Cold, flu season hits
FAIRMONT — Cold season is upon us, and flu season is right around the corner. There are a few challenges physicians face in regard to both.
The first point of confusion health care providers encounter when talking with patients about the flu is the word itself. “Flu” can mean different things to different people. There’s the vomiting and diarrhea of a “stomach flu” — technically gastroenteritis — and then there’s influenza — a virus that affects the respiratory system.
The flu shot is another source of confusion for many patients, according to Dr. Timothy Slama, a family medicine physician at Mayo Clinic Health System in Fairmont.
“The flu shot might cause me to get the flu” is one fear Slama hears countless times each year, which is often voiced by someone who got a flu shot and a day later got the flu. What those patients need to know is that they had already caught the flu, before they even got the shot. The virus just hadn’t had time to reveal itself yet, and it takes about two weeks after a flu shot for the body to develop the antibodies needed to fight off a flu virus.
“The flu shot contains the deactivated part of the virus,” Slama explained. “It’s impossible for it to cause the flu. The nasal spray does contain the live virus, but it’s weakened to where it can’t multiply and cause the flu.”
Another concern Slama frequently hears is “The flu shot doesn’t work for me.”
It’s true some years that the flu shot is less effective, since those making the vaccine have to predict which strains of influenza will be most prevalent in the upcoming flu season.
While the shot is never perfect in preventing the flu, Slama argues: “It is the best defense we do have against it, in addition to hand washing and coughing into your sleeve.”
Yet another fear that remains today is the now-debunked theory that autism is caused by vaccines containing thimerosal (a mercury-based preservative used in some vaccines to prevent growth of germs, bacteria and fungi). The U.S. Centers for Disease Control and Prevention addresses the confusion about vaccinating children on its website at www.cdc.gov/flu/protect/vaccine/thimerosal.htm, where it clearly states: “Numerous studies have found no association between thimerosal exposure and autism.”
“All the studies have disproved that claim,” Slama said. “There is no evidence to support it, and the one study that tried to show that claim was refuted.”
The need to educate patients about various misconceptions isn’t limited to the flu. There’s plenty of confusion about the common cold too, but the confusion doesn’t seem to be limited to patients.
On a bulletin board in Slama’s office is a newspaper article, its headline reading: “Doctors ignore advice on sore throats, bronchitis.”
The advice they’re ignoring is to cut back on antibiotic prescriptions, which are ineffective for treating viruses.
“Thirty percent of visits are treated with antibiotics,” Slama said, citing www.uptodate.com, an evidence-based website for physicians.
But, he continued, more than 98 percent of infections are actually viral, meaning only <0.5 to 2 percent of respiratory episodes should be treated with antibiotics. “The big thing to watch for is that it doesn’t turn into a secondary bacterial infection,” but clear evidence is needed to support the presence of that bacterial infection, such as an ear infection, pneumonia, or strep throat.
Part of the reason for the overuse of antibiotics is pressure from patients, who want doctors to prescribe something to make them feel better.
“I try to have a discussion about the expected course of the illness … and talk about why I’m not recommending antibiotics,” said Slama, citing the monetary cost, side effects, the risk of prescription interactions, and most of all, the ever-growing fear of drug-resistant bacteria known more commonly as “superbugs.”
What Slama does recommend is getting plenty of rest, staying hydrated — warm liquids seem to be particularly helpful, breathing in humidified air, and rinsing with saline sprays.