Transcript: Flu and Family Health | Oct 16, 2000

(music plays)

The opening sequence shows a wooden table with a small-lit candle as several
words fly by: Nutrition, medicine, prevention, treatment, and health. Fast clips
show different sets of hands performing activities on the table such as pulling
petals from a daisy, drawing a big red heart, tuning a violin, flipping through the
pages of a book, cooking, and pouring a glass of red wine. In animation, the title
appears inside the shape of a house: “More to life.”

Maureen Taylor sits in a studio with yellow walls and a small TV set in the
background, which reads “More to life.”

Maureen is in her late thirties, with wavy blond hair in a bob. She’s wearing a
green button up sweater over a green turtleneck sweater.

Then, Maureen reappears in the studio.

She says HELLO I’M MAUREEN TAYLOR AND WELCOME TO MEDICAL MONDAY
HERE ON MORE TO LIFE. STALK UP ON THE KLEENEX AND THE NEOCITRAN
BECAUSE FLU SEASON IS JUST AROUND THE CORNER AND FOR THE FIRST
TIME ONTARIANS CAN GET THEIR FLU VACCINE FOR FREE. DR. ROSS UPSHUR
IS A FAMILY PHYSICIAN AT SUNNYBROOK AND WOMAN’S COLLEGE HEALTH
SCIENCE CENTER IN TORONTO. HE’S HERE TO TALK ABOUT WHAT YOU CAN DO
TO MAKE THIS A FLU FREE SEASON SO GIVE US A CALL WITH YOUR
QUESTIONS ABOUT THE FLU, THE VACCINE, OR ANYTHING TO DO WITH YOUR
FAMILY’S HEALTH.

A caption appears on screen showing two phone numbers.

Maureen continues IN TORONTO DIAL 416-484-2727. CALL US TOLL FREE AT 1-
888-411-1234. YOU CAN USE THE INTERNET AND YOU CAN e-mail YOUR
QUESTION FOR Dr. UPSHUR JUST SEND IT TO moretolife@tvo.org AND
WELCOME TO THE PROGRAM, HI.

Dr. Upshur says Hi.

Maureen says WHAT DO YOU THINK OF THE PROVINCE OFFERING FREE FLU
VACCINES FOR EVERYBODY THIS YEAR?

A caption appears it reads “Dr. Ross Upshur: Family Physician.”

Dr. Upshur says I THINK IT’S A VERY GOOD IDEA IN GENERAL.
BASICALLY INFLUENZA'S A
SERIOUS ILLNESS.
PEOPLE TEND TO THINK OF THE
FLU AS ANY KIND OF COLD, BUT
ACTUALLY INFLUENZA IS A
SPECIFIC ILLNESS THAT CAN BE QUITE SERIOUS.
NOW, THE BEST WAY TO
PREVENT -- OR PROTECT
YOURSELF AGAINST THE FLU IS
TO BE AS HEALTHY AS POSSIBLE
AND THAT'S YOU KNOW TO EAT WELL, GET
PLENTY OF EXERCISE BUT WE
KNOW THAT WILL NOT
ALWAYS WORK, PARTICULARLY
WITH RESPECT TO VIRAL
ILLNESSES SUCH AS INFLUENZA,
AND WHAT WE KNOW FROM
RESEARCH EVIDENCE IS THAT
THE INFLUENZA VACCINE IS
EFFECTIVE AND WHERE YOU GET
PEOPLE USING THE VACCINE OR
TAKING THE VACCINATION, THE
RATINGS OF ILLNESS DROP, THE
RATES OF DOCTOR VISITS DROP
AND IT'S YOUR BEST WAY TO
PREVENT GETTING INFLUENZA.

Maureen says IT WORKS ESPECIALLY IF THEY'VE PICKED
THE RIGHT STRAINS, CORRECT?

Dr. Upshur says WELL ONE THING, INFLUENZA
IS A FASCINATING VIRUS,
NOT ONLY HISTORICALLY, IT'S
FASCINATING ECOLOGICALLY,
WHERE IT LIVES IN THE WILD
AND HOW IT INTERACTS WITH
HUMANS, BUT IT'S ALSO A VERY
TRICKY VIRUS.
I OFTEN THINK THAT WE ARE A
LOT LESS SMART THAN THE
VIRUS ITSELF.
IT CHANGES FROM YEAR TO
YEAR.
AND AS A RESULT OF
SURVEILLANCE, IT'S ALWAYS A
BIT OF A BET THAT THE
VACCINE THAT WE BELIEVE IS
GOING TO MATCH THE VIRUS
THAT'S CIRCULATING IN THE
POPULATION.
IF THE VACCINE MATCHES THE
VIRUS, THAT'S CIRCULATING
THE POPULATION, AND IT'S A
WIN-WIN SITUATION.
YOU'RE LIKELY TO HAVE
CONSIDERABLE REDUCTION IN
MORBIDITY IN THE POPULATION,
THAT’S SICKNESS IN THE POPULATION,
BUT MORTALITY.
MUST BE REMEMBERED THAT FOR PEOPLE THAT ARE SICK OR
HAVE CONDITIONS THAT PREDISPOSE THEM FROM BEING
ILL FROM INFLUENZA, INFLUENZA IS A FATAL ILLNESS. IT’S A VERY SERIOUS
ILLNESS.
IF THERE'S NOT A MATCH WELL

Maureen says RIGHT.

Dr. Upshur says THERE'S NOT MUCH YOU CAN DO.

Maureen says LAST YEAR'S SEEMED TO BE
A PARTICULARLY VIRULENT
STRAIN OF FLU, IS THAT
CORRECT?

Dr. Upshur says WELL I THINK WHAT HAPPENED
LAST YEAR IS FINALLY PEOPLE
STARTED PAYING ATTENTION TO
INFLUENZA.
IF YOU LOOK AT THE RECORD AND
SOME OF THE RESEARCH I'VE
DONE IS LOOKING AT WHAT'S
HAPPENED IN TERMS OF
HOSPITALIZATIONS OR WHAT THE
IMPACT OF INFLUENZA IS ON
THE HEALTH OF THE POPULATION,
WE HAVE A SIMILAR OCCASION
EVERY YEAR AND I THINK
PEOPLE ARE GETTING --
PEOPLE'S MEMORIES ARE FAIRLY
SHORT BECAUSE AROUND TWO
YEARS AGO, AROUND '97 '98
THERE WAS A BAD INFLUENZA
STRAIN AS WELL.
I THINK THEY CALLED IT THE
SYDNEY FLU BUT IT DIDN'T
COME UNTIL LATER IN THE
YEAR.
IT CAUGHT US AROUND FEBRUARY
AND I REMEMBER IT WAS
PARTICULARLY BAD IN NEW
BRUNSWICK.
SCHOOLS WERE CLOSED.
SO THIS WAS NOT SOMETHING
NEW BY ANY MEANS.
I THINK LAST YEAR WHAT
HAPPENED WAS IT WAS A
PARTICULARLY BAD COMBINATION
OF ARRIVING AT CHRISTMAS
TIME WHEN PHYSICIANS OFFICES
WERE CLOSED AND IT PUT AN
IMMENSE STRAIN UPON THE
HEALTHCARE SYSTEM AND IT WAS
ALL VERY SUDDEN, AND SO IT
HAD A FAIRLY WHAT WE CALL
STEEP OUTBREAK CURVE.
BUT THIS OCCURS EVERY YEAR.
PEOPLE SAY IS IT AN EPEDIMIC OR NOT AN EPIDEMIC
INFLUENZA HAS PREDICTABLE
IMPACT ON THE POPULATION
HEALTH ON AN ANNUAL BASIS.
AND YOU CAN LOOK AT IT AS
YOU LOOK AT THE NUMBERS.

Maureen says THEY'VE ALWAYS
SAID THAT SENIORS AND PEOPLE
WHO WORK IN HOSPITALS AND
NURSING HOMES SHOULD GET IT.
NOW IT'S BEING, YOU KNOW,
IT'S OUT THERE FOR EVERYONE
TO GET, BUT WOULD YOU HAVE
YOUR OWN CHILDREN
VACCINATED?

Dr. Upshur says YEAH,
I'D HAVE NO HESITATION.
THE INFLUENZA VACCINE IS
SAFE FOR EVERYONE.
THERE'S ONLY TWO CATEGORIES
OF PEOPLE WHO SHOULDN'T HAVE
IT.ONE IS PEOPLE WHO ARE

SENSITIVE TO EGGS,
PARTICULARLY HEN'S EGGS
BECAUSE THE VACCINE IS
PROPAGATED IN AN EGG, MADE
IN AN EGG SOLUTION, I THINK.
SOMETHING TO DO WITH EGGS.

Maureen says I HEARD THAT
TOO.

Dr. Upshur says SOMETHING TO DO WITH EGGS AND I’M NOT A BIOLOGIST
THOSE WHO HAVE AN
ALLERGY TO SOME OF THE TRACE
ELEMENTS OR THE PRESERVITIVES
THAT ARE FOUND IN THE
VACCINE ITSELF.
BUT THAT'S EXCEEDINGLY RARE.
YOU SHOULDN'T BE VACCINATED
IF YOU HAVE A FEVER.
IF YOU HAVE SNIFFLES OR
YOUR FEEL UNWELL, IT'S
PERFECTLY SAFE.
OVER THE AGE OF SIX MONTHS,
AND IF YOU LOOK FOR EXAMPLE
AT THE CDC'S RECOMMENDATIONS
IN THE STATES, IT'S CONSIDERED
SAFE FOR PREGNANT WOMEN.

Maureen says OKAY, NOW I DID
READ THAT IT DIDN'T SEEM TO
BE AS EFFECTIVE IN CHILDREN
FOR SOME REASON.

Dr. Upshur says WELL THERE WAS A RECENT
STUDY, I THINK IT WAS ABOUT
TWO WEEKS AGO IN A MAJOR
JOURNAL CALLED THE JOURNAL
OF THE AMERICAN MEDICAL
ASSOCIATION AND WHAT YOU'LL
FIND IF YOU LOOK CAREFULLY,
IF YOU CRITICALLY CHECK

OUT THAT ARTICLE...IT WAS A VERY SMALL NUMBER OF PEOPLE.
INFLUENZA VACCINE HAS VARIABLE EFFICACY IT MEANS THAT IT CAN HAVE
CASSIE, CAN BE AS HIGH
AS 80, 85 PERCENT EFFECTIVE IN
PREVENTING OR VERY LOW,
DEPENDING ON AGAIN WHAT WE SEE IN
THE MATCH BETWEEN THE STRAINS
IN THE VACCINE.
BUT THIS PARTICULAR STUDY
WAS VERY INTERESTING.
IT SHOWED THAT THE VACCINE EFFECTIVENESS
IN CHILDREN WAS RELATIVELY
LOW, DAYCARE CHILDREN,
CHILDREN OF MILITARY
PERSONNEL.
BUT IMPORTANT THING, THE
MESSAGE WE SHOULD GET OUT
FROM THAT STUDY IS THAT
THOSE WHO WERE IMMUNIZED
THERE WAS LESS TRANSMISSION
WITHIN THE HOUSEHOLD.
NOW JUST TO EXTEND THE TALK
ABOUT IMMUNIZING CHILDREN,
HISTORICALLY THE PATTERN OF
IMMUNIZATION IN NORTH
AMERICA IN CANADA AND THE
UNITED STATES HAS BEEN TO
TARGET HIGH RISK
POPULATIONS.
ELDERLY PEOPLE OVER THE AGE
OF 65, THOSE UNDER 65 WITH
SERIOUS CHRONIC ILLNESSES.
THAT POPULATION ACTUALLY,
THE VACCINES'S EFFECTIVENESS
OR EFFICACY, AS WE CALL IT,
IS THE LOWEST.
IN HEALTHY ADULTS IT'S THE
HIGHEST.
NOW, JAPAN, FOR A LONG TIME
IMMUNIZED CHILDREN AND WHAT
WE FIND THERE AND THERE'S A
STUDY THAT WILL BE PUBLISHED
VERY SHORTLY, THAT I'VE HAD
A CHANCE TO LOOK AT, IS THAT
IT HAS AN IMPACT ON
KEEPING -- AS SOON AS THEY
STOPPED MASS IMMUNIZATION OF
CHILDREN THE OVERALL

MORTALITY, THE ALL CAUSE
MORTALITY OF THE POPULATION
DURING INFLUENZA OUTBREAKS
STARTED TO GO UP.

Maureen says REALLY?

Dr. Upshur says I SIT ON A GROUP THAT'S
PREPARING FOR A PANDEMIC,
INFLUENZA PLAN RIGHT NOW
HEALTH CANADA THROUGHOUT
CANADA WE'RE ALL VERY CONCERNED
A NEW STRAIN OF INFLUENZA
WILL COME THERE IS NO VACCINE
FOR-

Maureen says NO VACCINE FOR.


