flu shot needle.

There's definitely a lot of hype when it comes to those dreaded shots. Needles strike fear into the hearts of many people, no matter how old they are. The most important thing a parent can do is to keep calm. If you're freaking out, your kids will follow suit.

Honesty is most important when it comes time to get any shot. Explain to your child that it may hurt for a second and tell them why the shot is important to protect them. Ask them to think about how strong their body is going to be, and how well the good immune systems cells will be able to fight the bad germs that this vaccine is protecting them against. Kids will be more receptive to shots if they understand why it's important for them to get them.

However, while honesty is key, don't give your child too much time to stew over the fact that a shot is coming. They may get more worked up, or they may be cool with a shot, it all depends on the child. And if they are going to be extremely anxious during the entire visit, I recommend telling them at the end of the visit. If they're older kids or kids that are not too afraid, then being honest with them before the appointment is best.

Once at the appointment, present a united front with the person who is giving the shot. Don't let your child cower, kick, or hide in your arms. That could end up hurting them more than the shot and may also result in an injury to the person giving the shot. Instead, help the person giving the shots put your child in the position that is the safest for administering shots, while still being there to comfort them.

Talk to your child while they're getting the shots. Make eye contact with them. Let them know you're right there and you'll give them the biggest hug when they're done because they've been so brave. I've sung to my boys when they were younger and had their kindergarten shots. That seemed to help.

Taking steps to help with the pain from shots can help as well. Give your child acetaminophen or ibuprofen but not until after the shot to reduce inflammation that may cause pain. We don't recommend giving anything beforehand anymore since some studies show that blocking the fever response may interfere with the immune system response.

With some shots, the pain, redness, and swelling may last for up to 24 hours. Pain may occur when medicine in the shot goes into the body and then again over the next few days as the body's immune system does its job building up antibodies. When all else fails, it may be time to make a deal with your child. One word: bribery. It goes a long way with kids. A special treat after the appointment for their bravery is always a hit.

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Interviewer: A study shows just how important getting a flu shot during pregnancy really is. Up next on The Scope.

Announcer: Examining the latest research and telling you about the latest breakthroughs. The Science and Research Show is on The Scope.

Interviewer: I'm talking with Dr. Julie Shakib. Assistant professor of pediatrics at the University of Utah School of Medicine and medical director of the well-baby and intermediate nursery. Dr Shakib, if you Google flu shot and pregnancy, you'll find that there are actually some very vocal people out there who say that you should not get a flu shot if you're pregnant. Did you in part do this study to address those concerns?

Dr. Shakib: I agree it's a concern that not enough pregnant women are getting the flu vaccine during pregnancy but the key driver for why we decided to do this study is we knew we had the opportunity to look at a large dataset over a number of influenza seasons.

We also knew that we had the opportunity to look at the gold standard for flu which is laboratory confirmed influenza and infants and no one had really done that before. We saw an opportunity to contribute to what's known about how maternal immunization can affect the baby.

Interviewer: What did those things tell you?

Dr. Shakib: What we found in our research is that when mom reported influenza immunization during pregnancy, their infants were 70% less likely to have laboratory confirmed flu than moms who didn't report immunization during pregnancy. Additionally we found that in the same cohort of women who did and did not report immunization, that moms who did report immunization their infants were 81% less likely to have influenza hospitalizations in their for six months of life.

Interviewer: Those are both indicators that these infants are not getting the flu if their mothers get the flu shot during pregnancy. That there's a benefit to the infant from the mom's flu shot. Why is that particularly important for the in the infant and for the mother?

Dr. Shakib: That's a great question. The reason it's important is because immunization against flu isn't indicated in newborns until they're six months of age. That's because the vaccine just isn't effective in that first six months. So maternal immunization is one of the only ways we have to provide the baby with some protection until they're old enough to receive and get benefit from the vaccines themselves.

Interviewer: What happens when infants get the flu? Is it worse for them than for say you or me?

Dr. Shakib: It is. It's much worse in the first year of life than it is for adults. They're much more likely to be hospitalized for flu. Much more likely to have complications such as pneumonia. They have higher rates of morbidity and mortality from flu than older age groups do.

Interviewer: Do we know how long the mother's immunization protects the baby after it's born?

Dr. Shakib: That's another interesting question. We do know that it's dependent on when the mom received the vaccine during pregnancy. But the mom needs to get the vaccine as soon as it's available during her pregnancy. That's not something that can be timed to be exactly right for the infant.

Interviewer: Well and of course I mean, we all know that not every flu shot works. The flu changes every year and so getting a flu shot doesn't necessarily guarantee that you're going to protect the baby?

Dr. Shakib: The one thing I would say about our study that's really interesting is that even though we looked over nine seasons of influenza data, we still saw a benefit. We know every year the vaccine isn't a perfect match. What I would suggest is there is protection. How perfect it is, no vaccine is perfect, no protection is 100%. But some protection from a serious illness that we couldn't get otherwise, is the purpose of immunizing during pregnancy.

Interviewer: How did you do the research?

Dr. Shakib: Essentially we did a data analysis of nine seasons of influenza, we basically retrieved all the records and looked at documentation for whether moms reported receiving flu vaccine versus those who didn't and then compared the specific outcomes including influenza like illness, laboratory confirmed flu and flu hospitalizations in infants based on their mom's immunization status.

Before the H1N1 pandemic a lot of women were not receiving the flu vaccine. So we had a number of years where we had low immunization rates and moms that changed thankfully a fair amount with H1N1 but didn't change enough because still only about 50% of women report getting the flu vaccine during pregnancy.

