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Ep. 14 - LiveWell Talk On...Influenza (Dr. Ahmed Abu Al-Foul and Kristin Baker, ARNP)

episode 14

Ep. 14 - LiveWell Talk On...Influenza

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Host: Dr. Dustin Arnold, chief medical officer, UnityPoint Health - St. Luke's Hospital

Guests: Dr. Ahmed Abu Al-Foul and Kristin Baker, ARNPUnityPoint Clinic Multi-Specialty

Dr. Arnold: This is LiveWell Talk On…Influenza. I'm Dr. Dustin Arnold, Chief Medical Officer at UnityPoint Health - St. Luke's Hospital. It's flu season and flu shots are highly recommended. Each year we try to guess our best at how serious the flu season will be. And with me today to the answer some of those questions and provide guidance for prevention and vaccination is Dr. Ahmed Abu Al-Foul, Infectious Disease Specialist joined by his trusty sidekick, nurse practitioner Kristin Baker. Welcome.

Dr. Abu Al-Foul: Thank you for having us. 

Dr. Arnold: Well, it is flu season and I know we spoke about this yesterday at a meeting about the influenza vaccination and whether or not it's going to be accurate or effective I should say this year. But what do you recommend as far as the flu shot of when they should get it based upon timing in the year? Is it ever too soon? Is it ever too late? What's your experience? 

Dr. Abu Al-Foul: Well, let's just talk about the influenza in general first. I mean, influenza is acute respiratory illness that comes in epidemics, usually during the winter season. So, usually if you want to get the flu vaccine to prevent that infection, usually we'd like to start and on that in October. It’s between October to May. So, basically if you want to start in September, that should be OK. Usually it is never too late. This is what I'm going to say. If you're like even still in November and you didn't get through the flu vaccine still get it. So never say that, “Oh, it's been March, we're done.” No, I would not recommend that.

Dr. Arnold: Is there a, a delay until the, the vaccination works? And how long is that delay?

Dr. Abu Al-Foul: Yeah, so it usually, this is the way how we come up with the flu vaccine. We have global surveys all over the world. We just look of the, a circulating viruses at the end of the flu season from the previous year. And then we come up with what are the most common strands of the virus circulating in the community. And according to that, we decide which vaccine, or which is strand, should be in the vaccine. And that takes around six months to develop the vaccine.

Dr. Arnold: You know, we'll get into the vaccines here in a minute, but there's other ways to prevent the transmission of flu. Kristen, what are some of those other ways that someone can do on their own to survive the flu season?

Kristin Baker: Like you said, the single best way to prevent the seasonal flu is to get the vaccination, but other measures that you can do is covering your mouth and your nose with sneezing and couging and making sure that you are washing your hands. Good hand hygiene with soap and water. The second best option is using an antibacterial hand cleanser. That's what I always tell patients that using soap and water that the best of the options that's available. Other ways to prevent it is making sure that you're not touching your hands to your face and your eyes. Those are some good measures to adhere by to prevent the flu.

Dr. Arnold: If I have the flu, how long am I contagious?

Kristen Baker: Five days.

Dr. Arnold: Five days. Okay. That's good. It's good advice for avoidance on that standpoint. Dr. Abu Al-Foul, There's been, over the years, there has been controversy with the vaccines we remember the autism association that's been completely disproven. And actually, that physician, I believe, was sanctioned, if not lost his license. But, tell us about what are the vaccines out there and what do I need to know about the vaccines if I'm a patient?

Dr. Abu Al-Foul: Well, I'll make it simple. Usually, we have two main categories of the vaccine. We have the live vaccine and we have the non-live vaccine. A live vaccine is indicated for a certain age group and usually people between the age of two and 49, as long as they're not immune compromised and not a pregnant individual, then we have the non-live vaccine. And we have live a quadrivalent vaccine. We have a trivalent vaccine, trivalent meaning that they have three strains of the influenza of virus to A, one B, the quadrivalent vaccine has four strains of the influenza vaccine two strains of the influenza A virus. And the other one is two of the influenza B virus. Now if you just, some of them are the development of the vaccine, sometimes it has something to do with the impregnated eggs and you know sometimes we have, we use different technology to come up with the vaccine. So, based on your age, health status, medical illnesses, we decide which is the best vaccine to go with. We have high dose influenza vaccine where we use in a higher concentration of the virus in the vaccine. And usually this is indicated in people above the age of 65. The reason for that or the rationale behind the a higher dose is a higher immunity because those people above the age of 65, they're at higher risk of complication after influenza infection.

Dr. Arnold: Excellent. Now it is the higher dose also quadrivalent or is it trivalent?
Dr. Abu Al-Foul: It's a quadrivalent. Yeah.

Dr. Arnold: And what do we give here in the hospital? I think we give the quadrivalent in patients as well.

Dr. Abu Al-Foul: I think so.

Dr. Arnold: Well, in the past there is this relationship with, I believe the swine flu and Ian VRA or Guillain-Barre. But it’s actually pronounced Guillain Barre, tell us about that, is that a risk? Should I be worried about getting the Guillain baree if I get the flu shot?

Dr. Abu Al-Foul: I think there was something about this around the swine flu. There was a lot of studies and even like there was a myth analysis, a study that was I remember I was a fill-in at that time when we looked at that. And then we found actually that the you know, Guillain Barre it comes, you know, whether it’s the flu season or not the flu season. So, basically if you look at the prevalence and the incidence of the Guillain Barre on that, on those years and the time when we gave the swine, you know, that the influenza of vaccine at that time, we've hung up the same thing. There's no difference. So, I don't think that, you know, the influenza of vaccine is associated with. We'll put you at the highest risk for the Guillain Barre. At the same time, I think you've talked about the autism. And even, I think right now we have a lot of mental illnesses. We have a lot of studies looking at kids and the risks with autism and the other vaccines too. And we didn't find any evidence of that. Even I think we have recent studies looking at kids with siblings with autism, which meaning that we understand there could be a genetic component for autism. So, basically we’re talking about siblings with autistic siblings, which means they are at higher risk for autism. Even with the vaccines, we didn't find any relationship between the autism and the vaccination.

Dr. Arnold: That's good to know. I mean, I think one of the greatest accomplishments other than perhaps going to the moon is the immunizations and vaccinations. I mean, we've eradicated polio, smallpox, measles. Well, we can talk in a future podcast about how that’s coming back, you know, if you didn't have Walter Reed in the yellow fever vaccine, you wouldn't have the Panama canal or the Suez canal. You know what I mean, those vaccinations help that get done. Well, that's really good information. Thanks for joining me today. Thanks for clearing some of that up. As you know, I said earlier, I think vaccinations are just amazing what they've done to eliminate death and disease in the world and really should not underestimate the power of that vaccination and getting a flu shot. That was Dr. Ahmed Abualfoul Infectious Disease Specialist and Kristin Baker, infectious disease, nurse practitioner. Great information, and thanks for coming in today. If you have you have a topic you'd like to suggest for our LiveWell Talk On… podcast, shoot us an email at and we encourage you to tell your family, friends, neighbors about our podcasts. Until next time, be well.