Tag Archives: flu2017

Student Health never gives antibiotics!

chart from CDC showing bacterial infections and viral infections

Huh?

We hear it often, especially during cold and flu season. It is the most common reason parents call to talk to our Director. It leads to negative reviews on social media sometimes. It sounds something like this……

Students come in asking for a zpack by name because “that’s the only thing that works”

Parents call and are upset we didn’t “do anything” for their student

“My doctor at home just calls me in an antibiotic”

“Student Health told me I have a cold but I really have an upper respiratory infection!”

“My snot is green so I know it is bacterial”

“You told me I have a virus, but I went to another facility and got an antibiotic”

And finally………………………”Student Health never gives antibiotics!”

 

SO WHAT’S THE DEAL, STUDENT HEALTH?

Sore throat, cough, nasal congestion/drainage, fever, aches, ear pain, sinus pressure, and headache are some of the most common reasons for visits to Student Health. As you see from the chart, VERY few need antibiotics.

Some important facts to know:

  • 90-98% of sinus infections are viral (and even in bacterial cases, antibiotics do not necessarily help)
  • 90-95% of sore throats in adults are NOT strep
  • over 200 strains of the common cold exist
  • bronchitis should not be treated with antibiotics
  • most adults experience 2-4 colds annually, each lasting 7-10 days
  • colored snot means NOTHING in regards to whether the cause is bacterial or viral
  • high fever can be present in either bacterial or viral infections

chart from CDC showing bacterial infections and viral infections

 

So how do Providers know whether a patient needs an antibiotic or not?

Providers at Student Health follow national treatment guidelines, which aid diagnosis and treatment planning. The Centers for Disease Control has an excellent chart that you can check out here to see why we make the decisions we do. Part of the diagnosis is on patient reporting of symptoms, duration of illness, etc and the other is based on physical assessment, such as vital sign readings, visual inspection of eyes/throat/nose/ears, and listening to lungs (among other things depending on symptoms).

Do we give antibiotics? Of course we do–when it is the medically appropriate treatment.


Yeah, but wouldn’t an antibiotic help anyway????

NO. Incorrect antibiotic use causes a whole host of problems. People tend to forget that antibiotics can have side effects, some which may even make a patient feel worse than their original illness! Allergic reactions, stomach upset, diarrhea, yeast infections, and rashes are just some of the common side effects people can experience with antibiotics. Another issue is drug resistance–every time you take an antibiotic that you do not need, you are contributing to the fact that the antibiotic is less effective over time to bacteria. Did you know that by taking an antibiotic, you can actually help unleash a dangerous different bacteria into your gut, one that can lead to hospitalization and even death? (Don’t believe me? Check out  info on C.Difficile)

Superbugs like MRSA exist now because of incorrect use of antibiotics, and the scary thing is, our ability to fight these super infections is limited or in some cases, there is no way at all to treat them! And what about cost? Prescriptions are not always cheap. Why take a medication that won’t help, may hurt, leads to drug resistance, and costs money?

Health care providers have a duty to prescribe responsibly and to only use antibiotics in acute illness when a patient shows signs that a bacterial infection is present.


So you aren’t going to help.

Here is the part that comes into conversation with a lot of our patient/parent feedback about viral infections: if you are not giving an antibiotic, you are not doing anything to help. The hard truth is this: with most illnesses, including flu, bronchitis, upper respiratory infections, colds, sinus infections and most sore throats, THERE IS NO MAGIC FIX. We always advise patients on the best way to treat their symptoms to hopefully get some relief, but the only thing that cures is TIME. Illnesses can take days or WEEKS to resolve (yes, weeks.) Rest, good nutrition, light exercise, and increasing fluid intake help. We recommend which over the counter medications to take, and provide prescriptions for cough medications or inhalers if warranted; our on site pharmacists are also happy to help patients decide what may help their symptoms. Having a pharmacy right inside Main Campus SHS makes it easy for patients to pick up what they need to start feeling better.

 

“You told me I have a virus, but I went to another facility and got an antibiotic.”

Ah.

Our advice to patients would be to always ask why you are, or are not, receiving an antibiotic. Ask what guidelines are being used. Ask why a provider thinks an illness is viral or bacterial. Any high quality provider will be happy to share information and education about their clinical decision.

