Audio file
THIT406 RSV Part 1.mp3
Transcript
Maureen Ward
Thank you for joining us for this episode of Talking Health in the 406 where we are one community under the Big Sky. I'm your host, Maureen Ward, and I work to promote safe and healthy lifestyle choices to help Montanans avoid common life changing injuries. Last year, hundreds of Montanans ended up in the hospital due to upper respiratory infections, such as flu, COVID, or. RSV. So in today's episode, we're going to hear about how to prepare for the upcoming flu and RSV season from some experts here at the state. Let's listen in to their tips and tricks to stay healthy this fall and. Sure. Thank you so much for joining us this morning. I wanted to start out just to let everyone know who you are. So if you can take a moment and just tell us who you are and what it is you do.
Sam Saycich
My name is Samantha Saycich I'm the viral respiratory epidemiologist for the state of Montana. I'm responsible for helping coordinating surveillance efforts for COVID-19 influenza and RSV. I'm Michelle Funchess. I'm the immunization section supervisor with DPH. Just. Hi, my name is Maggie Cook-Shimanek and I'm a public health physician with DPHS.
Maureen Ward
Great. So we are heading into fall. The kids are back to school, the mornings are getting brisker. I think I noticed some of the leaves are starting to change and fall is my favorite season. I love it. It always makes me think of the holidays. Pumpkin spice lattes. But along with that I also started thinking about ohh it is time to start getting ready for fall illnesses, especially our upper respiratory infections. Those things that get into our lungs. Things like the influenza or the flu or respiratory sensational virus or RSV, which I honestly didn't even know that's what it was called until I looked it up. I've just always heard RSV and then of course still COVID. So can you guys talk a little bit about some tried and true methods to help prevent these common illnesses? As we head into the fall and winter seasons.
Sam Saycich
Yeah, Maureen. So I also love fall. It's my favorite season and I think it just lines up perfectly. But I'm an epidemiologist that happens to manage all the big conditions that circulate during the season. So there are a few core prevention strategies that we and then the CDC also recommends these can be used to protect yourself and others from severe respiratory illnesses, respiratory season. So. Uh, the primary method for preventing common respiratory illnesses, so that's going to include COVID-19 influenza. Respiratory send special virus or RSV. And then you know all the other common respiratory illnesses like the common cold, human metapneumovirus, Parra influenza virus. The primary method for preventing these is to just stay home when you are experiencing symptoms of a respiratory illness. Symptoms can vary from person to person, so they won't always look the same, but they can include fever, chills, fatigue. Cough, runny or stuffy nose, a sore throat and headaches or body aches. So if someone is experiencing any of these symptoms of a respiratory illness, or maybe they tested positive with an at home COVID test, they should stay home and away from others until for at least 24 hours they've had an improvement in their symptoms. And are fever free without the use of a fever, reducing medication. So that's going to be something like acetaminophen or ibuprofen usually comes in the form of like Tylenol or Nyquil or Dayquil. The second method for preventing common respiratory illnesses is to really practice those good hygiene habits. So the first one is hand hygiene. You should be washing your hands often with soap and water. Soap helps remove those germs from your hands and it makes it less likely to infect your respiratory system if you touch your eyes, nose or mouth. And then if soap and water aren't available, use the hand sanitizer that has at least 60% alcohol to kill any germs on your hands. It will usually save us on the bottle, either on the front or the back, so you may have to look a little closely, but just make sure that the hand sanitizer has at least 60% alcohol in. And then you should cover your mouth and nose with the disposable tissue when you cough or sneeze. If tissues aren't available, you should cough or sneeze into your elbow, do not cough or sneeze into your hands. If you do on accident, wash your hands immediately. Use hand sanitizer. Make sure you're not touching things afterwards. When you cough or sneeze, that tends to expel the respiratory virus. And then frequently touched surfaces. So this includes countertops and tables, hand rails, door knobs, toys, especially with little kiddos who are maybe putting toys in their mouth, or, you know, sharing them among other other students, maybe in a daycare or something like that. They should be cleaned and disinfected regularly. The third method for preventing the spread of common respiratory illnesses is to really try and take steps for cleaner air. I know we live in Montana, where our winters are frigid, and we usually have at least a week where it's -30. But individuals and organizations really should try and crack or open windows and doors whenever possible to ensure that fresh air is entering closed spaces. Additionally, folks should make sure that they have new air filters. And they're heating ventilation and air conditioning systems moving into the fall and winter months, and they should change their air filter according to the manufacturers instructions. And then individuals could also consider using a portable high efficiency. The particulate air, which is also called a HEPA, so HEPA cleaner to help remove harmful particles from the air. So those are those portable air filters that you know, some folks set up either in their offices or in their bedrooms at night, just to kind of help clean the air and remove any harmful. Particulates and then whenever possible group activity should be moved outdoors, where individuals have enough space to kind of spread out, and there's plenty of fresh air circulating around. And then organization should aim for five or more air changes per hour of clean air in their facilities, and this can be achieved