ALL ABOUT THE FLU

At least 20 million people, including 500,000 U.S. citizens, died in the 1918 influenza pandemic. Today, as many as 36,000 Americans continue to die each year of what's commonly known as the flu, and more than 200,000 are hospitalized. Most outbreaks in North America occur between October and May. The peak season is usually late December to early March. Anyone can get influenza.

Influenza (commonly called the "flu") is a contagious respiratory illness caused by influenza viruses. The virus attacks the respiratory system, including nose, throat, bronchial tubes and lungs. The flu can cause mild to severe illness and at times can lead to death. Although most healthy people recover from the flu without complications, some people, such as seniors, children, infant and people with certain health conditions, are at high risk for serious complications from the flu. Influenza usually starts suddenly and may include the following symptoms:

  • Fever
  • Headache
  • Fatigue
  • Cough
  • Runny or stuffy nose
  • Nausea
  • Body aches
  • Diarrhea and vomiting (more common among children than adults)
  • Sore throat

These symptoms are shared among many other viral illnesses including the common cold. It is important for you to visit your doctor to determine the cause of your symptoms on a timely manner. Occasionally, the flu can cause serious complications, including bacterial pneumonia, dehydration, and deterioration of chronic medical conditions, such as congestive heart failure, asthma, or diabetes. Sinusitis and ear infections are often seen in patients inflicted with this virus.

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Who are most at risk?

  • Those who have chronic lung or heart disorders

  • Those who have chronic diseases such as diabetes, kidney disease, severe anemia, or immune deficiency including HIV/AIDS and other immunosuppressive disorders.

  • Pregnant women who are in their second or third trimester of pregnancy during flu season

  • Pregnant women who have medical conditions that increase their risk for complications, regardless of the stage of pregnancy

  • Residents of nursing homes and other health care facilities that care for people with chronic medical conditions

  • Health care workers and employees of hospitals, nursing homes, and other outpatient facilities who care for patients

  • Police, fire fighters, and public safety workers

  • Those planning to travel to the tropics at any time or to the Southern Hemisphere from April through September who did not receive a flu vaccine the previous year

  • Everyone 65 years of age or older

  • Out-of-home caregivers and household contacts of anyone in any of the high-risk groups

  • This year, the CDC is making a special recommendation for the flu shot for those displaced by hurricanes who are staying in crowded living conditions

Anyone else who wishes to reduce his or her risk of acquiring the flu can receive the vaccine. The flu vaccine reduces the average person's chance of catching the flu by up to 80% during the season.

How the Flu spreads among people

The flu usually spreads from person to person in respiratory droplets when people who are infected cough or sneeze. People occasionally may become infected by touching something with influenza virus on it and then touching their mouth, nose, or eyes. Healthy adults may infect others one day before getting symptoms and up to 5 days after getting sick. Therefore, it is possible to give someone the flu before you know you are sick as well as while you are sick.

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Get Flu shot every Fall and early in the season

To keep the flu away, the single most effective way is to get vaccinated against the influenza. To prevent getting the flu, or to lessen its severity, you should get a flu vaccine each fall, before flu season starts. This is particularly recommended if you are age 50 and older or have a chronic health problem listed in high risk group above. However everyone can benefit from a flu vaccination. Although the vaccine is not 100% effective, a flu vaccination is your best chance to protect against the flu. They are usually available in USA by mid September of each year. We recommend that you get the vaccination as early as they become available and no later than December of each year. Flu season can begin as early as October and last as late as springtime. So, if you are at risk you may still want to get your flu shot even in January if you can.

How to prevent getting the flu

  • If you don't get the flu vaccination or until the vaccine takes effect, you can still protect yourself and family members to some degree from catching the flu with the following simple measures.

  • Notify your physician as soon as the symptoms appear so that the treatment can be started.

  • Staying away from anyone who has been diagnosed with the flu. Avoid crowded places like school, social gathering, small spaces with other people.

  • Frequent hand washing even with just water alone is a preventive measure. You may use antiseptics as you wish.

  • Avoid crowded spaces during an outbreak.

  • Avoid second hand smoking by staying away from smoker and discouraging them from smoking.

  • Try not to touch your eyes, nose, or mouth. Germs often spread this way.

  • Reducing your stress, adequate rest and a healthy diet is important in prevention of many illnesses and are only common sense.

  • Cover your nose and mouth with a tissue when you cough or sneeze-throw the tissue away after you use it.

