>> 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.