through any combination of central ventilation system, natural ventilation or additional devices that provide equivalent air changes per hour to their existing dental. And the fourth method is to seek care if you are at risk for severe illness and are experiencing symptoms of respiratory illness. So in general, people at higher risk of having. Severe symptoms when infected with a respiratory illness include older adults, young children and infants, people with weakened immune systems, people with disabilities and pregnant women. We recommend that individuals seek care for testing and or treatment if they believe or know that they have a respiratory virus and are at risk for severe. On that. So again, this would be if you test positive for the COVID test at home and you're at risk for severe illness, reach out to a provider to see if you're eligible for an antiviral medication. So there are antiviral options available for COVID-19 and flu. These are medications that can help make a person symptoms less severe and possibly reduce the amount of time that they are sick. So a common one with flu is Tamiflu, and then treatments need to be started within a person's first few days of symptom onset. To be the most effective, so just really staying on top of that. If you think you're sick with something or know you're sick with something, and then the 5th method for preventing common respiratory illnesses is to stay up to date with your immunization. So these include vaccine. And then I do have a quick little blurb for healthcare settings. So to prevent the transmission of all respiratory infections in healthcare settings. So that again that includes flu, COVID, RSV, common cold, the following infection control measures could be implemented at the first point of contact. So for instance, the entrance. For the health care facility or the potentially infected person. They should be incorporated into infection control practices as one component of standard precautions, so visual alerts, there's posters available. We have them online that say, cover your cough and they have hand washing recommendations or just general guidance for individuals who are entering a healthcare. Sluty to help make sure that they're not going to spread the illness within the facility. There's respiratory hygiene and cough etiquette practices that people should use, so again, covering your mouth and nose with a tissue, using appropriate hand hygiene, considering using respiratory hygiene stations so like masking and separation of persons with respiratory symptoms. And then implementing droplet precautions in addition to standard precautions, when examining a patient with symptoms of a respiratory infection.
Maureen Ward
Great. Thanks, Sam. We hear a lot about these illnesses and I think we know you know about covering our coughs and and that's sort of thing. But how are these illnesses transmitted? They can be transmitted in a few different ways. The primary way is through droplets that are expelled when someone talks.
Sam Saycich
Your coughs or sneezes if you're in close proximity to someone. And you know, someone is talking to you and they're infected with the respiratory illness. It's possible that droplets are being expelled and entering the air, and you can breathe them in or, you know, if you touch something that has the virus on it and then touch your mouth or nose or eyes, it can enter your system that way.
Maureen Ward
So no air or surface are safe, OK.
Sam Saycich
Yeah, just make sure. Make sure you're washing your hands and not touching your eyes, nose and mouth. Perfect.
Maureen Ward
Well, and I know you talked a little bit about the members of our community who are higher risk. And when I think of RSS. The I often think children, you know, I always think about kiddos getting that RSV or and it being like kid pneumonia or kid flu. Can other people get RSV? Is it mostly seen in children in Montana? What does that look like?
Sam Saycich
Absolutely anyone is at risk of contracting. COVID flu RSV or other viral respiratory illnesses, but there are going to be some individuals who tend to be at increased risk of contracting the disease due to a setting. So school and daycare children and their families when kiddos are. Coming home at the end of the day, after you know, being around other kids and the height of flu season, it's possible kiddos are bringing it home to their. Family. Healthcare workers are at increased risk individuals and congregate living facilities. We have various different congregate living facilities in Montana from long term care facilities to group homes. And homeless shelters. Individuals that are in close proximity for an extended period of time are at increased risk and then individuals who are older or young children and infants who don't have developed immune systems are at higher risk of contracting these diseases. And then people with weakened immune systems for. Any number of reasons it could be because. A medication that's immunosuppressing, that's just kind of making their immune system a little weaker. Or it could be a pre-existing condition that they were born born with or developed people with disabilities and then pregnant women are at high risk as well. So. There was an RSV vaccine that was released for eligible individuals aged 65 and up during the fall of 2023, and this vaccine is designed to help prevent older adults from severe illness due to RSV. And then also, pregnant women can receive it. So that way when their infant is born. During RSV season, they already have a little bit of protection. I do just want to mention that there are also people who are, you know, quote UN quote, perfectly healthy that can have a severe health outcome. So severe health outcome. Could be hospitalization or death due to these illnesses. So you know, just because you're in tip top health and you know you exercise, you eat well. It doesn't mean if you get these viruses like you'll be totally OK like there is the possibility that you can have a severe health outcome so. It's important to still treat these very seriously, and it does just emphasize the importance for all maintenance to follow. The court prevention strategies that I just discussed.
