Most people recover on their own from influenza. Sometimes, the flu and its complications can be deadly. There is a flu vaccination, which can reduce your risk of getting the flu and the severity of flu symptoms. 

You are contagious for a period of time around your illness. Understanding when flu is contagious is important to stop the spread of seasonal flu. 

Understanding the flu virus

Flu is contagious via small droplets from your respiratory system that are expelled when you speak, cough or sneeze. These respiratory droplets can land in someone’s mouth, nose or eyes. In some cases, it spreads when someone touches an infected surface then touches their own nose or eyes. 

Common flu symptoms include:

• Fever, although not everyone with flu has a fever
• Cough
• Chills and sweating
• Muscle aches
• Fatigue
• Sore throat
• Runny nose

Symptoms come on suddenly with flu. Common cold symptoms build more gradually over time.

Contagious period with the flu

Flu takes one to four days to incubate in your system after you come into contact with the virus. You have the potential to spread flu before symptom appear. You are contagious for about three to seven days after symptoms appear. An infected person can spread flu even if they never develop symptoms severe enough to notice they are sick.

“Overall, you can be contagious or were contagious the day before you noticed any symptoms. You still can spread the flu for about a week after you started feeling sick or as long as you have symptoms,” said Rachel N. Alexander, APRN, nurse practitioner with Norton eCare. After symptoms decrease, the virus may continue to shed. Those with a weakened immune system may continue to shed flu virus for longer than an otherwise healthy person. 

The severity of your case of flu, your individual immune response and your flu vaccination status affect how long the flu is contagious. While the flu vaccination is not a guarantee you will not get the flu, it affects the severity of your symptoms and may help control overall flu spread.

Preventing flu spread

• Importance of staying home while contagious
• Proper hygiene practices (hand-washing, covering coughs, disinfecting surfaces)
• Use of masks in public or around vulnerable populations

If you develop symptoms of the flu, stay home and avoid contact with others. Wipe down surfaces in your home with antiviral wipes, wash your hands often and refrain from close contact with others in your home. If you are at higher risk for developing complications for the flu, seek immediate medical attention. 

Flu complications

Some people are at a higher risk of developing more severe symptoms of the flu. These groups include:

• Adults ages 65 and older
• Children under 5
• Pregnant women
• People with chronic health conditions
• People with weakened immune systems
• People with a body mass index of 40 or higher (Class III obesity)

If you develop these symptoms seek immediate medical attention:

• Difficulty breathing
• Persistent pain or pressure in the chest or abdomen
• Persistent dizziness, confusion or inability to wake up
• Seizures
• Not urinating (peeing)
• Severe muscle pain
• Fever or cough that improves then returns or worsens
• Worsening of chronic medical conditions

When can I resume normal activity after the flu?

Most flu symptoms go away in four to seven days for otherwise healthy adults, but you still may be contagious. You may go back to light exercise when you feel like it, but listen to your body and rest when you need to. The Centers for Disease Control and Prevention advises staying home for at least 24 hours after your fever goes away without the help of ibuprofen (Motril or Advil) or acetaminophen (Tylenol).

A flu vaccination is the best way to prevent spreading seasonal flu. The vaccine has been shown to reduce illness, doctor’s visits, time off work or school due to flu, and lower the risk of serious complications. 

Besides vaccination, everyday steps you can take to prevent seasonal flu spread include:

• Avoid contact with sick people and stay away from others if you are sick.
• Cover your nose and mouth with a tissue if you cough or sneeze, then throw the tissue away. If you cough or sneeze into your hand, wash your hands immediately.
• Wash hands often with soap and water. If those are not available, use an alcohol-based hand sanitizer.
• Avoid touching your mouth, eyes and nose. 
• Clean and disinfect surfaces that may be infected with flu virus.

There are many ways to protect yourself, your loved ones and your community from the flu. Getting a flu shot is the first step.

Read more on the flu

5 things to do if you have a fever

COVID-19 or flu? Each has some similar symptoms, but there are key differences

What’s the best time to get a flu shot?

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The $1.2 million investment to integrate the former Bowling Green Internal Medicine & Pediatric Associates into Norton Children’s and Norton Healthcare offices allows for enhanced primary care, building on significant investments already made through Norton Children’s existing specialty practices in the community.

The offices, located at 615 E. Seventh Ave., feature 9,000 square feet of space split between pediatric and adult primary care. The location will further streamline care for kids in the region, while also increasing offerings for adults seeking treatment.

