What Is the Flu and What Can Be Done to Prevent It

With Kathy Mariani, MD, University of Vermont Health Network Medical Group
UVM Medical Center Family Medicine, South Burlington

Influenza, or the flu, is a viral infection that affects 5 percent to 20 percent of the US population every year. That’s up to 60 million people. With this many people affected each year, it’s good to know how to reduce your chances of getting the flu, such as making sure you get your annual flu vaccine.

To tell us more about what happens when you get the flu, and how to reduce your chances of getting it we have Dr. Kathy Mariani, Medical Director at Family Medicine South Burlington at the UVM Medical Center.

Listen to the interview below or read the transcript that follows.

 

UVM Medical Center: What do a cough, sore throat, runny nose, fever, muscle aches, headaches, and fatigue all have in common? They’re all common symptoms of the infamous flu. Influenza, or the flu, is a viral infection that affects 5% – 20% of the US population every year. That’s up to 60 million people.

The flu is caused by the influenza virus, which can be spread through contact with an infected person, an object they have touched, or respiratory droplets that travel through the air when he or she coughs or sneezes. With this many people affected each year, it’s good to know how to reduce your chances of getting the flu, such as making sure you get your annual flu vaccine.

To tell us more about what happens when you get the flu, and how to reduce your chances of getting it we have Dr. Kathy Mariani, Medical Director at UVM South Burlington Family Medicine. Thanks for being with us today.

Dr. Kathy Mariani: Hi.

So, let’s talk about the flu. What is it?

Dr. Kathy Mariani: Just as you described, the flu is a virus that causes very specific symptoms – the runny nose, the fever, the body aches. The body aches seem to be really specific for the flu, and the high fevers. It usually also comes with a cough.

UVM Medical Center: Can you talk about how the flu affects our community every year?

Dr. Kathy Mariani: Well, on a national level, one of the really important things to keep in mind is that from 12,000 even up to 56,000 people die a year from the flu. So, this is a significant cause of death in our country. Within our own community, even amongst healthy adults, the loss of work, the possibility of spreading it to somebody more vulnerable and to children can be a really big impact.

Who is most vulnerable?

Dr. Kathy Mariani: Like with a lot of diseases, the oldest and the youngest. As well as pregnant women – they can get a really bad case of the flu, people with asthma, even if their asthma is really mild. When they get the flu they can get really, really sick. A lot of times it’s babies, young children, and elderly.

How can we reduce our chances of spreading the flu to the most vulnerable?

Dr. Kathy Mariani: As you probably know, we do recommend everybody getting the flu shot now. In the past, we used to try to figure out just high risk, like people who had asthma, people who were pregnant, people who were over the age of 65. But, what we found was even by trying to target people who were high risk, we weren’t really making a difference in the impact that flu was having on the community.

So, now we’re recommending that everybody get the flu shot, which will decrease overall the amount that’s in the whole community, which decreases the risk to everybody.

UVM Medical Center: So, is it important for those of us who might care for elderly parents or small children, more so than others? Or is it really just everybody at this point?

Dr. Kathy Mariani: Especially somebody who is around the elderly, but I would say everybody as much as possible. It’s one of the things I sometimes tell my patients. I really don’t own stock in the company. There’s no benefit that we have as a medical community to having people vaccinated, except just keeping people healthy.

What are the symptoms?

UVM Medical Center: At what point do I realize that I’m getting the flu? How many symptoms are the tipping point for when I should go and see my primary care doctor?

Dr. Kathy Mariani: It might be easier to tell you what’s not the flu, in some ways. Because when somebody comes in and says, “Well, last week I got a runny nose, and then I got some sneezing. Then I got a sore throat.” When they go through the whole gambit, it’s usually a run-of-the-mill cold virus. When you are fine in the morning and then you can barely get out of bed 12 hours later because you’re so sick, that’s the type of thing the flu does – it really knocks you off your feet.

