(light ethereal music)
- When people refer to the flu season,
they're talking about the period of time
between the months of October and May,
and typically the season peaks in February.
So, as many people know, when you get the flu,
there are a number of symptoms you can have.
You can get muscle aches, fevers, headaches,
sore throat, cough; the list is actually quite long.
And not all patients experience all of those symptoms,
but many patients experience many of them.
Most people are unaware of the large impact flu has
on the US healthcare system.
Every year, approximately 10 to 30 million patients
will get the flu.
Of that group, hundreds of thousands
will require hospitalization.
And out of that group, unfortunately,
tens of thousands will die.
For patients who have rheumatic diseases,
this is even more important
because the flu in this population can be even more severe,
and that's owing often to the fact
that their immune systems are suppressed
by medications they're taking.
Because the virus, influenza, that causes the flu
can change from year to year,
it's important to get vaccinated every year.
Sometimes you'll hear on the news
this vaccine this year is not as effective,
it's not a great vaccine,
but it's still providing protection.
So, even though there's a little bit of variability
in terms of how good the vaccine is,
patients should still receive the vaccine every year.
Many patients will ask,
"Well, how effective is the flu vaccine?"
And it's thought to be quite effective.
It's usually quoted as decreasing the risk
of getting the flu by about 50% to 60%.
There are actually a number of different flu vaccines.
The first distinction to make
is that there are vaccines that are alive or attenuated,
means it's a weakened virus they use,
and there are vaccines that are dead,
basically they killed the virus
and that's how they made the vaccine.
In patients who have a rheumatic disease
where their immune system might not be normal,
it's important that they always get
the dead or inactivated vaccine,
and that's basically the shot,
which I think most people are familiar with.
The nasal mist that some patients use,
that is based on the weakened
or attenuated version of the vaccine,
and that's really not recommended at all
for patients who do not have a normal immune system.
The last thing to say is that there is a high-dose flu shot
that is recommended for patients who are over the age of 65.
The rationale for that is as everyone ages,
our immune system kind of wanes over time.
I hate to say it,
but our immune system weakens as we get older.
So, it's thought that older people might need a larger dose
or a more potent vaccine to get the same response.
Oftentimes, patients who have a lower immune system
because of the medications they take will say,
"Should I get the big dose or the high-dose flu vaccine?"
And that's a great question,
but at this point we don't know the answer yet.
There are ongoing studies
to particularly answer that question, but time will tell.
Lastly, it's important for patients to understand
that even though they did receive the vaccine,
they can still get the flu,
and this is true for a number of reasons.
First off, for patients with rheumatic diseases
who were taking immune-suppressing medications,
similar to the older patients that we discussed
that don't have the proper working immune system
and therefore don't respond the same way,
that's also true for patients
taking immune-suppressing medications.
So, they can get the vaccine,
but they might not get the full protection from that vaccine
that a patient with a normal immune system might.
Second, the vaccine that particular year,
as luck would have it,
may just not protect against the specific viruses
that are causing the flu outbreak.
Many patients who suspect they might have the flu
will go to their healthcare provider to be tested,
and there is an easy test
that can be done to diagnose the flu.
It's usually a little cotton swab.
They'll put in the back of your throat or up your nose
and usually it'll have a result in a day or so.
Treatments are available for the flu.
The one most commonly used is an oral medication,
it's a pill.
It's called oseltamivir,
but perhaps it's better known as Tamiflu.
The important thing to know about treatment
is it's much more effective when you take it
as soon as possible after the onset of symptoms.
So, most people recommend within 48 hours of symptom onset
is when the medication is most effective.
Some patients who have an egg allergy
are concerned about getting the influenza vaccine.
A couple of things they should be aware of.
One, as of 2016-2017 season,
it's actually recommended that they can receive the vaccine.
The specifics are as follows.
If a patient has an egg allergy
and their allergy is limited to just kind of hives,
that rash they'll get kind of over their body
when they ingest eggs, they can still get the vaccine;
no special precautions need to be taken.
In patients who have a severe allergic reaction
when they ingest eggs,
things like anaphylaxis or difficulty breathing,
they actually also can still get the vaccine.
However, the vaccine must be given by a healthcare provider
who has experience dealing with allergic reactions
and it must be done in a healthcare setting.
Another common concern from patients
is that the vaccine cannot be given to pregnant women.
Pregnant women, in fact, can safely receive the vaccine
and they should.
Not only is the vaccine beneficial to the mother
but it's also beneficial to the baby.
We do not recommend vaccinating infants
until they are six months of age.
So, the first six months,
the baby can be vulnerable to getting viruses like the flu.
By getting the vaccine during pregnancy,
you're actually able to protect the baby
during that key first six months of life.