Dr. Upshur says IN THE POPULATION SO WE
NEED TO BE PLANNING AHEAD PREVENTION IS BEING PREPARED. AND ONE
OF THE THINGS WE KNOW IS
THAT IF YOU BREAK THE CHAIN
OF TRANSMISSION IN CHILDREN
IN PARTICULAR, THEN YOU'RE
NOT GOING -- BECAUSE THEY'RE
THE MOST VULNERABLE POOL?
THEY HAVEN'T ACCUMULATED THE
IMMUNITY THAT WE HAVE, YOU
AND I MAY NOT REMEMBER IT
BUT WE'VE PROBABLY HAD
INFLUENZA FIVE, SIX, SEVEN
TIMES IN OUR LIFE SO
IMMUNIZING CHILDREN IS AN
IMPORTANT WAY OF INFECTION,
CONTROLLING THE POPULATION.

Maureen says ALRIGHT DR. ROSS UPSHUR
HAS A SPECIALTY IN
PUBLIC HEALTH, ESPECIALLY
INTERESTED IN THE FLU, HE'S
A FAMILY PHYSICIAN AND HE'S
HERE TO TAKE YOUR QUESTIONS
ABOUT THE FLU, THE VACCINE

AND ANYTHING TO DO WITH YOUR
FAMILY'S HEALTH. IN TORONTON CALL (416) 484-2727. IF ITS LONG
DISTANCE CALL 1-888-411-1234 AND e-mail YOUR QUESTION TO
MORETOLIFE@TVO.ORG.

Maureen says AND JENNIFER IS
IN TORONTO.
HI JENNIFER, WELCOME.

Jennifer says HI, I JUST WANTED
ABOUT IF IT'S OKAY TO GET
THE FLU SHOT WHEN YOU'RE
BREAST FEEDING.

Dr. Upshur says YES.

Jennifer says OKAY.

Maureen says EASY AS THAT.
HOW OLD IS YOUR BABY,
JENNIFER?

Jennifer says JUST THREE MONTHS.

Maureen says SO YOU WOULDN'T
BE IMMUNIZING YOUR BABY
THEN.

Jennifer says NO.

Maureen says DID YOU HAVE THE
FLU LAST YEAR?

Jennifer says I HAD THE FLU
SHOT ACTUALLY LAST YEAR,
YEAH.
SO I DIDN'T GET THE FLU.

Maureen says OH, SO IT WORKED IN
YOUR FAMILY?
YOU'RE GOING GO WITH WHAT
YOU KNOW, I GUESS?

Jennifer says YEAH, WE WILL.
THANKS VERY MUCH.

Maureen says OKAY, 'BYE.
YEAH, I, I'VE NEVER HAD A
FLU SHOT BEFORE.
AND NEVER GOT -- I DON'T GET
THE FLU THAT OFTEN.
ARE THERE SOME PEOPLE WHO
EITHER BECAUSE -- YOU KNOW,
WE WASH OUR HANDS ALL DAY
LONG OR WE DON'T TOUCH THIS OR
THAT, DO WE HAVE A BETTER
IMMUNE SYSTEM THAN OTHER
PEOPLE?

Dr. Upshur says I THINK
IT MIGHT BE A COMBINATION OF
THE LUCK OF THE DRAW AND
MAYBE A BIT, AS I SAY, YOUR
BEST OVERALL WAY TO BE
HEALTHY IS TO --

Maureen says TO BE IN GOOD
HEALTH.

Dr. UPSHUR says IS TO BE
IN GOOD HEALTH.
IT SOUNDS A BIT REDUNDANT
BUT YOU ALLUDED TO A VERY
IMPORTANT POINT THERE.
FREQUENT HAND WASHING IS
CRUCIAL.
MANY PEOPLE BELIEVE THAT
INFLUENZA COMES DIRECTLY
THROUGH AIRBORNE SPREAD BUT
IT ACTUALLY DOESN'T.
THE MAJORITY IS BY DROPLET
SPREAD SO, CONTAMINATED
SURFACES AND WE'RE FOREVER
TOUCHING OUR NOSE AND
INOCULATING OURSELVES.
AND THAT’S THE WAY MOST VIRIUS’S ARE SPREAD
NOW FREQUENT HAND WASH, IT'S
NOT THAT I WANT TO CREATE A
CULTURE OF OBSESSIVE WASHERS
BUT DOES ,IT'S NOT JUST SPECIFIC
FOR INFLUENZA, IT'S FOR MANY
DIFFERENT VIRUSES, VIRUSES THAT CAUSE
GASTRO-INTESTINAL AND COMMON
COLD VIRUSES SO FREQUENT HANDWASHING IS A GOOD
HABIT TO BE IN AS OF COURSE A
HEALTHCARE PROFESSIONAL I
WASH MY HAND TONS.

Maureen says DO WE HAVE TO
USE THESE ANTIBACTERIAL
SOAPS THEY PUSH.

Dr. Upshur I THINK THAT TO BE HONEST I THINK
THERE'S A CERTAIN
CAPITALIZATION ON FEARS.
I WON'T SPEAK FOR THAT BUT
ALL OF A SUDDEN IT'S THE --
THE RISE OF SUPERBUGS HAS
BRED THE RISE OF SUPER
SOAPS.
IT SEEMS EVERYWHERE WE GO
IT'S GOING TO KILL
EVERYTHING.
I THINK REGULAR SOAP, AS
IT'S DURATION, RATHER THAN
STRENGTH OF SOAP.
YOU NEED TO GIVE YOUR HANDS
A COUPLE OF MINUTE SCRUB.

Maureen says OK.

Dr. Upshur says THE OTHER THING IS WHO YOU
COME IN CONTACT WITH.
SAY FOR EXAMPLE YOU WORK
WITH CHILDREN OR IN DAYCARES OR
HEALTHCARE SITUATIONS OR IN
OFFICES WHERE THERE'S LOTS
OF PEOPLE YOU'RE MORE LIKELY
TO COME IN CONTACT WITH THE
VIRUS.

Maureen says MHMM OK. WE'LL GO TO
DEBORAH IN ETOBICOKE.
HI DEBORAH.

Deborah says YES, HELLO.

Maureen says HI. WHAT'S YOUR
QUESTION?

Deborah says ACTUALLY WHAT I
WANTED TO ASK WE HAVE A
CHILD AND HE'LL BE FOUR IN
DECEMBER. AND HE'S IN SCHOOL RIGHT
NOW, AND HE ACTUALLY GOT
INFLUENZA HE'S BEEN SICK ABOUT FIVE
WEEKS NOW, AND WHAT I WAS
WONDERING WAS FOR HIM, WOULD
IT BE A GOOD IDEA TO HAVE
HIM VACCINATED AGAINST THE
FLU, AND IS THERE A CERTAIN
STRAIN THAT'S OUT THERE
RIGHT NOW THAT'S A VERY
LENGTHY ONE?

Dr. Upshur WELL A COUPLE OF COMMENTS,
WHEN YOU SAY HE HAD INFLUENZA
DID A DOCTOR DO A
TEST TO SHOW HE HAD

INFLUENZA? BECAUSE TO THE BEST OF MY
KNOWLEDGE THERE HASN'T BEEN
ANY ICEELETS OF INFLUENZA
YET IN CANADA.
BUT THERE ARE -- INFLUENZA'S
JUST ONE OF THOUSANDS OF
VIRUSES AND BACTERIA THAT
CAN CAUSE UPPER RESPIRATORY
TRACT INFECTIONS SOME OF
WHICH CAN BE AS SEVERE AS
INFLUENZA ITSELF AND IS
THERE A BUG OUT THERE NOW?
YES, ABSOLUTELY.
I SIT IN THE CLINIC AND I
SEE PEOPLE WITH HACKING
COUGHS AND FEVERS AND IT
DEPENDS. AS SOON AS SCHOOL STARTS IN
SEPTEMBER THE BUG SEASON OR
RESPIRATORY VIRUS SEASON
STARTS AND THERE'S, AS I
SAID, A WIDE VARIETIES OF THEM.
I'M NOT SURE. I HAVEN'T CHECKED THE
SURVEILLANCE DATA YET TO SEE
WHAT'S OUT THERE NOW BUT I
DO KNOW THERE IS SOMETHING.
THE THING ABOUT MOST UPPER
RESPIRATORY TRACT ILLNESSES, IS THAT
THE COUGH CAN BE QUITE
LENGTHY IN DURATION.
MOST PEOPLE THINK THAT YOU HAVE A VIRUS
AND GET BETTER WITHIN TWO OR
THREE DAYS BUT OFTEN IF YOU
GET A LOT OF IRRITATION AND
INFLAMMATION IN THE LUNGS
YOU CAN HAVE A COUGH FOR UP
TO TWO, THREE, FOUR, AS YOU
SAY UP TO FIVE WEEKS.
I ASSUME AND I WOULD
RECOMMEND YOU'VE HAD YOUR
CHILD ASSESSED BY FAMILY
DOCTOR OR PEDIATRICIAN.
WOULD I RECOMMEND HE GET A
VACCINATION? CERTAINLY.
IT WOULD PREVENT HIM- IT WOULD BE HIS BEST BET TO
PREVENT HIM FROM GETTING
INFLUENZA THIS YEAR.

Maureen says NOW THAT RAISES
A GOOD POINT.
A DOCTOR CAN TAKE A TEST AND
KNOW WHETHER YOU'VE GOT
INFLUENZA OR SOMETHING ELSE?

Dr. Upshur THERE ARE SOME TESTS THAT
CAN BE DONE.
THE MOST ACCURATE IS A VIRAL
CULTURE OR WHAT WE CALL SIROLOGY WHERE
YOU TAKE A BLOOD TEST AND
REPEAT IT AGAIN IN FOUR
WEEKS' TIME.
THESE TESTS ARE NOT
FREQUENTLY USED.
I DID A STUDY, ACTUALLY,
WHERE WE LOOKED AT HOW
FREQUENTLY -- YOU KNOW,
TESTS TO DIAGNOSE INFLUENZA
WERE DONE AND PEOPLE OVER
THE AGE OF 65 BEING ADMITTED
TO HOSPITAL FOR PNEUMONIA AND THEY’RE NEVER USED
BECAUSE THEY'RE NOT CLINICALLY
INFORMATIVE.
THEY DON'TIVE GIVE YOU
INFORMATION FAST ENOUGH TO
MAKE DECISIONS.
FOR EXAMPLE IN OLDER PEOPLE
ADMITTED TO HOSPITAL WITH
PNEUMONIA, THE ASSUMPTION
IS IT'S BACTERIAL. THEY GIVE YOU ANTIBIOTICS-

Maureen says ANTIBIOTICS.

Dr. Upshur says THEY GIVE YOU A SPUTUM TEST
AND CHEST X-RAYS AND BLOOD CULTURES TO LOOK FOR
BACTERIAL SOURCES WHEN IN
FACT A SUBSTANTIAL
PROPORTION OF PNEUMONIAS ARE
VIRAL. THERE ARE SOME NEW, BUT I
WOULD SAY THEIR ACCURACY
REMAINS TO BE DETERMINED IN
CLINICAL PRACTICE, THEY'RE
CALLED RAPID DETENTION
TESTS. THESE ARE INCREASINGLY
BECOMING COMMON.

YOU SEE THEM FOR STREP
THROAT, FOR EXAMPLE, AND
THERE IS ONE FOR INFLUENZA,
THOUGH IT'S NOT WIDELY
AVAILABLE I HAVEN'T USED IT.
YOU CAN DIAGNOSE INFLUENZA
FAIRLY PRECISELY ON CLINICAL
GROUNDS. IF IT'S GOING AROUND, YOU
KNOW THE BACKGROUND, AND
THERE IS ACTUALLY A VERY
NICE STUDY DONE BY SOME DOCTORS
IN THE NETHERLANDS WHERE
THEY EVALUATE ON WHAT'S
CALLED A CLINICAL SCORE, IN
OTHER WORDS YOUR FEVER
GREATER THAN THIS, COUGH,
RUNNY NOSE, ACHES -- MOST
CASES BY INFLUENZA, YOU
FEEL LIKE YOU'VE BEEN HIT BY
A TRUCK IT’S A SEVERE ILLNESS SO YOU CAN DIAGNOSE
IT ON CLINICAL GROUNDS.

Maureen says BUT I WONDER HOW
WILL YOU KNOW IF YOU PICKED
THE RIGHT VACCINE STRAIN UNLESS YOU
DO A TEST TO SEE WHAT STRAIN PEOPLE HAVE?

Dr. Upshur says AN
IMPORTANT POINT COMES OUT OF
THAT.THERE'S AN ONGOING
SURVEILLANCE PROGRAMME FOR
INFLUENZA IN CANADA AND ACTUALLY IF
YOU HAVE INTERNET ACCESS AND
YOU'RE REALLY INTERESTED IN
INFLUENZA, WHICH I AM THERE'S A SITE
CALLED FLUWATCH.

