Prevention

Personal hygiene

• Wash your hands frequently with soap and water.



• Avoid touching your eyes or nose before washing your hands.



• Do not share clothes or other personal items with another person during a flu outbreak.

Vaccination: The best means of preventing the flu is getting an influenza vaccination. Two types of vaccines are available. One is the injectable vaccine made from inactivated virus, known as the flu shot. The other is a live attenuated, or weakened, virus that is squirted into the nose. The flu shot contains only killed influenza viruses A and B. The shot is given in the upper arm once every year during the fall, prior to flu season. Immunity to the flu virus develops after about 2 weeks. Thus, the best time to get a flu shot is from October to mid November.

• Because of substantial vaccine distribution delays during previous influenza seasons and the possibility of similar delays in the future, it is recommended that anyone at high risk for complications from the flu get a flu shot in September. This same group of people can even get the vaccine in December and throughout the flu season.



• The vaccine is effective in about 70-90% of those who get the shot, especially in older people. Not only does it decrease the risk of getting flu infection, but it can also decrease the number of visits to a doctor's office, hospitalizations, and risk of death from the flu virus.



• Who should get the flu shot?
  
  
  • Anyone older than 50 years
  
  
  
  • A person of any age with chronic diseases of the heart, lungs, or kidneys
  
  
  
  • People with diabetes
  
  
  
  • Those who are HIV positive or have AIDS
  
  
  
  • Women who are more than 14 weeks pregnant during the flu season (Women who are pregnant at any stage of their pregnancy and have risk of complications from the flu should get the vaccine irrespective of how far they are into the pregnancy. Breastfeeding women can also get the flu shot without worry about harm to the baby.)
  
  
  
  • Residents of nursing homes and other facilities of long-term care
  
  
  
  • Children older than 6 months of age who have chronic heart or lung conditions, including asthma
  
  
  
  • Children older than 6 months of age who need regular medical care or had to be in a hospital because of metabolic diseases (such as diabetes), chronic kidney disease, or weakened immune systems (including immune system problems caused by medicine or by infection with human immunodeficiency virus [HIV/AIDS])
  
  
  
  • Children and teenagers (aged 6 months to 18 years) who are on long-term aspirin therapy and therefore could develop Reye Syndrome after a flu illness
  
  
  
  • Health care workers and volunteers who work with high-risk patients, including employees of nursing homes and chronic-care facilities
  
  
  
  • Household members (including children) of people in high-risk groups
  
  
  
  • Students or others living in institutional settings (for example, those who reside in dormitories or camps where close contact is likely)
  
  
  
  • Anyone interested in reducing the risk of getting the flu
  
  
  
  • The intranasal or live vaccine, known as FluMist, is an alternative to the flu shot in people who are healthy, aged 5-49 years old, and not pregnant. Exceptions are health care workers who care for severely immunosuppressed patients or persons caring for children younger than 6 months old.
  
  
  
  • People who are allergic to eggs or who have had Guillain-Barre syndrome (paralysis) within 6 weeks of a prior vaccination should check with their doctor before getting an influenza vaccine.




• 2004 influenza vaccine shortage update: Almost half of the expected supply of flu vaccine for the United States will not be delivered for the 2004-2005 flu season. Chiron, a major manufacturer of the vaccine (about 47 million doses), will not be distributing their vaccine. About 55 million doses from Aventis Pasteur and about 1 million doses of the live vaccine, FluMist, will be available. The Centers for Disease Control and Prevention (CDC) is working with the other major vaccine manufacturer, Aventis Pasteur, to coordinate vaccine distribution so that those who need it the most will be vaccinated. Regular flu shot clinics may not be operating according to their usual schedules. (Updates are available on the CDC Web site, Influenza [flu].) Because of the shortage, the CDC has prioritized groups that should be vaccinated first. This group includes the following:

• People aged 65 years and older



• Children aged 6 months to 23 months



• Adults and children older than 2 years with chronic diseases such as diabetes, kidney disease, blood disorders, or HIV infection



• Children aged 6-18 years on daily aspirin therapy



• Residents of nursing homes and chronic care facilities



• Household members and caregivers of children younger than 6 months old



• Health care workers who work directly with patients

• Travel: The risk of getting the flu during travel depends on the destination and time of the year when travel is done. In countries in the northern hemisphere, such as the United States, influenza occurs between November and March. In the southern hemisphere, most influenza occurs between April and September. In the tropical regions, such as the Caribbean, the flu occurs year round. For people who are traveling, the recommendations are as follows:
• • Because the availability of the vaccine in North America is limited in the summer season, those needing the vaccine for travel purposes should discuss the best option for flu prevention, vaccine versus carrying of antiviral medications, with their doctor.
  
  
  
  • Those who are at high risk of getting complications from the flu illness and anyone who wants to decrease the chances of getting the flu and is visiting the tropics or the southern hemisphere from April through September should take the vaccine at least 2 weeks before departure if they were not vaccinated in the previous winter or fall.
  
  
  
  • Anyone at high risk who received the previous season's vaccine should be revaccinated before travel in the fall or winter with the current vaccine.
  
  
  
  • Those who have missed the flu shot can still get the vaccine during an outbreak. This is usually combined with antiviral medications to decrease the risk of acquiring the flu. However, the best method of prevention is to get the shot prior to the flu season.
  
  
  
  • For more travel information, check the CDC National Center For Infectious Diseases Infectious Disease Information, Influenza (Flu, Influenza Virus Infection).




• Side effects: The most frequent side effects of vaccination are soreness and redness at the vaccination site that may last for up to 2 days. These reactions are generally mild and rarely interfere with the ability to conduct usual daily activities. Fever, weakness, muscle aches, and other symptoms can occur, most often in children, following vaccination. These reactions begin 6-12 hours after vaccination and can last for 1-2 days.
  
  • Side effects from the intranasal vaccine are usually mild. The viruses in the nasal-spray vaccine are weakened and will not cause severe symptoms often associated with influenza illness. In children, side effects can include runny nose, headache, vomiting, muscle aches, and fever. In adults, side effects can include runny nose, headache, sore throat, and cough.
  
  
  
  • Life-threatening allergic reactions are very rare but can happen in people who may have an allergy to one of the vaccine components, most commonly eggs. The influenza viruses used in the vaccine are grown in hens' eggs. Those who have an allergy to eggs or who have ever had a serious allergic reaction to a previous dose of influenza vaccine should consult with a doctor before getting the flu shot.




• Myths about the flu shot
  
  

  • You can get the flu from the shot. No. You cannot get the flu from the shot. The shot contains only an inactivated (killed) form of the virus and therefore cannot cause influenza.

  • You only need to have the shot once in your life. The flu shot must be taken every year in order to keep from getting the flu. The fact that influenza viruses continually change their structure is one of the reasons the vaccine must be taken every year. Antibodies formed by the body's immune system after the vaccination decline over time. Your own defenses, thus, may not be effective for the next flu season. Each year the vaccine is updated to include the most current influenza virus subtype.
    

• Even if you have a flu shot, you may still get the flu when the flu season arrives because the vaccine is not 100% effective in preventing the flu. The virus can be of a different subtype, so you may not be protected against it. The vaccine is made from the virus subtype that was prevalent in the previous flu season. Sometimes the new vaccine may not match the virus type that is causing flu the next year.



• People at high risk for complications from the flu, and who have not had the shot in time to be protected, can be given one of the antiviral medications for prevention during an outbreak. Only amantadine, rimantadine, and oseltamivir are useful for this purpose, and these are effective against influenza virus type A only.