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Flu
How can I prevent flu?
Get the flu vaccine.
A vaccine against colds hasn't been developed because colds can be caused by many types of viruses. But the flu vaccine remains the best way to prevent and control the flu.
Flu season in the United States runs from November to April. October to November is the usual vaccination time for most people. "But you can also get good results when the vaccine is used in December and January, even if influenza is already starting to spread through a community," says Roland A. Levandowski, M.D., a medical officer and virologist in the Food and Drug Administration's Center for Biologics Evaluation and Research. We need a new flu shot every year because the predominant flu viruses change every year.
The protective effect of the vaccine starts working rapidly in people who have been previously infected with flu viruses or have received a flu shot in the past. Infection-fighting antibodies in the blood reach a peak about three weeks after these people get the shot. But for some, such as children younger than 9 who haven't been previously vaccinated, two doses of the influenza vaccine about a month apart are recommended for the first vaccination. In older people and in those with chronic illnesses, the shot may not necessarily prevent the flu, but can reduce the symptoms and risk of complications if they do get sick.
The flu vaccine is made of killed virus and can't cause the flu. The most common side effect is soreness at the injection site. The flu shot is not recommended for certain people, including those allergic to eggs. The viruses for flu vaccines are grown in eggs.
In June 2003, the FDA approved FluMist, the first nasally administered flu vaccine to be marketed in the United States. The needle-free vaccine is for healthy children and adolescents ages 5 to 17 and in healthy adults ages 18 to 49. The nasal spray is manufactured by MedImmune Vaccines Inc. of Gaithersburg, Md., and is marketed by MedImmune and Wyeth Vaccines of Philadelphia.
FluMist is also the first live virus influenza vaccine to be approved in the United States. The most common side effects are nasal congestion, runny nose, sore throat, and cough. As with other live virus vaccines, FluMist should not be given to people with suppressed immunity, such as people with AIDS or cancer. The vaccine also shouldn't be given to pregnant women, people with a history of asthma or other reactive airway diseases, people age 50 and over, or to children under 5.
Wash your hands.
Both colds and flu can be passed through coughing, sneezing, and touching surfaces such as doorknobs and telephones. So it's wise to make a habit of washing your hands and to teach children to do the same. This helps you prevent spreading respiratory infections and picking them up from someone else.
According to the American Society for Microbiology, a national survey found that Americans were most likely to say they wash their hands after changing a diaper and before handling food. Most, however, said they don't wash their hands after coughing and sneezing.
The CDC recommends regular scrubbing of your hands with warm, soapy water for about 15 seconds. Touching your nose, mouth, and eyes with contaminated hands makes it easy for cold and flu viruses to enter the body. Others can become ill by just coming in contact with someone who has become infected with a cold or flu virus or who has come in contact with a contaminated area.
Limit exposure to infected people.
Sometimes people are infected with a virus and they don't know it because they haven't experienced symptoms yet. If possible, avoid people who you know have colds and flu. Keep infants away from crowds for the first few months of life. "This is especially important for premature babies who may have underlying abnormalities like lung disease and heart disease," says Larry Pickering, M.D., a fellow of the American Academy of Pediatrics and a pediatrician in Atlanta.
If keeping your distance is too difficult--say in the case of parents who can't help but hold and kiss their sick kids--then, in addition to washing your hands frequently, you can keep surfaces clean with a virus-killing disinfectant available at the grocery store. A solution of 1 part bleach mixed with 10 parts water also is effective in killing viruses.
Practice healthy habits.
Eating a balanced diet, getting enough sleep, and exercising can help the immune system better fight off the germs that cause illness. Because smoking interferes with the mechanisms that keep bacteria and debris out of the lungs, those who use tobacco or who are exposed to secondhand smoke are more prone to respiratory illnesses and more severe complications than nonsmokers.
If you've been feeling run down, some stress management might not be a bad idea. David Skoner, M.D., chief of allergy and immunology at Children's Hospital in Pittsburgh, has studied the effects of chronic stress on susceptibility to cold and flu infections. "We've found that people who experience more stress are more likely to get sick and experience worse symptoms," he says. Examples of chronic stress are personal crises such as going through a divorce or feeling stuck in a bad job.
"Research has also shown that the more social you are, the less likely you are to get sick," Skoner says. It could be because having more social contacts and support is less stressful than keeping to yourself, he says.
