Welcome to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health. Flu season is officially here. It’s ramping up, and I predict it’s going to be a doozy. In this Note, we are going to talk about influenza and how to get yourself prepared: keeping your immune system healthy, testing, and treatment options.
Let’s dive in.
We haven’t seen influenza in about two and a half years. It tends to peak between December and February but it’s coming on earlier this year for sure. Note: This is probably because Covid-19 took the spotlight and everyone stayed indoors (they were more worried about Covid, and rightfully so!). There is also RSV that we’re dealing with. RSV can be worse than the flu in a lot of people, and we still have Covid-19 going around. That’s three things to deal with! It’s hard to tell what you have unless you get tested for it. We will get into that a little later in the Note.
There are two types of influenza:
- Type A
- Type B
I recently talked to a laboratory specialist at our area hospital, and he said about 80% of what they’re finding now is Type A. Type A tends to be worse than Type B. It’s more lethal and takes longer to recover from. Note: Type B is still out there. It can be rough, especially in kids, so you can’t ignore it. Type A is probably the most contagious, because Type B takes longer to mutate. With Type A, people are contagious about one day before they come down with the symptoms. That’s the incubation period.
One thing to consider right now is that most everyone’s immunity is lowered. Our immune systems aren’t working as well as they could be. As we switch into high gear this winter season, you need to be ready.
If you have a cold, you’re going to have a runny nose, a mild sore throat, and some nasal congestion. If you have influenza, the symptoms are:
- Itchy, watery, eyes
- Itchy throat and nose
- Body aches
- Extreme fatigue
These are some of the same symptoms you’re going to have with Covid or RSV, so you need to know which one is which, because we treat them differently. Note: As you know, RSV is more dangerous for small children and elderly adults. Usually, it’s not too bad for adults and teenagers.
With RSV, you treat it symptomatically. There’s not a lot you can do besides supportive care, unless it gets real severe (children may need hospitalization). Note: RSV can get into the lungs of both children and adults, as can the Flu and Covid. At that point, you can get a secondary bacterial infection on top of it. So, you really have to stay on top of this.
Fortunately, for influenza, there are antivirals. Ideally, you need to take these within two days of when you come down with symptoms. Note: You can still take them up to 5 days after initial symptoms.
- TAMIFLU is the one we usually use. It’s the most popular antiviral. It’s a five day course. It’s been around for a while, and it’s very safe. Note: some people have a little nausea on it.
- RELENZA is another antiviral for influenza. It’s an inhaler and you use it for five days. Note: If you have asthma or COPD, you cannot take this one.
- RAPIVAB is an IV, one time treatment, only for influenza. Sometimes they give you this in the hospital, if you have a severe case.
- XOFLUZA is another one that’s been out there for two or three years. It’s a pill and you just take one. So, there’s an advantage to that as well. You should take this earlier than you would Tamiflu.
- OSCILLOCOCCINUM is a natural homeopathic medication that’s available in most vitamin stores. It’s a remedy that a lot of people swear by. Note: In my research it works about 50% of the time. You need to take it early. It has a little bit of what makes you sick, which means it has a little bit of the virus. But it’s diluted so many times you can’t detect it, and it’s not going to cause side effects. This particular one comes in oral pellets. It comes from wild duck heart and liver. You put it on your tongue (you don’t touch it). Take it on an empty stomach. A lot of people just prefer this over the other treatments. You can take it one day, or up to three days, until your symptoms are getting better. Note: The other treatments are more FDA approved and a little more researched. I’m not against it though, if you want to take this one.
I’ll always hit you with a few other things, too. One of my favorite things to have around the house for my home medical kit is COFIX. I have COFIX in each of my offices. It’s a throat and nasal spray.
As soon as you get a sore throat or runny nose there’s a few things I do.
- I immediately start spraying COFIX up my nose and down my throat.
- I pop my Vitamin D up to 50,000 units a day for 5 days.
