Selects: How the Flu Works

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Welcome to Stuff You Should Know, a production of iHeartRadio. Hey, and welcome to the podcast.
I'm Josh Clark. There's Charles W.
Chuck Bryant. There's Jerry.

This is Stuff You Should Know About the Flu, which I have.

You don't have the flu, do you?

I don't know, man. I can't.
I've been on the planet for 41 years.

I still can't really tell the difference between a flu and a cold.

I think the difference that I can tell, and I don't get the flu much. You know, I always get the stomach bug, which, as it turns out, is not a flu I just learned.
No, no. But I don't get the flu flu much.
But I can always tell, though, when I'm super achy. Like, the flu just makes me feel like dog doo-doo.
Right. Whereas a cold is just a big inconvenience.
Yeah, I've had, no, I've definitely had like lots of aches and I woke up like shivering one night. Oh, so you had a fever for sure.
I guess so. I guess it must've just been one night in the middle of the night.
So that's the flu, right? Probably. So I guess I do have the flu.
No joke, everybody. Well, I'm erecting the clear glass in between us.
Yeah. I think that I've had it long enough now, based on the research from this article, that I'm not contagious or else I would have called this off.
So did you get it in New York, I wonder? I think so. Dirty, dirty New Yorkers.
Right, yeah. Which I was like, I was just walking around with my hands inside of a couple of plastic Duane Reade bags, and it still didn't work.
Well, that was your problem probably right there. Right.
Duane Reade. Because I didn't take them off when I ate.
Gross. Yeah.
So, yes, we were in New York for some bell house shows, right? Those went pretty well. Yeah.
Thought they were great. All right.
So the flu check. We won't't reminisce about past victories we'll just talk about the flu instead yeah uh how about a stat right off the the get-go here okay um the flu the cdc and also sorry everybody for the sniffling that's going to inevitably happen i'm trying hard not to do it you're a method podcaster all right uh which is also what I said in my very first episode.
That's right. inevitably happen.
I'm trying hard not to do it. You're a method podcaster.
Right.

Which is also what I said in my very first episode. That's right.
Remember that? Yep. It's not any funnier now.
So the CDC right here in Atlanta, Centers for Disease Control and Prevention, not the CDCP. No, they just stuck with the original.
Yeah. They reckon that about 5% to 20% of United States peoples get the flu each year compared to about 10% to 25% in dirty, cold Canada.
Right, I know. And normally when you get the flu, it's just, you're laid up for a couple of days, right?

Yeah.

Like you said, you feel like dog dew or something like that.

Yeah.

That's the seasonal flu.

But even with a seasonal flu, which usually here in the United States or in North America, runs from what, like October to March?

Yeah, roughly.

And then, I didn't really think about this before, but in the Southern Hemisphere, it runs the opposite and actually peaks in August. Right.
Yeah. Most of the time, it's just an inconvenience for you, but it actually kills people sometimes.
Yeah, it can be dangerous for sure. So in 2011 and 12, that was a pretty low year for deaths from the flu in the U.S.
There were 12,000 people who died from the flu or complications from the flu. 2012-13 flu season, 56,000 people died that year.
And I think the average is something around 36,000 people in the U.S. die from the flu every year.
Yeah. And apparently the World Health Organization says around the world, as many as a quarter of a million people to a half a million people can die every year from the flu.
Right. There's a lot of folks.
It is. So, I mean, and the idea of dying from the flu, that's awful because, I mean, if you feel bad enough as it is from a flu that you recover from in a few days imagine dying from that that would just be a terrible way to die yeah um and the whole thing chuck comes down to this little tiny virus the influenza virus and there's different types and influenza i found um is actually a shout-out to the Italian name for it originally.
Did you know this? I did not. So I'm going to say it normally, but then you have to say it in your famous Italian accent.
Influenza di Fredo. Are you talking about the influenza di Fredo? Yeah, which means influenza of the cold.
Oh, all right. A lot of, for many, many, many, many years, because the flu is most predominant in the colder months, everybody just assumed that it was the actual cold that was getting you sick.
Right. That turns out not to be true.
It's an actual, it's a virus that does seem to favor the cold, drier conditions of the winter months. But this little tiny virus gets into your body and it starts this chain reaction that is just fascinating.
Yeah. So it is a respiratory illness.
So like I said before, when you hear people say the stomach flu, which I've said a lot in my life because I get it once a year with the poopy butt and the vomitous mouth and the ill belly. At the same time, though, I can't – I think I've asked you this before, but I don't really know.
Has it literally ever happened at the same time? Mm-hmm. I think once in my life.
Man, that's rough. I was on the john with a bucket.
Oh, God. It's so rough.
Well, the worst time I ever had it, I may have told this story before, I was sick at a friend's house, which is the worst, when I was not living in Atlanta, but I was in Atlanta. Oh, no.
And I was like, I just got to get to my mom's house. Mom? Yeah.
I was like, I just was much more comfortably being sick there. Yeah.
And he was working. It was just one of those things.

