Being Well 202 - Colds and flu

>> Lori: Is it a cold or the flu? Should you take an antibiotic? These questions and more will be answered next on Being Well. Joining me this week is Dr. Sheila Simons, professor of Health Studies at Eastern Illinois University. Dr. Simons' area of specialty is epidemiology. And she is going to give us some great information about the best ways to stay healthy during the cold and flu season. So, don't go away. Thanks, Dr. Simons, for coming on Being Well. Let's get right into the topic today and give our viewers a description of what are the differences between bacteria and viruses. >> Dr. Simons: Well, bacteria are much different than a virus. A bacterium is something that can actually be treated with an antibiotic. It is very small in size, it does cause many of our infectious diseases, it is treatable, and it is also something that comes in a variety of different types of shapes. Whereas viruses, are also very well defined, they are difficult to treat, and impossible for an antibiotic to penetrate their outside, or their exterior. >> Lori: And where do they, do they both come from certain places, I mean we can get them in food, we can get them from person to person, where do they come from? >> Dr. Simons: Well, they come from a lot of different types of places, and those places we actually call reservoirs, and reservoirs are where these particular, the bacteria and the viruses is, and other types of pathogens which are disease causing agents, live and develop. Some need humans to do that, some don't. Some can be in water, some can be in food, so there's lots of different places you can find it. The ones that we are affected by the most are actually either airborne, or more appropriately they are what we consider to be a fomite. A fomite is an inanimate object such as a table, or a doorknob, but not necessarily drinking fountains, like many people believe they come from. The design of drinking fountains actually prevents these illnesses from happening, because the water arcs and it actually keeps people from developing illnesses. Many of them are actually the result or when people do get sick, because of poor hand hygiene. And that is really the thing we need to focus on. >> Lori: So, I know it is hard to say how long viruses or bacteria will live on a surface, but do you have some sense of you know, if I blow my nose, and don't wash my hands, and I touch a door handle, how long does that if someone else comes along, and touches that, can they catch that? >> Dr. Simons: It's actually about 10 to fifteen minutes that they will live on that surface. You know, many of our local grocery stores, and discount stores actually use cart sanitizers where you can wipe down the cart. The cart has been outside in one of the corrals, it's not necessary to use that. In fact, we have a tendency as a society to over sanitize. And that is becoming a much larger issue for us, because the over-sanitizing can actually lead us to bacteria that are antibiotic resistant, and it becomes more difficult to treat. >> Lori: So, let's talk about if you have a lot of people depending on the time of the year, they get colds, they get flus, and I want to go to the doctor, I want to get rid of this, and they get mad if their doctor doesn't prescribe something. Talk about the treatment versus if you have a cold, well, first talk about symptoms of cold versus flu. That might be a better place to start. >> Dr. Simons: You know, symptoms of colds are very consistent as they are of flu. You know, when you get that flu, it's very quick, you start to feel the signs and symptoms very quickly, versus the cold, where you know that you have something coming on, you know that maybe someone made you sick, or you know what kind of brain that other person or we'll say, so and so made me sick, or I know where I got this from, because it takes a series of days to develop that. You usually feel like you can eat, you don't have any body aches, or pains. Influenza, it's very fast, you get body aches, you do have a fever, you generally don't have nausea or vomiting or diarrhea, but you can develop things like, you know that sensation that you don't want to eat, and you just feel miserable. So, there's a big difference between the two. With H1N1, which was our big concern on this campus, and the reason why it was really the concern, is the last time we had an H1N1 outbreak, it was during the Spanish Influenza in the 1900's so it's been quite some time, obviously. But the outbreak was bad amongst individuals who were healthy, that the average time frame, in which people would live to age-wise, dropped by 11 years. SO the life span actually dropped, it was that bad, we had that many people that actually died from it. So, we found that helping to prevent these illnesses, really the absolute best way to go. But with influenza, you are looking at about 14 days to recover that, if you are looking at a cold, 3-5 days, for you to develop the illness, and then you'll recover within a week, or week and a half, you may have some lingering signs and symptoms, but you will get past that. As opposed to allergies, >> Lori: Yes, which is what I am suffering from right