Search for tag: "flu"

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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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.

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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.

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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.

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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: How many times have you heard from somebody, "You know, the only time I ever got the flu was the year I got the flu shot." Well, it's actually impossible, but what might be happening that would cause somebody to think that? We'll explore that next on The Scope.

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Interviewer: Dr. Susan Terry is Executive Medical Director for the Community Clinics at University of Utah, and for the person that says that the only time that I got the flu was the year I got the flu shot, and that's their excuse for not getting the flu shot ever again. What would you say to that? First of all, is it possible to get the flu from the flu shot?

Dr. Terry: No. It's really not possible to get the flu from the flu shot.

Interviewer: All right. And why is that?

Dr. Terry: Because the virus that's in the flu shot is inactivated, and it's only there to help your body promote immunity. It's not really there to, in any way, make you sick.

Interviewer: So the fact that it's deactivated 100%, you cannot get the flu from the flu shot.

Dr. Terry: Correct.

Interviewer: All right. But yet there are some people that still say, "I got the flu shot and that was the year I got the flu." What might be going on there? Let's talk about the four possible reasons. Number one.

Dr. Terry: Sure. We know that it takes at least two weeks to become immune to the flu after you have your vaccination. So, you could pick up a virus in the meantime and come down with the flu.

Interviewer: All right. So you've got that two-week period there where you're kind of vulnerable.

Dr. Terry: Correct.

Interviewer: All right. The reason that somebody says that they got the flu after they got their flu shot number two.

Dr. Terry: We know that this time of year and any parent of school-age child will tell you, there are a lot of infections going around. We have the kids back in school. They're all together, and viruses of other kinds can spread like wildfire. And then, of course, they come home. So, you might feel really bad, and feel like you have the flu, but the likelihood that it is actually true influenza for which you have been vaccinated is pretty low.

Interviewer: So it's likely something else and you just you need to say it's the flu to feel better about the whole deal.

Dr. Terry: Right.

Interviewer: Okay. All right, reason why somebody might say they got the flu from the flu shot, number three.

Dr. Terry: You could be exposed to a flu virus that's not included in seasonal flu. We try to get as close as we can to what we expect to see in the influenza season, and it is a scientific process that's done, but we aren't always 100%.

Interviewer: So it's possible the flu you got was not accounted for in the shot.

Dr. Terry: Correct.

Interviewer: All right. And the reason somebody might think that they got the flu from the flu shot number four.

Dr. Terry: This is actually a little bit later on in the course in that some people just get infected with the flu virus after having a flu vaccine. Now, it is most likely to be the most protective for older children and younger healthy adults, but there are still people who have other types of illnesses or younger kids or older adults with chronic disease who, even though they are vaccinated and develop some immune response to the flu, can still come down with influenza.

Interviewer: And still can come down with one of the flu strains that they were... It's about 70% effective if I understand correctly.

Dr. Terry: That's right.

Interviewer: Yeah. All right. So, we've gone ahead and established that you cannot get the flu from the flu shot. People still deny that. Hopefully, we've given them some reasons why they might think that they got the flu from the flu shot, but bottom line is...

Dr. Terry: You won't get the flu from the flu shot. So, we strongly recommend that everyone over the age of six months gets a flu shot.

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Dr. Cindy Gellner: So it is flu season. It's here. Yep. So should my child get a flu shot even if they have an egg allergy? Absolutely. There is a lot of new guidelines out there and I am here to tell you all about flu shots and those new guidelines. I am Dr. Cindy Gellner and that's today on The Scope.

