When to Test and Treat: Influenza
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/ Categories: WELLNESS, 2022

When to Test and Treat: Influenza

We are experiencing higher influenza levels in our community, and it is important that influenza is identified and treated early in high-risk patients.

The Centers for Disease Control and Prevention (CDC) considers the following patients to be at greater risk for flu-related complications:

  • Patients under the age of 2
  • Pregnant patients
  • Those over the age of 65
  • Patients with asthma or COPD
  • Those with weakened immune systems
  • Patients with diabetes or liver, kidney, or heart conditions

Patients with any of these conditions should seek treatment and may be treated with an antiviral medication, called oseltamivir, if their symptoms started within the last 48 hours. The antiviral medication will prevent complications.

For those not at high risk, most influenza infections cause a mild illness with fever, headache, body aches, fatigue, cough, congestion, and sore throat.

  • Testing is not required, as a healthcare provider can reasonably make a diagnosis of influenza, particularly if community levels of influenza are high and you have the symptoms described above.
  • Currently, there are shortages in both the antiviral medication oseltamivir and influenza testing supplies. People who are at low risk of complications from the flu will be tested only in rare circumstances and at the discretion of your healthcare provider.
  • Infections of COVID-19 and influenza are very similar and can happen at the same time. Patients with respiratory symptoms should use an at-home rapid antigen test for COVID-19.
  • If you test positive COVID-19, follow the instructions for isolation as listed on the Vermont Department of Health website.
  • Those over 12 at higher risk for a severe case of COVID-19 can be treated with a different antiviral medication, Paxlovid.
  • If you suspect you have influenza, stay at home and away from others, rest, increase fluids, and try over-the-counter fever-reducing medications, such as ibuprofen and acetaminophen. Most people with this illness will have mild symptoms and will not need medical care or antiviral medications. 
  • You can reduce your risk of influenza and the risk of those close to you by receiving the seasonal influenza vaccine and consistently washing hands properly.

Crystal Labbe-Hasty, PA, is a physician assistant at SVMC’s Respiratory Evaluation Center/ExpressCare in Bennington. The practice is part of Southwestern Vermont Medical Center and Southwestern Vermont Health Care. 

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How to Maintain a Healthy Immune System

There are so many things that we have little control over. We can't control what genes we get, how old we are, or what viruses are circulating in our environment, but there is a lot we can do to prevent illness. Remarkably, many of the same habits that protect you from diseases like diabetes, cancer, and heart disease also help your immune system fight infections.

Most viruses can't hurt you until they get inside your body. So, we can help our immune system if we avoid viruses and cut off the ways they travel. Viruses can spread through the air, but not usually for very far. Keep your distance—at least 6 feet—from others, and be a good neighbor by wearing a mask in all public areas.

Viruses that cause the most common illnesses—respiratory infections, including the common cold, flu, and the new COVID-19—travel into the body through your mouth, nose, and eyes and make their way to the areas they infect, like the lungs. The best way to break this chain is to clean your hands frequently, and don't touch your face with hands that have touched anything else. In addition, you can reduce the number of viruses in your environment by cleaning frequently touched objects with a bleach- or alcohol-based cleaner.

Vaccinations are your next line of defense. Immunizations, like the flu shot, introduce a small and harmless part of a virus or bacteria. The vaccine gives your immune system an opportunity to make antibodies against the virus. A vaccinated immune system responds more quickly and effectively when illnesses are introduced. What's more, when we all get vaccinated, we decrease the likelihood that anyone will get sick. If you are unsure about whether you or your children are up to date on their vaccinations, call your primary care provider’s office.

Your third line of defense is living a healthy lifestyle. It is clear that the same things that help the rest of our bodies function also improve the strength of our immune response. Likewise, things that hinder our bodies' ability to function compromise the immune system.

Regular exercise might be the most powerful way to maintain a healthy immune system. By increasing heart rate and blood flow, we allow the cells and substances of the immune system to move through the body freely and do their job efficiently. Similarly, things that slow the movement of cells and substances, like smoking or drinking alcohol in excess, may decrease the body’s ability to function and decreases the immune response, as well.

Getting adequate sleep may also positively affect the immune response. Chronic sleep deprivation has been shown to decrease the beneficial boost in immunity from vaccinations.

Our emotional state, too—whether we are stressed, lonely, or depressed, for instance—affects our immune response so much that a relatively new specialty called psychoneuroimmunology now studies the connection. One pioneering study, conducted in the early 1980s, found that college students operating within a stressful 3-day exam period had fewer of the cells that fight tumors and viral infections. In simple terms, the students almost stopped producing immunity boosters and infection fighters.

Finally, physicians have concluded that eating a mostly plant-based diet—including fruits, vegetables, beans, nuts, whole grains, and lean protein—supports overall health and may also support immunity. Nutritious foods include important vitamins that the immune system needs to function, such as beta carotene, vitamin C, vitamin D, and zinc. Note, however, that supplements that claim to improve immune function have not yet been shown to do so to the extent necessary to protect against infection and disease. It is better to eat whole foods that are rich in vitamins rather than take supplements.

Always consult with your provider before making changes to your exercise plan or trying a new supplement and if you have any medical concerns. Physicians and the other professionals working in their offices also provide help for developing a plan for a healthier life. Call your primary care office or 802-447-5007 to find a primary care provider.

Healthy habits, like those that protect your body from disease and infection, are not always easy to adopt or maintain. Perhaps knowing just how important they are to maintaining a healthy immune response will provide the extra motivation necessary to make them a priority.

Kim Fodor, MD, is an internal medicine physician at SVMC Internal Medicine.

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