“Cold and Flu Information”

Flu Season is SURGING and is here to stay. What to do.

Are you SICK of hearing me talk about the flu? Or are you just SICK from the flu? You’ve probably heard stories of hospitals being so full that they’re turning patients away in Chicago, or treating patients in tents in Pennsylvania, and both of the ED’s where I work have initiated “emergency overflow protocols” for the influx of patients.  It’s always a bad thing when the “emergency department” has its own “emergency”.  So, when I received a recent update from the MA Department of Health, I wanted to share it with you.

The ER’s are FULL of people with the flu–volumes are up 25-30% daily, and the DOH reports that this may continue for weeks to months–it’s possible that we’re not even halfway there yet.   Many of my patients have been asking me about this, so here are the latest facts (including why you may have still gotten sick, even if you got the vaccine).

  • ER volumes everywhere are up 20-30% daily, and hospitals are also similarly full, causing backup in the ER because there are so few available inpatient beds
  • The current surge in flu is expected to increase (nope, we’re not there YET) and last for at least weeks, if not a couple of months
  • This year’s strain of flu is particularly virulent, but IS covered by the vaccine.  As a result, some people who received the vaccine are getting the flu, but they are getting milder and shorter durations of symptoms than people not vaccinated.
  • The majority of the cases are Influenza A, which is stronger than Influenza B (and one of the reasons why we’re having breakthrough despite the vaccine)
  • The Department of Health still strongly advises vaccination, but keep in mind that it takes 2 weeks to work.  Given that the flu season is expected to last for a while, you still have time to benefit from it
  • Most strains are sensitive to medications such as Tamiflu, but you have to start it in the first 48 hours to be effective (so call your doctor when you first get symptom.  However, keep in mind that these medications only shorten the symptoms by 1-2 days, so this medication is recommended mainly for people at higher risk, such as children under 5 (especially under 2),  adults over 65, pregnant women, or people with chronic medical problems).
  • If you have the flu, don’t return to work until after 24 hours after your fever has resolved (without having to take anything for fever).  You may STILL be infectious after this however, so use scrupulous hand-washing and cough into your sleeve for at least 2-3 more days
  • Check out the MA Department of Public Health “FLU-What you can do” or CDC Flu website
  • Classic symptoms of the flu include fever, body aches, sore throat, headache, nasal congestion and cough.  Go to the ER if you have difficulty breathing, a sore throat so severe that you are unable to swallow liquids, a severe headache with or without neck stiffness, or any other really frightening symptoms.  Otherwise, you should be able to convalesce at home and wont need the ER.
  • Home Treatment: For most adults, I recommend the following: (and note–i get no sponsorship from the following companies!!)
    • For fever/body aches/headache/sore throat:  Acetaminophen (tylenol) 650mg every 4-6 hours and Ibuprofen (Motrin/Advil) 600-800 mg every 8-12 hours
    • For nasal congestion:
      • Saline sprays – spray ample amount into nostrils, then blow out until you are able to clear congestion
      • Neti pot—accomplishes same as saline sprays, more effective (people swear by it), but some people find it uncomfortable
      • (topical spray) Afrin: great for constricting the vessels in the nostrils and decreasing swelling and congestion.  Do not use for more than 72 hours, as using it longer can cause rebound nasal congestion
      • Oral decongestants such as Pseudoephedrine (Sudafed–find it behind the pharmacy counter), or Phenylephrine (newest alternative to Pseudoephedrine)
    • Cough Suppressant: Dextrothorphan (Delsym), or Robitussin with Codeine (available via prescription)
    • Expectorant: thin the mucus in the air passages to facilitate coughing up the mucus and clearing airways: Guaifenesin (Robitussin, Mucinex, Vicks Dayquil Mucus Control)
    • If you’re having any nausea or vomiting, check out the link that I posted HERE

Fox News–The Flu is now “Widespread”. What to do about it.

The flu season 2012 has earned a new status–the Department of Health and CDC are now labeling it as “widespread”, the highest rating of flu activity (meaning that it has been found in over half of any state), so Fox had me on last night to talk about it (watch the clip here:    Dr. Darria Long talks about widespread influenza in Mass..

