Fall officially begins next Friday, and with it comes cold and flu season.
On Thursday, Dr. Vivian Torio, a family physician at Kaiser Permanente Fresno, talked about cold and influenza season for a live Fresno Bee Facebook chat.
Here are some of the questions posed to Torio and her answers. The chat has been edited for clarity and brevity. The full conversation can be seen on the Fresno Bee Facebook page.
Q. How do you know that you have the flu and that it’s not just a cold?
A. They are similar in that they are both caused by viruses. But the main difference that I can tell is by the way my patient presents – fever, body aches, longevity of illness. And also it’s really important that I see them because the way people look when I see them will tell me how sick they are.
Q. Flu season starts later in the fall typically here in the Valley. Should someone get a flu shot this early, and will it wear off before the end of flu season?
A. We recommend getting the flu shot vaccination as soon as it is available, which is two weeks from now. It takes about two to four weeks for the body to generate a response to it, because the body responds with antibody protection. And, no it won’t wear off. I’m not sure where the “wearing off” has come from because that’s a new question that I’ve been getting this year. Maybe there’s some thought the virus will reproduce in a different strain by the end of the season, which is possible, but the vaccination you receive will not wear off.
Q. Some people who get a flu shot will still get the flu, so how protective is it?
A. It will protect you against the expected flu strains. Can we predict all of the strains that will be present in the year? No. So it is possible that you could get the flu from a strain that was not included in the vaccination.
Come in if you think that you have the flu.
Dr. Vivian Torio, Kaiser Permanente Fresno family physician
Q. Who should get a flu shot?
A. We recommend the flu vaccination for everyone six months and above, including pregnant women. If it is a child’s first year to be getting a vaccination, they should get two flu shots at four weeks apart.
Q. A recent study suggests there could be an increased risk of miscarriage associated with the flu vaccine. Should pregnant women get a flu shot?
A. I did see that study and it is in the very early stages, but it has been shown to be a link. Our recommendation as a group and the CDC (federal Centers for Disease Control and Prevention) recommends that anyone six months old or older, including pregnant women, get the vaccination.
Q. Is there a separate, more powerful flu shot for the elderly?
A. Either the trivalent or quadrivalent vaccination is recommended for the elderly. The one we’re not giving this year is the nasal spray. That one we used to give to kids ages 2 and above. It’s not good for this year.
Q. When should you see a doctor if you think that you have the flu?
A. The treatment for influenza is Tamiflu, and it is most effective if we start it within 48 hours of your symptoms. Come in if you think that you have the flu.
Q. When should a baby be seen if the infant has the flu?
A. Anytime they have a temperatures or they’re a little more fussy or if you have any concerns, bring the child in so we can evaluate them.
Q. How do you know if you have pneumonia instead of the flu, or that the flu has progressed to pneumonia?
A. We would have to see you, because when we examine you we can see if there is an infection in the lungs. And pneumonia affects your ability to breathe and pass air and we can tell that by seeing you. Talking about the symptoms really won’t distinguish between bronchitis, pneumonia or a cold – a chest cold. So really being evaluated is the best way to diagnose pneumonia.
Q. Is there a shot for pneumonia?
A. It’s part of our regular vaccination schedule for kids and starts at 2 months, and then you get a booster in adult life, about age 60 or 65.
Q. Is it too warm for flu and cold viruses?
A. It’s such a myth. You can get it (a cold or flu virus) anywhere in the community. It doesn’t have to do with the weather.
Q. What is RSV and why is it a concern for infants?
The respiratory syncytial virus is more common in infants, but why they are more susceptible to it, we don’t know. It can really affect their lungs, their ability to breath. It is a virus and we don’t have an anti-viral for RSV.
Q. Can adults get RSV?
A. I’ve been seeing it more frequently the last couple of years. But it’s not common.
Q. How can I tell that I have RSV and not a cold?
A. The symptoms are very similar. The only way you can tell is to be swabbed.
Q. What is bronchitis?
A. Bronchitis is inflammation of the airways that can be caused by a virus or bacteria. Sometimes it’s infectious and sometimes it’s not. It’s more common in smokers and to people who are exposed to tobacco smoke. Where pneumonia is in the lobes of the lungs, bronchitis is in the bronchi, the tubes of the lungs. Sometimes we treat symptoms with supportive care, inhalers, steroids. If we feel it is bacterial, then we could treat it with antibiotics.
Q. Have you heard of the saying, “feed a cold, starve a fever?”
A. I have heard that quote and I don’t know what it’s referring to. I think you need to be healthy in order to get better. So you need nutrients. You need fluids. You should definitely have fluids and healthy eating to help your body. Don’t starve anything.
Q. What is whooping cough and how do we prevent it?
A. Whooping cough is caused by the pertussis bacteria and we are vaccinated against it with the Tdap vaccine.
Q. Why is there no vaccine for the common cold?
A. There are so many strains of the bacteria and viruses (that cause the common cold) that I don’t think we can keep up with them.
Q. How does influenza kill people?
A. It can go to your lungs. Again, pneumonia is an infection in the lungs that can cause a fluid buildup and make it difficult to breathe and recover from.
So that’s why …you put your kid in day care and they have been ill three times in the last month ... they don’t have the antibodies to those bacteria or viruses yet.
Dr. Vivian Torio, Kaiser Permanente Fresno family physician
Q. Why do children get more colds than we do?
A. Children are beginning to build antibodies, which are what we use to fight infections. As we age, we have been exposed to more viruses, more bacteria, more strains of those things. So we have more antibodies to the strains. So when you’re little, you’re still building those up. So that’s why … you put your kid in day care and they have been ill three times in the last month … they don’t have the antibodies to those bacteria or viruses yet.
Q. Are over-the-counter treatments safe for children?
A. I would really recommend for little kids that you talk to your doctor about over-the-counter medications. Because even though they are over-the-counter, they need to be dosed by weight. Over-the-counter cough medicines are controversial, and we say don’t give it to children under the age of 2 years because we want them to cough things up. So you don’t want to suppress that because it could really go into the lungs. Even with Tylenol and ibuprofen, you should really discuss with your doctor, because it should be weight-based. Just because it’s over the counter does not mean it’s 100 percent safe for your kids.
Q. How can we prevent getting a cold or the flu?
A. Just really good hygiene. Wash your hands. Use warm water and wash for at least 15 seconds. I tell my children to sing the ABCs song, when they’ve finished singing it, they can stop washing their hands.