Maureen Ward
So you talked a little bit about flu season. What do we see with seasonality with some of these more common upper respiratory diseases?
Sam Saycich
That's a super good question. So we do see trends in COVID, NYU and RSV data that indicate a seasonal trend in illness. And I do just want to take this moment to explain how we collect our data. We have administrative rules which. Current laws, but they have the force and effect of a law in Montana that require certain illnesses to be reported to the county health departments or tribal health departments, and then on to the state health department. So COVID-19 and influenza are individually listed in those rules. So we do have really good data for those. RSV is not individually listed. The main data we collect for that are from. Surveillance partners that submit laboratory testing. And then we collect outbreak data for any condition that even, even if it's caused by something we don't know. So if there's a daycare and everybody has the sniffles and a fever, we're still monitoring that and we're still considering it. An outbreak and tracking. Many cases so COVID and flu that is a bit more robust, we have more. More data elements compared to flu. But these conditions spread year round and we do see cases throughout the year even when we're out of season. COVID-19 is actually starting to shift to be more active in the mid to late summer and early fall months and there's reduction in activity in the winter months when flu and. RSD, or circulating more widely. We did see that this summer we were averaging about 500 cases a week in July and August. On last season we did peak towards the end of August into September and then just slowly. Kind of decrease. Throughout the season, flu tends to take in Montana around the end of December and usually has elevated levels of activity through the middle of February. During the peak of flu season here in Montana, we usually see anywhere from. 1300 to 1800 cases reported a week, so it is super active and it does have a pretty significant impact on the day-to-day lives of Montanans RSV activity. As I was mentioning earlier, we don't collect. Individual case data, but we do collect laboratory data. So we consider the season to be active when the total number of tests positive for RSV is above 3%. So this last season that happened towards the end of December and it usually remains active through March into middle of April. Those are the seasonality trends we see with COVID, NYU and RSV.
Maureen Ward
Great. Something to look forward to for Christmas. Time to Saint Patrick's Day then. So we talked a lot about prevention, but I think sometimes it's just inevitable. Obviously, many Montanans will get sick with one of these illnesses over the likely the winter months. Now, since we're through this, hopefully through this COVID peak. So if I'm at home. And I'm of course not going. Work because I wouldn't want to do that, but I don't feel very good. What are some of the things I can do to help? Just make sure that I make my symptoms feel as good as I can.
Maggie Cook-Shimanek
If you find that you're sick with a respiratory virus this season, most people are going to be able to manage their symptoms at home. Unfortunately, you're probably going to be looking mostly at comfort measures in terms of symptom reduction rather than curative agents, but there are products that are available for that. The most important thing is really to rest. Your body is fighting an infection and that's what is you manifesting as your symptoms and. So you want to make sure that you're listening to your body and getting plenty of rest. You also want to make sure that you're staying hydrated, especially if you have symptoms like diarrhea or other ways that you might lose fluids during the course of illness. There are a lot of over the counter medications, and Sam has already mentioned a couple of these. Some that are for analgesia, some that are anti inflammatories. So we often think of things like acetaminophen, which it has a brand name of type. Now or anti inflammatories like IDK profen which has a variety of brand names, but you'll see that on the shelf at your local grocery store or pharmacy and these medications can be helpful for things like fever, sore throat, muscle or body aches that you're experiencing. And then there are a host of other medications that are marketed for cough, cold, flu symptoms that are also available at your local pharmacies without a prescription. I think with any of these medications, especially if you have underlying medical conditions or you're on medications already, it's important to talk to your healthcare provider or a pharmacist to best understand what is safe for you to take at home. But these are some of the more common agents that you might see, so that. Acetaminophen, the ibuprofen and coughing cold sort of medications. It's especially important to talk to a pediatrician or your family Doc if you're planning on using any of these medications in kids. Because especially for cough and cold, some of the medications can actually be potentially harmful for kids. So just make sure you're clearing that with your provider burst. The other thing that Sam mentioned that I just want to touch on is the use of antivirals. So there are medications that are available for. By prescription for COVID-19 infection and influenza. These are medications that are generally reserved for people who have some of those conditions that are going to place them at greater risk for severe outcomes. So for things like hospitalization or more severe forms of the disease and what I would recommend is that if you have the underlying. Medical conditions. So you have heart disease, lung disease, diabetes. If you are immunosuppressed from a medication or from a medical condition. That you create. A plan with your healthcare provider before you're ever even sick with. One of these. Viruses, so that might consist of mentioning during your healthcare visits, your annual checkups to say, hey, if I get sick and I have symptoms, what do you recommend in terms of testing and then how can I go about getting treated? If that will be necessary for me specifically. That way you have this plan in place before you ever become sick, and you have a way to get a hold of your healthcare provider or their nurse to let them know you've tested positive and you can establish. The next step? And the reason that's super important with influenza in COVID-19 is that you do have to start those medications early in the course of illness. That's when they're going to be most effective. So you really want to do some work on the front end to have that plan in place before it ever becomes an issue. So those antivirals. They would require a prescription. Medication. And so you'd want to, you want to talk to your provider. In advance about.
