Ask the Doctor (2017–…): Season 1, Episode 10 - Cold and Flu - full transcript

[sneezing, coughing]

[Dr Shalin Naik] The dreaded lurgy,

nobody wants it but we've all had it.

Catching a cold
or coming down with the flu,

sucks at best
and is life-threatening at worst.

But the good news is, thanks to science,

we have defences in our arsenal.

So in this episode, we ask the question,

what can we do about colds and flu?

Sandro reveals which home remedies work

and which don't.



[Dr Sandro] Chicken soup has been
used to fight colds for centuries

and there is some science to support this.

I get a reminder about some simple tips
to prevent you getting sick...

So it's really important not to sneeze
or cough into your bare hands.

OK.

- Achoo!
- That's safer than using your hands.

...while science works on the holy grail
of flu prevention

a vaccine that can stop all flu viruses
dead in their tracks.

I believe you know this gentleman here.

And Renee meets one of the doctors

who brought a swine flu victim back
from the brink of death.

Thank you.

[Dr Shalin] Colds and flu
are often grouped together

but in fact, they are very different.



The influenza virus can easily
knock you out for two weeks

and in some cases, it can be deadly.

On the other hand...

[sneezes]

...there are lots of different viruses
that cause colds,

which are just snotty-nosed annoyances.

To get some tips on how we can
prevent colds and flu,

I've come to meet
Professor Raina Maclntyre.

She's an infectious disease epidemiologist

at the University of New South Wales.

She is also...

quite the artist.

- So, why have you brought me here, Raina?
[Raina] Well, look around you.

This is the city. It's where there's the
highest concentration of people

and therefore the greatest risk of
transmission of flu and colds.

I see.

[Shalin] Influenza claims up to
half a million lives worldwide every year.

A good reason to get vaccinated,
in my book.

But there is one concern
I'd like to ask Raina about.

A lot of people get the flu vaccine
and then say they got the flu.

- What's going on there?
- That's a really common myth.

It isn't technically possible
to get flu from the flu vaccine,

because there's no live virus
in the vaccine

and the vaccine only protects against flu

but there's over 90 other viruses
that cause colds

and the flu vaccine
won't protect against those.

Right.

[Shalin] Another hotbed
for virus transmission

is public transport.

Visited by millions each day, train
carriages are the perfect incubators.

Say I, for example, sneeze into my hands,
my bare hands.

[imitates sneezing]
Alright?

Then I get up and I hold on to this.

Say the next person who walks along here
holds on to that railing,

then as they get off, they rub their nose
or they, you know, rub their eyes.

You can even get infected
through your eyes.

Right.

The virus transmits from the surface
onto their face and into their body.

[Shalin] So, the next person...

When a person sneezes and the virus lands
on the surface,

how long can it stay there for?

Well, studies have shown

that viruses can stay on the surfaces
and be viable for days, up to seven days.

- Seven days?
- Yeah.

[coughs]

[Shalin] And if this guy with the cough
has a cold or flu,

anyone that rides this carriage over
the next three hours could get infected,

simply by breathing the same air.

When a virus enters your body,

it invades cells in the respiratory tract.

Once the virus gets inside a cell,

it starts to replicate.

These viruses then get shed
from your respiratory tract

when you cough or sneeze.

This is a process called viral shedding,

which can happen up to three days
before you show any symptoms.

So, how can we prevent
transmitting the virus to others?

OK, so, it's really important not to
sneeze or cough into your bare hands...

OK.

Because that just leaves a trail of virus
all over the place

for other people to get infected.

- Use a disposable tissue...
- OK.

...and get rid of the tissue afterwards.

If you don't have a tissue on hand?

Then you can sneeze into your elbow.

- Achoo!
- That's safer than using your hands.

- Or under the suit jacket.
- Yep.

- Stick it under your shirt.
- Yep.

Into your leg?

- If you can manage it!
- [laughs] Probably not.

[Shalin] The other things that's aiding
and abetting the spread of viruses

is international travel.

Nowadays even summer months
are seeing flu outbreaks,

because people travelling
from the opposite hemisphere

are carrying it home with them.

I've heard hand-shaking can be
a big transmitter of flu between people.

Yeah, absolutely. In fact, in some
cultures, hand-shaking isn't practised.