Your fever spikes really high, you’re starting to cough, sore throat. And you’re just pretty wiped out, really fast. That’s kind of the hallmark of the flu. If somebody is too sick, if I say, if you were too sick to come in two days ago, that’s a really good clue to me that they had the real flu.

UVM Medical Center: Do people often confuse the two?

Dr. Kathy Mariani: I think, probably, there’s some confusion. I think a lot of the confusion comes where everybody calls everything the flu, like the stomach flu. So, there’s a lot of things people call the flu. But, when somebody gets the real flu, when they’re that sick and can’t get out of bed, it’s usually like, “Yep, this is the flu. Now I know what everyone is talking about.”

How can I recover from the flu if I do have it?

Dr. Kathy Mariani: Good question, because antibiotics don’t work for the flu. We do have medications that can possibly decrease the severity of the flu and the number of days. But, by usually, by the time somebody comes to the doctor, the window of opportunity for that medication to work has already passed.

So, for somebody who thinks they might have the flu, and they have a high risk condition, like they’re immunosuppressed, they’re pregnant, they have asthma, they shouldn’t wait to try to figure out if it’s going to go away or not. If you think you have the symptoms of the flu, you probably should get seen and get put on the anti-virals that might decrease the course.

But, the most important thing is really staying really well hydrated, getting sleep, which can be really hard because you might be coughing a lot. So, really taking care of yourself.

What are some of the best ways to prevent myself from getting it? Do I just not interact with anybody?

Dr. Kathy Mariani: Yeah, I don’t recommend not interacting with anyone – then we’ll have another conversation about getting depressed, or the winter blues. But, I think getting vaccinated is really important. I think everyone should try to get vaccinated. It’s really not been shown that people get the flu from the flu shot. I think that’s one thing that I hear a lot, that they think that they got the flu from the vaccine. They might have had a cold coming on or something. The only time you shouldn’t get the flu shot is if you have a fever. So, you could have a little bit of a cold and still get [the shot].

Really good hand washing does make a difference. The use of the hand sanitizers, those things really do help because you know, the flu can be passed anywhere. At work, at the grocery store, and so really using some of the hand sanitizers is really important.

UVM Medical Center: How about for those of us who like to exercise outside? Skiing? Even snow shoeing, running, does that increase your chances of getting the flu or a winter cold?

Dr. Kathy Mariani: No. It really, actually, if anything, it might improve your recovery because you’re fit and healthy by staying really active. So, I would actually encourage people to stay active inside or outside in the winter.

UVM Medical Center: How about going outside with wet hair in the morning?

Dr. Kathy Mariani: Well, my twelve year old just told me recently that she just found out you don’t get a cold from the cold. That was really [new]… “Why do they call it a cold?”

At what point should somebody seek medical attention for their flu symptoms?

Dr. Kathy Mariani: Like we talked about, maybe if somebody has a high risk condition, anytime somebody has a high risk condition. If they’re having a high fever they definitely should get checked. But occasionally people can get severe cases of the flu, and secondary pneumonia, bacterial pneumonia, from the flu. So, if you feel like you started to get better – it’d probably be about 48 hours and you’re really starting to kind of improve, and then all of a sudden you get worse again – that would be a situation where you want to get checked out because that’s not usually what happens.

For most people who get the flu, you get really, really sick, really, really fast, and then you get better really fast. Which is really different than a cold that lingers. The flu usually comes and goes pretty fast.

Pregnancy and the Flu

UVM Medical Center: So, you mentioned that pregnant women are at high risk for the flu, could you talk more about why that is?

Dr. Kathy Mariani: Yeah. Probably because their immune systems are a little bit suppressed, and because they might not be able to take as deep breaths because of the pregnancy. But, we’re not exactly sure why the reason is, but they tend to get a much worse case of it. Really bad pneumonia is associated with it. Of course, that’s not everybody. I don’t want to freak people out. But, it is worse, it can be a worse case.