Maureen Ward
Thank you. Yeah, going back to the home therapeutics, some people think you know a little is good, a lot could be better, but they obviously we know that there are some specific guidelines especially around acetaminophen or Tylenol. And I always get a little nervous when I pick up those multi symptom. Them, you know, things like the severe cold and flu formulas because there's a lot of stuff in that and there's a lot of big words that I don't understand. Can you talk a little bit especially about the worries about taking too much Tylenol or acetaminophen in a day and how to look at those on the labels?
Maggie Cook-Shimanek
Right. That's a really good point because a lot of those medications, the cloth cough and cold especially will include acetaminophen as part of the base product. And usually it's a standard dose that's included. And then they have the dosing every four to six hours usually, but it's good to read the label and and see the. Specific product that you're looking. But if you're taking that in addition to the maximum or even not maximum dose of acetaminophen, then you could be putting yourself at risk for having some fairly severe complications. Acetaminophen Tylenol products are usually viewed in the public as. Fairly benign, but they can actually have pretty severe consequences, specifically with respect to liver function. If you take too much of it, so be sure that you're reading the labels for the products that you're using and if you have a coffin pulled with the. Immunogen. Then you're going to want to reduce what you're taking. Separate from that. It's it's a really important point and I'm glad you brought that. Up and we're. Green often, if you go to a pharmacy, if you have any questions, pharmacists are great at kind of working through the various products that you're interested in using and. And offer recommendations right there on the spot. So always ask your pharmacist or your healthcare provider which medications you should take and how much of those medications you should be using.
Maureen Ward
Thank you. So if I'm at home and I'm sick for multiple days and it just doesn't seem like things are getting better, you know, especially someone who maybe doesn't have some of the higher risk factors, but they just can't seem to shake it or maybe they're having certain symptoms. When is it time to call their physician or go to an urgent care to seek some additional help from a medical provider?
Maggie Cook-Shimanek
You know, generally when you have one of these illnesses, you might be more inclined to call earlier rather than later. If you have an underlying medical condition. So let's say you have asthma or heart disease or something like that. You might have a lower threshold for just reaching out and talking to your healthcare provider about, you know, their specific. Concerns for you and when you should. Present for care. It may be able to get in kind of for an office visit or an urgent care sort of visit versus having to go to the emergency department. Generally speaking, if you are an otherwise healthy person and have you know your marching along in the course of the illness but you notice the symptoms that are concerning to you, so you're having difficulty catching your breath, or it seems like things are getting worse in the sense that you know when you go up your stairs. Today you're more out of breath than you would expect that even the as a as compared to yesterday as an exam. Ohh, if you're experiencing chest pain or chest pressure, those are definitely symptoms that you want to be evaluated sooner rather than later, so I would recommend that you seek your healthcare providers advice or seek emergency care if you're noticing that family member who's sick. So let's say you're caring for an older family member. Seems confused or they're not using the bathroom as much as you would expect them to. And you think maybe they're not getting out enough fluids? It's important to keep an eye on your older family members who might be experiencing some of those symptoms so that you can help them seek the medical care that they need because it might be an indication that they're having more severe illness than they're letting on, or even able to communicate to you anytime you're experiencing. Seeing symptoms and you think this just isn't right, I think I need to get another take on this. Then I would recommend reaching out. To a healthcare. Better those generally apply to adults or people that are able to kind of verbalize what's going on with them. If you have an infant, we've talked a lot about RSV in the context of young infants, they may not articulate that something is getting worse or that they're having pain, that sort of thing. But you can look for other signs. So if children are having difficulty feeding or drinking because they're unable to breathe as they're doing that because they've got mucus or upper respiratory symptoms, then that might be a time. If you're noticing you're having decreased wet diapers, for example, that you want to get them evaluated more closely. If they're breathing faster than you would expect them to, or they're having trouble catching their breath, then that's an opportunity for you to get in touch with with a medical care provider to get them evaluated more thoroughly. So there are definitely signs for younger of people as well that might indicate. It's time to get a little bit more care.