Maureen says YEAH, I'M GOING
GET THAT ON THE HEALTHCANADA
PAGE.

Dr. UPSHUR says HEALTH CANADA AND THE CDC IN
ATLANTA AND THE WORLD HEALTH
ORGANIZATION ALL HAVE
EXCELLENT WEBSITES ON INFLUENZA IF YOU WANT MORE ADDITIONAL

INFORMATION. BUT WHAT THEY DO IS THEY
HAVE -- WHAT WE HAVE IS A
RANDOM SAMPLE OF PRACTITIONERS IN THE
COMMUNITY, AND THEY TAKE A
CERTAIN NUMBER OF PEOPLE WHO
MEET THE CRITERIA FOR
RESPIRATORY INFECTION AND
THEY DO THESE -- THEY RUN
SOME SALINE THROUGH THE NOSE
AND YOU SEND THAT OFF, OR DO
YOU A SWAB SENDS THAT OFF TO SEE.
NOW A CERTAIN NUMBER OF
ISOLETS, IT'LL SAY IT'S
INFLUENZA-A.
A CERTAIN SUBSET GO OFF TO A
MORE SPECIALIZED LAB TO FIND
OUT WHAT THE SUB-TYPE OF
INFLUENZA A.
THERE'S THREE INFLUENZA VIRUSES, A, B
AND C. ONLY A HAS DIFFERENT
SUBTYPES AND THEY TAKE A
RANDOM SAMPLE TO FIND OUT SO
WE OFTEN DON'T KNOW IF
THERE'S A MATCH BETWEEN THE
VACCINE AND THE STRAIN UNTIL
AFTER THE SEASON, THOUGH WE
HAVE PRETTY GOOD EVIDENCE
CLINICALLY BECAUSE, YOU KNOW,
PEOPLE SAY, “I WAS VACCINATED
AND I FEEL SICK.”
OR THEY GET SICK.

Maureen says ALL RIGHT, COOL.
LET'S THANK DEBORAH FOR HER
CALL AND GO TO ROGER IN
TAMWORTH.
HI ROGER.

Roger HI, HOW ARE YOU?

Maureen says GOOD, THANKS.

Roger says GOOD.
MY QUESTION CONCERNS MY
IMMUNE SYSTEM.
NO I'VE RECEIVED A FLU SHOT,
THREE IN THE LAST FOUR YEARS

AND STRANGELY ENOUGH I'VE
ONLY GOTTEN THE FLU THE YEAR
THAT I DIDN'T GET THE FLU
SHOT. I HAVE NO CONCERNS WITH MY
IMMUNE SYSTEM.
MY WIFE CERTAINLY DOES.
SHE'S FROM THE BELIEF THAT
IF WE GET FLU SHOT WE'RE
GOING TO NOT ALLOW OUR
BODIES BUILD UP IMMUNITY TO
CERTAIN STRAINS THAT WE
MIGHT OTHERS BE EXPOSED TO
AND I'M WONDERING HOW THAT
MIGHT EFFECT US WITH GETTING
THE FLU SHOT ON A REGULAR
BASIS, IF WE HAVE ANY CAUSE
FOR CONCERN.

Dr. Upshur I THINK IN GENERAL, THE
EVIDENCE BEARS OUT THERE IS
NO CAUSE FOR CONCERN.
I CERTAINLY RESPECT PEOPLE'S
VIEWS, AND IT'S A FAIRLY,
YOU KNOW, COMMON BELIEF MANY
HAVE, THAT ADMINISTERING
A VACCINE ROBS THE
DEVELOPMENT OF NATURAL IMMUNITY.
SO FAR THERE'S BEEN NO
COMPELLING EVIDENCE TO
SUGGEST THERE'S ANY
LONG-TERM IMMUNE-SUPPRESSING
EFFECTS OF VACCINATION.
YOU CAN SEE IT'S PERFECTLY
SAFE. I WOULD ACTUALLY GO FURTHER AND SAY
VACCINATION REPRESENTS
PROBABLY THE MOST EFFECTIVE
IN THE SENSE OF PREVENTING
ILLNESS, PREVENTING DEATH,
SAVING HEALTHCARE RESOURCES,
MODALITY OF HEALTHCARE THAT
WE'VE DEVELOPED.
IT DWARFES EMERGENCY WARDS.
I FIND IT'S BETTER THAN
M.R.I. SCANS.
IMMUNIZATION PREVENTS
SICKNESS AND DEATH AND TO ME
THAT'S WHAT THE AIM OF DELIVERING HEALTHCARE IS.

Maureen says THIS IS NOT A
LIVE VACCINE THAT WE GET IN
THIS SHOT, IS IT?

Dr. UPSHUR says NO.
SOME VACCINES ARE LIVE
ATTENUATED, IN OTHER WORDS
THEY'VE DONE SOMETHING TO
REDUCE THE INFECTIVITY.
FOR EXAMPLE MEASLES IS A
LIVE ATTENUATED VIRUS.
INFLUENZA IS A KILLED VIRUS
PREPARATION.
YOU CANNOT GET INFLUENZA
FROM A FLU SHOT.
IT'S NOT POSSIBLE.
YET.

Maureen says YET YOU HEAR
PEOPLE SAY I GOT MY FLU SHOT YESTERDAY
AND I FEEL --

Dr. Upshur says YOU CAN FEEL ACHY.
THE MOST COMMON SIDE EFFECTS
ARE A SORE ARM AND A
LITTLE LOCAL SWELLING AND IF
YOU LOOK AT THE CAREFULLY
DESIGNED STUDIES WHICH
LOOKED AT THE SIDE EFFECTS
OF THE INFLUENZA VACCINE
WHERE THEY RANDOMLY GAVE PEOPLE
FLU SHOT OR STERILE SALINE
INTRAMUSCULAR SHOT, THE
ONLY THING THAT WAS GREATER THAN
PLACEBO WAS SORE ARM AND
REDNESS.
SOME PEOPLE DO GET KIND OF ACHY AFTER
IT. IT'S MORE COMMON IN KIDS AND KIDS WHO
GET WHOLE CELL PREPARATION OF
THE VACCINE. CHILDREN SHOULD GET WHAT'S
CALLED A SPLIT VIRUS AND A
SPLIT VIRUS PREPARATION IS
LESS IMMUNOGENIC SO YOU
DON'T GET A FEVER AFTER IT
SO YOU FIND THE HIGHEST

NUMBER OF ACHES AND PAINS AND SPLIT VIRUS- I MEAN
WHOLE VIRUS IN YOUNGER CHILDREN
BUT IN TERMS OF -- YOU
CANNOT GET A FLU FROM THE
FLU SHOT, SORE ARM AND
REDNESS AROUND THE SITE ARE
THE MOST COMMON SIDE EFFECTS.

Maureen says I THINK TOM IN GRAND BEND
HAS QUESTIONS AROUND HOW YOU FEEL AFTER
THE FLU SHOT.
HI TOM.

Tom says HI.

Maureen says WHATS YOUR QUESTION?
WELL LAST YEAR WHEN I WAS ABOUT
16, I WAS AN ADOLESCENT, AND
LAST YEAR I GOT A SHOT AFTER
ABOUT A WEEK OF HAVING THE
FLU, AND I DON'T KNOW, I
FELT GOOD THE NEXT DAY, BUT
AFTER THAT I STARTED FEELING
LIKE EVEN WORSE FOR ABOUT
THREE WEEKS.

Maureen says YOU FELT EVEN
WORSE --

Tom says AFTER THE SHOT.
LIKE I FELT -- LIKE I HAD
THE COLD EVEN WORSE.
THE FLU EVEN WORSE.
LIKE I HAD TO STAY IN BED
AND I JUST COULDN'T DO
ANYTHING.
I WAS JUST REALLY, REALLY
SICK AFTER.

Maureen says OKAY, BUT DID
YOU HAVE THE FLU I WONDER OR
DID YOU HAVE A DIFFERENT
KIND OF UPPER RESPIRATORY
INFECTION?

Dr. Upshur says YEAH, ONE OF THE THINGS
THAT OFTEN CONFOUNDS VACCINE
SIDE EFFECTS IS THAT OTHER
THINGS ARE GOING ON IN LIFE
BESIDES THE VACCINATION.
YOU CAN GET AN IMMUNIZATION
AT THE SAME TIME AS THEY'RE
INCUBATING A VIRUS FROM SOME
OTHER CONTACT.
SO FAR AS WE KNOW, TO THE
BEST OF OUR SCIENTIFIC
KNOWLEDGE, AND THAT'S BEEN
QUITE EXTENSIVELY STUDIED,
YOU CANNOT GET THE FLU FROM
THE FLU SHOT.
NOW WE DO KNOW SOME
ADOLESCENTS WHO GET A WHOLE
CELL VACCINE PREPARATION MAY
FEEL A LITTLE BIT ROUGHER,
BUT IF I HEARD YOU CORRECTLY
YOU SAID YOU GOT THE FLU
SHOT WHEN YOU HAD THE FLU?

Tom says YEAH, ABOUT A WEEK AFTER
HAVING IT.

Maureen says YOU'RE NOT
SUPPOSED TO GET IT WHEN YOU HAVE A
FEVER, YOU WERE SAYING.

Dr. Upshur says YEAH, YOU SHOULDN'T GET
IT WHEN YOU HAVE A FEVER.
SO I MEAN, MAYBE THAT'S THAT
YOU'RE ONE OF THE PERSONS
WHO'S SENSITIVE TO A WHOLE
CELL PREPARATION BUT I THINK
WHAT'S LIKELY OR MORE LIKELY THE CASE
IS YOU HAD ANOTHER INFECTION
BREWING OR THE ORIGINAL
INFFECTION THAT YOU HAD IS WHAT
PROLONGED YOUR FEELING UNWELL.

Maureen says NOW THAT HE'S 17
WOULD HE GET THE WHOLE
CELL --

Dr. Upshur says HE SHOULD BE SAFE FOR THE WHOLE CELL ITS USUALLY
RECOMMENDED FOR OVER- SPLIT CELL IS RECOMMENDED FOR LESS THAN 13
YEARS OLD.

Maureen says OKAY, ALL RIGHT.
GOOD LUCK, TOM, THANKS.
JULIE IN BELL RIVER SAYS I'M
A STAY AT HOME MOTHER OF
THREE, AGES FIVE, FOUR AND
TWO. MY HUSBAND WORKS IN AN
OFFICE AND MY TWO OLDEST
BOYS ARE IN J.K. AND S.K.
THE FLU HIT US PRETTY HARD
LAST CHRISTMAS AND I'D LIKE
TO AVOID THAT THIS YEAR.
WOULD ALL FIVE OF US NEED
THE VACCINATION OR JUST MY
J.K. AND S.K. KIDS AS THEY
ARE THE CULPRITS WHO BRING
THE BUG HOME. ALSO IS IT TRUE THAT
SENIORS AND CHILDREN WILL BE
THE FIRST TO RECEIVE THE
VACCINES AND THEN THE REST OF
US?

Dr. Upshur says WITH
RESPECT TO THE LATTER I THINK IT
VARIES DEPENDING ON YOUR
LOCAL JURISDICTION.
YOU KNOW AT SUNNYBROOK WE'RE
RUNNING FLU CLINICS FOR
SENIORS IN OCTOBER AND FOR
EVERYBODY ELSE IN
NOVEMBER. SO, I MEAN, THE BEST THING
TO DO WOULD BE TO CONTACT
YOUR LOCAL PHYSICIAN'S
OFFICE OR WHO EVER IS GIVING
OUT THE VACCINATIONS AND
FIND OUT WHAT THE SCHEDULE
IS.
WITH RESPECT TO WHETHER YOU

SHOULD ALL OR SOME, I MEAN,
AGAIN, YOUR BEST BET AT
REDUCING YOUR CHANCE OF
GETTING FLU AT ALL IS TO
HAVE A FLU SHOT.
IT'S MOST EFFECTIVE.
I MEAN IN HEALTHY ADULTS AND
NOW THIS YEAR IT'S FREELY
AVAILABLE SO, THE COST IS
FOR YOU TO GO AND GET THE
SHOT AT THE TIME IT TAKES.
AND IT'S THE SAME THING FOR
THE CHILDREN.
IT'S SAFE IN CHILDREN.
A THEY'LL GET A SPLIT DOSE.
SOMETIMES FOR KIDS FOR YOUNGER KIDS,
THEY NEED TO SEPARATE THE
DOSE IF THEY'RE LESS THAN
SIX, THEY NEED ONE AND THEN
THEY NEED ANOTHER ONE FOUR
WEEKS DOWN THE LINE.