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What to do if you get the flu

Influenza infection can be a serious illness, particularly among the elderly and compromised individual. Those with chronic illness like emphysema, cancer, immune deficiency, etc are at significant risk for hospitalization or even death. This is why you need to report to your physician as early as the symptoms occur so that your specific risks could be determined and appropriate recommendation be made in your particular case. This is especially important for people 65 years or older, people with chronic medical conditions, pregnant women, and young children. It is very difficult to distinguish the flu from other infections on the basis of symptoms alone. A doctor's exam is needed to tell whether you have developed the flu or a complication of the flu. Also, there are tests that can determine if you have the flu as long you are tested within the first 2 or 3 days of illness.

Meanwhile, you could benefit from the following measures

  • Rest as much as you possibly can.

  • Adequate fluid intake to avoid dehydration from lack of appetite or excessive sweating. Warm liquids may relieve the feeling of congestion.

  • Take acetaminophen for your fever and body ache for temporary relief.

  • Avoid contact with others.

  • Make appointment with your doctor.

  • Avoid use of alcohol and tobacco. Stay away from smokers.

  • Never give aspirin to children or teenagers who have flu-like symptoms, particularly fever.

Antiviral Medications

Your doctor may recommend use of an antiviral medication to help treat the flu. Four antiviral drugs (amantadine, rimantadine, zanamavir, and oseltamivir) are approved for treatment of the flu. During the 2005-2006 influenza season, CDC recommended against the use of amantadine or rimandatine for the treatment or prophylaxis of influenza in the United States. (For details, see the January 14, 2006 CDC Health Alert Notice) These are prescription medications, and a doctor should be consulted before the drugs are used. Antiviral treatment lasts for 5 days and must be started within 2 days of illness. Therefore, if you get flu-like symptoms, seek medical care early.

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Do antibiotics help the flu?

All viral infections including Influenza virus infection do not respond to antibiotics. However, your doctor may occasionally choose an antibiotic to treat particular complications of the flu like sinusitis, ear infection or pneumonia.

How many kinds of vaccines are available?

The single best way to protect yourself and others against influenza is to get a flu vaccination each year. Two kinds of flu vaccine are available in the United States:

The "Injectable flu vaccine" -an inactivated vaccine (containing killed virus) that is given by a shot in the arm. The flu shot is approved for use in people older than 6 months, including healthy people and people with chronic medical conditions. The flu shot contains killed flu viruses that will not cause someone to get the flu, but will cause the body to fight off infection by the live flu virus. Getting a shot of the killed virus causes a person to become protected against that particular type of live flu virus if he or she comes into contact with it.

The nasal-spray flu vaccine -a vaccine made with live, weakened flu viruses that do not cause the flu (sometimes called LAIV for "live attenuated influenza vaccine"). LAIV is approved for use in healthy individuals 5 to 49 years of age who are not pregnant. This nasal mist vaccine came on the market in 2003 2003 under name of Flumist manufactured by Medimmune Company and has been approved for use in above age range since then. But this nasal mist isn't for everyone, and can't be used on high-risk children and adults. Also, because the nasal spray flu vaccine is made from live viruses, it may cause mild flu-like symptoms, including runny nose, headache, vomiting, muscle aches, and fever. Check with your child's doctor to see if your child can - or should - get this type of flu vaccine.

Each vaccine contains three influenza viruses-one A (H3N2) virus, one A (H1N1) virus, and one B virus. The viruses in the vaccine change each year based on international surveillance and scientists' estimations about which types and strains of viruses will circulate in a given year. About 2 weeks after vaccination, antibodies that provide protection against influenza virus infection develop in the body.

Currently, there are four major manufactures licensed to sell their flu vaccinations in United States; Sanofi Pasteur, Glaxo Smith Klein, Novartis and Medimmune. Flu Shot Center utilizes vaccines of all of these four manufacturers in mass immunization clinics.

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How are flu vaccines given?

The injectable flu vaccine is given as one injection in the upper arm, usually in deltoid muscle. The nasal spray is directly sprayed in the nostril.

When is the best time to get vaccinated?

Although the flu season is from November to April, with most cases occurring between late November and early March, the vaccine is usually offered between September and mid-December (but may be given at other times of the year).

Getting the shot before the flu season is in full-force gives the body a chance to build up immunity for protection against the virus. Although you can get a flu shot well into flu season, it's best to try to get it earlier rather than later. However, If your doctor thinks it's necessary for you to get the flu vaccine, it's still a good idea to get vaccinated as late as January.

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Who Should Get Vaccinated?