- I take high doses of Vitamin C. Note: You can take a gram of Vitamin C every hour until you feel better.
- And then of course, Zinc (50–75mg).
Note: All of the above is for adults.
Check out this video on vitamins for a strong immune system.
Should You Get The Flu Shot?
That’s up to you. I’ve had a lot of people over the years say that every time they take the flu shot, they get the flu. Those people, in my opinion, shouldn’t take the flu shot. But,on the other hand, there are certain people that definitely should take the flu shot, i.e., infants and elderly people. For them, the flu is much more dangerous.
With the flu shot, people have a little less than 50% efficacy against hospitalization. There is a different flu shot every year, based on an educated guess as to whether it’s going to work or not. The flu virus mutates so rapidly.
In recent years, the flu shot on average has provided about a 43% protection rate against the disease. In 2010-11 it had a 60% efficacy rate. In 2014-15, it had about a 19% efficacy against getting the flu. So, it really varies!
The new vaccines are called quadrivalent. That means they protect you against four different variants: Two Type A’s and two Type B’s. The Two A’s are against H1N1 and H3N2. They do serotype it, and sometimes it’s important to look at that for epidemiologic reasons. Note: anyone over 6 months can get the flu vaccine.
Here’s who SHOULDN’T get the flu vaccine:
- If you’re currently sick
- If you’ve had a severe previous reaction to the flu shot (like anaphylaxis)
- History of Guillain-Barre Syndrome after a flu shot (a bad progressive neurologic disease)
- If you have an egg allergy, you may think twice about it (although they say it’s not as important as it used to be)
It’s been noted that people over 65 should get something called Fluzone. It’s a vaccine that’s four times as potent with the antigen as your standard flu shot. There’s probably more side effects with this, as well. FluMist (nasal spray) actually has a weakened live virus in it and is only indicated for people aged 2-49 that are healthy. You cannot use this in pregnancy. It takes the flu shot about two weeks to start working and it lasts about 6 months.
Note: The vaccine is a killed virus. Don’t take the flu vaccine if you’ve ever experienced a severe reaction to it. I’m not against the Flu vaccine. I just tend to trust and believe in my patients’ judgment, if they don’t want to take one based on previous experiences.
Whether or not you take the flu vaccine, take precautions. Take care of your immune system and have some of this other stuff around in case you get it. If you get symptoms, get tested to see if you actually have the flu. If you have the flu, stay home!
How To Test
You need to get tested to see what it is. Is it Flu? Is it Covid-19? Is it RSV? At most pharmacies you can get a drive in test. There’s home tests as well. Labcorp now has an FDA approved test with a nasal swab. With this nasal swab, you don’t have to stick it to the back of your nasal cavity. You just do the anterior part of your nose. It’s not painful or uncomfortable.
The Labcorp test is a PCR test (which is more accurate than a rapid test) that detects Covid-19, influenza, and RSV. It’s an at-home test called Labcorp Seasonal Respiratory Virus RT PCT DTC test. You can FEDEX it in and get your results within 1-2 days. You want to treat this as early as possible.
You can also get a 4-plex test, if you go to an ER or urgent care center. They run this on site. It’s going to tell you whether it’s Flu A, Flu B, RSV, or Covid-19. This is a good one if you go to urgent care. I’m hoping some pharmacies will start doing this. Bottom line is, you need to identify what you’re dealing with. It’s triply important because you have three different viruses that can cause similar symptoms. Note: Quest is going to come out with a home test as well.
Take care of your immune system. Take your vitamins. Get sunshine. Exercise. Sleep. Keep your stress levels in check. Have some of this stuff around in case you need it. It may save you an ER visit and a lot of grief if you can treat influenza early.
I’m big on home medical kits. Some of these things you may want to just keep at your house (i.e., Labcorp test) so you can do home testing immediately and fedex it in. Also, remember a telemedicine visit is at your fingertips. I want you to be as proactive as you can be this winter, and have a safe holiday!
Till next week.