Maureen says OH NO!
I MEAN THEY'RE ALREADY GOING
TO BE SCREAMING AT THE SITE
OF THE -- SIGHT OF THE
NEEDLE.

Dr. Upshur says BUT YOU KNOW WHAT?
IN MY EXPERIENCE KIDS
REALLY -- YOU KNOW, YOU GO
AT THEM AND THEY START TO --
THE LITTLER ONES, USUALLY
AROUND 18 MONTHS ARE THE
ONES THAT PUT UP THE BIGGEST
FUSS. BUT YOU KNOW, AFTER THREE OR
FOUR THEY GET QUITE PROUD OF
THEMSELVES BECAUSE IT REALLY
DOESN'T HURT.
THESE ARE -- IT'S NOT LIKE
HORRIBLE NEEDLES WE GOT WHEN
WE WERE KIDS THAT WERE
JAGGED AND THINGS.
THEY'RE PRECISION MADE.
I MEAN FOR EXAMPLE A COUPLE OF YEARS BACK WHEN

WE WERE DOING THE MEASLES
CAMPAIGN, SECOND-DOSE
MEASLES CAMPAIGN, I MUST
HAVE GIVEN 1200 MEASLES
SHOT. AND KIDS WERE OH, THAT
DOESN'T HURT AT ALL.
AND WE DO THEM WITH THE LITTLE KINDERGARTEN ONES
WOULD COME BRAVELY WITH
THEIR TEDDY BEARS AND THEY WOULD SIT UP -- YOU
KNOW, IF YOU DON'T MAKE A
BIG DEAL OUT OF IT THEY'LL
BE FINE. THEY DON'T SCREAM, IT
DOESN'T HURT AND EVERYTHING
WORKS OUT OKAY.

Maureen says OKAY, NOW WHY
ARE YOU AT SUNNYBROOK VACCINATING
THE SENIORS FIRST AND
THEN EVERYBODY ELSE?

Dr. Upshur says I THINK IT'S JUST MOSTLY
BECAUSE YOU WANT TO -- THE
THING ABOUT INFLUENZA IS YOU
CAN'T PREDICT WHEN IT'S
GOING TO COME.
YOU WANT TO PROTECT, MAKE
SURE THOSE WHO ARE MOST AT
RISKS ARE DONE FIRST.
AND I THINK IT WAS MORE JUST
TIMING AND LOGISTICS MORE
THAN ANYTHING ELSE.

Maureen says WE'RE NOT GOING TO RUN
OUT OF VACCINE.

Dr. Upshur says NOPE, NOT IN ONTARIO
THERE IS SOME PROBLEMS IN THE
UNITED STATES, BUT I DON'T
THINK WE HAVE THAT PROBLEM
IN ONTARIO.

Maureen says OKAY.
ALL RIGHT, WE'LL GO TO
BEVERLY IN TORONTO.
HELLO, BEVERLY.

Beverly says HI.

Maureen says HI.

Beverly says IS THERE AN
ALTERNATIVE TO THE FLU
VACCINE IF YOU ARE ALLERGIC
TO EGGS?
I GET VERY SICK EVERY YEAR
WITH THE FLU AND I'M LOOKING
FOR AN ALTERNATIVE.

Dr. Upshur says HOW ALLERGIC TO EGGS ARE
YOU?

Beverly says FOUR ON THE SCALE, WHICH
IS HIGH.

Dr. Upshur says OKAY.
PROBABLY -- I THINK THERE
ARE SOME, AND I MIGHT BE
OVER-STEPPING MY EXPERTISE
HERE, I WOULD TALK TO YOUR
PHYSICIAN AND HAVE THEM TALK
TO AN ALLERGIST BECAUSE
THERE MAY BE A
DESENSITIZEATION PROCESS
THAT COULD BE CONSIDERED.

Maureen says HOW DOES THAT
SGHORK.

Dr. Upshur says WELL,
JUST LIKE FOR EXAMPLE IF
PEOPLE HAVE ALLERGIES TO
PENICILLIN OR SOME OTHER
DRUG THAT MIGHT BE
POTENTIALLY LIFE SAVING
THERE IS A WAY THAT
ALLERGISTS HAVE AND
IMMUNOLOGISTS AND
SPECIALISTS HAVE OF
ADMINISTERING SMALL BUT
INCREASING DOSES TO WORK ON
REVERSING THE ALLERGY.
AS I SAY, I'M PROBABLY
SPEAKING OUTSIDE MY
EXPERTISE HERE, BUT IF
YOU'RE WORRIED ABOUT THE FLU

AND YOU GET THE FLU,
BADLY IT'S AN AVENUE
WORTH PURSUING.

Maureen says WHAT ABOUT THE
FLU DRUGS THAT WE HEARD SO
MUCH ABOUT LAST YEAR?

Dr. Upshur says WHAT
ABOUT THEM?

Maureen says YOU'RE NOT AS
KEEN ON THEM ANYMORE?

Dr. Upshur says I NEVER WAS.
I MEAN, FIRST OFF, I MEAN,
TO -- IN TERMS OF MOLECULAR
BIOLOGY AND CHEMICAL
ENGINEERING, THEY'RE
WONDEROUS THINGS.
THEY REALLY ARE A MARVEL OF,
YOU KNOW, BIOLOGICAL
MEDICINE.
THAT BEING SAID, IF YOU LOOK
AT THE STUDIES, THE BENEFITS
THAT THEY PROMISE ARE
MODEST, AND THE WINDOW OF
OPPORTUNITY FOR YOU TO GET
THOSE BENEFITS IS VERY
SMALL. NOW, ONE THING YOU SHOULD
KNOW IS THAT YOU SHOULD HAVE
A CONFIRMATION OF INFLUENZA
A OR INFLUENZA INFECTION
BEFORE YOU TAKE IT.
WHICH MEANS YOU HAVE TO GET
IN THERE WITHIN 24 TO 28
HOURS AND I CAN ASSURE YOU
IF YOU HAVE ACCUTE INFLUENZA
THE LAST PLACE YOU
WANT TO BE IS SITTING IN A
DOCTOR'S OFFICE IS WAITING TO
SEE THE DOCTOR TO HAVE THE TEST
TO GET THE PRESCRIPTION.
SECONDLY IT'S THE SECOND WORST
PLACE YOU SHOULD BE BECAUSE
YOU'LL BE TRANSMITTING THE
VIRUS TO EVERYBODY THAT YOU

SEE.YOU SHOULD AT BE AT HOME, IN
BED, REST, TAKING TYLENOL,
DRINKING PLENTY OF FLUIDS.
THE DRUGS CAN SHOW -- I
THINK THIS IS RALENZA AND
TAMIFLU, WHAT THEY SHOW IS AABOUT A 24 HOUR REDUCTION IN
SYMPTOMS IF TAKEN WITHIN THAT SMALL
WINDOW.THAT BEING SAID YOU DON’T HAVE A CHOICE ON WHAT DAY IT IS.
YOU’RE GOING TO BE SICK, FIRST OFF, YOU'RE GOING TO
BE SICK, SECOND YOU'RE GOING
TO BE SICK FOR FIVE OR SIX
DAYS ANYWAYS.
IT'S A BIT OF A VALUE CHOICE
OF WEATHER YOU WANT THAT ONE
DAY LESS, BECAUSE YOU CAN'T
REALLY ANTICIPATE WHETHER
YOU'RE THE ONE THAT'S GOING
TO GET IT, AND NOT EVERYBODY
GETS IT BECAUSE IT'S NOT
100 PERCENTAVE EFFECTIVE MEDICATION.
AND FINALLY, YOU KNOW, I
WOULD RECOMMEND IF YOUR
INTERESTED IN NOT GETTING
SICK, GET THE FLU SHOT AND
KEEP YOURSELF WELL.

Maureen says IT'S LESS
EXPENSIVE, TOO, I THINK.

Dr. Upshur says ITS LESS EXPENSIVE TOO YEA THERE'S
ALSO SOME CONCERNS ABOUT THE
SIDE EFFECTS OF THE DRUGS AND THOSE HAVE BEEN
FOR EXAMPLE IN THIS WEEK'S
CANADIAN MEDICAL ASSOCIATION
JOURNAL THERE WAS SOME
WARNINGS WITH BOTH OF THE
DRUGS THAT HAVE HAD SOME
ADVERSE EFFECTS.
THEY'RE NEW IN THE GAME.
I THINK THEY WILL HAVE AN
IMPORTANT ROLE FOR EXAMPLE
IN PROPHALAXIS, WE DON'T
KNOW YET, THE STUDIES REMAIN TO BE DONE AND IN CONTROLLING
OUT BREAKS IN NURSING HOMES,
IT WILL PROBABLY BE AN ADVANCE OVER THE
CURRENT DRUGS, WHICH IS AMANTADINE OR RIMANTADINE, AND THEY
MIGHT BE USEFUL THERE BUT I
THINK FOR THE GENERAL PUBLIC,
FOR HEALTHY PEOPLE, I'M LESS INCLINED TO RECOMMEND THEM.

Maureen says OKAY.
BRENDA IS IN LISTOWELL.
HI BRENDA?

Brenda says HI.

Maureen says HI.

Brenda says I WAS CALLING, I
HAVE A FRIEND THAT HAS AN
EATING DISORDER.
WOULD IT BE ADVISABLE FOR
HER TO TAKE THE FLU SHOT?

Dr. Upshur says ITS
ADVISABLE FOR ANYBODY TO
TAKE THE FLU SHOT WHO'S
INTERESTED IN PREVENTING OR
MAXIMIZING THEIR CHANCE OF
PREVENTING THEMSELVES FROM
GETTING INFLUENZA.
I MEAN, THE EATING DISORDER
DOESN'T MAKE HER -- WELL IT
MAY MAKE HER, DEPENDING ON
HOW SERIOUS IT IS, IF HER
IMMUNE SYSTEM IS IN SOME WAY
IMPAIRED OR SHE'S AT RISK
FOR INFECTION BUT IT'S
NEITHER HERE NOR THERE.
EVERYONE CAN PROFIT FROM A
FLU SHOT IF THEY WISH TO
MAXIMIZE THEIR CHANCES OF
NOT GETTING THE FLU.

Maureen says ONCE AGAIN, THE
ONLY PEOPLE, AS YOU SAID,
WHO SHOULDN'T GET IT ARE
PEOPLE WITH AN ALLERGY TO
EGGS AND WHAT WAS THE OTHER
ONE?

Maureen says SOME OF THE PRESERVITIVES
WHICH ARE INCREDIBLY RARE.

Maureen says RIGHT THIS PERSON,
BY E-MAIL, JIM, IN DETROIT SAYS HE'S 50’S YEAR OLD AND IN
GOOD HEALTH BUT HE'S ALWAYS AVOIDED
FLU SHOTS BECAUSE HE HAS
ALLERGIES TO PENICILLIN, MYOSIN DRUGS, KEFLEX DRUGS ETC
ALTHOUGH HE’S NOT ALLERGIC TO EGGS.
WOULD IT BE OKAY FOR HIM TO
HAVE A FLU SHOT?

Dr. Upshur says YES.

Maureen says NONE OF THOSE THINGS ARE IN THE FLU SHOT?

Dr. Upshur says I DON’T THINK SO. I MEAN, IF THERE'S ANY
CONCERN HE SIMPLY HAS HIS
HEALTHCARE PROVIDER, HIS NURSE,
OR HIS DOCTOR, TAKE OUT THE PACKAGE
INSERT AND GO THROUGH THE
FINE PRINT TO LOOK AT SOME
OF THE OTHER SMALL TRACE
ELEMENTS THAT MIGHT BE IN
THERE.

Maureen says YOU SAY YOU'RE
WORKING ON THE FLU WATCH
PROGRAMME AND LOOKING AT THE
NEXT PANDEMIC.
FROM YOUR RESEARCH INTO THAT,
IS THIS INEVITABLE, OR ARE
WE -- YOU KNOW SO, ON TOP OF
THINGS MEDICALLY THESE DAYS
THAT WE CAN HEAD THIS OFF AT THE
PASS?