In general, anyone who wants to reduce their chances of getting the flu can get vaccinated. However, certain people should get vaccinated each year. They are either people who are at high risk of having serious flu complications or people who live with or care for those at high risk for serious complications.

  • People 65 years and older.

  • People who live in nursing homes and other long-term care facilities that house those with long-term illnesses.

  • Adults and children 6 months and older with chronic heart or lung conditions.

  • Adults and children 6 months and older with metabolic disease like diabetes, chronic kidney disease, or weakened immune systems like HIV/AIDS, etc.

  • Children 6 months to 18 years of age who are on long-term aspirin therapy.

  • Women who will be pregnant during the influenza season.

  • All children 6 to 23 months of age.

  • People with any condition that can compromise respiratory function or the handling of respiratory secretions (that is, a condition that makes it hard to breathe or swallow, such as brain injury or disease, spinal cord injuries, seizure disorders, or other nerve or muscle disorders.)

  • People 50 to 64 years of age. Because nearly one-third of population in this age group in the United States have one or more medical condition that place them at increased risk for serious flu complications, vaccination is recommended for all persons aged 50 - 64 years.

  • All health-care workers, household contacts and out-of-home caregivers of children 0 to 23 months of age, and close contacts of people 65 years and older.

  • Influenza vaccination is recommended for all people 6 months of age and older who have been displaced by hurricane Katrina and are living in crowded group settings. See Centers For Disease Control.

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Who Should Not Be Vaccinated?

There are some people who should not be vaccinated without first consulting a physician. These include:

  • People who have a severe allergy to chicken eggs.

  • People who have had a severe reaction to an influenza vaccination in the past.

  • People who developed Guillain-Barré syndrome (GBS) within 6 weeks of getting an influenza vaccine previously.

  • Influenza vaccine is not approved for use in children less than 6 months of age.

  • People who have a moderate or severe illness with a fever should wait to get vaccinated until their symptoms subside.

How effective is the Flu Vaccine?

The ability of flu vaccine to protect a person depends on the age and health status of the person getting the vaccine, and the similarity or "match" between the virus strains in the vaccine and those in circulation. Testing has shown that both the flu shot and the nasal-spray vaccine are effective at preventing the flu.

What are the side effects?

Different side effects can be associated with the flu shot and LAIV.

The “Injectable flu vaccine”

The viruses in the flu shot are killed (inactivated), so you cannot get the flu from a flu shot. Some minor side effects that could occur are:

  • Soreness, redness, or swelling where the shot was given

  • Fever (low grade)

  • Aches

If these problems occur, they begin soon after the shot and usually last 1 to 2 days. Almost all people who receive influenza vaccine have no serious problems from it. However, on rare occasions, flu vaccination can cause serious problems, such as severe allergic reaction.

“The Nasal Mist Flu Vaccine”

The viruses in the nasal-spray vaccine are weakened and do not cause severe symptoms often associated with influenza illness. (In clinical studies, transmission of vaccine viruses to close contacts has occurred only rarely.)

In children, side effects from LAIV can include

  • runny nose

  • headache

  • vomiting

  • muscle aches

  • fever (low grade)

In adults, side effects from LAIV can include:

  • runny nose

  • headache

  • sore throat

  • cough

(Source: www.cdc.gov)

Again, most people do not experience any side effects from the flu shot. According to the CDC, the flu shot rarely causes serious harm and less than one third of people vaccinated have soreness or swelling at the site of the shot or mild side effects, such as headache or low-grade fever.

Although these side effects may last for a day, the flu can knock you off your feet for 2 to 3 weeks and can have life-threatening complications, such as pneumonia, other respiratory complications including failure and death. Side effects of the flu shot are most likely to occur in children who have not been exposed to the flu before. If your child does have symptoms after getting the flu shot, consult you child physician about the side effects. Do not give your child aspirin unless your child's doctor instructs you to do so.

A common myth about the flu shot is that it can actually cause the flu. But the injectable flu shot made in the United States is made from killed influenza viruses and can not give you the flu. However, because the nasal mist form of flu vaccine is made from live viruses, it may cause mild flu-like symptoms, including runny nose, headache, vomiting, muscle aches, and fever.

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Is one flu shot enough?

For all adults one dose of flu vaccine either in form of injectable or the mist is sufficient for adequate immunization. Children age 8 and younger require two doses of the flu vaccine if it's the first time they've been vaccinated for influenza. That's because children don't develop an adequate antibody level the first time they get the vaccine. Antibodies help fight the virus if it enters your child's system. If a flu vaccine shortage was to occur and your child couldn't get two doses of vaccine, one dose might still offer some protection. After being vaccinated for the flu one season, children need only one dose of the flu vaccine in subsequent years.