We hear stories of “urgent care gave me an antibiotic for my bronchitis” (cringe) or “the ED diagnosed an upper respiratory infection and wrote me a zpack” (AKA, you have a COLD. Double cringe) or, possibly the most irresponsible, “I called my doctor at home and he called me in an antibiotic since that always helps” (ugh….)

Some outside facilities may not be willing to practice evidenced based medicine when it comes to antibiotic prescribing because that may mean a patient will be unhappy (and therefore will not pay to come back). We cannot control what other offices do, but we can insist that our facility follows recommendations and best practices. Just because you can walk out of another office with one or more prescriptions does not mean it was the medically sound thing to do.

 

Possibly the most important part…..that many patients miss…..

While most illnesses are viral in nature, we ALWAYS tell patients that if they are not getting better, something suddenly worsens, or if they have any emergency symptoms such as difficulty breathing, inability to put their chin to their chest, severe headache, chest pain, high fever that does not respond to medication, or prolonged vomiting, THEY NEED TO BE RE-EVALUATED. Infections that start out as viral, or appear early on as viral, can lead to bacterial infections that do need antibiotics or other treatments. Most patients will recover from viral illnesses on their own, but if that is not the case, we will always be glad to see patients for follow up appointments. The great thing about Student Health is that if you pay fees with your tuition, you do not have to pay to be seen and evaluated….so never hesitate to come back with any new concerns, symptoms that are not improving, or other questions about your care.

 

Our goal is help the ECU campus community be as healthy as possible. By communicating how we form diagnoses and treatment plans, we hope patients and others will feel more educated and confident that safe and appropriate antibiotic prescribing is a important part of the care we provide at Student Health Services. As always, feel free to drop us a line at gotquestions@ecu.edu with your health or service related questions.

Stay well, ECU!

 

Sources:

Antibiotics Aren’t Always the Answer https://www.cdc.gov/features/antibioticuse/infographic2.html

Appropriate Antibiotic Use https://www.cdc.gov/antibiotic-use/

CDC Treatment Guidelines https://www.cdc.gov/antibiotic-use/community/for-hcp/outpatient-hcp/adult-treatment-rec.html

Happy New Year! and unfortunately, welcome to flu season…………

fluview graphic of US states showing every state is having widespread flu activity

fluview graphic of US states showing every state is having widespread flu activity

 

We are seeing an increase of flu cases here at Student Health, which mirrors the activity across the United States. Here is some important information about flu and what to do if you (or someone close to you) gets sick.

Signs of the flu: sudden onset of fever, body aches, fatigue, cough, sore throat, runny or stuffy nose, headache. Rarely it can cause diarrhea or vomiting, but influenza and the “stomach flu” are NOT the same thing. Flu makes you feel horrible, fast. Like hit by a truck horrible.

What to do if you are sick: stay away from others until you have been fever-free for 24 hrs without having to take fever reducing medication. Take ibuprofen/tylenol for aches and fever, drink a lot of fluids, rest, and cover your sneezes and coughs with a tissue that you throw away. WASH YOUR HANDS. Are you high risk for flu complications?  Read this and if applies, call us at (252) 328-6841.

  • Do you need a friend to pick up food for you at the dining hall? You can fill out this form and let your buddy grab you something to eat.
  • Do you need to let your professors know you are sick?  Log onto Pirate Port and use the “Flu Self Reporting Form”. Be advised: this is NOT an excuse. It does let your professors know you are ill and they may work with you on missed work.

What to do if your roommate or someone you love is sickhttp://www.flu.gov/symptoms-treatment/caring-for-someone/index.html

If you aren’t sick, here are a few things to do to try to avoid the flu:

  • get a flu shot–although the best time to get vaccinated is early fall, it is not too late. Student Health has some vaccine available or visit one of your local retail pharmacies, urgent care centers, or your primary medical provider’s office.
  • Avoid sick people–if your friend says they don’t feel well, maybe you should cancel that study session or lunch date.
  • Don’t eat, drink, or smoke after others.
  • Avoid touching your eyes, nose and mouth–we don’t realize how much we introduce germs into our system just by our habits.
  • Wash your hands way more than you think is necessary. Also, alcohol based sanitizers do work against flu, so get you a bottle to keep in your bag.
  • Surfaces are gross–doorknobs, chair rails, keyboards, money, pens, phones, etc all can harbor flu virus particles. Remember to clean your hands often especially after touching items others have used.