If you do come down with a cold or flu, here's advice on safe relief from symptoms:
Drink up and rest.
Fluids such as water, juice, soup, and non-caffeinated beverages can help loosen mucus, keep you hydrated, and make you feel better, especially if you have a fever. Alcohol and drinks containing caffeine may have a dehydrating effect. To help others stay healthy, limit your exposure to them and promptly throw out tissues rather than letting them pile up on your nightstand.
Gargling with salt water can help relieve a sore throat. A cool-mist humidifier, which breaks water into droplets and releases them into the air, may help relieve stuffy noses. Keep the humidifier clean to avoid a buildup of mold, which could be harmful if inhaled. Saline nasal drops and suctioning with a bulb syringe can help infants and small children breathe better. But be gentle because aggravating the nasal passages could make swelling worse. Also, dress sick children comfortably--like you would dress yourself, Pickering says. "Some parents bundle them up if they have a fever, but that can make it worse."
Choose over-the-counter (OTC) medicines that are appropriate for your symptoms.
With all the choices on the shelves, it can be hard to know what medicine to pick. It may seem easier to grab a multi-symptom medicine that promises to take care of everything, but it's better to take a product specific to your symptoms, says Jeffrey Delafuente, a professor and director of geriatric programs at Virginia Commonwealth University's School of Pharmacy.
"If your only problem is a runny nose, why take a cough suppressant?" he says. Taking medicine for symptoms you don't have may not be harmful, he adds, but it unnecessarily exposes you to medicine and the accompanying side effects. "Multi-symptom medicines can be useful if you truly have many symptoms."
If you want to unclog a stuffy nose, then nasal decongestants may help. Cough suppressants quiet coughs; expectorants loosen mucus so you can cough it up; antihistamines help stop a runny nose and sneezing; and pain relievers such as acetaminophen can ease fever, headaches, and minor aches. Check with a pediatrician or your family physician first before treating children suffering from cold and flu symptoms with medicine.
Don't give aspirin or aspirin-containing medicines to children and teen-agers.
Children and teen-agers suffering from flu-like symptoms, chickenpox and other viral illnesses shouldn't take aspirin because of the possibility of Reye syndrome. Some medicine labels may refer to aspirin as salicylate or salicylic acid. Be sure to educate teen-agers, who may take OTC medicines without their parents' knowledge.
Children with Reye syndrome start vomiting and become drowsy within a few days of becoming sick. The disorder, which is now rare, can affect all body organs and lead to brain damage and death. Reye syndrome occurs almost exclusively in children 4 to 12 years of age and is rare in adults, Pickering says.
Read OTC medicine labels carefully and follow directions.
Use the dosing device that comes with the medicine and don't exceed recommended dosages or length of use. Taking a nasal spray for too long during a cold could result in an even stuffier nose, for example. Always check with a doctor first if the correct dose for a child isn't listed on a label and before giving a child more than one medicine at a time.
Delafuente says he tells older people, who often take multiple medications, to check with a doctor or pharmacist before taking a new OTC cough and cold medicine because some can worsen underlying health problems, such as high blood pressure or heart disease. Decongestants can speed up heart rate, for example, and antihistamines can cause urinary retention in men with prostate problems. For both young and old, antihistamines can make you drowsy, which could affect driving.
Be sure to check expiration dates and get rid of old medicine. The FDA has warned consumers against using OTC and prescription drug products containing phenylpropanolamine because the ingredient has been associated with an increased risk of hemorrhagic stroke (bleeding in the brain). This ingredient was commonly used as a decongestant in OTC and prescription cough and cold medicines before the warning.
Be careful not to double up on ingredients.
If you take more than one medication at a time, be careful not to duplicate ingredients, says Marina Chang, a pharmacist with the FDA's Center for Drug Evaluation and Research. "Look at the active ingredients of every medicine you take," she says.
For example, you don't want to accidentally take two different medicines that both contain acetaminophen. The same goes for taking acetaminophen tablets to relieve pain while also taking a cough medicine containing acetaminophen. Too much of this drug can result in liver damage.
Jon Temte, M.D., Ph.D., associate professor of family medicine at the University of Wisconsin Medical School, recalls a young woman who came in complaining of a racing heartbeat and anxiousness. He discovered her symptoms occurred because she had taken two different products, both containing a decongestant.