Interviewer: Pregnant women, are they particularly susceptible to flu?

Dr. Shakib: They're not more likely to get the flu, but they are more likely to have some severe outcomes from the flu because of changes to their immune system, their circulation during pregnancy. So we saw with H1N1 pandemic that pregnant women were disproportionately sicker and more severely affected. Flu vaccine is a little bit of a two for one benefit. Moms need to be protected while they're pregnant, but they're also providing protection to their baby with the same shot.

Interviewer: What's kind of the main message you want to get across?

Dr. Shakib: I think that the key message is that we need to take every opportunity to both support and provide flu vaccine to pregnant women during their pregnancy. Obstetricians, midwives, nurse practitioners, anyone who cares for pregnant women needs to actively endorse and offer flu vaccine to their patients. Patients need to feel empowered to ask for it if they haven't been offered it during their pregnancy.

Announcer: Interesting, informative, and all in the name of better health. This is The Scope Health Sciences Radio.

Interviewer: Can you test for the flu and should you ask for it when you go visit your physician if you think you have the flu? We'll examine that next on The Scope.

Announcer: Medical news and research from University of Utah Physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Interviewer: So wouldn't it just be easier if you could get a test for the flu to know if you have it or not? Well, we're going to find out right now. Dr. Tom Miller is internal medicine at the University of Utah Healthcare. First of all, is there a test for the flu?

Dr. Miller: There are tests for the flu, yes.

Scott: Okay, I want one.

Dr. Miller: You don't get one.

Interviewer: Why don't I want one or get one?

Dr. Miller: You don't need one. First you don't have flu symptoms, and if you do have flu symptoms and you're not severely ill, we would just treat you empirically. Meaning, if you have symptoms, you have a high fever that starts suddenly, shakes, chills, cough, you basically would have the flu until proven otherwise during the middle of the flu season.

Interviewer: So you're saying that the flu for a physician is a pretty obvious thing to diagnose. You don't need a test.

Dr. Miller: Should be, but everybody loves a test Scott.

Interviewer: Okay.

Dr. Miller: Everybody loves the test.

Interviewer: They like to know for sure.

Dr. Miller: So we've talked before on the program about being treated for the flu. So there is a treatment, an antiviral that you can give, but you should give it within the first 48 hours. So if one obtains a test to prove whether you have the flu or not it might be longer than 48 hours before you get the test results back, while in the meantime you're feeling miserable.

Interviewer: Oh. Yeah, so I come into the doctor and they're like, "I'll give you the flu test, if you want it," and then by then it's too late.

Dr. Miller: The decision is made based on a clinical presentation, so looks like the flu, smells like the flu, it's probably the flu. And we go ahead and treat it. We start the treatment.

Interviewer: What do I do if I'm convinced I have the flu, and you're not?

Dr. Miller: I guess we have a problem.

Interviewer: Do you get that? Do you get people that you say, "Oh I'm sorry you don't have the flu."

Dr. Miller: No, I generally don't. I mean it's pretty clear when people have the flu. They feel awful. Now they might have a cold, just a common cold. And I can usually explain to them that, "No, you don't have a high fever. It didn't start suddenly. I think this is a cold, which is due to a virus, but it's not the influenza virus." And basically when they are without a fever, that's something that they just get over after several days, and we really don't have effective treatment for that anyway.

Interviewer: That's the tell-tale sign, is you might feel completely miserable, but if you don't have a high fever above 101 then you likely don't have the flu.

Dr. Miller: Then if you have shaking, chills and you just feel awful and two hours ago you didn't feel bad, that's pretty much flu. Those are flu-like symptoms, and could be something else. The main thing is you want to get started on the therapy that could actually reduce the severity of the symptoms and turn the thing around, and cut it back by a day or so.

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Interviewer: Dr. Terry, why is it that some people seem to be so freaked out about flu vaccines? It seems like there is a movement. Is it a small movement, a large movement? I don't know. They think there is a conspiracy theory or we shouldn't get them, or something of that nature. What is going on with that?

Dr. Terry: Well, my personal opinion is that most of those people are afraid of shots.

Interviewer: They'll do anything.

Dr. Terry: They will use any excuse not to get stuck with a needle. The flu vaccine is given with tiny, tiny little needle. You can barely feel it when it goes in. It's not really a good reason not to get a flu shot. I think there are many people who have been conditioned through their lives to avoid needles. There are some people who have religious objections and, of course, we want to be respectful of that. But we now have evidence that for people who are allergic to eggs, whom we've always said they shouldn't get an egg based vaccine, we're finding there are ways to help them get through that and be able to get a flu vaccine.

Interviewer: I probably did one of the worst things I could possibly do. I went on the internet.

Dr. Terry: Oh, no.

Interviewer: Yeah, and I did a little reading on the flu vaccine and there are some people out there that talk about all the other bad things that are in them. Could you elaborate on what they seem to be concerned about?

Dr. Terry: They're probably concerned about some of the things that we use as a base, for example, for the flu vaccine, preservatives that are placed in the flu vaccine. But because there has been over the years such an uproar over the danger of the flu vaccine, all those things have been studied and been found to be really benign and safe and really not the issue.

Interviewer: So the medical community is not trying to hide anything from anybody.

Dr. Terry: No, not at all, not at all.

Interviewer: And you would have no problem getting a flu shot yourself.

Dr. Terry: I already had mine this year.

Interviewer: Or giving it to your kids.

Dr. Terry: My husband has had his and I hope the grown up kids have had theirs.

Interviewer: So I should rest at ease is what you're telling me.

Dr. Terry: Yes, rest at ease right after you get your flu shot.

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