And so I got in my brother's car that I was borrowing while I was in town. I don't like where this story's going.
And I drove, no lie, probably about 100 miles an hour to Snellville from Atlanta. Yeah.
Thinking, and I pooped in my pants in the car. and I remember thinking

if a cop pulls me over

he would have to be

a And I pooped in my pants in the car. And I remember thinking, if a cop pulls me over, he would have to be a cold, heartless individual to give me a ticket.
Because I would just say, sir, don't take me to prison. Take me to a hospital because I'm dying.
Yeah. So I drove 100 miles an hour.
It was kind of fun. So you made it home.
You showed up with poopy pants and your mom took care of you? Yep. Showed up to Diane's house and I lived.
But anyway, that was a long way of setting up this,

which is that is actually not a flu. The stomach flu is not because the flu is 100% a respiratory

illness. Right.
And it's not something that happens in your stomach or in your butt.

Right. And let's talk first before we talk about the actual effect of the flu.
Let's talk about the virus a little bit for a second, okay? So back in 1931, there was this Iowa farm physician, which is to say he was a human physician of humans, but he probably lived on a farm because it was Iowa in 1931. His name was Richard Shope.
And he was trying to figure out what this bug that was getting people was. And he investigated with pigs first because there are plenty of other animals that can come down with the flu, not just humans, right? Right.
And he finally isolated. He isolated the flu virus in swine and it led to this discovery of the isolation of the flu virus in humans too.
So right after that, they started classifying the flu by strains. You got A, B, and C, right? So A is the most common and most severe.
That's the bad news. Yeah.
B is a little milder, a little less prevalent, and then we go all the way down to C, which is, I get the feeling C doesn't happen a lot, and it definitely isn't the one that you're going to have like a big epidemic of the flu from a C. Yeah, I couldn't find much on C influenza either.
Poor C. Yeah, it'll make a comeback one day, and it'll shock heck out of all of us, right? Probably so.
So, type A infects all sorts of different species, right? Humans, birds of all kinds, pigs, bats, horses even. Yeah, I mean, remember the avian flu, that was, that scared the world.
Oh, yeah. And that was A.
Right. That was A strain.
B strain is almost exclusively infective of humans. Apparently, the only other species we've ever found a type B influenza virus in is seals.
God knows where they got it from. Or if we got it from seals, who knows? Maybe up north? I don't know.
And then that C1, it just infects humans and pigs. So you got the three types.
That's right. And then one other thing about them, about the classification of flu strains, is that there are also subtypes, right? And so you mentioned like avian flu.
And the one that scared everybody was, I think, H5N1. Yeah, that was it.
I remember. So the H and the N are the, they refer to the two kinds of, the two main proteins that you find on the outside of a flu virus.
Hemagglutinin and neurominiase. Okay? And so depending on those types of H protein or M protein, that's how they subtype flu strains.
Yeah. So, I mean, that's a good little factoid.
I don't think anyone really understands what those letters mean. That's what they mean.
You know? Yeah. But as far as you're concerned, just pay attention to the news.

And when they talk about the scary ones, they'll mention those letters and numbers,

and then you can impress your friends.

Yeah, you can be like, oh, well, they're talking about hemagglutinin and neuraminidase.

And they'll say, shut up, nerd.

I hope you get sick.

So as far as the standard flu that we're talking about here, the virus, it gets into your body and it kind of makes a beeline to your respiratory tract.

And it binds with your cells.

It's viruses.

Did we do a general one on viruses?

The one I think we really went in depth on was HIV, where we talked about how a virus enters the body and takes over.

It's just vicious.

It is, but it's also, it's kind of like admirable in a really like deadly efficient way, you know? It is. So they bind to the surface of the cells in that respiratory tract, and then they say, hey, I'd like you to meet my little friend, RNA.
Why don't I inject my genetic information into your nucleus and see how you like it?

Right.

