Episode Transcript
[00:00:03] Speaker A: Hello and welcome to a Wonder Care podcast with me, Sheena Mitchell. I am a pharmacist and mum of three and I am passionate about sharing lots of health information with you to keep your family healthy and well all year round. Thank you so much for joining me. If you enjoy this episode, please do follow or subscribe to the show and tell your friends.
[00:00:24] Speaker B: Thank you.
[00:00:25] Speaker C: Here we are in the second half of January. Thank God for that is all I have to say. And yeah, it's been one with very cold, mixed, weird weather. But anyway, today I'll be talking all about flu and how to manage it at home with kids and adults. I'll also be giving some advice on medication during pregnancy and breastfeeding so hopefully you find that helpful.
[00:00:48] Speaker B: Does look like we've reached the peak.
[00:00:50] Speaker C: Of flu levels for this season, so the 23 24 season.
[00:00:55] Speaker B: However, it does take a good few.
[00:00:57] Speaker C: Weeks for it to drop down to normal or low levels. So you can expect to see flu circulating certainly for another couple of months at moderate levels. I'll keep you updated anyway with my graphs and charts on Instagram at Wondercare underscore IRL.
[00:01:17] Speaker B: I do love a chart.
[00:01:18] Speaker C: Can't help myself. It's obviously also important to bear in mind at this time of year that we also have Covid circulating and RSV. Now. Again, thankfully, RSV seems to have peaked and we are coming out the other side of that, but it is possible to still pick up those infections in the community. It's still at high levels, but that is expected to subside nicely over the next few weeks. One other thing, a good few people have gotten in touch with me in relation to the tests that I do, the self home tests that check for four things.
[00:01:53] Speaker B: They check for RSV, they check for.
[00:01:55] Speaker C: Flu A and flu B, and they check for Covid. And one person got in touch lately and said I tested positive for RSV and flu A.
[00:02:03] Speaker B: How is that possible?
[00:02:05] Speaker C: And I had another person get in touch to say my husband tested positive for both flu A and flu b.
[00:02:11] Speaker B: Is that possible?
[00:02:12] Speaker C: And yes, it absolutely is. So unfortunately, when there's lots of viral illness circulating, it is possible to suffer from multiple infections all at once. And flu A is what normally circulates for the first half of the season. And now you can get cases at any time. But flu A certainly has been the dominant one so far. And from here on, levels of flu B start to take up more of a percentage of all of the flu cases.
[00:02:42] Speaker B: So it is possible to have both.
[00:02:44] Speaker C: Flu A and flu B, and it is possible to have flu and RSV, or indeed Covid. And I suppose, look, this is why I like these four way tests, because you can identify if you've had a recent infection of COVID so that you know where you stand in terms of vaccination. Obviously also, for young children, it's very good to know if they have RSV.
[00:03:06] Speaker B: Because you can just be that little.
[00:03:08] Speaker C: Bit more cognizant of watching their breathing. It's personal choice, but I'm someone who likes to know exactly what's going on, so I just wanted to address those questions first. Okay, I'll get started. Flu.
[00:03:22] Speaker B: In this episode, I am going to be talking all about the symptoms of flu and their treatment. Because there's so much going around. I decided not just to talk about kids in this episode, but also adults and pregnant women and women who are breastfeeding. I'll also talk a little bit about if and when flu is diagnosed. Okay, so first of all, what is seasonal flu? Well, obviously, we know it's been around for years, and it comes at this time of year, in winter and spring. So it's an acute respiratory infection and it's basically caused by influenza viruses. Illness can vary in severity, and sometimes it can lead to hospitalization and death. I ended up in hospital with flu B in 2020. I think it was March, early March, just before COVID kicked off, actually. And I ended up in hospital for nine days. So I definitely have personal experience on just how rotten you can feel with it and just how seriously we should take it. Luckily, most cases are mild to moderate and people will recover within a week at home without needing further medical attention. Kids, the elderly, so over 65 pregnant women, healthcare workers, or those with serious medical conditions are most at risk of developing severe cases of flu. There are four main types of flu viruses, and they are handily called ABC and D. So really what we need to know about are flu A and B. Because flu C is very mild and less frequent, it's not really posing a problem. And flu D mostly affects animals. So again, we don't need to worry about that. Flu A is what is circulating most at the moment in Ireland, and that always tends to be the way. So flu a tends to come earlier in the season and flu B comes later in the season. The incubation period for flu is one to four days, but it's usually around two days after you have contact with someone who is symptomatic. It does spread really rapidly and it spreads through infectious droplets, which are transmitted when someone coughs or sneezes. It can be airborne for up to 1 meter, and it also spreads on hands. So lots of hand hygiene will really help to stop the spread and also ensuring kids are coughing into their elbows and using tissues and using hand gel. So we are kind of back to the basic guidelines of good hand hygiene and cough etiquette that we talked a lot about during the pandemic. Okay, so signs and symptoms. With flu, generally you get a sudden onset of fever, so a high temperature, so over 38, 39 