Instead, they use other forms
of greeting, such as this

or the fist-pump's becoming more...

- Fist-pump! Alright.
- ...more common.

Anything to get the fist-pump
getting more traction is fine by me.

And so, what can we as individuals do

to help prevent the spread
of colds and flu in society?

So, one of the really important things is,
if you're sick, stay at home.

Don't go to work and infect other people.

[coughs]

[Shalin] This may seem obvious
but not many of us are heeding the advice.

[coughs]

Sick workers dragging themselves
into the office

and then sharing their sick germs
with colleagues

are costing economies around the world
billions of dollars a year

in lost productivity.

Also, if your child is sick,

don't send them to school

and if you've been out and about
shaking hands with lots of people,

touching lots of contaminated surfaces,

washing your hands
can really reduce your risk.

[Shalin] Well, Raina, I'm certainly
gonna take those tips on board.

See you later.

Oh! Fist pump!

[Dr Renee] Have you ever wondered
why your snot is green when you're sick?

Turns out, when your germ-fighting
white blood cells attack an infection,

they produce enzymes
to repel the invaders.

These enzymes contain iron

and that's what turns your snot green.

But what if your snot's got
a yellowish hue, I hear you ask.

Well, if this germ-busting, enzyme-packed
mucous sits around for a while,

like when you're asleep,

it becomes more concentrated
and can change colour.

Mmm, nice!

[Dr Sandro] Speaking of nice,
Gary's in an unusually good mood

but sadly for him, the next week of his
life will be a misery,

as Gary is about to experience
a typical seven-day cycle

of the flu.

It all started about 24 hours ago,

when Gary answered the phone.

Hello?

Unfortunately, the mouthpiece was
previously contaminated with flu virus

and because it touched his mouth,
Gary contracted it.

For the next 48 hours,
Gary is none the wiser

but the virus has been busy, aggressively
replicating itself inside his cells

and what happens next
will come on fast and strong.

Fever, a snotty nose,

uncontrolled coughing fits, chills,

sneezing, aches and pains.

[cries]

But all these symptoms
aren't caused by the flu itself.

They're the result of Gary's immune system
going to war against the virus.

By day four, Gary's immune system

has pushed his temperature
to above 38 degrees Celsius.

It's one of the body's primary means
of killing invading viruses.

By day five, Gary has coughed, sneezed
and rubbed his nose raw.

But all that snot
is the body's natural way

of trying to flush the flu virus
from his nasal passages.

[sneezes]

It's day six
and Gary still has the aches and pains.

They're a side effect of the chemicals
Gary's body is releasing

to help fight off the virus

and a result of muscle strain
from all that coughing.

And it's finally day seven.

No fever, no aches.

And while he still has
a bit of a post-viral cough,

the worst is over.

So, Gary, now that you're
back on your feet,

we need to infect you with gastro,
for next week's show.

Oh-- ****

We'll all get a cold or flu
at some time in our lives

and that got us wondering:

Colds suck.

They're not as bad as the flu

but you still feel pretty crappy

and instead of sympathy,

you get everyone blagging their grandma's
age-old home remedies at you.

So I thought it was high time
we head inside

and test out some of those home remedies.

Let's start with gargling salt water.

The thinking is pretty simple.

Mix half a teaspoon of salt
in a 250-mil glass of water,

then gargle for a few seconds.

And the science says yes.

A 2005 study found that those
who gargle regularly

had a 40% reduction in cold-season
respiratory tract infections

over those who didn't.

Studies also suggest

that a saltwater gargle can provide relief
from a sore throat.

While I'm pretty sure our next home remedy
is good for the soul,

is it really any good for a cold?

I'm talking, of course,
about chicken soup.

Now, history tells us that chicken soup
has been used to fight colds for centuries

and there is some science to support this.

Inflammation that causes sore throats

is driven by white blood cells

and something in chicken soup seems to
prevent the spread of white blood cells

through the upper respiratory tract,

thereby reducing inflammation.

But scientists are still unsure about the
exact mechanism that causes this.

Next up, I want to talk about
Echinacea supplements.

They've become the go-to panacea
for many people in the grips of a cold.