“Providing access to health care is essential to our mission,” said Russell F. Cox, president and CEO, Norton Healthcare. “High-quality, safe, innovative care should be available to every person across the region. The best way to achieve that vision is to bring care closer to home. Bringing this team into Norton Children’s and Norton Healthcare is a great step forward in our goal.”

The acquisition marks Norton Healthcare’s latest investment in the Bowling Green area. Norton Children’s began offering pediatric cardiology services here in the 1960s, and in the years since has added neurology, urology and neonatal follow-up services at Norton Children’s Outpatient Center located at 720 Second Ave. The outpatient center, much like Bowling Green itself, has seen ample growth in recent years. Patient visits increased 11% between 2022 and 2023. With a wealth of Norton Children’s specialty services well-established in Bowling Green, this newly acquired practice now brings primary care into the fold.

“Bowling Green has always been a great place to live, work, learn and play,” said Steven T. Hester, M.D., MBA, senior vice president and chief clinical and strategy officer, Norton Healthcare. “We have been part of this community for a very long time and are furthering our commitment to local families. Having these practices will allow us to help bridge the gap between primary care and specialty services, with the goal of supporting the area for years to come.”

The practices will maintain their existing team of nine providers, of whom the majority provides care to both children and adults. Expecting more than 25,000 visits this year, the offices will offer wellness checkups, sports physicals, vaccinations, sick visits, pulmonary function and electrocardiogram testing, and more.

“We’re thrilled to join the Norton Children’s and Norton Healthcare system,” said Paul A. Kniery, M.D., internal medicine physician with the former practice and now Norton Children’s and Norton Healthcare. “We’ve seen the positive impact of their specialized pediatric care in our community, and we are proud to take part in the growth of primary care services for families here in Bowling Green.”

“Norton Children’s and Norton Healthcare have had a great relationship with the physicians in Bowling Green,” Dr. Hester said. “Our goal is to support their great work by bringing to bear all of the tools and resources we have to support timely access to care and the patient and family experience.”

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The 21,000-square-foot space — a $9.5 million investment — includes Norton Healthcare’s first same-day orthopedic injury care center and the first multidisciplinary office to house both pediatric and adult orthopedic and endocrinology care under the same roof.

“Norton Healthcare is committed to expanding access to health care,” said Russell F. Cox, president and CEO, Norton Healthcare. “The comprehensive and specialized services that will be provided in this new space will make it easier for children and adults of all ages to receive the care they need.”

The orthopedic injury care center will be staffed by seven specialists from Norton Orthopedic Institute and Norton Children’s Orthopedics of Louisville, affiliated with the UofL School of Medicine. X-ray capability will help providers accurately diagnose a variety of injuries, while on-site physical therapists from KORT and a unique turf area will allow for better assessments after injury or surgery. More specialists are expected to join the center in the future.

“This is a huge step forward for patients and athletes of all ages,” said Nathan L. McKinney, D.O., orthopedic sports medicine physician, Norton Orthopedic Institute. “This new space creates a seamless operation for athletes who can now receive their diagnoses, receive physical therapy and return to training all in the same location. Even more, providing care on the same day someone suffers an injury can alleviate fear and confusion from patients and families who are desperately awaiting results.”

The new office also will house Wendy Novak Diabetes Institute, a Part of Norton Healthcare and Norton Children’s, for patients with diabetes and other endocrinology needs. Dedicated endocrinologists will provide family-centered care as well as offer a Transition to Adult Diabetes Program to assist adolescents as they move to adult-based care. Diabetes education and pediatric virtual behavioral health services also will be available to patients.

Norton Sports Health Performance & Wellness Center, adjacent to the new space, will offer a Wendy Novak Diabetes Institute Sports & Activity Program. This new sports lab, staffed by a dedicated research scientist and exercise physiologist, will allow for state-of-the-art fitness and metabolic evaluations. The program was made possible thanks to generous donations to the Norton Children’s Hospital Foundation and is expected to take shape in the coming weeks.

“Not only are we looking out for the best interests of patients with diabetes to ensure they can maintain healthy and active lifestyles, but we’re also gathering data on the relationship between diabetes and how the body reacts to exercise,” said Kupper A. Wintergerst, M.D., pediatric endocrinologist and executive director, Wendy Novak Diabetes Institute. “This facility will allow us to personalize the care we provide to improve health outcomes for our patients and participate in cutting-edge research in diabetes and exercise science.”

The Norton Children’s Hospital Foundation contributed $350,000 toward Wendy Novak Diabetes Institute services.