degrees, you also get a cough. And this cough is usually dry. It's also quite persistent. So you might find that even after a couple of weeks, when you've recovered from the flu, you'll still have a lingering dry cough, and it can actually go on for quite a while. It is normal, and it will resolve by itself. It just takes a little bit of time. People with flu also suffer from headache and muscle and joint pain. They can also feel really unwell. So in medical terms, we call this severe malaise, where you just feel rotten. Can also get a sore throat and runny nose. With all the strep aid that's going around at the moment, it is no harm to use a little torch, or even the torch on your phone to have a little look at your or your child's throat if they are complaining of a sore throat, because fever and sore throat can also be a sign of strep a, which requires antibiotics, but that is defined by white spots and patches on the throat and tongue. So it's an easy way to kind of differentiate between a bacterial and viral infection. So with viral infections, you have no white spots, you just have a red, raw, irritated throat. People with flu will also suffer from a runny nose. Okay. That is most of the signs and symptoms of flu.
The treatment, as I said, there is not with antibiotics. So the flu is a virus, obviously. Sometimes it can develop into severe disease, and sometimes after flu, you can be more susceptible to developing a strep a infection. So it is worth understanding that that flu itself is not bacterial, it's viral. But it does put you more at risk of developing a bacterial infection afterwards. So I would urge people to just really try and recover well and build yourself back up as much as you can and I suppose, stay vigilant, especially in young kids, just to make sure that they're recovering well and that their symptoms are going away after one to two weeks. Okay. Because treatment relies on symptomatic treatment rather than a cure. As such, I decided to work through the different symptoms and medication types, and hopefully I will point out some useful info about all of them as we go along. So the first thing we would do is treat a fever or headache, muscle joint pain, sore throat. These can all actually be treated with paracetamol or ibuprofen, whether you're an adult or a child. So obviously for adults, there's a lot of different products out there which contain paracetamol and ibuprofen. So if it's just that item you need, you have no other symptoms, then you can just select one from your pharmacy. We have them for sale on our website as well for delivery. And then for children, obviously you will be giving liquid versions or there are calpol melts and neurofun chewables. For older kids, they're all available. And just make sure to read the packaging to make sure it's suitable for your child before use. So paracetamol works to reduce fever and resolve pain, and ibuprofen will do the same thing. You can use them together if one on its own has not resolved the symptoms within an hour. I have an article about that on my website. I just wouldn't recommend routinely giving both in terms of runny nose and congestion and sinus pain. There is something called pseudoephadrine, which is decongestined, so that basically relieves sore, painful sinuses and can help to dry up a runny nose. So there are lots of different products on the market and I just want to make it a bit easier for you to understand. So for paracetamol and pseudoephydrine combined, you can get either sulfacinus or pseudoplus. That's all they contain. Either of those brands do the same thing and then you can also get a product which has paracetamol, which is your painkiller and fever treatment, pseudoepyne, which is your decongestant, and also a drug called diphenhydramine, which is an old style antihistamine. And it can also help dry up runny nose, but can cause drowsiness. So that combination of three drugs is what's in Benlin four, flu. So you would use that instead of another paracetamol containing product. Another cool product. Benline do is Benline day and night. So it has just the paracetamol and pseudoephydrine in the daytime tablets, so it doesn't make you drowsy. And then the nighttime one contains just paracetamol and diphenhydramine. So it will help to resolve your runny, irritating nose, but it'll also help you sleep. A bit. And sometimes when you flu, you don't sleep great. So it can be very welcome to have a product like that which can help promote good sleep. They're your main paracetamol products that are on the market and currently available for the treatment of flulike symptoms. I'm putting emphasis there on the fact that they're available because there are a lot of things that, as we've heard in the media, are coming in and out of stock. So if you choose to go with an ibuprofen based combination product instead of a paracetamol based one, then you could use something that has ibuprofen and pseudoephadrine. Again, the pseudoephadrine is our decongestant. So products which contain this combination and are available at the moment are neurofen, cold and flu, neurophen, sinus and pain. They're actually the same thing, those two products, they both contain the same levels of the same ingredients. So, yeah, make it that what you will, and also brew pro cold and flu. So again, that contains the same ingredients as the neurofilm, cold and flu and the neurophen, sinus and pain. If your symptoms are really severe, you're going to choose a combination product. So either a paracetamol based one or an ibuprofen based one. If you don't get relief from taking that combination product, you can either add in plain paracetamol or plain ibuprofen, depending on which one you're already taking. That's the best way to relieve the symptoms of headache, runny nose, fever and sore throat, that kind of thing.