Dr. Upshur says, I
THINK IT IS INEVITABLE.
THERE WAS ACTUALLY AN
INTERESTING -- I WAS
ACTUALLY JUST REFRESHING MY
MEMORY LAST NIGHT ON SOME OF
THE FINER POINTS OF
INFLUENZA-OLOGY.
THERE WAS A VIROLOGIST IN
THE STATES, A VERY
IMMINENT VIROLIGIST NAMED
ROBERT WEBSTER WHO POINTED
OUT THAT INFLUENZA IS THE
HUMBLING VIRUS AND IT ALWAYS
MAKES US SEEM WRONG IS IT
INEVITABLE?
I THINK THE ANSWER IS YES.
IF YOU LOOK AT THE
HISTORICAL RECORD AS FAR
BACK AS WE HAVE, THERE'S
BEEN INFLUENZA PANDEMICS.
THEY'VE EXERTED ACTUALLY
QUITE A PROFOUND INFLUENCE
ON THE COURSE OF HUMAN
HISTORY. I MEAN, THOSE OF US WHO CAN
REMEMBER -- WELL I CAN'T,
BUT BACK TO 1918, 1919, WILL
REMEMBER THAT INFLUENZA-A
KILLED MORE PEOPLE
IMMEDIATELY AFTER WORLD WAR
I THAN WERE KILLED IN WORLD
WAR I.CONSERVATIVE ESTIMATES?
20 MILLION PEOPLE WORLDWIDE
IN SIX MONTHS, PROBABLY MORE
LIKE 60 TO 80, BECAUSE THE
DEATH RECORDS WERE NOT KEPT
ACCURATELY IN SOME OF THE
OTHER COUNTRIES.
IT'S -- AND SO 1918 THERE
WAS A REASSORTMENT AND
THERE'S BEEN MINOR CHANGES.
1958 AND 1968, I THINK, WERE
THE LAST COMPLETE CHANGES.
SO IT HAPPENS ON A FAIRLY
REGULAR BUT UNPREDICTABLE
OCCASIONS.
AND SOME OF THE MOST ASTUTE
AND KNOWLEDGEABLE PEOPLE
ABOUT INFLUENZA BELIEVE THAT
WE'RE OVERDUE.

Maureen says WHAT ARE THE
PLANS THAT HEALTH CANADA HAS
IF THAT SHOULD HAPPEN?
WOULD SOME KIND OF
QUARANTINE DIRECTIVE GO INTO
EFFECT?

Dr. Upshur says WELL, I
MEAN QUARANTINE IS PROBABLY
THE MOST DRAMATIC PUBLIC
HEALTH -- IT HAS NOT BEEN
USED FOR A LONG TIME.

I THINK PLANNING AND
PREVENTION AND BEING
PREPARED, PREPAREDNESS IS
THE IMPORTANT WATCH WORD,
AND THAT'S WHAT IS GOING ON
HERE. THE WORLD HEALTH
ORGANIZATION'S FLU
SURVEILLANCE PROGRAMME WILL
GIVE YOU SOME EARLY
INDICATIONS OF WHAT'S GOING
ON, WHICH HOPEFULLY WILL
ALLOW FOR THE PRODUCTION OF
VACCINE TO PREPARE.
THERE'LL BE COMMUNICATIONS
AND PREPARATIONS WITH THE COORDINATED
THROUGH ALL THE -- HEALTH
CANADA, ALL THE MINISTRY --
MINISTRIES OF HEALTH IN
CANADA, AND DOWN TO THE
LOCAL MUNICIPAL LEVEL TO,
YOU KNOW, HOSPITALS.
AND IT'S AN INTERNATIONAL
COLLABORATION.
CANADA'S NOT THE ONLY JURISDICTION
INVOLVED IN PANDEMIC
FLU PLANNING.
THE WORLD HEALTH
ORGANIZATION HAS SET OUT A
FRAMEWORK.
GREAT BRITAIN, THE UNITED
STATES, AUSTRALIA, MANY
PLACES HAVE BEEN INVOLVED IN
THIS.
I THINK IT'S THE RIGHT THING
TO DO. WE NEED TO BE PREPARED IN
ADVANCE.

Maureen says MHMM ALL RIGHT.
Dr. ROSS UPSHUR IS A FAMILY
PHYSICIAN AT WOMEN'S COLLEGE
AND HEALTH -- SUNNYBROOK AND
WOMEN'S COLLEGE HEALTH
SCIENCES CENTRE IN TORONTO.
TAKING YOUR QUESTIONS TODAY
MOSTLY ABOUT THE FLU BUT AS
A FAMILY PHYSICIAN HE CAN
CERTAINLY TALK TO OTHER

FAMILY HEALTH PROBLEMS AS WELL.
SO GIVE US A CALL IN TORONTO DIAL 416-484-2727. IF IT’S LONG DISTANCE
CALL US 1-888-411-1234. AND THE e-mail ADDRESS moretolife@tvo.org.
AND SANDY IS IN
OTTAWA.
HI SANDY.

Sandy says HI.
I GOT THE FLU SHOT FOR THE
FIRST TIME AT THE BEGINNING
OF THE MONTH, AND THE NEXT
DAY MY SISTER TELLS ME THAT
IT WAS ONLY EFFECTIVE FOR
THREE MONTHS.
IF THAT'S TRUE, AM I ABLE TO
GET A SECOND SHOT IN JANUARY?

Dr. Upshur says IT'S NOT
NECESSARILY TRUE THAT IT'S
ONLY -- I MEAN, IF YOU'RE IN
GOOD HEALTH, THE PROTECTION
SHOULD LAST FOR LONGER THAN
THREE MONTHS.
WHAT THE CONCERN IS THAT IN
SOME PEOPLE THE IMMUNITY
WILL WANE. THREE MONTHS?
POSSIBLY. BUT I MEAN IF YOU'RE IN
OTHERWISE GOOD HEALTH YOU
SHOULD HAVE MORE THAN THREE
MONTHS' PROTECTION.
THE THING IS THAT THE
IMMUNITY TO THE FLU SHOT IS
NOT LIKE SAY IMMUNITY TO SAY A
MEASLES SHOT OR POLIO SHOT
WHICH IS ALMOST LIFE LONG
IMMUNITY. YOU NEED- BECAUSE THE INFLUENZA VIRUS
IS SO SUCCESSFUL AT CHANGING
ITS SHAPE, IT'S LIKE
SOMETHING OUT OF “STAR
TREK.” IT'S A SHAPE SHIFTER, THAT
YOU NEED TO GET YOUR, GET IT
DONE ON AN ANNUAL BASIS.

Maureen says DID SHE GO TO
EARLY WOULD YOU
RECOMMEND PEOPLE WAIT?

Dr. Upshur says NO, ANY
TIME AT THE BEGINNING OF
OCTOBER, THAT'S WHEN WE
RECOMMEND.

Maureen says OKAY.

Dr. Upshur says AND UNTIL WE HAVE ANY REASON
TO SUGGEST THAT THE IMMUNITY
IS WANNING AND PEOPLE WHO
WERE PREVIOUSLY IMMUNIZED
ARE BECOMING ILL, THEN WE
WOULDN'T RECOMMEND A SECOND SHOT.
THE OTHER THING TO REMEMBER
IS THAT FLU SEASON'S ALREADY
COME AND GONE IN THE
SOUTHERN HEMISPHERE IN
AUSTRALIA. AND OFTEN WE GET OUR
SURVEILLANCE OR IDEAS OF WHAT
THE FLU SEASON'S GOING TO BE
LIKE BY SEEING WHAT'S
HAPPENING IN OTHER
LOCATIONS. SO THE INTERESTING THING
ABOUT INFLUENZA IS THAT ITS
OCCURRENCE IS FAIRLY
SEASONAL IN THE NORTHERN AND
SOUTHERN HEMISPHERES, WHERE
AS IT'S CONSTANT IN THE
TROPICS.

Maureen says I SEE.
NOW YOU SAID EARLIER TO A
CALLER, TO YOUR KNOWLEDGE NO
INFLUENZA HAD BEEN REPORTED
YET IN CANADA THIS YEAR.
BUT IF WE'RE STAYING HOME
AND DRINKING THE FLUIDS AND
NURSING OURSELVES HOW WOULD
YOU GUYS KNOW?

Dr. Upshur says BECAUSE
IF YOU LOOK AT THE
EPIDEMIOLOGY OR PATTERNS HAVE
INFLUENZA, IT'S FAIRLY
DRAMATIC WHEN IT HITS.

Maureen says SO SOMEONE WOULD
END UP IN AN EMERGENCY ROOM.

Dr. Upshur says YEAH,
USUALLY YOU START TO SEE A
FEW LITTLE CASES AND THEN
BOOM!
SO THERE MIGHT BE A FEW.
IF THERE IS, A HARBINGER'S
OUT THERE BUT I HAVEN'T SEEN
ANY EVIDENCE OF INFLUENZA
CLINICALLY.

Maureen says BY THIS TIME
LAST YEAR THOUGH, WE HAD
ALREADY --

Dr. Upshur says OCTOBER, I CAN'T
RECALL OFF HAND.

Maureen says WASN'T THAT THE
BIG DEAL?
IT WAS EARLY LAST YEAR.

Dr. Upshur says NO, LAST
YEAR IT PEAKED RIGHT AT
CHRISTMAS TIME.
SO THE OTHER THING IS
THERE'S CONSIDERABLE
GEOGRAPHIC VARIATION IT
DOESN'T OCCUR AT THE SAME
PLACE ALL OVER ONTARIO,
IT'LL START HERE AND IT’LL START THERE
AND COME IN AND VARIES
FROM YEAR TO YEAR.
A VERY INTERESTING WEBSITE
MAINTAINED IN FRANCE CALLED
SANTIWEB WHERE YOU CAN GO ON
AND INTERACTIVELY MAKE A MAP
OF THE OUTBREAKS OF
INFLUENZA AND YOU'LL SEE
FROM YEAR TO YEAR IT STARTS
IN LEON ONE YEAR, PARIS THE
NEXT YEAR, GETS VERY INTENSE
AND THEN MOVES OUT.
SO IT'S A FASCINATING VIRUS.

Maureen says OKAY WE WILL GO TO JOAN IN
TORONTO NEXT.
HELLO JOAN?

Joan says HELLO.

Maureen says HI.

Joan says HI.
I HAD A QUESTION ABOUT
CONTRAINDICATIONS IF
YOU'RE ON MEDICATIONS FOR
OTHER TYPES OF CONDITIONS.
JUST AS A BIT OF BACKGROUND,
I'M 56 YEARS OLD, I'M IN
PRETTY GOOD HEALTH.
I DON'T BELIEVE I'VE HAD AN
ACTUAL FLU FOR MANY YEARS,
AND I'VE NEVER HAD A FLU
SHOT. BUT I'M TAKING H.R.T., AND
SINCE THE BEGINNING THIS
YEAR I'VE BEEN TAKING
ATENELOL FOR HYPERTENSION
AND I TAKE CELEBREX
SOMETIMES, NOT EVERYDAY, FOR
OSTEO ARTHRITIS.
SO I WONDERED IF THERE WOULD
BE ANY CONTRA INDICATIONS.

Dr. Upshur says NONE WHATSOEVER.
MOST OF OUR RECOMMENDATIONS
UP UNTIL THIS YEAR WAS TO
IMMUNIZE THE ELDERLY, MANY
OF WHOM ARE ON MANY
MEDICATIONS SO FAR AS WE
KNOW, THERE IS NO
INTERACTION BETWEEN
INFLUENZA VACCINE AND ANY
MEDICATIONS.

Maureen says NO MEDICATIONS
AT ALL?

Dr. Upshur says NONE.

Maureen says OKAY.
WE TALKED A BIT ABOUT THE
EMERGENCY ROOM.
THIS IS WHAT THE GOVERNMENT
IS HOPING TO AVOID BY
OFFERING THE VACCINE TO
EVERYONE.
DO YOU THINK THIS IS GOING
TO HAVE AN IMPACT AT THE
LEVEL OF THE EMERGENCY ROOM?