“This comprehensive approach can only be made possible through donations,” said Lynnie Meyer, R.N., Ed.D., FAHP, CFRE, senior vice president and chief development officer, Norton Healthcare. “It will help countless children and their families navigate life to the fullest with diabetes.”

Wendy Novak Diabetes Institute is supported by the “Just Imagine” campaign, a visionary journey that will help bring better health care to patients throughout Kentucky, Southern Indiana and beyond. Just imagine what your help can do. Learn more or make a donation at JustImagineCampaign.com.

Along with orthopedic and endocrinology services, the new space also will house an adult primary care office, timeshare space for several specialty practices and a Norton Prompt Care clinic, which will offer same-day appointments for minor illnesses and injuries for patients ages 2 and older.

Schedule an appointment for a child by calling (502) 629-5437 (KIDS).

Adult patients can schedule an appointment by calling (502) 629-1234.

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The offices, located in Limestone at Franklin Square, Suite 1A, at 202 Limestone Drive, feature approximately 34,000 square feet of space split among adult and pediatric primary care, various adult and pediatric specialties, and a Norton Immediate Care Center.

“Providing access to health care is essential to our mission,” said Russell F. Cox, president and CEO, Norton Healthcare. “Norton Healthcare is committed to bringing quality care to families in our commonwealth’s capital and the surrounding area. We believe this new space and the services that will be provided there for both children and adults, is a great step toward building that for generations to come.”

The adult services are a first for Norton Healthcare in Frankfort and will include primary care, neurology and endocrinology specialty services. A dedicated endocrinologist will allow for better care of patients with diabetes and is part of Wendy Novak Diabetes Institute. According to the Centers for Disease Control and Prevention, 14% (more than 500,000) of Kentuckians have some type of diabetes. Expanding capacity will help treat more patients for a disease that continues to expand its reach across Kentucky and America. Norton Neuroscience Institute will have a dedicated neurologist present several days a week to care for patients with conditions ranging from headache to epilepsy.

“Making neurological care accessible to everyone is so important,” said Jessica F. Cain, PA-C, physician assistant, Norton Neuroscience Institute. “Giving people the opportunity to receive that specialty care close to home in Frankfort, as opposed to driving to Lexington or Louisville, only helps patients receive better outcomes.”

The expansion of the pediatric practice, including the specialty services, is possible in part thanks to generous donations to the Norton Children’s Hospital Foundation.

“We’re grateful to everyone who has supported this project and will help us imagine a brighter future for children in the Frankfort area,” said Lynnie Meyer, Ed.D., R.N., FAHP, CFRE, senior vice president and chief development officer, Norton Healthcare. “This directly impacts our vision to ensure children have access to these kinds of critical resources from Norton Children’s.”

The pediatric primary care services build on a long history of quality children’s care in Frankfort. The practice was started by Murvel C. Blair, M.D., in 1948 and has grown to currently consist of 10 pediatric providers, including Dr. Blair’s son Robert. Robert A. Blair, M.D., has been caring for patients in Franklin County and the surrounding area since 1972 and, at times, has cared for several generations of the same family.

“I can’t begin to describe my excitement that Norton Children’s is expanding its pediatric footprint in Frankfort,” said Robert A. Blair, pediatrician, Norton Children’s Medical Group. “Over my five decades in practice, I’ve seen the evolution of children’s health care and the need for more specialized care. I’m thrilled we’re bringing that much-needed specialized care to this community.”

Along with pediatric primary care, the new space will provide several pediatric specialties, including gynecology, neurology, cardiology, urology and care for children with autism. Pediatric care as part of Wendy Novak Diabetes Institute will soon be added to the clinic, allowing specialty care for children who have Type 1 and Type 2 diabetes.

Pediatric patients can schedule an appointment here or call (502) 629-KIDS (5437).

Adult patients can schedule an appointment here or call (502) 629-1234.

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In addition to the groin area, a monkey pox rash can break out on the hands, feet, chest, face or mouth.

If you are concerned about symptoms or possible exposure to Mpox, use MyNortonChart to set up an eCare video visit with a Norton Heathcare provider.

“We have a lot of worried patients who are coming into our practices,” said Angela Burgan, R.N., Infection Preventionist with Norton Medical Group. “People have rashes and lesions for a variety of reasons, so our providers really have to get into that information with the patient about their level of exposure to infected individuals.”Mpox

Mpox is spread by close contact, often skin-to-skin. That includes sexual contact as well as kissing, hugging or massage. The virus also can spread on surfaces, bedding, towels and other objects used by someone with Mpox. Respiratory droplets also can be a source of infection, though most cases appear to spread by close contact.

