everything you wanted to ask the pharmacist about the flu, but didn't

The flu? What’s that?

Influenza aka the flu is a contagious respiratory illness caused by various types of influenza viruses. (CDC)

How do you get the flu?

People with flu can spread it to others up to about 6 feet away. The flu viruses are thought to spread mainly by droplets made when people with flu cough, sneeze or talk. People with flu are most contagious in the first three to four days after their illness begins. (CDC)

When is flu season?

Influenza activity often begins to increase in October. Flu activity peaks between December and February, although activity can last as late as May. (CDC)
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How do I know if I have the flu?

Symptoms can begin about 2 days (but can range from 1 to 4 days)  after the virus enters the body. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick.Some people can be infected with the flu virus but have no symptoms. During this time, those people may still spread the virus to others. (CDC)

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How can I prevent this?

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  • Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too. (CDC)
  • Stay home when you are sick.
    If possible, stay home from work, school, and errands when you are sick. This will help prevent spreading your illness to others. (CDC)
  • Cover your mouth and nose.
    Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick. (CDC)
  • Clean your hands.
    Washing your hands often will help protect you from germs. If soap and water are not available, use an alcohol-based hand rub. (CDC)
  • Avoid touching your eyes, nose or mouth.
    Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth. (CDC)
  • Practice other good health habits.
    Clean and disinfect frequently touched surfaces at home, work or school, especially when someone is ill. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food. (CDC)

How does the flu shot work?

Flu vaccines cause antibodies to develop in the body about two weeks after vaccination. These antibodies provide protection against infection with the viruses that are in the vaccine. (CDC) Think of antibodies as your immune systems soldiers. The soldiers provide “protection” because they know all the enemies weak spots. 

How can I get a flu shot?

Everyone* 6 months of age and older should get a flu vaccine every season.(CDC) (*There are certain patient populations that can’t receive flu shots, talk to your doctor and find out if you are one of them.) You can walk up to the consultation window at pharmacies that offer flu shots and ask the pharmacist about which type of vaccine is best for you. Remember to mention if you have an egg allergy and if you’ve ever developed anaphylaxis from ingesting eggs. Anaphylaxis is a type of allergic reaction that can cause you to suddenly stop breathing. It sounds scary, but the reason we ask about the egg allergy is because the flu vaccine is “grown in eggs”.

When can I get a flu shot?

As soon as the 2019-2020 vaccine is available (this is usually around the end of September – beginning of October). 
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I think I have the flu, now what?

Flu signs and symptoms usually come on suddenly. (CDC)

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  • Fever* or feeling feverish/chills
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Muscle or body aches
  • Headaches
  • Fatigue (tiredness)
  • Some people may have vomiting and diarrhea, though this is more common in children than adults.

*It’s important to note that not everyone with flu will have a fever.

What medicine can I take?

If you suspect you have the flu, you should go to your primary care physician, urgent care or nearest ER. Please wear a mask when at these places to avoid the possible spread of the flu. Remember those at risk people mentioned above, do your best to protect them. Also, you must start antiviral treatment within 48 hrs of becoming sick. The medication has a better offensive advantage when taken early.

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Prescription Antiviral Medication

Oseltamivir (Tamiflu)taken twice daily for 5 days Approved from as young as full-term infants to older adults
Recommended for treatment of pregnant women
Most common side effect is nausea and vomiting Lower doses available for those with impaired renal function 
Zanamivir (Relenza) taken twice daily for 5 days Inhaled formulation
Most common side effect is bronchospasm
Not recommended for patients with COPD or asthma 
Peramivir (Rapivab) given intravenously over a period of 15 to 30 minutesApproved for ages 2 years old and aboveInfusion can be repeated if needed 
Lower doses available for those with impaired renal function 
Most common side effects is diarrhea
Baloxavir (Xofluza) given as a single oral doseApproved for ages 12 years old and above Weight based doseNot recommended for pregnant women, breastfeeding mothers, outpatients with complicated or progressive illness, or hospitalized patients 

The antiviral medications work by either blocking the replication of the flu virus or stopping the release of viral particles. Essentially, if the virus can’t continue to grow at a faster rate than one’s immune system can fight it off, eventually it will die. Thus shortening the life span of the flu. Without the antiviral medication you might have felt sick for more than five days. Although taking the antiviral medication doesn’t guarantee that the symptoms will disappear in five days. This happens largely in part because of timing. How fast you got diagnosed and started treatment or how long the virus sat idle lurking inside of you waiting for the right time to strike. Every patient is different! I can’t stress this enough when I counsel patients. Don’t compare your bodies response to the vaccine or antiviral medication treatment to someone else. 

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Over the counter Medication

Cold and flu medications can be used to help alleviate the symptoms of the flu. Over the counter cold and flu medication will not make the flu “go away”. Those medications will help with the symptoms alone. Be careful to monitor the amount of tylenol aka acetaminophen in these products because the daily recommended maximum is ONLY 3,000 milligrams (mg) or 3 grams (g).

Which viruses will this years flu vaccine protect me against? 

For 2019-2020, trivalent (three-component) vaccines are recommended to contain:

  • A/Brisbane/02/2018 (H1N1)pdm09-like virus (updated)
  • A/Kansas/14/2017 (H3N2)-like virus (updated)
  • B/Colorado/06/2017-like (Victoria lineage) virus

Quadrivalent (four-component) vaccines, which protect against a second lineage of B viruses, are recommended to contain:

  • the three recommended viruses above, plus B/Phuket/3073/2013-like (Yamagata lineage) virus.

Yes, remember, you could have already been in contact with the flu virus but you were not showing symptoms yet. Also keep in mind that the flu vaccine protects you against the three or four most common flu virus expected to impact your region. 

As my biology professor would say: virus are living tiny creatures out here trying to survive just like you. A virus needs a host (aka you) in order to live. It ain’t the virus fault, it’s just trying to find a nice place to call home

Can I still get the flu even if I got the vaccine?

-asking for a friend

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