And when it does that, the cell has been officially hijacked. And the virus uses the cell's own RNA transcription process to create the proteins that are needed to make new versions of the virus.
So the virus is using this host cell in your respiratory tract to make copies of itself. And suddenly, before the cell knows what's going on, it's made millions of copies of these viruses, right? And apparently, when you talk about it step by step, it seems like this takes a little while.
No, in seconds, seconds after that the virus has entered your respiratory cell, millions of copies of it have been made. Yeah.
Like this is happening so fast. It moves in there.
It says, I'm in charge now. Yeah.
Out of the way. Yeah, completely out of the way.
I'm running the show here. We're copying each other and we're going to move out to the cell membrane because this cell is going to die very quickly.
And then that's just going to poof me out into the body further to infect other cells. And it's scary how quickly this happens.
Right. So if you think about it, if that first cell produces millions of viruses, viral copies, and then they're released from the cell out into the rest of the other respiratory cells, and each of those infects another cell, and then those cells all make millions.
You see how quickly these viruses reproduce in your body. And once that starts to happen, you are infectious.
I think once that first cell ruptures, you become infectious. But this can be like a day before symptoms, right? So this is something people are always saying, like, oh, I'm not infectious anymore.
Like me. I said it earlier too, right? I know.
But supposedly the day before you even know you're sick, the day before the first symptoms start, before you start, like, sniffling a little bit or whatever, you're infectious, buddy. Yeah.
And you're infectious up to seven days after that day you first start showing symptoms with the flu. And if you're a kid, you can be infectious even longer because if kids are anything, they're walking germ factories.
They are disgusting monsters. It's hilarious.
It's true, man. Like, my kid didn't get sick at all for the first 18 months of her life.
And I thought, I've got a wonder baby. Yeah, really? I don't know what's going on.
We put her in daycare a couple of days a week and she was sick nonstop for the next six months. Man, that is rough.
It is rough. And then they get the family sick.
And we'll talk a little bit about that and how that happens. But all this is to say, during flu season, especially if you work in like an office where, you know, when you hear like the flu's going around or whatever, or anywhere you work or in school, if you hear about the flu going around, even if you don't feel sick or your cube mate doesn't feel or look sick, just start washing your hands a lot.

Oh, yeah. That's like they say that's the best way to prevent getting the flu or spreading the

flu is washing your hands a lot. And it's so simple that you almost might discount it,

but it's actually true. Like that's the best way to do it.
You can wash the flu virus off of your

hands with some soap that will bind to it and the water will wash it right off.

Wash that flu right out of your hair.

Yeah, and if you have the flu, stay home. Yeah.
Everybody but me. Stay home.
Well, we're up against it. We had to record today.
And also wash your hands just constantly. Like if I'm about to touch anything, I'll wash my hands first.
Right. If I'm going to go somewhere outside of the hot zone, which is whatever room I'm sequestered in, you know, I will wash my hands, you know? I appreciate that.
I mean, trust me, we're in this tiny studio now, the three of us. I know, I'm trying not to breathe.
Yeah, you've done all this on one breath. It's impressive.
Yeah know. Well, quickly, before we take a break so you can breathe again,

we're going to talk about symptoms afterward.

Before you get these symptoms, though,

what's happening is your respiratory system is going to become inflamed.

And this inflammation might stick around for a few weeks,

but from there it moves into your bloodstream, and then that's when you're going to get these symptoms, once it sort of moves into the bloodstream. Right.
And we're going to talk about those symptoms as promised, right after this. We were getting where we couldn't pay the bill.
PG&E asked customers about their biggest concerns so we could address them one by one. That's terrifying.
That's fair. Joe, Regional Vice President, PG&E.
We have to run the business in a way that keeps people safe, but it starts driving costs down. I would love to see that.
We're on our way. I hope so.
PG&E electricity rates are now lower than they were last year. Hear what other customers have to say and what PG&E is doing about it at pge.com slash open dash lines.
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or wherever you get your podcasts. Alright, Chuck.
Did you breathe? Yeah, a little bit. Let's talk symptoms.
Okay? You know what I need? I need one of those, like, reeds that Bugs Bugs Bunny used to like hide in the water when Elmer Fudd was hunting him. I could just like get a long one and maybe a crazy straw would be even better and just like pipe it out to the air duct right there.
That's a great idea. What do you think? We'll get everybody else sick except you and Jerry.
So, um, the symptoms sound a lot like a cold because the symptoms are kind of the same. A cold is usually not as fraught with potential complications and maybe a little less severe, but they're pretty close, which is why you couldn't tell earlier if you had a cold or flu.
Right. But that fever, that's the big one, apparently.
It's a big distinction between the Yeah. Yeah, I think that's kind of the way I distinguish it, right? Yeah, and colds are also caused by viruses.
They're caused by coronaviruses, which can— there are types of coronaviruses that are really bad that cause, like, MERS and SARS. Yeah.
But for the most part, when you catch a cold from a coronavirus, it's a low-level virus, or it's a rhinovirus. That's the other one that causes the common cold, right? So it's just a different kind of virus producing similar symptoms to a flu.
Do you remember when Peter Sarsgaard was on Saturday Night Live years ago? No. He was, you know, the actor? Sure.
He was on there during the SARS, when there was that SARS scare in the United States.

And one of their skits was he had developed the SARS guard, SARS guard, which was just basically a surgical mask.

But it was just funny.

They said SARS guard, SARS guard like 30 times, and I laughed every time.

I think his younger brother was Pennywise the Clown in the It movie, right?

Oh, I don't know. I'm pretty sure that was a SARS the clown in the It movie, right? Oh, I don't know.