now. >> Dr. Simons: Yes, and actually this year is going to be a terrible season for allergies. Our recent reports are showing us that because our winter wasn't cold, we are going to have far more pollens, far more molds that what we've had in the past. So, we have a whole new season in front of us in which allergy sufferers are going to be absolutely miserable. Now on occasion, I have had students who say they have a cold, and the cold that they are talking about is something they've had for weeks on end. Sometimes they have had a cold the entire semester. That is not a cold. What that probably is, is allergies, and that will cause you to recognize a difference between that is when individuals have a cold, they usually have some form of colored mucous, same thing with the flu. When they have allergies, they have mucous that is clear. And it can be difficult sometimes to treat allergies, because it takes a little bit of heads-upness to say I need to start taking something now, as soon as you start to recognize your signs and symptoms. And there are quite a few things over the counter that people can use to treat that with. Many of them that were prescriptions within the last five to ten years >> Lori: So which, when you have an illness, either cold or flu, and you go to the doctor, and you say, I want an antibiotic. What is that for? Is that for colds? Is that for flu? >> Dr. Simons: Well, it's probably going to be for something that is bacterial. Like strep throat. Strep throat is big on college campuses, very big this time of year, because people live together, it's so easily transmitted, and I just personally got over a case viral pharyngitis. Pharyngitis is a really fancy word for sore throat. When people get the bacterial pharyngitis, that's the strep throat, and people have had it in the past, they know that that's what it is. >> Lori: That's the white spots in the throat. >> Dr. Simon's: Precisely. They develop those white spots on the back of their throat, they almost always have their tonsils, but there are some individuals that will develop it without their tonsils. Their tonsils are very inflamed, their throat will be very red, and periliant, and it will be an awful feeling for them, difficult to swallow, coughing, that is a strep infection. Strep and Staph infections we can treat with antibiotics. A cold and the flu are viral, the only treatment that you have for them, is time. >> Lori: Which, sometimes we are not very patient. >> Dr. Simons: But you can use, you know, over the counter pain relievers, to help either with the fever, or just general discomfort. You can do that, and there are some other over-the-counter things but some research studies show that it takes individuals a little bit longer to get over the cold, if they do use a lot of these over-the-counter products. It's best to let it go, and in addition to that, there are people who are prone to sinus infections. And there are two things associated with that. One is that they may be individuals who literally blow their nose to hard. When we have inflamed sinuses and we blow our nose too hard, we force that mucous back up into the cavities, and then it creates a medium for infection. Whereas, individuals who don't do that, may be able to get away with some different types of treatments, and even people who do, I shouldn't say that, but some of the nasal steroids that are by prescription, those can actually be taken and shown to treat individuals much more effectively than anything else. Especially an antibiotic. And we have been seeing that as a trend, and the journal of American Medical Association has published that. >> Lori: Well, let's talk about antibiotics. And use and abuse. I think sometimes people get an antibiotic, they think well; I'm just going to save some of it, because if I get sick again, then I don't have to go to the doctor. Talk about you know that that can be a dangerous thing to do. >> Dr. Simons: It is a very dangerous thing to do. What people have a tendency to do, is they start to feel better, and as soon as they feel better, they decide that it's no longer important to finish the prescription, and it is essential they finish that prescription. Just because you are feeling better, doesn't mean that they still don't have that bug. So, if you continue to take that, you establish a quite a big defense against that bug and hopefully you recover nicely from that. But people who save a little bit back, I have to say, that would be my mother, and of course, other people do that, they start to feel better, they set it aside, and they are not quite over the infection, what they are doing is really training that illness that they have, to come back and hit them a little bit harder next time. And a little bit harder after that. And what happens is they start to develop an antibiotic resistance, which is a major problem for us today. It is my personal and my professional feeling that antibiotics should be used just as strictly regulated as narcotics. >> Lori: Really? >> Dr. Simons: Yeah. >> Lori: And talk about antibiotic resistant. I know MRSA came out, people were really, are still afraid of MRSA, because it is so hard to treat. Is it because of antibiotic