Prevention

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To avoid getting the flu, or to reduce its severity, you should get a flu vaccine each fall, especially if you are 50 or older, are pregnant, have a chronic health problem, are a health care worker or live or work around the elderly. The vaccine helps your immune system fight off the flu virus when you're exposed. If you're allergic to eggs or running a fever, don't get a vaccine without talking first with your health care professional. The flu vaccine has been shown to be completely safe to take during pregnancy, but again, discuss this with your health care professional. The most common side effect of the vaccine is soreness at the site of the injection.

When the flu vaccine is a good "match" to the circulating strains, it has a 70 to 90 percent success rate in people under 65. While the vaccine itself cannot cause the flu, you could be exposed to the flu within two weeks after vaccination, before you have time to develop antibodies, or immune resistance. Then, when you get sick, you might think the vaccine caused it.

Because your immune system needs several weeks to respond to the vaccine, the best time to get vaccinated is in October or November since most flu activity occurs in January or later. Some flu seasons can last as late as May. No matter the date, it's still worth getting vaccinated any time during flu season. You start to develop some immunity from the vaccine within a few days to two weeks.

Planning Ahead: Recommendations for Flu Vaccinations

As of July 2007, the U.S. Centers for Disease Control and Prevention (CDC) recommended that anyone who wanted to reduce their chances of the flu get vaccinated. If vaccine supplies become limited or delayed, there are certain priority groups for vaccination, including:

• pregnant women

• children from six to 59 months

• people age 50 or over

• anyone with chronic medical conditions, especially asthma or chronic bronchitis and emphysema

• anyone in a long-term care facility or nursing home

• health care workers

• household contacts and out-of-home caregivers of children younger than six months

• people within regular contact with those at risk for flu complications

The above recommendations do not apply to live-active-influenza-virus-type vaccines. FluMist, an intranasal flu vaccine that prevents influenza types A and B, is recommended for children at least two years old and adults up to age 49, including most health care personnel and those in close contact with groups at high risk for influenza-related complications.

Pregnant women and those who care for people with weakened immune systems should not receive the FluMist vaccine. FluMist appears to be as effective as injected flu vaccine, although it costs more and should not be given to people with asthma.

If you or a family member wants to receive a flu vaccine but cannot locate a source, you can search by zip code at the following American Lung Association Web site: www.findaflushot.com/lungusa.

In addition, some public clinics offer the vaccine. Ask your health care professional for more information about restrictions and availability of the flu vaccine.

Who Should Not Be Vaccinated

There are some people who should not be vaccinated with injected influenza vaccine, according to the CDC. These include infants under six months of age and those who:

• have a severe allergy to chicken eggs

• have had a severe reaction to a previous influenza vaccination

• developed Guillain-Barré syndrome within six weeks of getting an influenza vaccine

• have a fever (wait until your fever subsides)

Prescription Antiviral Medication for Flu Prevention

Prescription antiviral medications, used as an adjunct to vaccination, may be extremely helpful in preventing the onset of flu. If you have been around someone who has the flu, a doctor can prescribe antiviral medication to help prevent you from catching the virus. However, it's important to contact the doctor fast, as antiviral medication should be taken within the first 12 to 48 hours of exposure to the virus. When administered within 48 hours of exposure, oseltamivir (Tamiflu) is up to 92 percent effective at preventing flu in adults, and 82 percent effective in preventing flu in children.

Antivirals are particularly recommended as a preventative measure in a variety of special situations:

• for people who have egg allergies and therefore cannot receive a flu vaccine
• for people who have a chronic disease, such as asthma, diabetes, heart disease, anemia, lung/kidney disease or AIDS/HIV
• for people who may not have received a vaccine but are exposed to flu
• for health care workers and people who work in institutional settings, such as nursing homes and hospitals

When outbreaks occur in institutions, antiviral medication should be administered for at least two weeks to all residents, regardless of whether they received influenza vaccinations.

Additionally, antivirals can be particularly useful in helping to control flu outbreaks in households, schools, day-care settings and communities. In the event of an outbreak, antivirals can be administered to those who were exposed to reduce the chances of passing the virus to others.

Minimizing Your Risk

There are several simple common-sense things you can do to protect yourself from the flu and to help prevent the spread of the flu virus in general:

• Cover your mouth and nose when you sneeze or cough and teach your children to do the same. Use tissues, not handkerchiefs, and dispose of the tissue after one use. Also, try not to touch your mouth, nose or eyes to avoid spreading germs.

• Keep your distance (at least three feet), if possible, from people who have the flu, because the virus is spread when an infected person coughs or sneezes.

• Wash your hands frequently to reduce your risk of catching a cold or flu. Ordinary soap is sufficient. If soap and water are not available, use an alcohol-based hand cleaner. Antibacterial soaps add little protection, particularly against viruses. In fact, a study suggests that although hand washing with soap reduced the number of pneumonia-related infections in children under five by 50 percent, there was no difference in the results when antibacterial soap was used instead of regular soap.

• Avoid second-hand cigarette smoke and, if you smoke, try to quit.

• Try to maintain a healthy lifestyle to build your immunity by following a nutritious diet, getting enough sleep, drinking lots of water and minimizing stress. Eating lots of fruits and vegetables, which are rich in antioxidants and other important plant-based chemicals, may help strengthen your immune system.

The herbal remedy echinacea gets a lot of attention for its claims to prevent colds and flu or for minimizing symptoms, if they do develop. However, most studies on this herb find no benefits when it comes to preventing either colds or flu. Studies do find, however, that using echinacea at the beginning of a cold can reduce the length and intensity of the illness. Because there are no standards or quality controls available for supplements like echinacea (including what part of the plant is used in the supplement) and some supplements may cause toxic side effects in large doses, you should always discuss natural remedies with your health care professional before taking them.

There is no evidence that large doses of vitamin C prevent or cure colds or the flu. However, several studies find that zinc lozenges may reduce the length and intensity of colds and flu, and that nasal zinc gel appears to reduce the length and intensity of illnesses related to those viruses. Zinc nasal spray does not show the same effects, however.