Maureen Ward
We touched on it a little bit earlier, but I wanted to go back to the talk about vaccines. There are some vaccines available for some of these respiratory illnesses, especially for folks who are at higher risk for getting them. Can we get a little bit more information? On what vaccines are available and who should take them?
Michelle Funchess
Absolutely, Maureen. And yes, Sam talked earlier about all those wonderful and practical ways to help reduce the spread of respiratory illnesses and and certainly one of the additional and important ones is vaccination as a means of prevention. So currently there are vaccinations for influenza COVID-19. And RSV for certain populations, we'll just start off with flu. Probably the one that most people are familiar with. Everyone six months and older is typically recommended to receive influenza vaccination each year, and Sam spoke wonderfully about the trends that we see about the increases of incidence of of flu and other respiratory illnesses throughout the year and in timing for this, one can be really important as well. So the general recommendations for flu. Is for everyone in that window. Six months and older to get an annual dose and if we can maybe targeting that September to October window? For optimal protection, as we see those trends increasing, it's important to note that in certain younger kiddos or kids that are younger than 9 May need an additional dose if they've never had a dose before. So really important to have those conversations early with your healthcare provider to make sure that you're getting. Protection on track with those recommendations so that we can have the best outcomes possible as we enter enter that season. It gets more complicated as we go along, right? So. So then we're looking at COVID-19 and you know everybody really knows. That COVID-19 vaccination has changed so much over the years, but luckily we're entering a time of increased simplicity with the vaccination schedules and recommendations. So same as flu, the age recommendation, six months and older are recommended at this time to get that annual dose or doses, depending on the situation. Of COVID-19 vaccine to provide that protection for the circulating strains. Right. Just like we do with flu when you hear. Hear very frequently. For our youngest kids, so six months through four years old who've never had a previous dose of COVID. Those guys might need more than one dose to be considered up to date and protected to kick them off right into this seasonal schedule, but in most cases for our people that are five years and older, it's just one dose. It's very much similar to your annual flu. So one dose is recommended for five years and up. As long as they're that individual is not moderately or severely immunocompromised, so the moderately or severely immunocompromised persons might be indicated to receive an additional. Those after their first dose for that season, so again talking to your healthcare provider, talking through those those schedules and getting those vaccinations lined up very, very important because of some changes. I think it's really important to mention that for adults 65 and older, these recommendations did kind of shift. Overtime for COVID-19. So right now if you have a 65 year old and older who's not moderately or severely immunocompromised, there is no indication to get an additional dose. So those are those additional doses are really going to be aim. Towards your kids in that six months to four years, if they've never had a history or your immunocompromised population as far as when to get it, this one is just as the vaccine becomes available, people who have had recent infection of COVID-19 might elect to hold off on that vaccination for three months from their symptom onset or positive. Yes, that's certainly still a recommendation that's that's maintained throughout the. And I think it's important too, because we saw some increases in COVID disease spreading. So some folks may have gotten their dose maybe in the late summer even of the the previous presentation, there is a recommendation to look for a 2 month interval before they take the newest updated COVID-19 vaccine. So. Saving the most complicated for last right now is RSV. So this is our newer one. As Sam mentioned, this is this has really been rolling out over the past. Two years or so. So and and so we're all kind of adjusting to these newer recommendations. So starting off with your adults 75 years and older are all recommended to receive one dose of RSV. Now this is where it becomes a little tricky because in the adult population, there is not a season, it is just one dose and then they're considered up to date for subsequent years, right. Just one dose, 75 years and up. There's a recommendation that people who are 60 to 74, so in that window have also that one dose if they are increased risk for RSV disease. So again cannot say it enough talking to your healthcare provider talking about your your medical history and seeing if that's a good path for you. To take if you're in those age groups. Then we move into two other groups that RSV vaccination currently is available for. The first is maternal RSV. So women who are pregnant and the intention of course is to protect the mom and then have that protection move to the baby after birth. So in these recommendations then we start entering these more complex seasons. Moving into the next category for RSV, vaccination is your maternal group. So maternal RSV is also given only once that is only going to be administered between the 32nd and 36th week of pregnancy. So talking to your healthcare provider to see where you are. In your pregnancy, and if this vaccine is recommended for you, we have an additional layer of of complexity because maternal RSV does have a season and that season it's usually the vaccine itself is only given during a certain period of time. And so right now, maternal RSV. He is. Typically, given from September to January in that window to women who are in that 32 to 36 weeks of pregnancy. So it's a really limited window to talking to that healthcare provider, absolutely essential, moving