by Michelle Meadows
This time of year presents plenty of opportunities for viruses to spread. Chilly weather keeps more of us indoors at the same time, and the holiday season brings together family members of all ages. Colds and flu (influenza) can occur anytime, but appear mostly in the fall and winter.
For most people, viral respiratory illnesses are usually self-limited and last only a few days. But along with making millions of us feel lousy every year, colds and flu can cause serious problems and can even be deadly. The flu leads to more than 100,000 hospitalizations each year and about 20,000 deaths, according to the Centers for Disease Control and Prevention (CDC). Death rates are highest for people aged 65 and up and for those with medical conditions that put them at increased risk for flu complications. (Also see “Keeping Up with Flu Shots” below.)
Here are tips to ward off colds and flu and to ease the misery if they strike:
Get a flu shot.
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.
Influenza viruses are classified as types A, B, or C. Type A and B viruses are the most serious because they are the ones most often responsible for cases of the flu and all of its complications. Type C viruses are mostly associated with cold symptoms.
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 you 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.
Researchers continue to hold out hope for a nasal spray flu vaccine, which is still being tested. The nasal spray vaccine may boost immunization rates, especially for children, who are most likely to spread the flu virus. (For more on the flu vaccine, see “Keeping Up with Flu Shots” below.)
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 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.
People who get the flu usually know the exact day that it hit, whereas a cold tends to come on gradually. Both colds and flu cause inflammation of the mucous membranes (found in the nose, throat and mouth). Symptoms for colds and flu can be similar; both can cause a stuffy nose, sore throat, cough, and fever. Symptoms generally last about a week or two.
Colds are usually distinguished by a runny nose and sneezing. Along with coming on suddenly, the flu is more serious than a cold, lasts longer, and often leaves you with a wiped-out feeling, a headache, chills, dry cough, and body aches.
Young children may also experience nausea and vomiting with flu, but what many people call “stomach flu” is something different—probably gastroenteritis, which is usually caused by other viruses, bacteria, and toxins.
In preparation for possible delays with the 2001 flu vaccine supply, the Centers for Disease Control and Prevention (CDC) encouraged health-care providers to target doses of flu vaccine to high-risk groups and health-care workers in September and October.
People age 6 months and up who are not considered at high risk should seek the vaccine as it is available, in November or later. Children under 9 need two doses of vaccine separated by at least one month if they haven’t previously had a flu shot.
A recent CDC study shows that while flu vaccination rates increased during the past decade, rates may be leveling off, and racial gaps persist. In 1999, 69 percent of whites age 65 and over reported getting a flu shot, compared with 59 percent of Hispanics, and 48 percent of African Americans. Differences in access to care and socioeconomic status don’t appear to explain the gap, says James Singleton with the CDC’s National Immunization Program. The CDC is planning a series of interviews, surveys, and other research over the next year to uncover the key factors, Singleton says.
Visit the CDC’s influenza web site at www.cdc.gov/nip/flu/.
Unvaccinated high-risk persons, health-care workers, those living with high-risk people, and all people ages 50 and older should try to be vaccinated by November, and should continue to seek influenza vaccine in December or later if necessary.
Here are the primary target groups for annual flu vaccination:
People at increased risk for complications from the flu, including
People who can transmit influenza to those at high risk
People ages 50-64 because this group has increased prevalence of high-risk conditions.