Some people with Mpox will get a rash followed by other symptoms, but some will have just a rash.

If you think you may have Mpox, either because of a new and unexplained rash or other symptoms, the Centers for Disease Control and Prevention recommends taking the following steps:

• Avoid close contact, including sex or being intimate with anyone, until you have been checked out by a health care provider.
• If you don’t have a provider or health insurance, visit a public health clinic near you.
• When you see a health care provider, wear a mask.

“Most patients are not acutely ill. Unless you’re having signs and symptoms of distress, the emergency room wouldn’t be appropriate,” Angela said.

Mpox rash symptoms usually start less than three weeks after virus exposure and a few days after developing flu-like symptoms. Mpox lasts up to four weeks until the rash has healed and a fresh layer of skin has formed.

Mpox symptoms also can include:

• Fever
• Headache
• Muscle aches
• Swollen lymph nodes
• Chills
• Exhaustion
• Respiratory complaints (sore throat, congestion, cough)

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As medical directors for community outreach, Drs. Narcisse, Nota and Patton will:

• Provide direct community outreach and participate in educational health programs throughout various communities, especially those in underserved areas.
• Assist in the planning and coordination of community health fairs and events and actively participate in health fairs, neighborhood community activities, health screenings and special events.
• Assist in the organization’s communications efforts and participate in media opportunities, speaking engagements and mentorship opportunities, all of which will help to provide information and education to the communities served by Norton Healthcare.
• Collaborate with Kelly C. McCants, M.D., cardiologist and executive director of the Institute for Health Equity, a Part of Norton Healthcare, to strengthen community relations and access to care in an effort to improve health equity statistics.
• Participate in the review of grant opportunities and potential investments in permanent facilities, health care services and programming, as part of Norton Healthcare’s commitment to invest an additional $20 million over five years to address health needs in underserved areas.

The three physicians shared a little of their why behind accepting their appointments:

“Knowing the history of my community gives me a sense of purpose and it gives me a charge – I’m responsible now not just to help my children, my family and myself, but also to help others and to make the world better,” said Dr. Narcisse, who practices at Norton Community Medical Associates ­– Hurstbourne. “It’s why I went into medicine and why I am excited for this additional opportunity to help strengthen our communities.”

“Everyone deserves care sensitive to their cultural preferences,” said Dr. Nota, who practices at Norton Children’s Medical Group – Germantown. “Underserved communities face so many barriers when it comes to access to health care. Wouldn’t it be wonderful to offer a place where they can relax knowing that they are supported, heard and appreciated; a place they can call their medical home?”

“A big issue in the community I came from was a lack of mentorship and role models to show pathways to professional development or even improved health for that matter,” said Dr. Patton, who practices at  Norton Community Medical Associates ­– Preston. “I’m thrilled to now be in a position where I can work to open doors for others and help to provide a positive influence for both working and living in wellness.”

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“It’s exciting. I can actually make a difference in the community. You go to Walmart or Kroger, and you see your patients,” Kimberly said.

Kimberly started recently at Norton Community Medical Associates – Shelbyville, a primary care practice located in Governor’s Square shopping center, next to Norton Children’s Medical Associates – Shelbyville and the new Norton Immediate Care Center – Shelbyville. She takes same-day appointments and accepts walk-in patients.

Kimberly said she chose to become an advanced nurse practitioner because helping people makes her happy. She worked as an emergency room nurse for 16 years before making the switch to a primary care nurse practitioner.

“As a family nurse practitioner, you can follow through on your patients,” Kimberly said. “Just making my community healthier makes me feel like I’m doing a worthwhile job.”

She spent six years going to school at night to earn a master’s degree to become a nurse practitioner, all the while working full time and raising her family. The schedule was tough, but Kimberly refused to quit.

“I’m not a quitter. Even if it gets hard, it makes me more determined to finish,” Kimberly said, adding that she wanted to set a good example for her two sons still at home. She also has a grown son and daughter, and one grandson.

In the rare moments when she has free time, Kimberly enjoys reading and riding her bike. She is also a dog lover and has two standard poodles.

Kimberly said her experience in the emergency room will help in her new role.

“You have to be able to adapt and change to each patient that comes in. That’s where my emergency room experience helps me. You never know what’s going to come in the door,” Kimberly said. “It’s exciting and challenging at the same time.”

In addition to conditions like colds and minor injuries, Kimberly also treats chronic conditions like hypertension and diabetes. She also can test for the coronavirus.