resistance? >> Dr. Simons: It is because of antibiotic resistance, and MRSA actually stand for Methicillin-resistant Staphylococcus aureus and what have found is that there are certain kinds of staph infections that are resistant to specific antibiotics, like methicillin. And we find that we try and treat it, and we don't get a lot of success for that, the infection is contagious when it oozes, you have to keep it covered, it's painful to some people, it can not just be on the skin, and also appear internally, people can develop it systemically. Now when it appears on the skin, it usually looks a little bit like a spider bite. And that the same for a new antibiotic resistant strain that we have called VRSA, which is Vancomycin-resistant Staphylococcus aureus so now we have MRSA, and VRSA. A lot of people in the past have been afraid of those, actually picking them up in hospitals. Hospitals have done much better at managing those strains. In fact, we've actually seen the numbers of infections go down. In comparison, the seeing them the community, most infections are community associated, not health-care associated. >> Lori: Let's talk about if you are taking, if you take an antibiotic for something like the cold, are you doing some damage to yourself by doing that? Or are you just doing nothing? >> Dr. Simons: Well, it's actually a little bit of both. >> Lori: Ok. >> Dr. Simons: If you are hoping that you are going to get better, and it's going to defeat the cold, you are out of luck. It's just simply not going to happen. You are in a sense doing a little bit of damage, because you are taking a medication that you don't need, and again, one of the major things that happens with that is teach, especially when you are taking it for a bacterial infection, you are teaching that bacteria to become stronger. Now, using an antibiotic when you don't need one is slightly different. Antibiotics when you don't need one actually kill the good bacteria in your body that keeps the bad bacteria in check. And that's the same thing that we see happening with many of the new hand sanitizers that develop. >> Lori: Ok, let's talk a little bit about over sanitizing, because we are kind of all into sanitizing, because we you know, especially in the workplace, one person gets sick, and you start thinking about, oh, we share computers, we share this, and all, and everyone wants to get out their disinfectant. Let's talk about sanitizing and over sanitizing. Pros and cons. >> Dr. Simons: Well, the sanitizing is a good thing to do, as long as it is alcohol based. There's lots of alcohol based ones that you can purchase, you'll find them, essentially everywhere, even at gas stations, you'll find them now. It's actually a pretty good product, but it should not be used in replacing hand washing. You should only use an alcohol-based sanitizer if soap and water are not available. Soap and water is still our best hand hygiene defense. On the other hand, sometimes, we have individuals like the convenience of a hand sanitizer. I prefer they use soap and water, but if they are going to use a hand sanitizer, that is alcohol based, it's ok with me too. Again, my preference is the soap and water. I often get questions about hand washing, usually you wash you hands with warm soapy water for at least the length of singing your ABC's, >> Lori: Which a lot of people don't. >> Dr. Simons: A lot of people don't and you can also do it to singing Happy Birthday song that works as well. But we suggest that they wash their hands, again, warm soapy water, do that for at least 30 seconds, and dry them thoroughly. Teaching children to actually wash their hands, which sometimes can be a challenge, I suggest dishwashing soap. Because dishwashing detergent are >> Lori: Are harder to get off. >> Dr. Simons: That's precisely right. They start to wash their hands, it takes longer to rinse them off, and it forces them to keep their hands under the water longer, and if they don't, they'll find out very quickly next time they eat something, or put something in their mouth, that they still have soap on their hands. So, it's a great teaching tool. From my professional standpoint, one of the hand sanitizers that is used, is a product called triclosan, and triclosan is actually, many people don't know this, a pesticide, that has antimicrobial properties. So it has some antibacterial properties for adults that are not a problem. They can use those products. Children, we are going to see some trends that it is actually causing some problems with the immune system, in that they just are becoming sick, they are becoming more antibiotic resistant because of the particular product being absorbed through their skin. And you can find it in child seats, in shoes, in toothpaste, toys; you can find it in virtually anything that says it's antibacterial. >> Lori: I was going to talk to you, you and I grew up in a era where we probably drank out of garden hoses, you know the five second rule, do you think kids today because of now all these products we weren't exposed to when we were kids, and even people older than us, do you think children today are becoming more antibiotic resistant because everything is over