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Tag: flu

The Real Scoop On The Flu Shot For 2016-2017 Season

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Posted by Dr. Monica Wonnacott | October 7, 2016

Discussion of the flu shot seems to evoke a lot of emotion in people. I’ve heard the flu shot referred to as ‘the shot we love to hate.’ That’s a pretty accurate statement for me. I hate that it causes my medical assistants to be spread thin (we offer vaccines to the whole family at anytime without appointments). I hate that some years the strains covered aren’t exactly the strains in our community (making it essentially a swing and a miss). I especially hate that there is no flu mist for the 2016-2017 season.

In case you haven’t heard, the studies showed that the flu mist this year wasn’t effective, so it was pulled from the market. But despite my frustrations, it’s the best that medicine has to offer to protect us. Even though sometimes it isn’t perfectly effective, or there are occasional people who get reactions to the shot, I feel like something is better than nothing.

Every year, I take care of dozens of patients who have true “influenza” (the actual bug that the shot is protecting against, not the vomit “flu” that people sometimes refer to). Influenza is classically a virus that causes horrible fever, body aches, and respiratory symptoms. Without exception, if they didn’t get the shot and catch the bug, they all say something about wishing they had gotten the shot. It’s absolutely a miserable virus.

Who should get the shot?

  1. Technically everyone over 6 months of age should get the shot.
  2. However, certain groups are at highest risk for having serious illness or complications from influenza and those patients we make special effort to get vaccinated. They are:
    1. The very young (6 months to 3 years)
    2. Those with underlying respiratory diseases (like asthma)
    3. Those with immune problems
    4. Those in high exposure professions who may be exposed to vulnerable populations (like doctors and nurses)
    5. Children who were premies (and are now older than 6 months)
    6. Pregnant or breastfeeding women
    7. Elderly

Can I get the flu from the flu shot?

No. The flu shot (the injectable version) is a killed vaccination. It is medically impossible to get the flu from the flu shot. Now the flu mist (which again isn’t available this year) is technically “live,” so it is technically possible to get the flu from that shot.

Do I recommend it?

Yes. I recognize the short comings of the shot, but it’s the best we’ve got. I haven’t broken the news to my own kids yet that they are getting shots this year (I always bring home flu mists for them) and I imagine that they aren’t going to be happy with me, but I don’t want them to get sick. But shots will happen this month. October is a good month to get your flu shot.

Rhinovirus – The Bug That’s Going Around

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Posted by Dr. Monica Wonnacott | May 4, 2016

Rhinovirus seems to be the virus de jour in the last few weeks. In medicine, we often don’t go to the effort to do specific viral testing on kids who appear to have “just a cold.” The test is painful (a swab up the nose), is expensive (hundreds of dollars), and takes time and effort. If there was a cure, it would probably be worth doing more often. However, there are still plenty of reasons to test (e.g., a child who isn’t getting better, a child with an underlying immune problem, a newborn with fever). In the last few weeks, most of the kids we have tested for one reason or another have been positive for rhinovirus. So it is definitely going around.

What is rhinovirus and do I need to stress about it?

Rhinovirus is the most common viral infection in humans. It is the predominant cause of the “common cold,” although there are other viruses that cause colds. It typically infects the upper respiratory system. Random trivia: “rhino” comes from the Greek word meaning nose, so I always think of it as the bug that causes all your crummy runny/stuffy nose symptoms. Rhinovirus is the most common in the fall and spring.

Rhinovirus Signs and Symptoms

  1. Runny or stuffy nose
  2. Cough
  3. Sore throat
  4. Fever
  5. Headache
  6. Decreased appetite
  7. Muscle and body aches (can happen, but are atypical).

Rhinovirus Incubation

Everyone always wants to know where they got a bug (secretly we want to shake our fist and curse the person who possibly gave us the bug). Knowing the incubation period (the time it takes from exposure to showing signs of illness) will help in your detective work. The typical incubation period is 2 days. There have been reports of as short as 20 hours and as long as 4 days, but usually 2 days. The bug is passed via respiratory droplets (people coughing/sneezing around you) and from direct contact or touching (e.g., an infected child wipes his/her nose with his hand, touches a toy, then your child plays with the infected toy and later touches his/her own face).

Rhinovirus Treatment

In case you haven’t heard, there is no cure for the common cold. I’m working on it, but failing miserably. For now, treatment is all symptomatic. (See my article DECODING COUGH AND COLD MEDICATIONS for specifics.) As a quick reminder, rhinovirus is a virus and an antibiotic won’t help (since antibiotics only treat bacteria). So unless there is a complication (e.g., pneumonia, an ear infection), your doctor shouldn’t prescribe an antibiotic. In general:

  1. Treat fever, sore throat, and/or body aches with Tylenol (if over 2 months) or Motrin (if over 6 months)
  2. Run a humidifier
  3. Keep the nose as clear as possible
  4. Try OTC meds (depending on age of child and symptoms)
  5. Encourage fluids
  6. Rest
  7. Let time pass

Colds tend to go away on their own, so be patient. Rhinovirus typically lasts 7-10 days. Complications can happen (e.g., pneumonia, ear infections), but are uncommon. Complications tend to happen in children who are compromised in some way (e.g., have weakened immune systems, asthma). FYI, there is not a vaccine to prevent rhinovirus.