But while good-quality analyses suggest

that regularly taking Echinacea can
reduce your chances of getting a cold

and shorten time spent sick,

a recent trial showed no benefit if you
take them as your cold symptoms begin.

Which brings us to that old chestnut,
vitamin C.

Research suggests that immune-enhancing
vitamin C

won't stop the average person
from getting a cold,

nor will it reduce their symptoms

but those who take it regularly

might see a small reduction
in the time they spend sick.

Rounding out our group of home remedies

is glorious, delicious garlic.

But even though there is some evidence

that garlic has antibacterial
and antiviral properties,

the science is inconclusive,

although one as-yet unreplicated study

has shown that people who eat it regularly
have fewer sick days with colds

than those who don't.

It's important to remember
that these remedies aren't cures.

If anything, they'd only be
relieving symptoms.

But as a doctor,
I would always tell my patients

that your best bet for avoiding
days spent in bed with a cold

is a healthy, balanced diet.

So if your weekly budget means a choice
between this and this,

you're almost always better off spending
your money on the fresh stuff.

[Dr Shalin] If you're anything like me,

you're too busy to get sick!

[doctor] Come on in.

Which is one of the reasons why I get the
flu shot every year from my GP, Rich.

- Have a seat.
- Cheers, Rich.

Now, I thought it'd be cool
to actually see

how the flu vaccine creates the
antibodies against influenza in my blood.

So today I'm getting a blood sample taken
before I get my flu shot,

so I can then measure the changes.

But don't worry. For the flu shot to work,
you don't need to do this.

So, the flu jab makes antibodies
against the virus.

Is it safe in pregnant women?

It's perfectly safe
in all stages of pregnancy.

The other thing is

that your baby is offered immunity
for the first six months of its life.

Right.

- Hi.
- Hello.

[Shalin] So, what's in the vaccine, Rich?
What are you gonna inject into me?

- Well, it's got parts of dead flu viruses.
- Uh-huh.

And those are the best-guess viruses

that the World Health Organisation thinks

might be going round the Southern
Hemisphere this year.

Ow!

[Dr Shalin] But it's only a little prick
and there's a whole lot of benefit.

If you get the jab, your chance
of getting sick drops dramatically,

as does the virus's ability to spread
and do harm to others,

which is excellent news for babies,
pregnant women and the over-65s,

who are among the most in danger

of becoming critically ill
during a flu outbreak.

Now that I've been vaccinated,

hopefully my immune system
does what it's supposed to do

and create the antibodies
to protect me against the flu virus.

I have my pre-vaccination
blood sample here

and in four weeks' time,
I'll have another one taken

and they'll be compared for the amount
of antibodies generated in that time.

[pig grunts]

So, human beings aren't the only species
that can catch the flu.

Some animals can actually contract
certain strains of the influenza virus

and these strains can sometimes
change enough

that they can then infect
human beings as well.

When this happens, it can become
a serious health risk.

[coughs]

[Dr Renee] To understand
how the flu can escalate

from a snotty nose, needing bedrest

to a global pandemic
potentially killing millions,

I'm meeting up with Professor
Kanta Subbarao.

She's the Director of Influenza Research

at the World Health Organisation
Collaborating Centre.

So, what is the difference between,
say, a seasonal flu

and what we would know
as a pandemic flu virus?

There are three types
of influenza viruses, A, B and C.

Influenza C generally causes mild illness.

Most of us have had it.

So epidemic influenza is caused
by influenza A or B.

Influenza B only affects humans.

Influenza A, on the other hand,

can infect many different species.

Pigs can be infected, horses,

dogs, waterfowl and shore birds

and humans.

So when a novel influenza A or B virus
infects people and causes disease,

if it can spread efficiently
from person to person,

it can cause a pandemic,

because the population is not immune.

It's completely new.

[Dr Renee] And it's these pandemics

that the professor hopes to eliminate
altogether.

Over the past 100 years,

the world has been crippled
by four major influenza pandemics.

In 1918, the Spanish flu killed
up to 50 million people globally.

In 1957, the Asian flu hit,

followed by the Hong Kong flu in 1968.

Swine flu has become the first pandemic
of the 21st century.

And in 2009,

swine flu spread
to more than 74 countries.

It killed more than 200,000 people.

