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Brainerd lakes area doctors give advice on early flu season

Make smart choices to prevent respiratory illness

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Local health experts are warning that respiratory illnesses have made an early appearance, even before the holidays.

On the bright side, most people already know what to do about it.

"We're seeing an increase in RSV (respiratory syncytial virus) and the influenza season is very early right now for us," said Dr. Christine Albrecht, chief medical officer with Lakewood Health System in Staples. "Normally we don't see influenza this hard this early."

Dr. Rob Westin, chief medical officer at Cuyuna Regional Medical Center in Crosby, agreed.

"Typically, wintertime is when the infectious diseases spike. But this year it's starting early," Westin said. "So we're seeing three to four times more infectious diseases early on. November is kind of earlier in the season than we would normally see."

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Traditionally, respiratory illnesses like influenza, rhinovirus and RSV show up around the same time each year, often dubbed "flu season" or similar.

Often, that season is late December or into January, commonly driven by people spending more time indoors with others, celebrating holidays with friends and family in enclosed spaces and traveling.

"I can tell you that in the past week we've had 28 positive cases," Albrecht said. "In our facility we normally would not even see half of that."

The cause of the early onset is unclear, though Albrecht said isolation and masking in the past two years may have shifted the time and nature of traditional flu seasons.

The early surge of these common illnesses, combined with continued COVID-19 infections, has put strain on resources in some hospitals. Children's hospitals in the metro area are currently full, so more patients are staying at area hospitals instead.

Still, area health care providers say there is no crisis at this time. Those who need to go to the hospital should still go.

Indeed, the common wisdom among area health networks is to simply take account of symptoms before resorting to hospital care.

"With RSV, some of these kids are getting very hypoxic, so they don't have enough oxygen," Albrecht said. "They are getting dehydrated because they are working so hard to breathe they can't get enough fluid."

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Westin said kids who truly need to be seen are those having respiratory distress or symptoms that seem to be causing them to become more sick with dehydration or lethargy.

"You're OK as long as you are able to keep liquids down," said Dr. Jennifer Mahling-Stadum, family medicine practitioner with Essentia Health. "For babies, if they're making two wet diapers a day minimum, ideally more, then we know they are staying hydrated enough."

Other major symptoms include flaring nostrils or children breathing in a way that uses their rib cage more than normal. These are signs of serious breathing obstruction.

Most symptoms, however, can be treated at home.

"If your child isn't showing severe symptoms of dehydration or respiratory distress, or high, unremitting fevers or things like that, just managing them like a cold at home without having to bring them in for confirmation would be appreciated," Westin said.

In many cases, advice on whether to bring a loved one into a hospital or clinic may be obtained via virtual visits with health care providers. Such visits are often cheaper or even free with insurance.

Often those who are getting most sick are those with more than one infection.

"We're seeing children that are quite ill with influenza, and sometimes influenza and COVID, or influenza and strep throat," Albrecht said. "Children are getting really quite sick when they get hit with two of these different illnesses at the same time. They are being hospitalized, on average, one child per day in our hospital."

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Mahling-Stadum said Essentia Health is also seeing a lot of people with coinfection.

"So, people who have RSV plus influenza, or influenza plus COVID. Those do seem to be the patients that are getting sicker, especially the kiddos who have a couple at the same time. That's a pretty heavy load for a body," she said.

Of course, people with higher risk might benefit from a hospital visit earlier than others.

"Very young infants that get sick might have a harder time dealing with this," Westin said. "Certainly adults and older folks complicated by other health related problems would be at risk. It isn't necessarily that they have to come in at the drop of a hat, but as they are getting sicker and are at risk we'd want to hear about that."

Pregnant women who have influenza exposure and develop illness should contact their provider, Mahling-Stadum said.

"Most people with other chronic health conditions most of the time will know who they are," she said.

The common respiratory illnesses listed above have no miracle cure with treatments being mostly therapeutic. Those same treatments can usually be done at home, often with natural, well-known treatment methods — primarily rest and fluids.

"Take some of Grandma's old advice," Mahling-Stadum said. "Be the cleanest kid in town. Take a couple showers to loosen that up so your kiddo can cough it up. Sip on hot beverages all day so you're getting that steam all the time.

“That's what my grandma said. It helps with those secretions so you don't have to work so hard to get them out,” she said. “That's some of the best advice and it's natural, which is certainly in vogue right now.”

There are also over-the-counter medicines to reduce cough, congestion and fever; however, they should only be used as a means of increasing comfort and rest and not as a means of masking an illness to continue to work or go out into the public.

Perhaps the most difficult pill to swallow is advice that everybody knows, but some are hesitant to follow. When sick, stay home from work, school or family gatherings. This is especially difficult during times of economic hardship and holiday gatherings.

"Being able to tell people you are sick and you need to stay home because you are sick and you're trying to protect them is OK," Albrecht said. "I think people nowadays are trying to mask symptoms with medications so that they can still visit because they haven't seen people for so long and they just want life to be back to normal."

Staying home, especially when early symptoms are mild, is key to limiting spread. Prevention is still best, and prevention methods are free and well-known.

"Washing your hands often is the best way to prevent a lot of these viral illnesses from spreading," Albrecht said. "I also think people should stay home when they're sick. They could really stop the spread. Another thing to do is to get your influenza and COVID vaccinations, though there is no vaccination for RSV."

Westin asked people to take the common sense approach to try to prevent infection spread.

"If you have a sick child and you have an opportunity to not expose other people to that, it would be helpful," he said.

“Then, also, if needed we certainly still have good health care systems in our region to take care of the people in need,” Westin said. “We want them to know to use those systems and not be afraid of coming into the hospital just because these things are high."

The advice given during the real surge of COVID-19 is still good advice, Mahling-Stadum said.

"When you go out around people, sanitize before and after. If you are sick, stay home. Get your shots if you haven't already. Just common sense things," she said. "If you choose to be in a crowd, you've probably chosen to get sick."

Prevention, as always, is key.

"We need to work really hard to prevent kids from getting sick," Albrecht said. "Some hospitals just don't have any capacity right now."

Improvements in technology and testing have revealed trends that have either been uncommon or undiagnosed in the past.

Specifically, RSV, an illness mostly diagnosed in children, is being documented in adults, a population traditionally at low risk of dangerous symptoms, and, therefore, traditionally not tested for it.

"Normally we don't test for RSV in adults, but currently we are doing what we call a fourplex swab," Albrecht said. "It checks for COVID, influenza A, influenza B and RSV. We are seeing RSV especially in our elderly population with COPD and they're getting quite sick with it.”

The better the testing, unfortunately, the more disease you pick up, Westin said.

"So then the question is, does that mean there's actually more disease? Or does it just mean you're doing better screening?" he asked.

Even if this does not change the way RSV is viewed in adults, it will at least provide data that had traditionally been missed.

Travis Grimler is a staff writer for the Pineandlakes Echo Journal weekly newspaper in Pequot Lakes/Pine River. He may be reached at 218-855-5853 or travis.grimler@pineandlakes.com.

Travis Grimler began work at the Echo Journal Jan. 2 of 2013 while the publication was still split in two as the Pine River Journal and Lake Country Echo. He is a full time reporter/photographer/videographer for the paper and operates primarily out of the northern stretch of the coverage area (Hackensack to Jenkins).
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