Dr. Upshur says UM, I
THINK IT MIGHT.
AND I SAY -- IT'S HIGHLY
CONTINGENT UPON THE SEVERITY OF
THE INFLUENZA SEASON, THE
MATCH STRAIN, AND THE DEGREE
TO WHICH PEOPLE TAKE UP THE
VACCINATION PROGRAMME.
VACCINATIONS WORK BEST WHEN
YOU HAVE WHAT'S CALLED HERD
IMMUNITY THAT IS THE MORE
PEOPLE THAT ARE IMMUNIZED,
FOR EXAMPLE THE LESS THERE
ARE SUSCEPTIBLE TO THE
ILLNESS, THE LESS OF A POOL
OF PEOPLE THERE IS FOR THE
VIRUS TO COME IN AND SPREAD.
THAT'S THE THEORY UPON WHICH
CHILDHOOD IMMUNIZATION
PROGRAMMES ARE BASED.
IN OTHER WORDS IF YOU GET
YOUR IMMUNIZATION COVERAGE
UP HIGH, THERE'S NOWHERE FOR
THE BUG TO GO.
THAT BEING SAID, I THINK IT
WOULD BE PRUDENT NOT TO PUT
TOO MUCH ON THE FIRST YEAR
OF THE CAMPAIGN.
INFLUENZA IS A VERY TRICKY
VIRUS.
AND WE NEED TO LOOK FIVE,
TEN YEARS AT THE SAME
PROGRAMME.
SO I WOULD STRONGLY
RECOMMEND TO THOSE HIGHER
ABOVE ME THAT THEY STAY THE
COURSE WITH THIS PROGRAMME,
BECAUSE YOU MAY NOT
NECESSARILY SEE DRAMATIC
IMPACT IN ONE YEAR.
YOU MIGHT SEE IT OVER A
PERIOD OF TIME.
THE THING THAT BOLSTERS THAT
ARGUMENT IS THE JAPANESE
EXPERIENCE WHICH SAW TOTAL
MORTALITY RISE IN INFLUENZA
SEASONS AFTER THEY LOOSENED,
OR RELEASED THEIR PROGRAMME
BEING OR STOPPED THEIR
PROGRAMME.
IF YOU LOOK AT WHAT THE KIND
OF WORK I DO, WHICH IS
CALLED TIME SERIES ANALYSIS
OF MY STUDY, WE'RE LOOKING
AT THE PRECISE RELATIONSHIP
BETWEEN THE CIRCULATION OF
INFLUENZA VIRUS AND THE
INCREASE IN ADMISSIONS IN
THE ELDERLY IN PARTICULAR
FOR PNEUMONIA OR
EXACERBATIONS OF CHRONIC
LUNG DISEASE OR HEARTFAILURE, THEY'RE VERY
TIGHTLY CORRELATED AND SINCE
THEY'RE VERY DRAMATIC AND
SERIOUS ILLNESSES, THEY TEND
TO DIRECT PEOPLE TO THE
EMERGENCY DEPARTMENT.
I KNOW THERE IS SOME STUDIES
BEING DONE, THERE WERE SOME STUDIES
DONE IN MANITOBA THAT SHOWED
THAT THE CHIEF CAUSE OF
EMERGENCY ROOM CROWDING IN
THE WINTER WAS INFLUENZA
CIRCULATION.
THERE'S BEEN OTHER STUDIES,
FOR EXAMPLE IN ENGLAND,
WHICH QUESTION THAT.
SO IT REMAINS -- IT'S NOT --
NOT EVERYBODY BELIEVES IT'S
THE CHIEF REASON FOR THE
CROWDING OF EMERGENCY ROOMS.
I WILL SAY THAT I BELIEVE
IT'S A STRONGLY IMPORTANT
REASON, AND THAT A BAD
INFLUENZA SEASON IS ONE OF
THE MOST IMPORTANT
DETERMINENANTS OF THE NEED
TO SEEK HEALTHCARE, OR YOU
KNOW, RUNS ON THE HEALTHCARE
SYSTEM.
Maureen says BUT RATHER THAN
GO TO EMERGE -- AND BE THEN
THERE'S THAT BASIC QUESTION.
AT WHAT POINT DO YOU SAY “MY
CHILD IS SICK, THE FEVER'S
HIGH, I'M TAKING HER IN?”

Dr. Upshur says WELL, I
COMPLETELY UNDERSTAND THE
DESIRE OF PEOPLE TO SEEK
HEALTHCARE ATTENTION WHEN
THEY GET INFLUENZE.
YOU FEEL DREADFUL.
EVERYBODY WILL SAY, “I'VE
NEVER FELT THIS SICK BEFORE
AND IT'S HARD TO BELIEVE YOU
CAN GO FROM FEELING
PERFECTLY WELL TO PROSTATE.
AND THEY TALK ABOUT
PROSTRATION AND MALLAISE
WHICH ARE CARDINAL FEATURES OF INFLUENZA
WHICH DISTINGUISH IT FROM YOUR REGULAR RHINOVIRUS
WHICH CAUSE THE COMMON COLD.
YOU FEEL ILL.
YOU FEEL LIKE YOU HAVE BEEN RUN OVER,
YOU'RE KNOCKED OUT AND AFTER
24 OR 48 HOURS OF THIS, MOST
PEOPLE ARE KIND OF TIRED OF
IT AND EITHER THINK THAT
THEY'VE HAD SOME SORT OF
BACTERIAL COMPLICATION,
BECAUSE NO VIRUS CAN MAKE
YOU FEEL THIS SICK.
BELIEVE ME, VIRUSES CAN MAKE
YOU FEEL VERY SICK INDEED.
SHOULD YOU RUN TO THE
EMERGENCY DEPARTMENT?
I DON'T KNOW. IT'S HARD FOR ME TO SAY.
I WOULD SAY IF YOU KNOW IT'S
GOING AROUND, YOU SHOULD AT
LEAST YOU KNOW MAKE PHONE CONTACT FOR
ADVICE. GET YOUR FEVER DOWN. TAKE SOME ACETIMITOPHEN IN
PREFERENCE TO ASPIRIN OR ADVIL PARTICULARLY FOR CHILDREN, AND MAKE SURE YOU
TAKE THE APPROPRIATE AMOUNT OF ACETIMITOPHEN
FOR YOUR BODY WEIGHT, OR
TYLENOL, AS IT'S CALLED.
LOTS AND LOTS OF FLUIDS.

DRINK DRINK DRINK DRINK
DRINK BECAUSE YOUR
FEVER IS HIGH, THERE'S MANY
DEMANDS ON YOUR METABOLISM,
AND YOU'VE GOT A FEVER AND
YOU'RE PERSPIRING, SO YOU NEED TO
REPLACE FLUIDS SO YOU DON'T
BECOME DEHYDRATED.
REST. IF I COULD ONLY EVERYBODY ALWAYS COMES IN
AND I SAY YOU NEED TO REST.
I CAN'T REST, I'VE GOT TO GO
TO WORK. WELL TWO THING, YOU DON'T BELONG
AT WORK BECAUSE ALL YOU'RE
GOING DO IS SHARE YOUR
WEALTH OF VIRUSES WITH YOUR
CO-WORKERS AND YOU'RE NOT
GOING TO BE A VERY
PRODUCTIVE EMPLOYEE SO
IF YOU GET THE INFLUENZA OR ANY
SERIOUS VIRUSES AND YOU
FEEL UNWELL AND YOUR SORT OF RUNNING AND
SNEEZING OR COUGHING OR SOMEHOW
EXCRETING VIRUSES, STAY HOME
STAY IN BED, TAKE TYLENOL
RELIGIOUSLY BY THE CLOCK, THOSE ARE EVERY FOUR HOURS AND DRINK
PLENTY OF FLUIDS. YOU WILL START TO FEEL
BETTER IN THREE TO FIVE DAYS
THOUGH THE COUGH CAN LAST UP
TO TWO TO THREE WEEKS.
IF THERE'S ANYTHING THAT'S --
PARTICULARLY FOR CHILDREN,
IF THE FEVER'S VERY HIGH,
THE CHILD IS LOOKING
LETHARGIC, THEY'RE UNWELL,
OR YOU'RE FRIGHTENED IN ANYWAY AND NEED ADVICE, THAT'S
WHAT WE'RE HERE FOR AS
HEALTHCARE PROVIDERS, YOU
KNOW, THAT'S OUR JOB.

Maureen says OKAY ALL RIGHT LET'S GO TO
MICHAEL IN PETERBOROUGH
NEXT.
HI MICHAEL.

Michael says HELLO.
I MUST ADMIT I'M QUITE
DISAPPOINTED WHEN I HEAR
DOCTORS PUSHING MEDICATION
LIKE VACCINES INSTEAD OF
PUSHING, YOU KNOW, FRESH
FOODS, FRESH FRUITS AND
VEGETABLES, EXERCISE, ALL OF
THE THINGS THAT, YOU KNOW,
THAT ONE NORMALLY USES TO
BOOST YOUR IMMUNE SYSTEM.
I NEVER GET SICK.
I HAVEN'T BEEN SICK IN FIVE YEARS.
I EAT RAW FOODS ONLY, BUT,
YOU KNOW, HEARING Dr. ROSS
TALK ABOUT VACCINATIONS AS
BEING THE MOST ECONOMICALLY
BENEFICIAL APPROACH --

Dr. Upshur says NO,
THAT'S NOT WHAT I SAID.

Michael says IT'S REALLY, YOU
KNOW, A GOOD DIET AND A GOOD
LIFESTYLE THAT GIVES, YOU
KNOW, THE GREATEST CHANCE OF
BEING WELL.

Maureen says I DON'T KNOW IF
YOU TUNED IN OFF THE TOP OF
THE SHOW.

Dr. Upshur says YEAH,
YOU MUSTN'T HAVE HEARD WHAT I SAID. RIGHT FROM
THE BEGINNING.
I SAID TO MAXIMIZE YOUR CHANCE
OF NOT GETTING ILL TO
PRACTICE THE BEST HEALTH
HABITS POSSIBLE SO I DON'T
THINK WE'RE IN DISAGREEMENT
HERE AT ALL.

Maureen says BUT CAN EATING
FRESH FRUITS AND VEGETABLES
PREVENT ME FROM GETTING THE
FLU IF IT'S GOING AROUND.

Dr. ROSS UPSHUR says THAT IN
AND OF ITSELF WON'T.
AS I SAID THE OTHER
IMPORTANT THING IS HAND
WASHING, HAND WASHING IS
PROBABLY MORE IMPORTANT THAN
FRESH FRUIT AND VEGETABLESES
ALTHOUGH A GOOD DIET LOTS OF EXCERCISE, ALL
THOSE THINGS YOU SAID I
COMPLETELY AGREE WITH, ARE
GOING TO MAXIMIZE YOUR
CHANCES OF BEING HEALTHY AND IN FACT
YOU MIGHT HAVE AN IMMUNE
SYSTEM THAT MIGHT BE ABLE TO
FEND OFF A SUB CLINICAL OR
MILD ILLNESS THAT BEING SAID
ALMOST ALL OF US, YOU SAY
YOU'VE NEVER BEEN SICK BUT
MOST OF US HAD
INFLUENZA AT ONE TIME IN OUR
LIFE. THE PROOF IS IF YOU TAKE A LOOK AT
YOUR SIROLOGY THERE'S A
TRACE OF WHICH YOUR ANTIBODIES OF
VIRUSES YOU'VE COME IN
CONTACT WITH YOUR LIFE. SO I AGREE WITH WHAT YOU SAY
I'M NOT PUSHING IMMUNIZATION
OVER AND ABOVE GOOD HEALTH
HABITS.

Maureen says MICHAEL, IS IT
THAT YOU THINK THE
GOVERNMENT'S DIRECTIVE IN
GIVING EVERYONE THE FLU SHOT
FREE, DO YOU THINK THAT'S
WRONG-HEADED?

Michael says I THINK IT'S VERY
WRONG-HEADED.
I'M VERY CRITICAL OF
INTERNATIONAL PHARMACEUTICAL
COMPANIES.
I THINK THAT THEIR, YOU KNOW,
THEIR AGENDA IS TO MAKE
MONEY, AND THEY DO THAT AT
THE EXPENSE OF PEOPLE'S
LONG-TERM HEALTH.
I MEAN YOU TALK ABOUT THE DIFFERENT
STRAINS OF INFLUENZA
CHANGING AND TRANSMOGRIFYING
AND HAVING TO THINK FIVE AND
TEN YEARS IN ADVANCE, AND I
THINK THE BEST WAY -- I MEAN,
THE NATURAL SYSTEMS ARE SO

MUCH MORE COMPLICATED THAN
OUR COMPREHENSION, AND YET
OUR BODIES, I THINK IF WE
GIVE OUR BODIES, YOU KNOW,
THE MAXIMUM STRENGTH AND YOU
KNOW, THE MAXIMUM SUPPORT,
OUR BODIES ARE MORE LIKELY
TO BE ABLE TO ADAPT TO THESE
COMPLEX CHANGES THAN, YOU
KNOW, THAN OUR FAIRLY
ARCHAIC MEDICAL AND
PHARMACEUTICAL SYSTEMS.