For children, you are a bit more restricted, but in general, you're giving paracetamol based product. If they have fever or headache, you can give neurofen instead of that, and if absolutely necessary, you can give both. Kind of alternate between the two of them, use them together. It's important to keep hydrated, so ensuring your child is having lots of fluids. And you can give boiled, cooled seven up. I will say for children, there is a decongestant available, so it's pseudophed suspension. It is only suitable for children age six years and up, but it can be very, very helpful if they have a lot of nasal symptoms, because they can get very irritated by that. I also recommend the use of nasal sprays. So saline nasal sprays and steam. You can even use albus oil and snuffle babe oil. I actually have an episode all on blocked and stuffy noses. So if you flick back through the podcast episodes, you will see that. And I talk in detail there about the best way to resolve nasal congestion in kids.
If you are an adult and you have a headache but you, for whatever reason, don't want to take a combination product or you don't want to take an oral decongestant, you can also use the nasal saline sprays, and you can also try the otravine range of decongestant nasal sprays. There's a few other on the market as well, so that's definitely worth a shot. It can really relieve sinus symptoms quite quickly. And then for women who are pregnant, I don't want you to feel left out. So you can also use a nasal spray. You can use the stereomars saline nasal spray, and you can use a product called avogal sinu force. So sinu force is actually suitable for kids over two, and it's suitable in pregnancy. With pregnancy. I'll give more information about that in a minute. But the general advice is to use as little medication as possible. Really. So you limit your use of any products, whether they be herbal, natural, homeopathic essential oils or paracetamol based products. With any of these, it is always best to use the lowest dose for the shortest duration of time that is needed to resolve your symptoms. Okay. So for pregnancy, in terms of pain and fever and all of that kind of thing, you can use paracetamol, as I said there, at the lowest dose needed. You can't use ibuprofen. This is especially important in the first and third trimester. But during pregnancy, obviously, you've got paracetamol at your disposal for short term use, and you've got sinu force nasal spray. You've got all the stereomar nasal sprays. You can use steam inhalation, and hopefully those treatments combined will alleviate your symptoms of fever, pain and congestion.
The reason that paracetamol isn't recommended for long term use is because it's actually linked to ADHD and other problems in neurodevelopment in unborn babies. So it's something, just a flag. Don't be afraid to take it, because these risks aren't there for kind of short term use. And actually, the damage a maternal fever could do is a risk far greater than using some short term paracetamol. So absolutely, take what you need, but if it's long term pain relief or something, you're better talk to your doctor than to continue to just take paracetamol. For breastfeeding moms out there, you can take paracetamol and ibuprofen, no problem. I would avoid generally the use of pseudoephadrine containing products because they can cause a reduction in breast milk supply. And this is actually not due to kind of decreased breast blood flow. But the thoughts is that it's actually due to decreasing prolactin concentrations. So yeah, unless you have an uber great supply of breast milk, then I would avoid the combo products and the plain pseudoephyrine products like pseudophed. Sometimes it can be useful if your nasal problems are very severe to use an antihistamine. I find this helps kids and adults alike. It is suitable in breastfeeding to use a non sedating antihistamine. One which contains laratidine or ceterazine is probably best.
Again, just use it as needed. For children, there are antihistamine suspensions like Zertech liquid, and the one thing I'd say is they're not kind of really strongly licensed or marketed towards nasal congestion associated with viral infection. So I suppose, look, it's something that might be worth trying once and seeing if it helps. And if it doesn't, just give up on that idea and go back to the steam and other products.
