• Key Facts About the Flu
• Preventing the Flu & Getting Vaccinated
• What to Do if You Get Sick
• Is it the Cold or The Flu?
• For Clinicians
• Pandemic Flu Community Roundtables (Autumn 2006)

Key Facts About the Flu

What is Influenza (also called Flu)?

The flu is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness, and at times can lead to death. The best way to prevent this illness is by getting a flu vaccination each fall.

Every year in the United States, on average:

• 5% to 20% of the population gets the flu;
• more than 200,000 people are hospitalized from flu complications, and;
• about 36,000 people die from flu.

Some people, such as older people, young children, and people with certain health conditions, are at high risk for serious flu complications.
Symptoms of Flu

Symptoms of flu include:

• fever (usually high)
• headache
• extreme tiredness
• dry cough
• sore throat
• runny or stuffy nose
• muscle aches
• tomach symptoms, such as nausea, vomiting, and diarrhea, also can occur but are more common in children than adults

Complications of Flu

Complications of flu can include bacterial pneumonia, dehydration, and worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes. Children may get sinus problems and ear infections.

How Flu Spreads

Flu viruses spread in respiratory droplets caused by coughing and sneezing. They usually spread from person to person, though sometimes people become infected by touching something with flu viruses on it and then touching their mouth or nose. Most healthy adults may be able to infect others beginning 1 day before symptoms develop and up to 5 days after becoming sick. That means that you can pass on the flu to someone else before you know you are sick, as well as while you are sick.

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Preventing the Flu: Get Vaccinated

The single best way to prevent the flu is to get a flu vaccination each fall. There are two types of vaccines:

• The "flu shot" – an inactivated vaccine (containing killed virus) that is given with a needle. The flu shot is approved for use in people older than 6 months, including healthy people and people with chronic medical conditions.
• 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 people 5 years to 49 years of age who are not pregnant.

About two weeks after vaccination, antibodies develop that protect against influenza virus infection. Flu vaccines will not protect against influenza-like illnesses caused by other viruses.

When to Get Vaccinated

October or November is the best time to get vaccinated, but getting vaccinated in December or even later can still be beneficial. Flu season can begin as early as October and last as late as May.

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 who should get vaccinated each year are:

1. People at high risk for complications from the flu:
   • People 50 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, including asthma;
   • Adults and children 6 months and older who needed regular medical care or were in a hospital during the previous year because of a metabolic disease (like diabetes), chronic kidney disease, or weakened immune system (including immune system problems caused by medicines or by infection with human immunodeficiency virus [HIV/AIDS]);
   • Children 6 months to 18 years of age who are on long-term aspirin therapy. (Children given aspirin while they have influenza are at risk of Reye syndrome.);
   • Women who will be pregnant during the influenza season;
   • All children 6 to 59 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.)
2. People who can transmit flu to others at high risk for complications. Any person in close contact with someone in a high-risk group (see above) should get vaccinated. This includes all health-care workers, household contacts and out-of-home caregivers of children 6 to 23 months of age, and close contacts of people 65 years and older.
   

Is CDC recommending that flu shots go to “priority groups”, as was recommended last season?

To ensure that those who are at highest risk of complications from influenza have access to vaccine this season, CDC recommends that people in certain priority groups receive inactivated influenza vaccine (i.e., the “flu shot”) until October 24, 2006:

• people aged 50 years and older, with and without chronic health conditions
• residents of long-term care facilities
• people aged 2–64 years with chronic health conditions
• children aged 6–59 months
• pregnant women
• health-care personnel who provide direct patient care
• household contacts and out-of-home caregivers of children less than 6 months of age

Beginning October 24, 2006, all persons can get a flu shot.

Use of the Nasal Spray Flu Vaccine

It should be noted that vaccination with the nasal-spray flu vaccine is always an option for healthy persons aged 5-49 years who are not pregnant. This vaccine is not subject to prioritization and can be given to healthy 5-49 year olds at any time.

People Displaced by Hurricane Katrina

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 http://www.bt.cdc.gov/disasters/hurricanes/katrina/vaccrecdisplaced.asp

Who Should Not Be Vaccinated

Some people should not be vaccinated without first consulting a physician. They 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.
• Children less than 6 months of age (influenza vaccine is not approved for use in this age group).
• People who have a moderate or severe illness with a fever should wait to get vaccinated until their symptoms lessen.

If you have questions about whether you should get a flu vaccine, consult your health-care provider.

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What to Do If You Get Sick

Diagnosing the Flu

It is very difficult to distinguish the flu from other infections on the basis of symptoms alone. A doctor's exam may be needed to tell whether you have developed the flu or a complication of the flu. 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.

If you develop flu-like symptoms and are concerned about your illness, especially if are at high risk for complications of the flu, you should consult your health-care provider. Those at high risk for complications include people 65 years or older, people with chronic medical conditions, pregnant women, and young children.

Antiviral Medications

Is it a Cold or the Flu? (CDC, January 2004)

The flu

What is the flu? Generally flu symptoms include a dry cough, a high fever, general malaise and muscle aches.

What should I do to treat the flu? If you are sick with the flu, you should rest, drink plenty of fluids and treat symptoms with over-the-counter products so you can rest comfortably. If complications arise, call your physician.

The common cold

What is a cold? A cold is caused by a number of different viruses that create symptoms such as runny nose, nasal congestion, a cough and possibly fever.

How can you catch a cold? Colds are usually acquired through exposure to respiratory droplets when somebody coughs or sneezes. You can also be exposed to cold viruses by shaking hands or coming in physical contact with something touched by an infected person.

Can I keep from catching a cold? These methods are not foolproof, but washing your hands, encouraging people with colds to cover their mouths when they sneeze or cough, and staying home when sick can reduce the spread of cold viruses.

How will I know if I have a cold? The first stage of a cold is usually a dry cough that is treatable with any number of cough medicines (suppressants and expectorants) available at your local pharmacy. They will not only make you feel better, but by reducing your coughing it may also decrease the spread of the cold virus.

How should I treat a cold? Drink plenty of fluids to avoid dehydration. Get plenty of rest. You may also take cough medicines, either expectorants or suppressants. Cough suppressants generally contain either dextromethorphan (the DM of many products) or codeine. These products will quiet your cough, which can be a relief in the office or while trying to sleep. When you begin having a productive cough (bringing up phlegm), it may be a sign that your cold is on its way out. You should not suppress this kind of cough unless it is keeping you awake at night. Expectorants, such as guaifenesin, claim to loosen up the mucus when you're congested but not coughing. While these products claim to be effective, they have never been proven in clinical trials. Increasing your fluid intake will make your cough more productive without the assistance of an expectorant. For aches and pains generally associated with a cold, take acetaminophen (Tylenol®), ibuprofen or one of the new anti inflammatory medications on the market. While taking aspirin is rarely a problem for adults, it should not be given for colds or the flu to anyone under the age of 20.

Should I see a doctor if I have a cold? Generally not. There is not much the medical community can do for a common cold because viruses are not treatable with antibiotics or other medications. However, if you run a high fever for more than a week, you may want to seek medical attention.

• CDC: Flu Information for Health Care Professionals
• Community Health Administration: Information for Health Care Providers (DHMH)
• Directory of Health Departments