Dr. Upshur says WELL
THAT BEING SAID, I'LL JUST
DIRECT YOUR ATTENTION BACK
TO 1918, 1919, BEFORE THERE
WERE VACCINES, BEFORE THERE
WAS AN EVOLVED HEALTHCARE
SYSTEM AND 20 TO 60 MILLION
PEOPLE DIED GLOBALLY.
AND THAT'S JUST THE DEATHS.
NOT THE MORBIDITY, MORBIDITY BEING THE
SICKNESS.
I COMPLETELY RESPECT YOUR
OPINION HERE, AND ACTUALLY
YOU ECHO A FAIRLY STRONG
SENTIMENT IN THE HISTORY OF
PUBLIC HEALTH, WHICH IS THE
HYGIENE MOVEMENT.
IF YOU LOOK BACK IN THE LATE
19th CENTURY, THIS IS ONE OF
MY FAVOURITE STORIES, WHEN
SMALLPOX WAS THE FIRST
DISEASE FOR WHICH THERE WAS
A MASS VACCINATION CAMPAIGN
MOUNTED, THERE WAS GROUP OF
PEOPLE CALLED THE HYGIENISTS
WHO BELIEVED EXACTLY AS THIS
GENTLEMEN BELIEVE.
THAT VACCINATION WAS
ACTUALLY DETRACTING FROM
PEOPLE'S RESPONSIBILITY FOR
THEIR OWN HEALTH SO THAT
THEY WOULDN'T WASH THEIR
HANDS, THEY WOULDN’T EAT A PROPER DIET,
THEY WOULDN'T GET PROPER SLEEP.
AND SO THEY REFUSED – THE
BRITISH GOVERNMENT MADE
SMALLPOX VACCINATION
MANDATORY IN A VERY STRONG
SENSE THAT IF YOU DIDN'T
TAKE IT THEY WOULD ACTUALLY
FORCE YOU TO TAKE IT.
THEY RESISTED AND THERE WAS
A GROUP OF THEM ORGANIZED IN
LEICESTER, CALLED THE LEICESTER
ANTIVACCINATION MOVEMENT AND
SOME OF THE LEADERS WERE
IMPRISONED AND AS A
CONSEQUENCE OF THE BRITISH
GOVERNMENT REFLECTING UPON
THE DIFFICULTIES THEY HAD,
THE FIRST CONSCIOUS OBJECTIVE
LEGISLATION IN BRITISH
TRADITION WAS WRITTEN, NOT
FOR OPPOSITION TO WAR BUT
FOR OPPOSITION TO
VACCINATION AND SO THIS
GENTLEMEN IS ACTUALLY ADHERING
TO A FINE AND LONG NOBLE
TRADITION.
BUT I WOULD STILL SAY THAT
IF YOU -- NOT EVERYBODY CAN
MAKE THEMSELVES HEALTHY.
THERE ARE IN FACT A
SUBSTANTIAL NUMBER OF PEOPLE
WHO ARE OLDER OR WHO HAVE
CHRONIC CONDITIONS THAT PUT
THEMSELVES AT RISK FOR
SERIOUS MORBIDITY AND
MORTALITY AS INFLUENZA.
I BELIEVE AS A SOCIETY THAT
CARES FOR PEOPLE THAT WE
SHOULD GIVE THEM AN
OPPORTUNITY TO MAXIMIZE
THEIR PROTECTION AND LET
THEM CHOOSE IT OF THEIR OWN
FREE WILL.
THAT THE GOVERNMENT IS
EXTENDING THIS TO ALL OF THE
CITIZENS OF ONTARIO I THINK
IS A GOOD THING.
PEOPLE CAN MAKE UP THEIR
MINDS ABOUT WHAT THEY THINK
ABOUT DRUG COMPANIES.
AS A HEALTHCARE PROVIDER, I

THINK THAT A FLU VACCINE, IS
YOU KNOW, AN EXCELLENT
ADJUNCT TO GOOD HEALTH.

Maureen says I WILL JUST
POINT OUT IN YOUR DEFENCE
I ASKED YOU ABOUT TWO
FLU DRUGS AND YOU PRETTY
MUCH SUMMARILY DISMISSED
THEM SO, YOU DON'T ALWAYS
SIDE WITH THE DRUG COMPANIES
THERE.

Dr. Upshur says YEAH.
NO, I DON'T.
I HAVE MY OWN MIND

Maureen says SUZANNE IN KANATA IS NEXT.
HI SUZANNE.

Suzanne says HI.

Maureen says HI.

Suzanne YES, I HAVE THREE
CHILDREN AND THEY'RE ALL SCHOOL
AGE, OF COURSE, SO LAST YEAR
WE GOT HIT REALLY BADLY WITH
THE FLU, BUT OUT OF THE
THREE CHILDREN I HAVE TWO
THAT HAVE ALLERGY-RELATED
ASTHMA AND I'M JUST WONDERING
WOULD THE FLU VACCINE HAVE
ANY INFLUENCE ON THEM WITH
THEIR ALLERGIES?
I HAVEN'T HAD THEM TESTED
FOR ALLERGIES AS TO WHAT
SPECIFICALLY THEY'RE
ALLERGIC TO.

Dr. Upshur says DO THEY HAVE EGGS IN
THEIR DIET AND TOLERATE
THEM OKAY?


Suzanne says YES.

Dr. Upshur says THEN THEY WOULDN'T HAVE
ANY PROBLEM WITH THE FLU
VACCINE.

Suzanne says NONE AT ALL?

Dr. Upshur says NO.

Suzanne says OKAY.

Maureen says ALL RIGHT,
THANKS SUZANNE.
BYE-BYE.
WHAT DO YOU THINK OF THE WAY
THE VACCINE IS BEING DONE IN
CLINICS AND THINGS?
SHOULD WE WAIT FOR THIS TO
GO ON IN OUR WORKPLACE OR AT
THE LOCAL HOSPITAL OR JUST
GO TO OUR G.P. FOR THIS?

Dr. Upshur says I WOULD CALL
FIRST YOUR FAMILY
PHYSICIAN.
THE ONE REASON I'M IN FAVOUR
OF THAT IS BECAUSE THEN
THERE WILL BE A CODE
ATTACHED TO YOUR BEING
VACCINATED WHICH MAKES IT
EASIER TO SORT OUT WHETHER
THE FLU VACCINE PROGRAMME
HAS HAD A BENEFIT OR NOT.
WORKPLACE PROGRAMMES ARE
ALSO VERY EFFECTIVE BECAUSE
THEY'RE CONVENIENT.
BY HOOK OR BY CROOK, IF
YOU'RE INTERESTED IN HAVING
A FLU SHOT THERE SHOULD BE A
PLACE WHERE YOU CAN GO AND
HAVE ONE.

Maureen says YEAH.
OKAY.
BARBARA IN HAMILTON IS NEXT.
HI BARBARA.

Barbara says YES.

Maureen says HI, GO AHEAD.

Barbara says HI.
WELL THIS IS A LITTLE
COMPLICATED, I'M SURE, BUT I
HAVE A SWINE FLU SHOT.
MIGHT BE EVEN BEFORE YOUR
TIME, I DON'T KNOW.
AND I WAS DEATHLY SICK AFTER
THAT SHOT.
I ALMOST DIED AND I HAD
PNEUMONIA.
AND I'VE HAD PNEUMONIA ALL
MY LIFE.
I DIDN'T KNOW -- THEY DIDN'T
KNOW WHAT WAS WRONG WITH ME.
FINALLY TEN YEARS AGO I HAD
A LUPUS ATTACK AND WENT INTO
THE HOSPITAL AND THEY PUT ME
ON COUMADIN AND PREDNISONE,
AND THAT WAS REALLY THE LAST
TIME I GOT A PNEUMONIA.
BELIEVE IT OR NOT.
I'M ON ANTIBIOTICS ALL THE
TIME TO -- BECAUSE I HAVE A
SINUS INFECTION ALL THE TIME
THAT WAS PROBABLY CAUSING
ALL THIS, BUT I READ IN ONE
OF THE MEDICAL PIECES THAT I
GOT TO BE VERY CAREFUL OF
TAKING ANY IMMUNIZATION
BECAUSE WHEN I TOOK THE
SWINE FLU SHOT I WAS SICK
AND THEN I HAD POLIO SHOTS,
BOOSTERS.
AND THAT WASN'T TOO LONG AGO,
AND MY BOWLS SEIZED UP AND
SO I'M DEATHLY AFRAID OF
TAKING A FLU SHOT.

Dr. Upshur says WELL I'M
ACTUALLY GLAD YOU RAISED THE
SWINE FLU.
I THINK THE SWINE FLU – WHERE YOU IN

CANADA OR THE
STATES WHEN THIS OCCURRED?

Barbara says IN CANADA.

Dr. Upshur says YEAH, THERE WAS A SWINE
FLU SCARE IN 1976, AND THE
REASON WHY IT WAS A SCARE IS
BECAUSE AGAIN, WE'RE ALL
AWAITING THE NEXT PANDEMIC.
THERE IS FAIRLY COMPELLING
EVIDENCE THAT THE 1918
PANDEMIC ORIGINATED IN SWINE.
YOU GET INFLUENZA IS FOUND IN BIRDS,
SEALS, ALL SORTS OF -- IT'S
QUITE ABUNDANT IN NATURE AND
WHAT HAPPENED WAS THAT THEY
MADE A DECISION.
I MEAN, NOBODY SAID THAT
PUBLIC HEALTH DECISION
MAKING IS EASY.
IF YOU'RE AFRAID THAT A
PANDEMIC IS ABOUT TO OCCUR,
YOU NEED TO TAKE STEPS TO
PROTECT THE HEALTH OF THE
POPULATION.
THEY DECIDED THAT THEY WOULD
TRY TO IMMUNIZE THE ENTIRE
AMERICAN POPULATION, AND
WITH THAT THEY QUICKLY PUT
THE VACCINE INTO MASSIVE
VACCINE PRODUCTION.
THERE WERE SOME PROBLEMS
WITH SOME OF THE VACCINES
AND THERE WAS AN OUTBREAK OF
WHAT'S CALLED DE-EMBARE
SYNDROME, OR A PROGRESSIVE NEUROLOGICAL DISEASE YOUR
LOGICAL DISEASE AND THAT SET,
I THINK, PEOPLE'S
APPRECIATION OF THE BENEFITS
OF INFLUENZA VACCINE BACK
SEVERAL YEARS.
MANY PEOPLE REMEMBER THAT.

Maureen says THE VACCINE GAVE
THEM THIS SINNED DISPLOM.

Dr. Upshur says YES, IT WAS A
COMPLICATION.
NOW IT HASN'T HAPPENED
WITH ANY OF THE -- IT'S NOT AN ISSUE
WITH ANY OF THE NEW
VACCINES.
MODERN VACCINE TECHNOLOGY HAS
ADVANCED IN THE LAST 25
YEARS AND CERTAINLY MORE SO
THAN THE PREVIOUS VACCINES.
I MEAN, ESSENTIALLY EACH
GENERATION -- OF
VACCINES IS MORE AND MORE
REFINED.
THE ORIGINAL ONES WERE
FAIRLY CRUDE PREPARATIONS
AND NOW WE'RE GETTING MORE
AND MORE REFINED.
AND SO THE SWINE FLU
ACTUALLY HAD A BAD EFFECT ON
PEOPLE'S APPRECIATION OF THE
IMPORTANCE OF INFLUENZA VACCINATIONS.

Maureen says WAS THERE
ANYTHING THAT BARBARA JUST
MENTIONED THERE THAT MAKE
YOU THINK THAT SHE SHOULDN'T
GET THE FLU SHOT.

Dr. Upshur says NO.
I THINK -- AS I SAY,
ULTIMATELY YOU'VE GOT TO
THINK OF TWO THINGS THE PHYSICIAN'S JOB,
WHICH IS TO RECOMMEND WHAT
MIGHT BE BEST FOR YOUR
HEALTH.
ON THE OTHER SIDE, I KNOW
PEOPLE NEED TO SIT AND THINK
WHAT'S BEST FOR THEIR.
IT'S THEIR CHOICE ULTIMATELY,
AFTER THEY'VE WEIGHED THE
HARMS AND BENEFIT AND WHAT
THEY THINK WORKS BEST.
I'D ASK PEOPLE TO REALLY
LOOK CRITICALLY AT THE

SOURCE OF INFORMATION OF WHOSE
TELLING YOU WHAT'S
SAFE AND WHAT'S NOT SAFE.
I DON'T THINK IT WOULD BE IN
THE INTEREST OF THE
GOVERNMENT OF ONTARIO TO
RECOMMEND TO THE ENTIRE
POPULATION TO GET A VACCINATION IF THEY THOUGHT THAT
IT WAS HARMFUL.


Maureen says ESPECIALLY NOT
IN LIGHT OF THE WALKERTON
INQUIRY THAT'S STARTED
TODAY.

Dr. Upshur says NO, I
THINK NOT, YEAH.

Maureen says YOUR GOING TO HAVE TO BE CAREFUL. ALL RIGHT,
THANK YOU BARBARA, YOU WERE
TALKING EARLIER ABOUT AREAS
IN THE WORLD AND TIMING.
KAREN IN THUNDER BAY SAYS
“MY MOTHER WAS SUPPOSED TO
GO TO AUSTRALIA LATER THIS
MONTH AND SHE GOT A FLU SHOT
LAST WEEK BUT NOW THERE'S A
LAST-MINUTE CHANGE OF PLANS
AND SHE WON'T BE GOING TO
AUSTRALIA UNTIL MID-MARCH.”
SHOULD SHE GET ANOTHER FLU
SHOT PRIOR TO GOING IN
MARCH?

Dr. Upshur says MARCH
THERE IS THEIR SUMMER SO, IT
WOULD BE THEIR LOW FLU
SEASON.

Maureen says LOW FLU SEASON ANYWAYS?