A few FAQ:

  • Does SHS test for flu?
    Sometimes. In many cases though, testing is not helpful since the treatment for flu is based on symptoms, not test results, so your treatment is the same regardless of whether or not you have a test. Right now there is a national shortage of flu tests, but as flu becomes widespread in communities there is less need to test since we know the virus is circulating.
  • Should I see a doctor?
    In most cases, if you are healthy and have no underlying major medical issues like asthma, pregnancy, diabetes, HIV, heart conditions, cancer, etc, you do not need to see a health care provider since flu typically resolves on its own.  However, if you have severe symptoms or feel that you are not improving, you need to call your doctor or if you have an emergency, call 911.
  • Can SHS give me a note to miss class?
    No. SHS can not give class excuses. While we do not want students going to class ill, decisions about class attendance policies rest solely with instructors. Students should notify their instructor when they have the flu.
  • If I have flu, do I need Tamiflu (antiviral medication)?
    Again, probably not. Learn more here. If you have a severe case, or are at high risk for complications, then your doctor will probably prescribe an anti-viral; however, low risk otherwise healthy people do not need prescription medication for flu. Tamiflu has side effects of its own and while it *may* shorten duration of illness by 24 hours or so, it will not take symptoms away. It is indicated for helping prevent serious complications in high risk patients, but it is not a magic bullet for making the flu go away in otherwise healthy individuals.

Still have more flu related questions?  Email us at fluquestions@ecu.edu

Also, don’t forget: anytime we are not open, you always have the 24hr nurse line available to you for medical advice. Call our main number, (252) 328-6841, and listen to the instructions for speaking with a nurse.

Student Health continually monitors the flu situation. Look to www.ecu.edu/studenthealth for updates and please follow us on Twitter (@ECU_SHS) and Facebook (ECU Student Health Services) for the most up to date information for campus.

Source:

CDC                       http://www.cdc.gov/flu/

Still on the fence about the flu shot?????

image states "keep health and get your flu shot"

image states "keep health and get your flu shot"

 

If you are opting out of a flu shot because of some rumors you have heard, let us help fact check the claims.

If you decide to change your mind and get vaccinated, call us at (252) 328-6841. We have a small supply of flu vaccine left….get it while you can! Our cases of people being sick with the flu are increasing, so don’t wait much longer to get your flu shot.

Is it too late to get my flu shot? No. We are starting to see an increase in influenza cases at SHS. This is likely to persist for the next 6 weeks or possibly longer. The flu shot offers full protection about a month after receiving it, so if you get it soon, you may still benefit from it.

I heard the flu shot wasn’t very good this year. Why should I get it? We don’t know how well the flu shot will work this year. The flu virus mutates quickly and that can make the vaccine less effective. Last year’s flu vaccine (2016-2017) was about 39% effective against all circulating types of influenza. The CDC is predicting that this year is likely to be similar. However, the flu virus mutates quickly and that means sometimes the vaccine is just not a good match for the types of virus that are floating around. That being said, the flu vaccine has been shown again and again to reduce complications of the flu such as pneumonia and to reduce hospitalizations and deaths. This suggests that those who get the vaccine are getting some protection from it, even if they do happen to catch the flu.

I got the flu shot one time and it made me sick. The flu shot cannot give you the flu. There is no live virus in the shot. It is not uncommon, though, for people to feel a bit achy after the shot. Sometimes they will develop some sinus drainage or headaches or mild elevations in body temperature. This is not the flu. The purpose of the flu shot is to put your immune system on guard against the flu. This mild ill feeling is likely an indicator that the shot is doing its job—your body is reacting to it. If you get the shot and then have fever (temp greater than 100.4), that would be an uncommon reaction and is more likely to be a different viral illness—not related to the flu shot.

There is excellent information (and much more detail) about the flu shot on the CDC website. The address is www.cdc.gov. Search:flu shot.

~Dr. Ashton Johnson, SHS Physician