I'm pretty sure that was a Sarsgaard, and he is amazing. Yeah? Have you seen it? No.
Oh, you got to see it. You're going to love it.
Now, was he a Sarsgaard or a Skarsgaard? Oh, God. I didn't know there were two different things.
Well, there are the Skarsgaards, which is like Stellan Skarsgaard is the dad. and then the son was the dude on

True Blood, the vampire show, and then recently on that Pretty Little Liars, I think. I don't know.
One with Nicole Kidman. Okay.
That's Alexander Skarsgård. I think that might be him.
Is Sarsgård the one who Sarsgaard? No. Who's that? Peter Sarsgaard.

Yeah, that's another dude. What is up with all these guys?

So are you sure you're not just dropping the K off of Peter Sarsgaard?

All right, here's the deal. Okay.
The guy in Fargo. Man, this is such a bad sidetrack already.

It's pretty bad. The guy in Fargo was Peter Stormare.
Okay. So he's not even in the equation then.
No, but I definitely know that there is Peter Sarsgaard. Okay.
Because he either was or is married to Maggie Gyllenhaal. Oh, yeah.
I guess I knew that. Peter Sarsgaard.
Okay. And then there's Stellan and Alexander Skarsgaard,

and I don't know who it the clown was.

It's Bill Skarsgaard.

And is he related to the Skarsgaards?

I guess so.

Yeah, I believe he's the youngest of them.

Okay.

Oh, I'm sorry.

I was wrong.

It was Tim Curry I was talking about.

No, actually, we never looked stuff up,

but I did look that up.

Yeah.

Because the headline here says, Alexander Skarsgård's reaction to his brother Bill's clown costume. Yeah, his acting goes way beyond the costume.
They did good with the costume, but it was his acting. Oh, yeah, it was good.
I know there were so many people screaming at their phones, but I think we finally got it right.

Yeah, sorry about that, everybody.

I also want to apologize for any medical students

who are being forced to listen to this as part of their class.

Hopefully your instructor fast-forwarded through that part.

All right.

This all got started with SARS-Guard SARS-Guard.

Oh, yeah, that's right, because that's from the coronavirus.

This is the influenza virus we're talking about that creates this inflammation, which is your immune response, right, in your lungs? That's correct. And the symptoms, like a cold or coughing, sneezing, the fever, which is different, like we said, with the flu, achy body, which usually comes with that fever, and then Josh's runny nose and congestion that you can hear in your overall lethargy.

Yeah, I am a little under the weather, I guess, is a good way to put it. I can tell.
So those are just standard flu symptoms. You can have secondary symptoms from complications of the flu, right? one thing that has long gone hand in hand with the flu

as far as like death from flu complications goes

is bacterial pneumonia. Yeah, that's no good.
And, um, for a very long time, science wasn't quite sure why that, why you were just so susceptible to bacterial infections when you were battling the flu and they figured it out. It's actually your body's immune response that is responsible for it, right? Right.
So when you have the flu and your body starts to battle it off and you get a fever and your lungs become inflamed, that's your immune system's response to the flu virus. But when your body says, okay, calm down, everybody, let's bring the temperature back down, and your body represses its own immune response, it opens the door for bacteria that normally it would be able to fight off to take advantage of this kind of naturally weakened state that your immune system's in, and you're much more susceptible to infections from bacteria.
And that's where pneumonia comes from. You can get viral pneumonia, but you usually get bacterial pneumonia.
And that's the stuff that people can die from because that bacteria infects your air sacs in your lungs, which fill with fluid and pus and blood, and you die from choking on bloody froth that fills up your airway. Oh, my God.
Yeah, it's a bad jam, man. Severe dehydration is another secondary symptom of the flu.
That's why, of course, you always want to drink plenty of water when you have a cold or flu. I looked that one up too, Chuck, because if you think about it, why? Why would you be dehydrated from the flu? It's from sweating.
Yeah, sure. Your nose running.
Yeah. You're just leaking fluids.
Yeah, you are. And, like, they start to add up, and all of a sudden you're dehydrated before you even know it.
That's right. Ear infections, especially if you're a kid, sinus issues.
Emily always gets bad sinus problems along with this stuff. I know.
She was starting to get a little sniffly. Is she sick? She did get sick.
Oh, that poor lady. Yeah, New York, man.
Yeah. It killed everyone I love.
And then if you, like in Emily's case, she's slightly asthmatic. But if you are asthmatic, you have like diabetes, it can make that stuff worse.
Yeah. She doesn't have diabetes, right? No.
Well, the reason diabetes is comorbid with the flu or is problematic when you have the flu is because type 1 diabetes especially is an autoimmune disease, so your immune system is already repressed, I guess. Yeah.
And then heart conditions can be exacerbated by it because you're getting less oxygen from your lungs into your bloodstream, which strains the heart. And if it's already weak, people have heart attacks from the flu if they already have a heart condition.
Isn't that crazy? Yeah. Again, it's a bad jam.
Well, actually, in the episode coming up about the silly one about the 10 cursed movies, remember the little girl from Poltergeist died at 12 from a heart attack brought on by the flu. Yeah.
Right? Yeah. Or she had like a stomach blockage.
They initially diagnosed it as the flu. Oh, okay.
But I thought it was not never like a