Dr. Upshur says SHE
SHOULD PROBABLY STILL HAVE
SOME RESIDUAL PROTECTION FROM
HER FLU SHOT HERE.

Maureen says HER CHILDREN- KAREN’S CHILDREN
MAY BE GOING MALAYSIA?

- MALAYSIA IN MARCH.
SHOULD THEY GET A FLU SHOT
NOW OR WAIT UNTIL CLOSER TO THAT MONTH--

Dr. Upshur says GOOD
QUESTION. I MEAN
THE FLU SHOT IS AVAILABLE
NOW, MIGHT AS WELL GET IT NOW, THE KIDS
WOULD PROBABLY BE PROTECTED
UNTIL MARCH.

Maureen says OKAY THE HODA
IS IN SARNIA.
HI HODA?

Hoda says I AM A MOTHER OF
THREE CHILDREN, I AM 37
YEARS OLD AND I AM ASTHMATIC
AND DIABETIC.
I HAVE BEEN TAKING THE FLU
SHOT FOR SIX YEARS NOW, AND
I HAVE BEEN TOLD IF I KEEP
ONE YEAR OF TAKING THE SHOT,
I'LL GET THE WORST YEAR OF
MY LIFE BECAUSE MY IMMUNE
SYSTEM NOW IS REALLY
DEPENDING ON THESE SHOTS.
SO DOES THAT MEAN THAT ALL
MY LIFE I'LL BE TAKING THIS
SHOT?
AND I HAVE TWO KIDS WHO ARE
ASTHMATIC AND NOW I'M REALLY
SCARED TO KILL THEIR NATURAL
IMMUNE SYSTEM IF I START THEM
ON THE SHOT TOO.

Dr. Upshur says YEAH,
IT'S A MISCONCEPTION THAT
THE FLU SHOT IS GOING TO
HARM OR SOMEHOW IMPAIR YOUR
IMMUNE SYSTEM.
WHAT IT DOES IS IT OFFERS A
PROTECTION.
I'M NOT SURE WHO'S TELLING
YOU YOU'RE GOING TO HAVE THE
WORST THIS OR THAT MANY
PEOPLE SAY MANY THINGS.
I'M NOT SURE WHAT THEY'RE
MEANING.
IF YOU HAVE ASTHMA OR
DIABETES, THEN YOU'RE IN ONE
OF THE HIGH RISK GROUPS.
IF YOU GET INFLUENZA AT ANY
TIME, NOT -- I MEAN, FIRST
OFF, IF YOU GET INFLUENZA
AND YOU DON'T HAVE THE FLU
SHOT, YOU'RE AT RISK FOR
SERIOUS COMPLICATIONS.
THOSE BEING PNEUMONIA, WOULD
BE THE MOST COMMON
COMPLICATION, PERHAPS
REQUIRING HOSPITAL
ADMISSION. THE OTHER THING IS THAT --
BUT THE FLU SHOT ITSELF IS
NOT GOING TO ALTER OR CHANGE
YOUR NATURAL IMMUNITY, IT'S
MEANT TO ENHANCE AND PROTECT
YOUR IMMUNE SYSTEM --

Maureen says JUST FROM THIS
ONE THING.

Dr. Upshur says JUST FROM THIS INFLUENZA
THE OTHER REASON THAT
DEFEATS PEOPLE'S BELIEF IN
FLU SHOTS IS ANOTHER
COMPANION VIRUS CALLED RESPIRATORY SYNCYTIAL
VIRUS WHICH ALSO CIRCULATES IN THE WINTER WHICH ALSO
CAUSES FAIRLY SEVERE DISEASE, ITS
THE NEXT CANDIDATE FOR A
MAJOR IMMUNIZATION. THERE IS A LOT OF RESEARCH BEING DOING
TO LOOK AT AN APPROPRIATE VACCINATION FOR WHATS CALLED RSV --

Maureen says THAT’S IN
CHILDREN ESPECIALLY?

Dr. Upshur says NO, NO. R.S.V
OCCURS IN ELDERLY PEOPLE.
THERE'S SOME VERY GOOD STUDIES THAT
SHOWS R.S.V. IS AS SERIOUS A
THREAT IN ELDERLY AS
INFLUENZA VIRUS.
NATURALLY THEY'RE CLINICALLY
INDISTINGUISHABLE WHICH IS
WHY PEOPLE WHO GET R.S.V.
WHEN THEY GET THE FLU SHOT
PROBABLY THINK THE FLU SHOT
DIDN'T WORK, AND IT COMES UP AND SOMETIMES IT CAN
CO-CIRCULATE WITH INFLUENZA.

Maureen says OKAY SO GOOD. SO HODA CAN GET IT THIS YEAR
OR NOT GET IT THIS YEAR.
SHE MAY GET THE FLU IF SHE
DOESN'T GET IT --

Dr. Upshur says THAT’S CORRECT ,BUT IT WOULD HAVE
NOTHING TO DO WITH HER
REDUCED OR IMPAIRED IMMUNITY,
IT WOULD BE THE FACT THAT SHE DOESN'T
HAVE THE SPECIFIC ANTIBODIES
TO INFLUENZA VIRUS.

Maureen says GOT IT. WE HAVE A QUESTION FROM
LAURIE.
MY 27 MONTH YEAR OLD DAUGHTER HAS
CHRONIC HEART AND LUNG
DISEASE. I WAS WONDERING IF THE
DOCTOR COULD GIVE ME HIS
OPINION TO SEE IF IT WOULD
BE OKAY FOR HER TO RECEIVE
HER FLU, PNEUMONIA AND
R.S.V. NEEDLES TWO OF THEM AT ONE
TIME.THE OTHER THING IS THE
R.S.V. HAS NOT AARRIVED AT OUR DOCTOR'S OFFICE.
SHOULD SHE GET HER FLU AND PNEUMONIA NOW OR IS IT OKAY TO WAIT?

Dr. Upshur says DON’T GIVE THE
FLU AND PNEUMONIA SHOTS NOW YOU CAN GET THEM BOTH AT THE SAME
TIME AND THEN YOU WOULD HAVE TO PROBABLY TALK TO YOUR
PEDIATRICIAN ABOUT WHATS YOUR BEST REGIMEN THERE.

Maureen says SO KIDS WHO ARE AT RISK
WITH CHRONIC HEART AND LUNG
DISEASE THEY GET AN
R.S.V. --

Dr. ROSS UPSHUR says YEAH PROBABLY SOME KIDS DON’T AND SOME KIDS DO.
I MEAN WE DON'T ADMINISTER IT AT
OUR CLINIC.

Maureen says OH NO? OKAY. ALL RIGHT,
CONNIE IS IN HAMILTON.
HI CONNIE?

Connie says HI MAUREEN,
THANKS FOR THIS TOPIC.
I'D LIKE TO ASK THE DOCTOR
ABOUT A PROBLEM THAT MY
FAMILY HAS.
THEY HAVE MYOTONIC
DYSTROPHYES, ONE OF THE MUSCULAR DYSTROPHY, AND OUR
DAUGHTER HAS -- OF COURSE
THE SHOT GOES RIGHT INTO THE
ARM INTO THE MUSCLE, AND
EVERY YEAR SHE'S IN QUITE A
BIT OF PAIN IN THE MUSCLE
FOR SOME TIMES A WEEK.
IS THERE ANYTHING THAT WE
CAN DO TO STOP THIS PAIN
FROM HAPPENING?

Dr. Upshur says TO REDUCE THE PAIN FROM THE --

Maureen says FROM THE
HYPODERMIC NEEDLE.

Dr. Upshur says PROBABLY THE BEST THING
TO DO IS GIVE TYLENOL
BEFORE.
DO YOU PUT ICE ON THE LOCAL
SITE AFTER YOU'VE HAD THE
INJECTION.

Connie says SOMETIMES WE DO, YEAH.

Dr. Upshur says I WOULD SAY RATHER THAN
SOMETIMES, MAKE IT A REGULAR HABIT.
AFTER THE INJECTION TO PUT
AN ICE PACK ON FOR 10, 15
MINUTES ON, AND OFF FOR
ABOUT AN HOUR, AND THAT --
AND CONTINUE WITH THE
TYLENOL ON A REGULAR BASIS.

Maureen says OKAY, NOW --
SORRY GO, AHEAD?

Connie says NO, THAT WAS IT.

Maureen says IS THAT IT?
WE WERE TALKING BEFORE THE
SHOW ABOUT THEIR TESTING A
NASAL SPRAY TO DELIVER THIS
VACCINE.

Dr. Upshur says THAT’S
RIGHT. YEAH, THE NASAL SPRAY, NASAL
VAX, NASALLY DELIVERED
VACCINES HAVE BEEN AROUND FOR
SOME TIME I THINK THEY WERE FIRST DEVELOPED IN THE SOVIET UNION
AND THEY ARE IDEAL FOR CHILDREN.
IT'S A LIVE ATTENUATED VIRUS
SO THERE'S A SMALL CHANCE OF
GETTING SYMPTOMS WITH IT BUT
IT REDUCES THE PIN CUSHION
EFFECT. SO I THINK THERE'S GOING TO
BE SOME CLINICAL TRIALS
LOOKING AT ITS EFFECTIVENESS EFFICACY
COMPARED TO THE
INTRAMUSCULAR-VACCINE IT’S AN EXCITING NEW DEVELOPMENT.

Maureen says DO YOU THINK IT
WILL BE ABLE JUST TO CHILDREN OR TO ADULTS TOO?

Dr. Upshur says WELL,
I'M SURE IT'LL BE AVAILABLE FOR
EVERYBODY TOO.

Maureen says WHY WOULD IT BE
DELIVERED LIVE, THAT WAT?

Dr. Upshur says GOOD
QUESTION.
YOU WOULD HAVE TO ASK THE VIRALOGIST
[laughs]

Maureen says SO IT DOESN’T STAND TO REASON THAT ITS GOT TO BE LIVE?

Dr. Upshur says PROBABLY HAS SOMETHING TO DO
WITH ORAL POLIO, HOW IT
INDUCES WHAT'S CALLED MUCOSAL
IMMUNITY. SO IT CAUSES A LOCAL REACTION WHICH RECRUITS THE
ANTIBODIES IN.

Maureen says JUST MADE YOU
WORK THERE --

Dr. UPSHUR says YOUR RIGHT THAT WAS
A GOOD ONE.

Maureen says LAST 30 SECONDS IS THERE ANY
POINT IN TRYING TO BOOST OUR
IMMUNE SYSTEM WITH THINGS
LIKE ECHINACCEA OR ZINC OR
WHATEVER?

Dr. Upshur says UM...
PROBABLY NOT.
I MEAN IT CERTAINLY WON'T
HURT.
I MEAN, I DON'T KNOW.
ZINC ACTUALLY IS GOOD FOR
COMMON COLD BUT IT'S NOT
GOOD FOR PREVENTING IT,

Maureen says RIGHT?

Dr. Upshur continues ONCE YOU'VE GOT IT, IT HELPS
TO TREAT.
SIMPLY PUT AS I SAID AT THE
BEGINNING, MAINTAIN AS GOOD
A HEALTH AS POSSIBLE.
LIKE THE ONE GENTLEMEN IS
SAYING.
EAT WELL, GET PLENTY OF REST,
EXERCISE REGULARLY, WASH
YOUR HANDS, IF YOU'RE SICK,
PLEASE STAY HOME IN BED.
DON'T TAKE IT TO YOUR
FRIENDS AND LOVED ONES OR
COLLEAGUES AT SCHOOL.

Maureen says ALL RIGHT,
THANKS VERY MUCH FOR THIS
DOCTOR UPSHUR.

Dr. Upshur says THANK
YOU VERY MUCH, MAUREEN, I
APPRECIATE THE OPPORTUNITY.

Maureen says Dr. ROSS UPSHUR
IS A FAMILY PHYSICIAN AT
SUNNYBROOK AND WOMAN’S COLLEGE HEALTH SCIENCES CENTRE IN
TORONTO. FOR GENERAL INFORMATION ABOUT INFLUENZA THE VACCINE OR
THE LOCATION OF A CLINIC NEAR YOU CALL1-866-FLU’ YOU
1-866-358-6968. AND WE MENTIONED THE FLUWATCH PAGE AT HEALTH
CANADA’S WEBSITE YOU’LL FIND THAT AT WWW.HC-SC.GC.CA AND FOLLOW
THE LINKS TO FLUWATCH AND THANK YOU FOR TUNING IN FOR MORE TO
LIFE TODAY. I’M MAUREEN TAYLOR AND JOIN US ON MONDAY THROUGH
FRIDAY 1-2 OCLOCK ON TVO.

A panel appears under the title “Ontario Flu Information” It reads “1-866-FLU’
YOU 1-866-358-6968.

Watch: Flu and Family Health