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Dr. Cindy Gellner: Do flu vaccines really make a difference? Yes. Absolutely. So if your child happens to actually get true influenza and they've had a flu vaccine they are going to be much less sick than if they did not get the flu vaccine. If your child has not gotten the flu vaccine and they do get the flu, it can be pretty bad.
The flu can cause all sorts of symptoms like not only making you have a high fever, feeling like you've been hit by a truck, not wanting to eat, not wanting to drink, a really sore throat, just feeling absolutely horrible. It can also cause pneumonia. It can also cause them to be hospitalized because they are very ill.
The flu is deadly to some children as well so the best thing you can do for your child is to make sure they get a flu vaccine every single year.
So there is a lot of questions about flu shots and I hope that today we can help calm some of your fears. All children should get flu vaccines starting at the age of six months but if everyone in the family or anyone who takes care of that baby gets the flu vaccine they will actually help protect that baby from the flu.
Kids who are under eight years old who have never gotten the flu vaccine, or if they have only had one vaccine in the year prior and that was the first time that they ever got a flu vaccine, they actually need two doses one month apart to help boost up their immune system. Any child over nine can only have one flu vaccine every year.
If your child is over the age of two and they are otherwise healthy, they are currently not having any respiratory problems and they are not currently receiving chemotherapy, then they can actually get the flu mist. The difference is the flu shot is a dead virus. You cannot get the flu from a dead virus.
What they do is they actually take the virus and take out all the ability of that virus to make new virus and put it in the vaccine. So your body is going to recognize the outside shell of that flu virus and start building antibodies against it but that virus that they put in to you for the flu shot cannot make more virus so you cannot get the flu from the flu vaccine.
Chances are if you have been around somebody who has true influenza within two weeks of getting the flu shot or you been around somebody else that has another virus, one of the 300 floating around here, then you are going to feel sick after the flu vaccine but you cannot get the flu from the flu vaccine.
Flu mist, that is the little spray that goes up the nose. That is for ages two and up, remember, and that vaccine is a weakened version of the flu virus which is why we can only give it to kids who are over the age of two. The kids under the age of two don't have the immunity to protect themselves against this weakened live virus.
So the main side effects for flu vaccine are pretty much just the same as any other vaccine. A lot of kids will have a fever. Their legs might hurt. They might feel a little bit run down. The main side effect of the flu mist is actually a little bit of a runny nose but most kids tolerate the flu vaccine very, very well.
If you have ever gone on the Internet, you might see a whole bunch of other information out there specifically about mercury or thimerosal which is the preservative which used to be higher in many different vaccines and that has actually been taken out of a lot of vaccines.
There is a tiny amount of thimerosal in the flu vaccines that are still available and honestly you can get just as much mercury if you just eat a couple handfuls of dirt. So the flu vaccines are actually very safe. The research has shown that the amount of mercury in a flu vaccine is really not harmful. You have got more in your environment than you will get in a flu vaccine.
So a lot of parents wonder about what that red swelling is after they get a shot and this is for any vaccine not just the flu vaccine. It is actually your body's immune system making antibodies against the virus so it actually a good thing.
It is a sign showing that your body's immune system is doing its job and making antibodies so when you see the real virus, not just the vaccine, but when you see the real virus, it knows exactly what to do with it.
So one big question is what if my child has an egg allergy and actually it is really good that people ask this question because the information just changed. In the past we were referring people to an allergist's office to get their flu vaccines if their child has an egg allergy.
I found out recently a lot of allergists are not stocking the flu vaccine anymore and the main reason is because recently the American College of Allergy, Asthma and Immunology has decided the benefits of receiving the flu vaccine outweighs the risk even for those with egg allergies.
In the past they used to say that someone who got an egg allergy and got a flu vaccine had to have it done in an allergist's office and they had to wait for 30 minutes afterwards and honestly they said that special precautions aren't really warranted anymore. Studies involving over 4,000 egg allergic people, there have been no cases of allergic reactions when given the flu vaccine even among those with the severe egg allergy.
What they actually said was that people with an egg allergy are not at additional risk even though the vaccine may contain some amount of egg protein; however, they did say that with any vaccine, anybody giving the flu vaccine should have procedures in place on the very rare occasion that somebody would have an anaphylactic or life threatening illness.
In those cases somebody would have an EpiPen nearby. Anybody with a severe allergy should have an EpiPen nearby anyways and so they have said that this should be still something that you keep on hand anytime you are giving a flu vaccine to someone with an egg allergy. So if you or your child have an egg allergy and you have concerns about getting a flu vaccine, please talk to your doctor about this.
As a physician and as a parent, I strongly recommend that your family all get vaccinated for the flu if they are over six months old. Everybody is at risk for the flu. Kids are more at risk. Asthmatic kids absolutely should get a flu vaccine. Diabetics should absolutely get a flu vaccine.
So flu vaccines will definitely help prevent you from getting the flu. If you do get the flu it is going to be a much, much more mild case that you would have had if you didn't get your shot. I am Dr. Cindy Gellner and thank you for listening to The Scope.