sanitized? >> Dr. Simons: Well, it may be that the triclosan is playing a role in it, but you are right, as kids, I grew up on a farm, so we were into everything, absolutely everything. And we didn't really develop those types of sicknesses that we see children developing today. What we do see differently though, is that we have a larger population of people now. We are seeing more illnesses, simply because there is more people. So that is a big factor. You know, when we look at food safety, my mom will say, we didn't have these problems when we were farming, or anything. Well, we didn't have the number of consumers that we used to have, so food safety has changed, antibiotic use is still in demand by consumers, many feel that if they don't get an antibiotic from a physician, that that person is a quack, and it's simply is not true. They are just trying to prevent the abuse of antibiotics. We do see a lot of children though, that are having problems with antibiotics, again we relate that back to the triclosan, and it may also just be some really poor hygiene, which is a major, major factor. >> Lori: Let's talk a little bit about how weather affects viruses and bacteria. You know, the winter of 2012 has been very mild. Does a really cold winter bring out more of those diseases? Or vice versa? >> Dr. Simons: It's interesting that you ask that, because we find with influenza in particular, for years and years, we believed that why people got sick during the winter is because they were together all the time. That's not necessarily true. What we now know about influenza, as a virus is that it prefers the cold. And since it prefers cold conditions, we are seeing more people becoming infected with that. Now when you look at say a preschool, they are what I like to call a year-round petri dish. Those kids are, you know, they are always sick. They give it to each other. It's poor hygiene, I would just once like to see an immunity sample or some blood samples from a preschool teacher. I imagine that they are just fantastic, because they are sick all the time for their first year. But there certainly is some different types of things that we are seeing with that. Now, back to the cold, many people believe that cold temperatures will make you sick, and that simply is not true. I heard of a particular case last weekend in which a woman was going to go for a walk over her lunch period, and couldn't decide if she wanted to wear a coat or not, because she didn't know if it was so cold, or cold enough, that she herself would develop a cold. And again, it's not possible. Cold and temperatures do not cause illness. What causes illness is viruses and bacteria. Not temperature. Very misleading. But you know, part of that is the old wives tales that people have believed that for years, and its difficult to get past those believe systems. >> Lori: So what about the old wives tales, feed a cold, starve a fever, or vice versa. >> Dr. Simons: You know, I can't remember either, and I think of that often, which way is it? IF the person feels well enough to eat, >> Lori: You should eat. >> Dr. Simons: Go ahead and eat. Let's not starve them. Same goes with exercise. If the person feels well enough to exercise, go ahead. If you have a fever, you probably shouldn't. But that is something to consider, as well. >> Lori: Ok, I saw something recently online and it was directed at commuters. All the things that people who commute in larger cities than what we live in, all the things that they touch that are really germy, >> Dr. Simons: They are germy. >> Lori: And if you think about that too much, we'd never leave our house. But let's talk about some places in our everyday life, public places that can pick up a lot of germs. What are some of the germiest? >> Dr. Simons: Well, what you are talking about right now, is the fomites. You know we have airborne illnesses where we cough and someone else can inhale that. It has been recorded that when people sneeze, some people can sneeze up to 100 MPH, which is just fascinating to me, that that could be done. And a little disgusting. But when you look at again, the surfaces that people touch, probably door knobs is one, and people think they get around that by pushing the handicap pad to get into, but everybody else is doing that same thing. Pharmacies where you may have to sign for a prescription, remote controls, >> Lori: In hotels. >> Dr. Simons: In hotel rooms, you know the bathtub, right at the base of the drain, is a big place for that to happen. Toilet handles, toilet floors, sinks in which people don't really clean them, so there's lots of different types of places, essentially anything that you touch, that someone else touches, can put you at risk. You know, computer labs on our campus, a lot of them have wipes for the computers. The key is, if you touch anyone of these things, don't touch your face. Don't touch, don't eat without washing your hands, don't put your fingers in your ears, or your nose, or your mouth. That is what is going to cause the problem. >> Lori: What about if you said ears, nose, eyes? What >> Dr. Simons: You know people who wear contact lenses, and people who don't, when they rub their eyes, they usually rub them