Kimberly was born in Shelbyville and went to Shelby County High School. She earned a nursing degree at Midway University in Kentucky and a bachelor’s degree at Indiana Wesleyan University before her master’s degree as an advanced nurse practitioner at Spalding University in Louisville.

Kimberly said she is looking forward to making a difference in the community she adores.

“They’re my family,” she said. I grew up with everybody here.”

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Rain was pouring on the brisk day in February 2019, and Dr. Narcisse, an internal medicine physician and pediatrician at Norton Community Medical Associates – Hurstbourne, simply could not let the patient, a woman in her 70s facing the early stages of dementia, leave without handing over her shoes.

Although they happened to wear the same size, the woman hesitated to take Dr. Narcisse’s shoes, but after some encouragement, she finally agreed.

Dr. Narcisse said her kindness toward others comes from how she was raised. If her mother and father saw someone who was hungry, they would give them money or go to the store and buy food for them.

“My parents would literally take the shirt off their backs and give it to someone,” Dr. Narcisse said. “They set that example for me since I was small, so for me to give the patient my shoes, it wasn’t even a second thought.”

Dr. Narcisse went into medicine because she wanted to help others through the care she provides. She said helping people live better lives is what grounds her.

“To motivate patients to lead healthy lives and make them feel better about themselves, that’s how we as health care providers make the world a better place,” Dr. Narcisse said. “If I can change someone’s thinking about themselves, that’s huge.”

Norton Healthcare conferred the Good Samaritan Award to Dr. Narcisse in 2019 for setting the standard for quality and caring by exhibiting the highest compassion for her patients and others. 

The Good Samaritan Award honors The Rev. John N. Norton, whose name Norton Healthcare carries and who became recognized as a good Samaritan because of his dedicated, selfless service to individuals in our community. This honor is given to employees who go above and beyond the call of duty by performing extraordinary acts of service for others. It represents the pinnacle of recognition for service excellence at Norton Healthcare.

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It’s a fair question. After all, it’s not like you’re using a bottle with ounces marked clearly on the side that let you see exactly how much milk your baby takes in with each feeding.

Elizabeth M. Doyle, M.D., Norton Children’s Medical Associates – Shepherdsville and Norton Healthcare’s system medical director for lactation, offers these useful guidelines to help moms know when their babies are getting enough nutrition and liquids from breastfeeding:

• Baby is feeding a minimum of eight times per day; optimal is 10 to 12 times per day.
• Infant is active and alert.
• Infant actively feeds at breast, with sucking and swallowing for at least 10 minutes.
• Baby is producing seven to eight wet diapers per day.
• Baby has met the general “4-by-4” goal to produce four stools by day four of life.
• Breasts feel full before feeding and empty afterward.

Dr. Doyle reminds moms — especially new moms — that breastfeeding can look and work differently for every mom and baby.

“Never be shy about asking questions when it comes to your baby’s well-being,” she said. “If you think something isn’t right with your baby, call your pediatrician!  You know your baby best.”

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“As I finished the checkup, the mom asked if we had any food vouchers,” Dr. Frazier said. “Unfortunately, we didn’t have anything readily available. We did end up helping the family, but we had to scramble.”

That started a change. Dr. Frazier and her colleagues Becky S. Carothers, M.D., and Nancee Spillman, APRN, teamed up with Dare to Care Food Bank to open a food pantry in their pediatric practice.

Norton Children’s Hospital Medical Associates – Broadway now takes a proactive approach to identifying which families are battling hunger. As part of all wellness visits, patients are asked a couple of basic questions to determine if they have food insecurities (a fear of running out of food).

“Our job is to treat the whole patient, and food and proper nutrition are a big part of physical and mental health,” Spillman said. “It turns out we see multiple patients and families each week who are facing this hardship.”

The  pantry  stocks healthy options such as cereals low in sugar, brown rice, nuts, spices, canned fruit in natural juices and canned vegetables with no added salt.

“We are always promoting good eating habits, so we need to make sure that’s what we’re providing,” Dr. Frazier said. “We also have foods that are helpful to people battling conditions such as diabetes, high blood pressure and heart problems.”

The food pantry program already is drawing rave reviews.

“Our families — even the ones who don’t have food insecurities — are so appreciative that we even ask,” Dr. Carothers said. “And the ones that do really are grateful that we have their backs during such a time of despair and uncertainty. It’s great we can make a difference.”

To learn more about local food pantry programs, visit DareToCare.org.

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