to our final group. Infants and young children. So infants and young children have access to. A. A product. It's not technically a vaccine, it's a monoclonal antibody that can be administered seasonally to a defined group of infants and small children. So that product, it has a recommendation for children who are 8 months and younger who are entering their first RSV season. And then we also have an additional indication. That some kids from 8 to 19 months may also have a recommendation to receive an additional dose if they're in. Increased risk for that RSV disease. So talking to that pediatrician is essential to make sure that we are you know targeting the right windows. So that window is typically of administration is October through March. So very, very complex. And I I feel like I've said it just 100 times, but really talking to your provider to make sure. That they're going to be screening and they're going to be making sure that you and your family get the doses that are recommended for you at the recommended intervals. With all these vaccines and products, they're typically covered by private health insurance, Medicare, Medicaid. But there are plans out there that may not cover specific vaccines. And so the best thing we can really do is if folks are concerned about their coverage, is to contact their insurance provider and ask those questions, look over at some other additional groups that might qualify for vaccine. Programs through different avenues nationwide, there's a federal entitlement program called the Vaccines for Children Program, so often referred to as just BF. And there's a VFC eligibility category that children may fall into that would allow them to gain access to free vaccines at a local VFC provider. And those eligibility categories are typically kids that are on Medicaid or eligible to be on Medicaid, children who might be uninsured or underinsured. Maybe their insurance doesn't quite cover. All the vaccines that they might be recommended to get. Or if they're American, Indian or Alaska native, all those kiddos would automatically be eligible for VFC here in Montana. We've got over 225 VFC providers just scattered all around the state, and those guys do a wonderful job of holding and maintaining supply to provide access to vaccines. For their communities in the VFC program, all the vaccines that I've just talked about are included. So RSV for those kiddos cause the vaccines for children program is is for kids through 18. So the infants and young children RSV product is included as well as COVID-19 and flu vaccinations are all included in available through that program. There's a smaller program that we refer to as the vaccines for adults program and we have a limited amount of supplies and locations that are enrolled. But we do our best. To get those folks vaccines now, RSV unfortunately isn't something that's offered through the vaccines for adults program here in Montana. But COVID and flu are, and so accessing one of those locations would be an Ave. that adults who are uninsured or underinsured would be able to maybe reach out and gain access to those vaccines. At no cost to them.
Maureen Ward
For folks who are going in to get their flu shot, and possibly they're also in that window where they would be in need of the new COVID booster, you know they didn't have COVID maybe in the late summer, they're going in for their flu shot in, you know, late September, early October. Is it OK for them to get them at? The.
Michelle Funchess
Same time? Absolutely. And that would be a recommendation. We're busy people, right? Getting those both those doses at the same time, is it wonderful way to get those protections up and moving?
Maureen Ward
What are some of the frequently asked questions that you all get in your office about any of these upper respiratory illnesses?
Sam Saycich
Some frequently asked questions. We do still get our, you know, COVID related. Do I need to report my home test like if you have a positive or sometimes we even get people calling asking if they need to report their negative home tests either to the County Health Department or to the state and the answer. Because no, it is not required if you have a positive home test and you're concerned that you may be at increased risk for severe illness, definitely reach out to your provider and talk with them about options for helping reduce the chances of having a severe health outcome and then another one we get quite frequently. Is. Is that possible to have both influenza and COVID-19 at the same time and absolutely they are different viruses? They cause different illnesses so it is possible that someone could be what we call Co infected so highlights the importance of taking those preventative measures to make sure. You're not getting. Sick. Another one? We do get quite often is, can my child attend school while they are ill? Individuals should really follow the previously discussed guidance of staying home while ill until they have an improvement of symptoms and are fever free. Some schools specifically like private ones. Our charter schools may have specific rules related to that, so parents and guardians should reach out to the school if they suspect that their child. Like just to make sure that they're following all the school policies and then keeping their kiddo and other kiddos at school and other staff members at school safe, you know, we don't want to get all of our teachers sick going into a busy school year. We want to make sure we're keeping them safe as well. But then, daycares there are. Actually, administrative rules in Montana. So again those are not laws, but they do have the force and effect of the. So administrative rule 37 dot 95.139 is related to daycares and it has specific exclusion guidance in there. So if a child has a fever of 100 and 1�F or higher, they need to be excluded from daycare until they've been without that fever for at least 24 hours. Then that rule has a few other, UM, guidelines in it for other conditions like rashes, vomiting, and diarrhea illness. Things like that and so daycares do have quite a few responsibilities when it comes to kiddos who are possibly sick for making sure you know they notify the parent and the parents responsible for coming in. Picking up the kiddo, getting them out of the daycare setting. Another one I thought of is do I need to get a new COVID and flu vaccine every year and if so, why? We do recommend staying up to date on your immunizations and the flu vaccine does tend to change year to year, depending on what the dominant type of flu is circulating. So influenza we have influenza A and influenza B people probably remember in 2000. 