with their hands, but you should wash your hands before you touch anything from the neck up. And you know, sometimes we'll see like pink eye outbreaks, or conjunctivitis, which is really just an inflammation of the membrane of the eye. When that happens it is highly contagious, people rub their eyes, they touch things. other people touch things, they also rub their eyes. You know rub your eye with the back of your hand. Sneeze or cough into the crook of your arm. Coughing into your hand, or rubbing you eyes with your hands, and then touching things is just not helping other people. And it's approximated that about every minute we touch our face three times. So, if you think about how many minutes are in a day, and how many times you touch your face within that timeframe, you do put yourself at higher risk to develop an illness. >> Lori: Now we are all going to be thinking >> Dr. Simons: But you know, if I can recommend one thing more than anything else, wash your hands. You know, thirty, forty, fifty years ago, one of the things they taught in school was hygiene. Before they started teaching health, which is really my field. And then we started looking at behaviors in my field, and infections and a variety of other things. But hygiene, especially hand hygiene, is paramount. It has to be something that is practiced. >> Lori: Right. We've got about three minutes left. Is there some other areas that you'd like to talk about? >> Dr. Simons: I think that to recap the importance of finishing prescriptions for antibiotics. Knowing ultimately that hand hygiene is the thing that matters. Only use sanitizers or hand sanitizers when there is no soap or water that is available. I see people use the hand sanitizers in our building right outside out bathroom. Wash your hands, not use hand sanitizers, but you know part of that is also how our society is. We are kind of a quick fix society. We'd rather use something simple, like a hand sanitizer than anything else. Avoid touching your face when you are sick. Certainly when you are not sick, try to avoid doing that. Watch the surfaces that you touch. And really, let's go back to days when my grandmother was teaching us simple rules. You know, wash your hands before you eat. >> Lori: Are there, not to scare people, but you know we always hear, this is going to be a bad year for influenza, are there emergent diseases out there that we should be aware of that are on the horizon? >> Dr. Simons: Well, there are always emerging diseases. Especially with the viruses, and bacteria. If I can put my money on anything in the end of who's going to win the battle, I am putting money on the bugs. It will be them, if it's not us. But we do see especially with influenza every year the Centers for Disease Control and Prevention puts out a list and then vaccinates for the three most common influenza strains, and we'll see [00:25:05.21] that year. What they do is they generally wait for a trend to start that year, then we get an idea of which ones to be vaccinated for, and that's what we vaccinate the public for, there are a large number of individuals that do not believe in vaccination, in fact, we have about a 50% vaccination culture, meaning 50% of individuals get vaccinated for influenza that really can be vaccinated for it. They influenza vaccine is made with eggs, hen eggs, and if you have an egg allergy you cannot have it. But, you do get a lot of protection from that. Some people say I haven't had the flu, I don't get sick, but it is quite possible that if you have an elderly person in your family, maybe a person who is getting chemotherapy because they are sick with cancer, or maybe they have another immune disease, you can expose them to influenza, even if you do not get sick. Also here, just very briefly, a lot of people who say that the influenza vaccine makes them sick, it does not. It is not possible, it's kind of thinking along the same line of thinking that cold makes you sick. It kind of something that people have bought into over the years, when we look at influenza and people becoming ill with the vaccine, in the vaccine itself, the influenza virus is dead. And because of that, it cannot give it to someone else. That is the one thing. The other thing is once you get vaccinated, it takes about two weeks to develop immunity, so it is possible that you can get vaccinated, and before that two weeks is up, you could expose yourself, and pick up, that's exactly right. >> Lori: Normally your shoulder hurts a little bit, but that's about it. >> Dr. Simons: Yeah, but actually they are changing that. They are developing a shorter needle, that doesn't go as deep in to the shoulder or the deltoid, is where it's typically being given, and a finer needle, so that one is to be given to adults to avoid a lot of that shoulder discomfort. And of course, we have the nasal vaccine that is children only. Not for adults. >> Lori: Darn! >> Dr. Simons: I know, a lot of people want that, but it's not for adults. >> Lori: Well, Sheila, thank you for coming on and giving us some good advice, and if people follow that, they can have hopefully a year free of colds and flus. >> Dr. Simons: Hopefully, thanks so much. >> Lori: Thank you.