virus like that. I don't think so.
I think they mistook it. All right.
Well, then forget all that. But people do.
So your point still remains correct. Okay.
So how you get the flu is this. Like you said, it's generally about November through March.
January and February tend to to be the worst it here in the United States. And as we mentioned, offices and schools especially, because children are filthy monsters, who just don't wash hands and they breathe on each other and touch each other and they don't cover their mouths when they cough or sneeze.
But it's pretty cute when they hug each other. It's very cute, actually.
It's worth all the sickness in the world. It's pretty great.
But that's the reason that kids tend to spread it more, because as much as you try and teach them to cover their mouth when they cough and sneeze and wash their hands a lot, it's just not really on their radar like it is for adults. No, not at all.
Because they are dirty, dirty, dirty creatures. And then, you know, the kid then in turn brings it home and the family gets infected pretty quickly because try as you might, there's just a lot of close contact with kids that you can't avoid.
And even if you're washing your hands, they will find a way to infect you. Right.
And if you go even further back, there's an even earlier origin before kids picking it up at daycare or preschool for the flu. Usually it comes from other animals we're finding, right? Yes.
Very frequently birds, like we were saying, right? And they used to think that for a human to catch a flu from a bird especially, that flu had to show up in a mixing vessel, usually a pig, which was capable of taking it. It could be infected by a bird flu and a human flu.
And flu viruses have this amazing talent called reassortment, where a flu strain and another flu strain can get together and be like, oh, hey, you have eight proteins that make up your RNA? I do too. Let's mix and match and see what happens.
And they thought for a long time that this really only took place in pigs. And then out would come a new super virus that no one had ever seen before that humans could catch.
But from Southeast Asia, people being in close contact with infected birds, especially like in the poultry industry or something, there have been cases that started in the 90s of avian flu coming directly from birds to humans. So that, that theory went out the window.

Yeah. And that's what set off those fears of a bird flu pandemic that we lived with for many years.
Yeah, that's right. As far as, and you know, that a lot of that was just spread from bird poop.
Yeah. And it scared people because that, that those bird flus are no joke.
Like they, they have like a 60% mortality rate.

60%, six out of 10 people who come down with H5N1 bird flu die, right? Yeah. Luckily, it's really, really difficult to catch it even when you are around sick birds.
It doesn't very frequently make the jump to humans, but it can is what they found. Yeah.
As far as the regular flu, the garden variety flu that we're talking about mainly here, it spreads from, well, like we said, from touching stuff, from coughing and sneezing. When you cough and sneeze, even if you think you're covering your mouth pretty well, there may be little fluids squirting out between your fingers

up to a few feet. Like a fire hose.
It's in the air around you. That stuff can travel, you know.
So if that lands on a doorknob or if someone covers their mouth like a normal and then opens a door or borrows a stapler or whatever, it's going to be on that doorknob. And then you touch it.
And that's why, like, handwashing by the sick and by the non-sick is so crucial. Yeah.
And if you're, like, having an anxious day at work and you're doing your normal thing of chewing on your stapler to relieve anxiety and the guy who borrowed it was sick, you're toast. You are toast.
And as you mentioned earlier, it bears repeating. You can be sick a day before symptoms and you can, or you can be contagious a day before symptoms and still remain contagious up to seven days after the symptoms start.
Right. So even if you feel better after day four, you could still be spreading that junk around for a few more days.
Right. And they say that even after you feel better, you should stay in bed an extra day because, again, your immune system is compromised and you can catch other stuff.
So you want to be careful. That extra day really pays off.
And that's when you just lay in bed and watch Stranger Things 2. Right.
I haven't seen it yet. Is it good? Yeah, we just finished it last night.
Cool. Did you see the first season? Oh, yeah.
Yeah, that was great. Season 2 is just as great, if not better.
I'm happy to say. I'm glad to say that, too.
I was a little nervous, you know, because it was something I loved. And it's like, oh, man, season two, a lot of pressure.

Well, yeah, that's how it happens.

The sophomore season is very frequently like everyone's aware of the success of the show and what people are saying about it.

And they try to adapt to the expectations rather than continuing on doing what they were doing before.

But good for you guys, Stranger Things.

Yeah, so great.

I want to get those Duffer brothers on Movie Crush.

Oh, yeah, that'd be cool.

Those guys would be great.

Should we take a break?

Yeah, I think so.