Okay, so for coughs with flu, the cough tends to be a dry cough. Obviously it can develop into a secondary bacterial chesty cough. For a cough that isn't going away after kind of two to three weeks, you probably do need to see your GP and check out my episodes on the treatment of coughs in children. There's a lot of other types of cough out there at the moment. With rsv levels still really high, we know that that causes a cough that significantly worsens on day three to five and can cause difficulty breathing. So with flu, you're watching out for all of the same things and just alleviating symptoms where you can. So bronchostop Jr. Is quite a good general cough bottle for kids over one, it just soothes their throat. Steam again is great. I really love the medisana humidifier for nighttime for any of these kind of viral infections. It just helps to calm the airways and to help keep the mucus running from nasal drip at night so that it doesn't end up clogging and causing a secondary infection. For adults, a dry cough really as well, there is bronchostop and you can use that, but even a bit of honey and lemon in hot water can be really, really beneficial. Honey helps to coat the throat if the throat is irritated, and lemon helps to break down and thin out mucus if there's any coming from a nasal post nasal drip. So sometimes the basic things are the best. If your cough gets chesty. The best cough bottle for a chesty cough is exutex or viscolex. These help to thin down mucus, which prevents it clogging within the lungs and causing infection. Do remember that it is normal for a cough to persist after flu for a number of weeks, and so long as it's not a new cough or not getting worse, then it's okay just to treat it regularly. I know after I had flu, I found the bronchosop pastels really, really good just to have in my pocket because the cough was irritating and dry and it just helped to reduce the irritation a little bit and soothe my throat.
So for diagnosis of flu, really, you're just looking out for the symptoms as described above. RSV. It's a different kind of a cough that almost. You can hear the inflammation in the lungs because it's a lower respiratory infection. So it is quite different to flu with things like scarlet fever, which is also circulating at the moment. You can kind of tell flu apart from that because it isn't localized, you feel crappy everywhere, whereas with strep a in your throat or scarlet fever, it's quite localized to the throat area and you get headaches and a bit of a temperature. But with flu, you get much more widespread muscle and joint pain diagnosis. So you won't be officially diagnosed unless you end up attending a GP or hospital. And even at that, your GP may not swab you because it's so hard to get GP appointments at the moment. I got in a product which I think is fab just for reassurance, to help you navigate your way to try and figure out what illness you're dealing with in terms of flu, Covid or RSV. So they're called floracare combo tests, and I have them in my link, in my bio on Instagram. I'll put a link in the show notes, but the spelling is fluoreca or e, and they are handy because it is one nasal swab that tests for three things. It can tell you whether you have flu A or flu B, which I think is really cool. I think that's useful because it gives you a bit of reassurance that unless your symptoms become unmanageable at home, you're kind of reassured knowing that you don't need an antibiotic unless it's persisting beyond a couple of weeks where you might need to be assessed at that point. But generally with flu, it does resolve itself with time and the treatment is just symptomatic treatment, so you can continue to do that at home.
With breastfeeding, keeping hydrated yourself is really important. It's also really important to highlight that by continuing to breastfeed when you're sick, even though sometimes you really don't feel like it and you are just exhausted. But get into bed. Get into bed with the baby if you can, or have someone bring them to and from you, because all of those antibodies that you're making are being passed on to your baby and offering them protection in terms of medication. You can, when you're breastfeeding, take paracetamol or ibuprofen if needed. As I said, pseudoepadrine is probably okay if you have a really high supply of milk, but if you are struggling with milk supplier in the early days at all, I would avoid it and just use something like the sinu force nasal spray to relieve symptoms of congestion. If there's anything else you want to know, of course, just reach out, send me a message on insta and I will try and get back to you. Obviously it's a busy period, but I suppose I've always taken it on as my role to try and help people when healthcare isn't accessible. And I think at the moment that is a really big issue. And you'll all know that I'm campaigning our government at the moment to try and resolve that by allowing pharmacists to provide an expanded role of healthcare within our communities. So thank you all for supporting this podcast. If you can give it a little review that does wonders for the rankings. So I would love that. If you can, you can review it on Spotify or on Apple Podcasts and even just yeah. Share this episode there's a lot of flu going around at the moment and hopefully this has made the range of products a lot easier to understand because while there's lots of different names of products, a lot of them contain the same ingredients. So just have a listen back to that section where I discussed the ingredients that you need and you can work then within the supply chain, because sometimes the product that you're used to mightn't be available, but actually there could be a product that's identical, which is very likely in irish pharmacy. So you don't need to panic. There are alternative products out there. Thank you so much for listening. Bye.