But it was in 2014,

when Australia saw a resurgence
in swine flu,

that Kelly McClelland, a 35-year-old mum
of three from Mount Isa in Queensland,

came close to the brink of death.

So, Kelly, how did this all start?

I woke up on a Sunday morning.

I had symptoms like
I felt like I was getting a cold

and then, come Tuesday,

it developed into a cough

and on the Friday morning,

my husband, Sean, came home
from the school drop-off

to find me delirious
on the bathroom floor.

What do you mean by 'delirious'?

I was... I was out of it.
I was talking gibberish.

Um, there was vomit all through the house.

- Oh, wow.
- Yeah.

He took me straight up to the hospital

and, um, in ICU that night,

so, Sunday, cold-like symptoms

and Friday, fighting for my life.

[Dr Renee] Blood pathology
confirmed it was the swine flu

and Kelly was medivac'd from Mount Isa
to Townsville Hospital.

But her only hope of survival
was with specialist equipment

at the Prince Charles Hospital
in Brisbane.

En route, Kelly stopped breathing

and had to be resuscitated.

Her family were told
to prepare for the worst.

Kelly hasn't been back to this hospital
since her ordeal.

- I believe you know this gentleman.
- Yeah, I do.

This is one of the doctors
who saved her life.

Welcome back.

- In an upright position.
[she laughs]

- You been keeping well?
- Yes, yes.

- Good.
- I'm standing, thanks to you.

Well, welcome back to the ICU.

- I believe you're Dr Marc.
- I am indeed.

- Renee.
- Renee, nice to meet you.

How're you going?

Dr Marc Ziegenfuss is the director

of the Adult Intensive Care Service
at Prince Charles Hospital.

Kelly doesn't remember much
from her time in hospital

but to aid her recovery, she wants
to understand what happened to her.

When she got to you, how was she?

Uh, she was desperately ill.
She was actually dying.

Um, so we knew that without
pretty aggressive intervention,

that her body would ultimately cave in
and she would, uh, pass away.

So what was the first thing
that you guys did?

So, Kelly's condition
continued to deteriorate,

to the point that we could not
keep her alive with her own lungs

and we decided to put her onto ECMO.

Extracorporeal Membranous Oxygenation,
or ECMO,

acts as an artificial lung
or heart-and-lung machine

for critically ill patients.

I want to come and show you something.

- Come here.
[weeps, sniffles]

Give me your hand. Alright.

[Dr Marc] So, this is an ECMO machine.

That young man there is also
fighting for his life but he will be OK.

You can see two tubes coming out. One is
dark blood. The other one's bright blood.

That's because his lungs aren't working.
Same thing with you.

[Dr Renee] ECMO works by passing the
patient's blood through a filter

that adds oxygen
and removes carbon dioxide,

before warming it
and pumping it back into the body,

allowing patients like Kelly to focus
all their energy on beating the virus.

- You alright?
- Thank you.

It's alright.

[Dr Marc] The machine is merely a machine.
I really want to stress that.

- If it wasn't for your team here...
- Correct.

- ...the machine is useless.
- That's right.

And the team wants to get to know
who they're treating,

so we want family photographs
so that we can make that connection,

because it's that connection that actually
motivates us to go that little bit harder.

You were wonderful.

Felt like an, um, extended family.

Good. I want a Christmas card, please.

[all laugh]

[Dr Renee] Understanding
what happened to her

and meeting one of the doctors
that saved her life

is part of Kelly's healing.

And while her body is still recovering,

three years on from swine flu,
things are looking up.

So, what I want to know is
what does the future hold for Kelly?

Well, hopefully getting back
to my old self.

- Yep.
- To be a mum and a wife again,

that I haven't been able to be,
the last few years.

- Yeah.
- Do you look at the world differently now?

- Absolutely, yeah.
- Yeah?

And I don't tend to, sort of, get upset
with the little things so much anymore.

Uh, don't take each other for granted,
really. Yeah.

- I want to give you a hug.
[laughs]

[tram bell dings]

[Dr Shalin] While the flu can be deadly,
science is catching up.

Researchers are making headway
on a universal flu vaccine

that could spell the end
for all flu viruses.

To learn more about this

and to get the results from my blood test,

I'm catching up with Professor lan Barr.

He's the deputy director

of the World Health Organisation
Collaborating Centre for Influenza.