Rhinovirus Prevention:

  1. Wash your hands often
  2. Don’t touch your face (the virus enters through the mouth, nose, and eyes)
  3. Steer clear of sick people (if one of your children is sick, try to keep them away from the others as much as possible)
  4. Disinfect infected surfaces
  5. Improve your immune function (eat healthy, exercise, and sleep well)

Call your doctor if (because I’m worried about developing complications)

  1. Your sick child is under 2 months old (just about any bug under 2 months should be seen by a doc)
  2. The fever goes beyond 5 days or reoccurs (e.g., has been gone for 3 days and starts again)
  3. Any one of the symptoms is getting significantly worse when it should be getting better (e.g., after a week of coughing it should be gradually improving not getting worse)
  4. Your child is disproportionately symptomatic or miserable (e.g., a child shouldn’t cry inconsolably for hours with the common cold)
  5. Your child is having trouble breathing

Rhinovirus isn’t fun, but also isn’t the worst virus out there. If you or your child falls victim, take heart. It too shall pass.

Zika Virus: How Worried Should I Be?

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Posted by Dr. Monica Wonnacott | April 19, 2016

Everyone has heard something about the Zika virus. You may be surprised to know that while it has gotten a lot of press (because of its spread and link to birth defects), it’s not new. Zika was in fact, discovered in 1947 and is named for the Zika Forest in Uganda. The first cases of human infection were reported in 1952. So how worried should you be about this nearly 70 year-old virus? Well, that all depends on where you live, whether you are planning on traveling, or if you are pregnant (or trying to become pregnant). Here are the quick highlights on Zika:

ZIKA SYMPTOMS

Interestingly, most infected people don’t even know they have it. For those who experience symptoms, they are usually mild and last 2-7 days. Symptoms include: red eyes, fever, muscle and joint pains, malaise (overall feeling crummy), headache, and rash. Of note, there have been a few reported cases of rare neurological complications (including Guillain-Barre syndrome).

ZIKA SPREAD

Zika virus is spread primarily via Aedes mosquitoes (not typically the variety found in the continental US).  There have been a few reported cases of human-to-human spread via sex. This is especially important for pregnant women’s sex partners living in or returning from areas where there is local transmission of Zika. FYI, the incubation period (the time from exposure to symptoms) is thought to be anywhere from 3 days to 2 weeks. This means that if your exposure was over 2 weeks ago and you didn’t get it or any symptoms, you are probably in the clear.

ZIKA PREVENTION

The best way to prevent contracting Zika is preventing mosquito bites (if you are in an area where Zika has been reported). Use insect repellents (especially those with DEET, picaridin, IR3535, OLE, or PMD), wear long-sleeved shirts and long pants, use a bed net, apply window screens, and reduce breeding sites (standing water). It is also best to use condoms when having sex (again, if you or your partner are or have been in locations with Zika). Pediatrician’s note: don’t use mosquito repellents on children younger than 2 months (some experts say younger than 6 months), and don’t use products that contain more than 30% DEET.

ZIKA DIAGNOSIS

The diagnosis of Zika is suspected if the symptoms match AND there is a history of recent travel to affected areas of the world. Confirmation is made via laboratory testing in blood, urine, or saliva.

ZIKA TREATMENT

There is no specific treatment, cure, or vaccine. Any treatment would be supportive only (e.g., Tylenol or Motrin for headaches or joint pain). As with many viruses, it just takes time for the body to recover on its own.

AFFECTED AREAS IN THE WORLD

The most affected areas are: the Caribbean (including Puerto Rico and the US Virgin Islands), the Americas (extending from Mexico to Paraguay), Africa (Cape Verde), and the Pacific Islands. Areas of Southeast Asia were also affected prior to 2015. As of April 2016, there are no reported cases of transmissions from mosquitoes in the continental US. There have been a number of reported travel-associated cases (358 to be exact, as of April 13, 2016).

TRAVEL WARNING

The CDC has issued a Level 2 “travel notice” which means practice enhanced precautions for people traveling to areas with Zika. There are specific warnings for women who are pregnant (in any trimester) or trying to get pregnant to consider postponing travel to areas with Zika.

ZIKA PREGNANCY WARNINGS

Zika virus can be passed from mother to fetus. From the outbreak that started in Brazil in 2015, we are learning of the associated risk of birth defects including microcephaly (small heads) and brain malformations. Women who are pregnant or wanting to become pregnant should heed travel warnings and practice prevention strategies. If there has been exposure, seek medical care.

Now that you know all there is to know about the Zika virus, you can make an informed decision on whether to take that awesome trip to the Fiji or the Caribbean. As for me and my house, we’ll be hanging at home (mostly because we have nothing planned, not because of Zika).