They also… For the newborn, newborns can’t be vaccinated. So, you definitely want to be protected as much as you can and everybody around the newborn because newborns can’t vaccinated.

UVM Medical Center: So, if you’re going to visit a friend with a newborn baby definitely get your vaccine, wash your hands.

Dr. Kathy Mariani: Right.

Myths Versus Facts

UVM Medical Center: Maybe let’s talk more about the flu vaccine. Myths versus facts, I know you touched on a couple earlier. But, could you talk about where people can get it, why they should get it?

Dr. Kathy Mariani: Most people could get it at their doctor’s office, and the pharmacies do a really good job. And they do a lot of them. So, I think it’s a pretty good quality. A lot of people get them at work. So, there’s opportunities to get them in different places in your community.

There is the concern about people who have an egg allergy, so there are some people who are excluded because of what’s in the vaccine. But, the vaccine otherwise is really safe.

UVM Medical Center: Yet, some people are reluctant to get it for whatever reason, thinking they might get the flu from it.

Dr. Kathy Mariani: Yeah. I think that’s what I hear the most. Even though I’ve been in medicine for 30 years, I still don’t like getting shots, so I think that’s pretty natural. They’re not recommending the nasal one right now. There is one that’s, we call it interdermal, so it’s more superficial in the skin and it’s not as painful. So some people can get that one.

One thing, especially in our community here in Burlington, just to mention, is a lot of times college students, young adults feel like they’re not included in some of these risks, they’re usually so healthy. But, in fact, college students are really high risk for getting the flu because they’re in close contact with a lot of people. They have their winter break, where everyone goes away and comes back with whatever people all over the country were having.

So, it’s a population that’s especially at risk in our community. And some of them, they can get some really bad cases, but, even if they are a typical young person, who is pretty healthy, and gets better in a week, missing a week of your semester from the flu can really – even if you got excused – it’s a huge impact on your semester.

You know, I can miss a week of work and it’s really awful because I have to cancel patients but I can make that up. A lot of jobs, it’s really hard to miss a week of work. But, missing a week of college can be really devastating.

UVM Medical Center: That’s a good point. So, when should everybody start getting their flu vaccine? Should we wait until we’re all back from winter break in January? Or should we do it now?

Dr. Kathy Mariani: So, now is the best time to do it because it takes a few weeks for your body’s immune system to peak. So, January or February, the winter months are when the flu is at its highest. A lot of times the best time to get it is when you have the opportunity, I mean, kind of stating the obvious.

So, a lot of times people just put it off. Like, “I’ll do it over Thanksgiving break, I’ll do it when I’m off. I’ll do it.” That’s one of the advantages of the pharmacies. And getting it done whenever you actually have the opportunity, and not putting it off, even if you intend to do it is really important.

UVM Medical Center: What are our big takeaways from this conversation about the flu?

Dr. Kathy Mariani: The flu is a really serious illness that kills a lot of people, but makes millions of people sick, miss work, miss school, expose other people to a serious illness. And our best tool right now is to be vaccinated every year.

How to Stay Healthy During Flu Season

UVM Medical Center: What are the best other ways to keep yourself healthy throughout the winter?

Dr. Kathy Mariani: Nutrition, and exercise, and sleeping well. Those are some of my other favorite topics, but we talk about that a lot. But, it really is true. I think we’re going to look back and think how undervalued sleep is. And how we live in a country that is chronically… Overall, a lot of people are really sleep deprived, and are functioning just okay. But, their immune systems are taking a hit, their cognition, their thoughts.

So, all of those. I think sleep and eating well are really important.

UVM Medical Center: So, maybe my giant pot of chicken stock isn’t such a bad idea after all.

Dr. Kathy Mariani: It’s a good idea.

UVM Medical Center: All right. Well, our guest today on health source has been Dr. Kathy Mariani, Medical Director at UVM South Burlington Family Medicine. Thanks for joining us today.

Dr. Kathy Mariani: Thank you.