Of course, I didn’t need the CDC to tell me that–Wednesday I worked in the ER and it was flooded with patients with flu-like symptoms.  Most of these people were  really sick–some were vomiting and couldn’t keep down fluids, some had developed respiratory infections.  I treated one lady for symptoms (her stomach pain and vomiting were so severe that we got a CT scan on her to make sure she didn’t have appendicitis), then as she was finishing, her husband checked in with the same symptoms.  This bug is contagious!

What does this mean for you? (I posted about this a couple of weeks ago, which you can also read HERE)

  • GET YOUR FLU SHOT! If not for yourself, then for your family, that doesn’t want you to make them sick.  (and if you wont do it for yourself or for them, then just do it for ME, because I dont want to get sick when you come to see me in the ER either!).  And no, it’s not too late–we expect the flu season to continue well into January and February, so the shot you get right now will at least protect you starting in January (it takes 2 weeks to kick in). Find more details about the flu shot HERE
  • Wash your hands.  I know.  How many times can I say this? But it’s true.  Especially around this time of year when we’re hugging people, shaking hands, and traveling, it’s especially important.
  • Don’t share food.  Around the holidays this can be especially tough, but shared food and food serving utensils can easily spread not only the flu but other stomach viruses that are going around right now.  So just keep this in mind this year–it may not be the year to try food off of everyone else’s plate

My Dr Oz Show Guest Segment Airs TOMORROW Tuesday December 4

Want to know how to protect yourself and your family from the cold and flu this season? (Yep, we’re already having patients come into the ER with these symptoms!).  Last week Dr Oz had me as a guest on his show to address this, and it’s being broadcast tomorrow (Tuesday, December 4).

So,  set your DVR’s tomorrow for the Dr Oz show (check your local listings or go to www.droz.com and click in the upper right-hand corner box to enter your zip code and see showtimes).  If you’re in the Boston area, it’s shown on Fox at 10am and 5pm.

I’ll also post it here after it’s available.



Norovirus outbreak tied to reusable grocery bags

Ewww… we know that reusable grocery bags are better for the environment, but they may be carrying more than just your food–so CLEAN BETWEEN USES!

Reusable grocery bag the culprit

Epidemiologists have linked a prior norovirus outbreak among a young soccer team to a reusable grocery bag–highlighting how easily the virus can spread.  Norovirus is the EXTREMELY contagious virus that causes vomiting, stomach cramps, and diarrhea, and has caused outbreaks everywhere from elementary schools to cruise ships.  (For more details, see my prior post earlier this year during our seasonal outbreak:  “Have  You Gotten This Season’s Stomach Flu Yet?”)

We already knew that the virus is very hardy–it can live for days on surfaces (doorknobs, stairway railings, sinks).  But this highlights another source–those bags in which we carry our food weekly.  Do you ever clean your bags between shopping trips? You know, the bag that last week was used for raw meats and this week may have been used for your fresh fruit?

If not, then it’s time to start!

Research on Deadly Avian Flu Virus Censored

The National Science Advisory Board for Biosecurity (NSABB) has requested that research on mutated forms of the Avian Flu Virus, or H5N1, that could be more transmissible to people, be published without information on how the mutated virus was created.  Up to this point H5N1 cannot easily infect from person-to-person. However, it is highly lethal, killing 60% of people infected with it since 1997.  Hence, research that involved mutations that increased transmissibility among humans has sparked a crucial international debate.

Scientists state that this type of research—and the ability to share their methods with other researchers worldwide—is imperative to understand how to better detect, prevent, and treat the virus.  However, the NSABB argued that the altered strain presented “a grave concern for global biosecurity, biosafety, and public health”.   The NSABB worries that the information could also be used for more nefarious purposes—namely, for production of a biological weapon.

Concerns about the potential for use by terrorists, as well as the risk of the virus escaping from the labs and mutating further to spread from person to person, have led the research labs to temporarily halt their work for 60 days.  In addition, the NSABB has recommended that planned publications of the research omit some of the more sensitive details.

The research was conducted in two separate labs—one at the University of Wisconsin and the other in the Netherlands, and involved ferrets, which are believed to have similar responses to the flu as humans.  The mutated virus showed that it could cause infection from one ferret to another, and in the Netherlands lab, the disease was lethal in at least some of the ferrets.  While results in ferrets are not a perfect parallel for how the disease would behave in humans, they can be a good representation.

Clearly, there is a very fine line between research to understand a deadly disease and the risk of unleashing it.  As we continue to advance our technology, where this boundary exists will continue to be an ever-pressing debate.