9 When H1N1 was circulating and it was a really big deal and vaccines were rolled out for that, so each one and one is a type of flu a. So there's a ton of different types of flu and the vaccine every year is updated to reflect. Those tights and make sure that folks have protection against the dominant circulating strains. And another thing people may have noticed is that this year the flu vaccine is going to be trivalent instead of quadrivalent. So the flu vaccine was previously. Quadrivalent, meaning it provided protection against four different types of flu. So we had flu, H1N1 flu, AH3N2. Flu B Yamagata and Flu B Victoria lineage after COVID. It was really strange. Flu Bee Yamagata just kind of disappeared, so we haven't been seeing any cases of that. And vaccine manufacturers have since decided to remove that part from the flu vaccine. So now to trivalent. Vaccines and then similar with COVID the COVID vaccine is updated yearly to make sure that it's protecting against the dominant strains that are circulating. One thing I would I would ask for Michelle and Sam is whether you feel this question. I know I hear it quite a bit, but you know, can I get sick? Will I get sick when I get the flu vaccine or when I get the COVID vaccine? And if you, how do you typically respond to that one? I think there is a lot of questions that come up related to what's going to happen after I get vaccinated and the real important take home point is. But some of these responses our body is experiencing after vaccination are completely normal and and represent really the uptake or the integration of that protection, right? It's your body responding to what's the components of the vaccination to build your. Eventual immunity protection or prevention measure. And so those symptoms, it's normal to have a mild fever, to have some, some chills, to have some fatigue. For a limited amount of time before your body gets kind of back on track, we saw this a lot with COVID and there were certainly some bigger responses. Our bodies were having to being exposed to that vaccination. But as many of us experienced those past relatively quickly, you haven't been infected. You are actually just responding in a completely normal. Way and I don't know, Maggie, if you want to speak to the things that maybe they need to look out for to win to maybe call their healthcare provider. Generally speaking, people are going to stick around for a little bit after they get vaccinated to make sure that they're not having a true allergy to some of the components of a vaccine. But I would echo what you said, Michelle, in terms of the COVID vaccine, it was framed more or we perceived it a little bit more as this is my body. Creating an adequate immune response to the vaccine, and so you might have had body aches you might have had, you know, felt poorly and and felt fatigued. In the end, that was fairly short lived and you do. Then you know have this immunity as a result of it. And so another thing I'll usually mention to people when they when they say that they became sick in a prior season from the flu vaccine specifically, is that you know, these are often inactivated. Vaccines that people are receiving, and so you know, we're not concerned about this converted. Theme to a virus that's actually capable of infection and then you know more. So even now with with protein subunits where there's. Just. Pieces of viral particles that is of less concern that it is going to refer to or form a virus that is actually capable of infection. So. You know, you may experience some of those transient effects after getting a vaccine. I think one of the most common reactions is just redness and soreness at the. Site of vaccination.
Maureen Ward
I know I always try to keep my arms really active after I get my flu and COVID nots because it seems to make it feel better. But yeah, that that redness and soreness at the site is certainly one that I have experienced. And I I think you know having people think about that, if they've had some reactions to vaccines in the past, maybe planning their vaccines for a Friday afternoon. So they can do just that. And you know, for me, I usually don't get a very big reaction to the flu vaccine the first time I got my my COVID maccini. Had a little bit of a reaction, but as I got my boosters it seemed to get a little better every time, like my body was like Oh yeah, I got this. I remember this. So hopefully with this newest iteration of the of the COVID vaccine, it'll be similar. But yeah, that's another good. You know, it's a good tip to plan if if you think you might have a small reaction just. Plan it for when you can take a little time to rest and drink your hot tea and and watch your favor. Small show.
Maggie Cook-Shimanek
When you get a vaccine, you shouldn't have the expectation that you are absolutely not going to get. That virus, during the course of. The respiratory season, the ultimate goal of getting a. Vaccine is that you? Will have reduced severity of symptoms that your body will more quickly and efficiently react to that. Virus and hopefully shorten the duration of. Illness and prevent some of those severe outcomes, especially things like hospitalization and of course death. So you certainly can still become infected with that virus. Another thing to be cognizant of is that, you know, during the course of when you're getting these vaccines, it is actively. Coming into respiratory season, so you may get another virus that at the same time we're around the same time really the only way to tell is by testing because many of the symptoms overlap among the different respiratory viruses.