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Scott: If you're like most people, you're probably still in denial that summer should still be here and the flu shot is the last thing on your mind, but actually flu shots are available right now. Dr. Susan Terry with University of Utah Hospitals and Clinics, thank you for joining us today and when did the flu shots become available?

Dr. Susan Terry: We actually got our flu shots about two weeks ago, and so there're available now, usually mid to late August.

Scott: And should somebody get one as soon as it becomes available, or should you wait until it gets a little closer to flu season.

Dr. Susan Terry: Actually, we would like to see people to start getting their flu shots as soon as they're available, so that we can make sure that we get as many people vaccinated as possible.

Scott: As a general rule, who should be getting the flu shot?

Dr. Susan Terry: We recommend that everyone over the age of 6 months get a flu shot, unless they have some real reason not to get it, such as a religious restriction or a serious significant allergic reaction to previous flu injections or to eggs.

Scott: And I got my flu shot last year, so I'm covered this year, right?

Dr. Susan Terry: No, Scott, unfortunately you have to get a flu shot every year because we change the vaccine every year. So we look at what was around last year, as far as the typical antigens of influenza and we also look at what happens in the Southern Hemisphere, in places like South America, over their flu season because of course, they're in the winter when we're in the summer. We're looking at all of the different types of viruses that are out there and we change the vaccine to meet those viruses.

Scott: And you have, is it four new viruses that you're kind of thinking are going to be the super stars, or the problems this year?

Dr. Susan Terry: Yes, we have four antigens in this year's vaccine, in most of this year's vaccine. Some of the vaccine that's available this year has three antigens, two A and one B, because that's what we saw in our own area last year. And now they're producing a vaccine that's called Quadrivalent, which is four things, so we have two A and two B in the Quadrivalent vaccine.

Scott: And how, kind of bad are these particular strains of flu that you're adding this year?

Dr. Susan Terry: We don't really have any super influenza, like we had some concern about a few years ago, but any influenza can be serious for anyone who becomes ill, but particularly for anyone with any risk factors.

Scott: Let's talk about that for a second. So how bad is the flu really if I don't get my shot.

Dr. Susan Terry: Well it can be serious. You can be hospitalized, you can get pneumonia, and, unfortunately every year a few people die from influenza.

Scott: And about how long, if you do get it and you don't get the shot, does the flu kind of stay in your system?

Dr. Susan Terry: Oh you can be sick for 10 to 14 days with influenza.

Scott: And if you get the shot does it completely eliminate that chance or?

Dr. Susan Terry: No vaccine is 100% effective, because as you can see, this year we have different antigens than we had last year, a different influenza virus was around last year than the previous year. So every year something new creeps in and you may still get sick. But even getting a vaccine that is not 100% protective against what's out there is better than not getting any vaccine at all, because it does stimulate your immune system to react to a virus that comes along.

Scott: All right, what about this excuse, every time I get the flu shot I seem to get sick right afterwards.

Dr. Susan Terry: Well there can be some side effects. You don't get the flu from the flu shot, that's just the truth, you don't get the flu from the flu shot. But you can get a little achy, you can get a runny nose, some people even get an upset stomach, but those are really side effects of the vaccine, that's not really influenza.

Scott: Are there other excuses that people tend to use? Let's talk about those right now.

Dr. Susan Terry: Some people do have concerns about being allergic to the flu shot because their arm gets sore, but that's really a reaction, your body is reacting, starting to create immunity to the influenza so you do get a red swollen arm sometimes, but again, that's not a bad thing.

Scott: And what about the notion, I've heard of something called herd immunity, so it's almost as if I as a healthy adult should get the flu shot, because the more people that get the vaccines the better.

Dr. Susan Terry: That's true. The more people who are immune to the virus, the better it is for all the people who are around them, and it is called herd immunity, and it is one of the things that we count on, because we know that we will not get 100% of the people who should have a flu shot, getting a flu shot.

Scott: As a health care professional then your final thoughts, flu shots definitely worthwhile regardless of any little side effects that somebody might get.

Dr. Susan Terry: Definitely worthwhile and anyone with asthma or chronic obstructive lung disease, anyone who is pregnant, anyone who has cancer, or any kind of immune suppression, like HIV-Aids, children less than 2, and anyone over 65, definitely, definitely think about getting a flu shot.

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