He's also...

an intrepid bushwalker.

[heroic music]

- Alright?
- OK.

So, what's the role
of the World Health Organisation

in developing flu vaccine?

So, the WHO has a global influenza network

that analyses and then selects
influenza viruses or strains

to go into the vaccine each year

and that's important, because the
influenza virus is constantly changing,

so we need to update the vaccine
every year or two.

[Dr Shalin] These vaccines are made

from viruses taken from people
around the Asia-Pacific region

that had influenza.

These viruses are then used
to manufacture vaccines,

using one of my favourite
breakfast ingredients.

So, what we've got here is,
Cleve is inoculating some hens' eggs

with a clinical sample that we've obtained
from a member of the public.

And so right now,
that's a syringe of virus

that he's injecting into the eggs

so that the eggs themselves get infected.

[Prof. Ian Barr] Correct.

[Dr Shalin] Once the eggs are infected,
they're stored in a fridge for three days.

This allows the virus to replicate
in the egg membrane,

the bit just underneath the shell.

Turns out that the influenza virus
grows very well in chicken eggs.

Alright. So, little virus factories.

- They're little virus factories.
- Who knew?

They're good on toast
and good for viruses!

[both laugh]

Does that mean the vaccine I got
four weeks ago started its life here?

That's correct.

[Dr Shalin] Using this machine,
Professor Barr was able to test my blood

to see the effectiveness
of the flu shot I had four weeks ago.

The flu vaccine works by
prompting our immune system

to produce protective antibodies

that can fight the flu virus
if we are exposed to it in the future.

So, Shalin, before we look
at your results,

let's look at a typical result for
a person who has been vaccinated

that hasn't been vaccinated before.

[Shalin] Right.

[Prof. Barr] Here we have
the four vaccine components

and we're testing them pre-vaccination
and post-vaccination.

So, the number of red dots indicates the
amount of antibody to a particular virus

and you can see here, for the H1 virus,
there's only 1 in 10,

indicating a low level of antibody

and here, post-vaccination,
you see the dots go out much further,

indicating a much higher level
of antibody.

So this actually demonstrates that the
vaccine is doing what it's supposed to do.

- In this person, it's worked very well.
- Alright.

- Does it work in everyone?
- Well, let's see how yours goes.

Let's do it!

[Prof. Barr] So, you did get a rise
against the H1 component,

from 40 to 160.

You did get a rise from the H3 component,

from 320 to 640

and no change in the B-Victoria component

and a small rise
in the B-Yamagata component.

[Shalin] Right.

The reason why I have antibodies
to some of the flu viruses already

is because I get the flu shot every year.

Studies show the flu vaccine
reduces children's risk

of flu-related hospitalisation

by 74%

and by 57% in people over the age of 50.

So, is there anything in the pipeline

that means we don't have to keep
getting our flu shot every year

and might protect us
against those pandemic flus?

Scientists are working on that currently

and for the universal vaccine,
is what they call,

we're trying to target
a very small part of that virus.

[Dr Shalin] When we get sick,

our immune system defends us

by primarily targeting two
surface proteins of the virus.

The haemagglutinin, HA

and the neuraminidase, NA.

The trick is these HA and NA proteins
can change

and evade being detected
by our immune system

and infect us anyway.

But if we can make a universal vaccine

that helps our immune system

to target a different part of the virus
that doesn't change,

we can potentially stop all
influenza viruses dead in their tracks.

So, when will we see
this universal vaccine?

Initial results are looking
quite encouraging,

so we're hopeful that it will be here
before not too much longer.

Alright.

So, in the battle against colds and flu,

the science is looking strong.

[Dr Shalin] If you've got a cold,
it's a thumbs-up to home remedies

like chicken soup and saltwater gargles.

But for the best prevention,
keep a healthy, balanced diet.

To fend off the flu...

Ow!

...remember to get an annual flu shot,

particularly if you're
in a high-risk group.

[coughs]

Try to keep your germs to yourself,

take a day off work if you're sick

and maintain good hygiene...

Oh! Fist pump!

...because cold and flu viruses can
survive up to seven days on surfaces.

And one day, hopefully
in the not-too-distant future,

we'll have a vaccine that can protect us
against all forms of the flu.