Michelle Funchess
I know one of the big messages we've had with influenza vaccination and COVID was that two weeks like it typically takes two weeks after vaccination to build your body up to this level of prime immunity, as you're kind of encountering these viruses that are circulating. So if someone got a like a Sam. Mentioned getting that dose on a Friday coming in, contact it with on a Sunday may not, you know that may still end up being a a virus that you you end up with. And on that as well, so viruses and diseases in general that are caused by bacteria and viruses and other pathogens have what are called incubation windows. So with COVID-19, we usually see after someone's exposed it takes about 3 1/2 days. For them to develop the illness, so like Michelle said, if it takes two weeks for your body to develop immunity after a vaccine and you're exposed, it is possible. That you know, you do get the infection. And with flu we usually see anywhere from two to four days after someones exposed. They may develop the illness.
Maureen Ward
Great. Well, I know as a general population we've. Definitely become more aware of the upper respiratory illnesses in general. You know with with the onslaught of COVID just wow just you know, 4 1/2 short years ago. And then a lot of education has gone out about respiratory infections, you know, with COVID and flu. But what if any, are there myths that you still hear out there that are kind of persistent? And what would you say to address them?
Sam Saycich
I think the one I hear the most is. People say. COVID is just the same as the flu and they are not. They are caused by completely different viruses. COVID-19 is caused by the SARS COVID 2 virus. Influenza is caused by the influenza virus. So totally different causes. They result in different illnesses and we do see different trends in data in Montana. So between October 1st, 2023 and June 1st, 2024, Montana reported 19,000 cases of influenza and during that same time period we only reported 15,000 cases of COVID. So you know there was that difference and. For flu, we had 44 deaths, while for COVID we had 98 deaths. So there were more deaths reported due to COVID-19. So there is a difference between these conditions. Folks really should talk with their healthcare provider or pharmacist about getting them back. And making sure they're protected. Another one. I think we do get quite a bit is that flu and COVID aren't that serious. So I don't need to get the vaccine. You know, people think. I exercise frequently. I eat healthy, my chances of getting sick are lower, and I'll if I do get sick, I'll be fine. And as I mentioned, you know a few Times Now anyone can get these illnesses and anyone can have a severe. Health outcome so. So it is important to get the vaccine and you know, take it seriously. Double down on what Sam just said, which is really important. We have seen how these respiratory virus seasons have a Community level impact and so your risk may be low for having a severe outcome. And so we think about it in that individual context. But I would invite people to also consider the folks that they're going to come into contact with. So is it your friend with a baby who was born prematurely and maybe has some underlying medical conditions? Is it an older person in your life that you might see intermittently where even if you have that virus and you have a mild? Infection. It might not affect the other people around you in the same way. So I think that's a really important point and it does come up often that that, especially with young, healthy folks that don't feel that they are going to be susceptible to those more severe outcomes, think about the community.
Maureen Ward
So kind of back to that, that thought of herd immunity, right. So the more people that have the vaccine, the more protected we are has a population. Well, is there anything else that we have not talked about today that you think would be important for Montanans to know as we head into this upper respiratory system when we're all going to be spending more time indoors? Together, as the weather gets.
Sam Saycich
There. One big thing is we do have our data published publicly on the Montana DPH Trust website, so I do recommend that folks check out the website, see what's going on in their communities. And you know, this has already been stated, but I think it's worth mentioning one more time. We are in such a different position than we were five years ago when we had a flu vaccine going into the respiratory season we had. Of flu COVID-19 and our RSV vaccines. And so I think we have a really great opportunity for protection, prevention of severe outcomes and illness that we just didn't even imagine five years ago. And and we have that at our fingertips now. So take advantage of that and and help protect the community. Yeah. And I wanted to just add one additional thing about these updated COVID-19. Vaccines are starting to ship within our communities, unlike flu, that's been kind of on the shelf for a while, waiting for the opening of that. Season. The COVID machine products that are updated were a little bit more delayed than than that kind of schedule. So I we've been getting that question. Not where. Where are they? When? When are they arriving? They're already arriving. So we would just point people back to their healthcare provider, pharmacist, wherever they seek immunization services and know that that those those supplies are being delivered daily.
Maureen Ward
Thanks for listening to talking health in the 406 where we are one community under the Big Sky. I'm your host, Maureen Ward. Our guests today were Sam Saycich and Michelle Funchess from the Communicable Disease Bureau at DHS and Doctor Maggie Cook Shimanek a physician here at the state. If you'd like more information on what we discussed today. You can head on over to talkinghealthinthe406.mt.gov, we'll be back soon for another episode to take a deeper dive into what the data around flu RSV and COVID tells us about the trends with these illnesses. In the meantime, don't forget to rate, review and subscribe until next time. Take care and stay healthy.