All right, we'll come back and talking about how seasonal flu has seasons. That's why it's called seasonal flu, right? That's, I guess, one classification of flus.
There's also a pandemic flu. And the same kind of flu virus can be a pandemic flu or a seasonal flu.
And I think usually the way it happens is a new virus will emerge from, say, like livestock or poultry or something like that and infect humans. And if it's totally novel where no human has ever encountered a flu of this type before, it can just lay waste to people.
It can kill a lot of people. It can infect a lot of people.
It can spread the world. And when that happens, it becomes classified as a pandemic flu.
After a couple of rounds around the world, people will have started to develop an immunity to it, but it'll still be passed around. And so for the decade or so, it can be the predominant strain of the flu, but it'll have changed over to a seasonal type of flu.
So it's almost like the pandemic versus seasonal type flu describes how contagious it is and how virulent it is. I think that's the big distinction.
Yeah, and I think also in a pandemic, doesn't that mean it has left the country? Yeah, I think that is kind of one of the indicators of it too. 1918, these numbers are staggering.
This is the worst flu pandemic in world history in 1918. For, I don't know what months exactly, but 1918 and 19.
And it killed more than 20 million people around the world. And it killed most of those people actually in four months from

September to December. Isn't that crazy? More lives were lost than all 20th century wars combined

to the flu. Yeah.
You said 20 million? 20 million worldwide, about half a million in the United

States. I saw in many reputable places, 50 million people died around the world.
Man, that is just,

it's staggering. Yeah.
And that was like right at the end of World War I and just came out of nowhere. And one of the other really noteworthy things about it that just baffled people was it was killing like healthy people under the age of like 22, 23, 24.
Like just healthy young people killed by the flu. A lot of them died from pneumonia.
And they finally figured out that it was because it had been about 20 something years since a flu resembling that type of strain had made the rounds. So people under say like age 25 had never been exposed to it.
So it was a novel flu, which just leveled the people it was exposed to who had never encountered something like it before. Yeah.
I mean, it's scary to think about. I mean, surely that couldn't happen today, could it? Or could it? Oh, yeah.
Yeah? Sure. Man, you'd think that we could head something like that off these days.
Do you know like a third of the population of the world was infected with that

flu that year? Wow. Isn't that crazy? I know.
That's hard to believe. Yeah, that can totally happen.
It's a real concern. All right.
So as far as your risk of getting the flu, if you're a kid, like there's different risk groups, like high risk, low risk, whatever, medium or average risk.

But if you're under two years old, your little immune system isn't quite smart enough yet

to know how to fight things off. So you're definitely more at risk.
And as always,

what affects the children also affect the elderly. So if you're over 65,

seniors, is elderly wrong to say? I think elderly, it's technically 81. Oh, really? Yeah.
All right. So we'll go 65 seniors.
Is elderly wrong to say? I think elderly.

It's technically 81.

Oh, really?

Yeah.

All right.

So we'll go with seniors.

Seniors.

Active senior adults who have decades left ahead of them.

That's right.

Who else?

Anyone who has any kind of chronic, like I mentioned, asthma or diabetes,

any kind of chronic condition?

If you're pregnant, if you work in a hospital or a doctor's office?

Yeah.

Or a nursing home?

Nursing home is... asthma or diabetes, any kind of chronic condition, if you're pregnant, if you work in a hospital or a doctor's office or a nursing home.

Nursing home, not just people who work there,

but the residents too are in a really vulnerable position because they are in the elderly age range.

Their immune systems are pretty compromised.

If they're in a nursing home, they're probably ill already,

and then they're living in close quarters with other people who are ill.

That's a recipe for disaster. Yeah, it sure is.
It's also a recipe for tapioca pudding. It is.
The best around. Remedy-wise, and we'll talk about vaccinations here in a minute because I thought that was kind of one of the most interesting parts of this.
but as far as remedies, if you get the flu, it's a virus, so you can't take antibiotics. No.
You can't take a pill that's going to cure you. There are some antiviral drugs, which I've never tried any of these.
Have you? No. No.
I tried Zycam last year once. I think that's for colds.
Yeah, I thought that was like discredited. Well, I mean, I had a few people say, oh, you know, you should try Zycam.
It helps knock out your cold faster. It killed my sense of taste and smell.
Oh, no. For several days to the point where I was scared.
I don't remember that. I'll bet you were scared.
Yeah, and I looked it up, and it's a. Oh, I do remember that actually.
Yeah. Yeah.
That's just really unnerving, the idea of maybe it's permanent. Yeah.
It was, it was pretty, pretty freaky. Yeah.
I'll bet. And super noticeable.
It wasn't like a subtle thing. You'd be like, chilly.
I miss you. So that was my experience.
I'm not making some sweeping statement about that medication. Way to COA, man.
But there are antiviral drugs called, there's one called Tamiflu, Relenza, Flumidine. A little on the nose if you ask me.
Flu stop. Well, antiviral drugs, they seem like a good idea, but they seem like a good idea under the premise that seasonal flu strains were used to think they, they used to think that they died out at the end of a season, right? Right.
Well, they started tracking them. Like our global monitoring system is really top notch and they can track flu around the world.
And they found that seasonal flu at the end of the season in North America, it just goes to South America. So since that's the case, when you use antivirals and you're exposing these flus that go on to survive, you're also training them, evolutionarily speaking, to adapt so that those antiviral drugs are useless against them for people who like

really need them. So just like with antibiotics, using antivirals just to cure a common flu or to shorten a common flu is probably a bad idea when you're talking about the whole population.
Yeah. And that's what they do.
What they try to do is just keep the spread, cellular spread, from happening as much as it can.