Will the flu shot protect me from bird flu?

An annual flu shot won't protect you specifically from bird flu, but it will reduce the risk of simultaneous infection with human and bird flu viruses. This is important because simultaneous infections are the main way that viruses swap genes and create new strains that potentially can cause flu pandemics.

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Will there be enough vaccine for everyone this year?

The Centers for Disease Control and Prevention (CDC) expects there to be enough vaccine for everyone this year. The current recommendation is that all U.S. residents older than 6 months of age receive the flu vaccine, including pregnant women and people displaced by Hurricane Katrina.

Why do I need to get vaccinated every year?

You need annual flu shots because the vaccine changes from year to year. The flu vaccine you got last year wasn't designed to fight the virus strains in circulation now. Influenza viruses mutate so quickly that they can render one season's vaccine ineffective by the next season. A CDC advisory committee meets early in the year to estimate which strains of influenza virus will be most prevalent during the upcoming flu season, and the manufacturers produce vaccine based on those recommendations. The current vaccine protects against H3N2, this season's most prevalent strain.

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Is flu vaccine safe for the pregnant women?

The Centers for Disease Control and Prevention (CDC) recommends flu shots for all women who will be pregnant during flu season. In North America, peak flu season is usually November to March. Because the flu shot is made from killed (inactivated) influenza virus, it is considered safe during any stage of pregnancy. However, pregnant women must not use the nasal-spray flu vaccine, which is made of live, weakened influenza virus.

Pregnancy can affect your immune system and also put extra stress on your heart and lungs. As a result, you may be at increased risk of not only getting the flu but of developing serious complications of the flu, including pneumonia. In addition, pregnant women with the flu are far more likely to require hospitalization for flu complications than women with the flu who are not pregnant.

What about the preservatives in the flu vaccines?

Inactivated influenza vaccine used in the United States may contain thimerosal, a preservative that contains a very small amount of mercury. There's no evidence that thimerosal in vaccines causes any health problems, according to the Centers for Disease Control and Prevention (CDC).

In 1999, the U.S. Public Health Service and other groups recommended reducing the thimerosal content in vaccines to decrease total mercury exposure, especially in infants and pregnant women. Today, with the exception of some flu vaccines, none of the routine vaccines given in childhood contains thimerosal.

According to the CDC, removal of thimerosal in influenza vaccine is a complicated process. The production of flu vaccine without thimerosal will be increased as vaccine manufacturing capabilities are expanded. In the meantime, it's important to keep in mind that the benefits of influenza vaccine far outweigh the theoretical risk, if any, for exposure to thimerosal. Each year, about 36,000 people in the United States die of influenza.

Commonly thought or asked questions about Flu Shot

"Is flu just a bad cold?"
Influenza (flu) is far more dangerous than a bad cold. It is a disease of the lungs, and it can lead to pneumonia and other lethal complications. Each year about 200,000 people in U.S.A. are hospitalized and about 36,000 people die from the flu.

"Does Flu Shot give me the flu?"
The injectable flu vaccine is made from killed influenza viruses. This can not give you the flu.

"The vaccine is not 100% effective"
Am I better off getting the flu?
No, this vaccine is not 100% effective. However, if you get a flu shot but still get the flu, you are likely to be far less sick than you would have been without the protection.

"Are the side effects worse than the flu?"
The worst side effect you are likely to get is a sore arm. The risk of a rare allergic reaction is far less than the risk of severe complications from influenza.

"Only the very old and sick need a flu shot!"
Both adults and children who are in good health can benefit from the flu shot to stay healthy. Even if you are not at high risk of complications, you should get a flu shot to prevent the flu and to protect everyone you live with and have contact with.

"Is December too late to get the flu shot?"
The flu shot can be given before or during the flu season. While the best time to get a flu shot is September through November, flu shot in December or later will protect you against the flu.

"Even if I get a flu shot, can I still get the flu?"
This can happen, but the flu shot usually protects most people from flu. However, the flu shot will not protect you from other viruses that can cause illnesses that sometimes feel like the flu.

"Can anyone get a flu shot?"
If you are allergic to eggs (used in making the vaccine) or have had a severe reaction to the flu vaccine in the past, you can not get flu shot. You should discuss this with your doctor.

To learn more about the flu and flu vaccines we encourage you to visit the following sites:

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