Right.

And that's sort of the easiest way to say it. What they try to do is just keep the spread, cellular spread, from happening as much as it can.

Right.

Isn't that sort of the easiest way to say it?

Yeah.

Yeah, there's one keeps them, well, a pair of them keep them from replicating,

and then another one traps them inside a cell once they enter.

Right.

It's like, oh, God, I can't get out.

The door is locked.

And then death.

And they're all prescription drugs.

Right.

If I'm not mistaken.

So – It's like, oh, God, I can't get out. The door is locked.
And then death. And they're all prescription drugs.
Right. If I'm not mistaken.
So vaccines are, like, pretty hot. They're like the hot thing to do on a Friday night is to go get a flu vaccine, right? Yeah.
I didn't get flu shots for many, many, many, many years until I had a kid. Yeah.
And they say, like, if you, especially if you have a baby under six months of age,

they can't be vaccinated.

And so everyone around them should be vaccinated is the recommendation from the CDC.

Yeah, like our close family, the grand-grands and the Abbas,

all, and the Pop-Pops and the Papas and the Pupas and the Memangs and the Momos. Hey, all right.
Yeah, Momo got a flu shot. That was nice of her.
She's very kind. So, yeah, we all got flu shots, and I just wasn't, you know, I never got the flu much.
I never, I didn't have a disbelief in the flu vaccine.

I was just like, nah, I don't really need to bother with that.

Yeah.

That's kind of, I was fine.

Do you get them now though?

Is it a habit of yours now?

Well, yeah.

Now just, they just sort of recommend it when you have kids up until they're a certain age,

you should get vaccinated as a family.

Right.

And when you have kids, if you get them vaccinated, you, once they're able to be vaccinated again, under six months, they say, no, no, no, don't do that. When they're young though, and you're getting them vaccinated, they need to be vaccinated twice, like a month apart.
Yes. And so with flu vaccines in general, they recommend that you get it as early in the season as possible because it takes about two weeks for that to take effect.
So with a kid then, I guess you would want to get, so that six weeks before the flu season? I don't know. Or is that second one pretty much like, okay, now it's taking effect.
So is it four weeks plus two weeks? I don't remember the schedule.

Yeah, I don't remember the schedule.

Well, ask your doctor, okay? We're not doctors.

Stop pressuring us.

Well, they'll tell you.

Like when you go to get your little kitty checkups,

they say, you know, come back in this month and get your flu shot.

Right.

Number one, and then flu shot number two.

And so for a while there,

there were two kinds of flu shots that the CDC recommended.

One was an actual shot, the flu vaccine that was in a shot form. Yes.
And then there was another one that's called live attenuated influenza virus, which came in the form of a nasal spray. And that was usually recommended for kids.
I don't know if it's because kids don't like needles or what, but the CDC has officially stopped recommending nasal flu vaccines. Yeah.
Don't do those anymore. Well, and when they were doing it, when we say kids, you had to be over five because it was a, like you said, a live virus.
Right. It was a live weakened virus.
Yeah. And that's different.
Like if you think, all right, I'm going to get a flu shot. So that means I'm going to get the flu virus shot into me.
And so I might feel like I have the flu. That's not really the case.
It's really kind of neat how they do it. These scientists and doctors, like you said, track what's going on in the world of flu all over the world.

And they sort of make a – well, they don't sort of. They very definitely make a prediction and say, here's the flu strain specific to the United States, let's say, that I think we're going to be faced with this year.
And they make their best scientific guess possible. And that is the, you get a not live version of that virus injected into your body.
Your body sees, hey, foreign invaders here, let me produce antibodies. Then if that virus or if the real flu knocks on your door later that winter, your body says, wait, I've met you before.
I'm going to fight you. But it's pretty cool.
And it literally, the effectiveness, I looked up this year, and it's a year-to-year thing. It's 40% to 60% on this year's strain.
And it varies because it really just depends on how well those scientists have predicted, how much they get it right. Right.
Because if they get all three wrong, well, then you're toast when you encounter the flu that's going around that season. Yeah, it's really interesting.
But even when they do get it right, it's kind of baffling that sometimes the flu vaccine just doesn't bestow any kind of immunity. Yeah.
Apparently, Australia just came out of a really bad epidemic flu season down there. And it didn't cause a lot of deaths, but everybody was sick with the flu.
It was a H3 type flu that went around. And even though that strain showed up in the vaccine that was given out, only like 15% of people who got vaccinated and were exposed to the flu were immune to it.

Like 85% of people who got flu vaccines and then encountered the flu still got sick.

That's a pretty bad track record for a flu vaccine.

And they're just not sure why.

One of the theories is so when they make flu vaccines, they grow them in egg protein typically, like hen's eggs.

That's the medium they use to actually grow the viruses that they then kill. One researcher pointed out that at least one kind of flu virus mutates in the presence of egg protein so that the virus that you put in to grow in there is different from the one that comes out.
It's a mutated version, and so maybe that would prevent your body from recognizing the original one that you were trying to introduce it to in the vaccine. So interesting.
It is pretty interesting. Well, and they say there's a list of people who should not receive the flu shot, and one of those qualifications is if you are allergic to chicken eggs, then you shouldn't get a flu shot.
Yeah. There's like a couple of other ways that they make flu shots, flu vaccines, but that chicken egg is the most predominant way to do it.
Yeah. If you currently have a fever, wait on your flu shot.
Under six months, of course, we said you cannot. If you have had flu shots in the past and you had a bad reaction,

because like I said, it's not going to make you sick,

but you might feel a little achy or have sore muscles or something.

But you can have a bad reaction.

And if that's the case, then maybe flu shots aren't for you.

Right.

And if you're an anti-vaxxer, then you probably already decided that flu shots aren't for you.

Correct. Which we will never do an episode on that.
On vaccinations? Right. Oh, you don't think so? I don't know, man.
So the idea that a flu vaccine can, you know, check all the boxes but still just be wrong, wrong, wrong or not confer immunity has some people looking for a universal vaccine or one that lasts way longer than just a year. What they're targeting is, so when you get a normal vaccine, that vaccine is based on that HA protein, the hemagglutin.
Yeah. And that's the most quickly evolving

part of any flu virus,

right? So they're saying, well, let's look

at other parts of the flu virus that

don't evolve nearly as quickly and target

that. And some of those

parts are even basically universal among

all flu viruses. So if you can find,

if you can create a vaccine

based on a stable part of a flu virus

that's a part of every flu virus,

one vaccine could confer

I don't know. If you can create a vaccine based on a stable part of a flu virus that's a part of every flu virus, one vaccine could confer ideally lifelong immunity from all influenza for anybody who takes the vaccine.
One vaccine to cure them all? Exactly. Wow.
Yeah. So you got anything else? No.
I mean, I guess we're not going to cover the boogie-woogie flu.

I thought that was boogie-woogie fever.

No, it's the rockin' pneumonia and the boogie-woogie flu.

Oh, that's nice.

What's that from?

Is that an Atlanta rhythm section song?

No, they're better than that.

Oh, okay.

Well, since I said Atlanta rhythm section, everybody,

that means it's time for listener mail.

Yeah, this is a Simpsons overlooked,

overlooked Simpsons bit from us.

And this is not one of those,

we get plenty of things where people are like,

how could you not have mentioned this quote?

Yeah, I know.

Or this episode.

Yeah, I know. But the response was good.
Then people weren't necessarily poo-pooing it. No, and also I want to say thank you to everybody who wrote in to just say congratulations or to thank us.
That was all, every single one of those emails or tweets or posts were all well received. So thanks for those guys.
Totally. But this is something we failed to mention,

which definitely deserves its own email.

And this is from Rich,

our man on Cape Cod, as he says.

Hey guys, was listening to the Simpsons 2-parter.

Enjoyed it very much.

You explained how an episode came to be from conception to animation, et cetera,

and you paid respect to each portion.

But then you slided off one of the most important men in the franchise. You just said, and then they slapped Danny Elfman's score on it, and it's done.
Well, as any true Simpsons aficionado would know, Danny Elfman has never once written a score to The Simpsons. He wrote, as we know, just the title, or the theme song.
So he says, that job fell to the immensely talented and recently terminated via email Alf Clausen. Wow.
For 27 years, every score, every cue, every song was composed, orchestrated and conducted by Clausen and his live orchestra. He's won two Emmys and seven Annie Awards for his work.
The reason this is such a painful sight was because this omission has been happening for years. Clausen has worked insane hours writing music for a live orchestra to accompany an animated show.
He's always played second fiddle. Nailed it, he said.
To all those who think Elfman is any part of the show after he penned the main title. In fact, the main title theme song we all know and love is actually Clausen's reorchestration of Elfman's theme that took place mid-season three.
With a lush or more crisp orchestration. Wow.
I bet you anything, Rich plays the oboe. Alf Clausen, I'm so sorry.
I know. He said, I admire your podcast for bringing light to information that has been stuck lurking in the shadows.
You always make sure credit is given to those who sometimes went their entire lives without getting the nod they deserve. Well, this guy's really turning the knife in our backs, isn't he? And I feel you owe Clausen that respect.
So Alf Clausen for real. And then he it was a bit of a longer email.
He told the story of how he was recently fired by email, which is not cool. No, it's definitely not.
After 27 years of dedicated work. I know, man.
Not cool, guys. So that is Rich, our man on Cape Cod.
Well, thanks a lot, Rich. Appreciate that.
That was one of the better emails I've heard in a while. Agreed.
If you want to try and top rich, let's see what you got.

Send us an email.

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