Options for preventing the flu

VOL 118 / NO 3 / SEPTEMBER 2005 / POSTGRADUATE MEDICINE

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Influenza, or the flu, kills about 36,000 people in the United States each year. Infection with the virus that causes influenza can result in miserable symptoms, such as muscle aches, fever, sore throat, cough, fatigue, runny nose, and nausea. Experts say that getting a flu shot is still the best way to avoid getting the illness, but other options, including flu vaccine nasal spray and antiviral drugs, are also available.

Is the flu shot the best choice for me?
Flu vaccines contain the virus strains that scientists predict will be most widespread during the upcoming flu season. The viruses have been killed, so they cannot cause infection. The vaccine is injected into the upper arm. It takes about 2 weeks after vaccination to be protected, so the best time to get the shot is between October 15 and November 15.

People who are at high risk for complications of the flu should get a flu shot every year. They include:

• Children aged 6 months to 23 months
• Parents or caretakers of babies younger than 6 months
• Children aged 2 years or older who have a chronic illness, such as heart or lung disease, diabetes, kidney disease, a blood disorder, or a weakened immune system
• Adults aged 65 years or older
• People who live in nursing homes or long-term care facilities
• Women who plan to become pregnant in the months of the flu season
• People aged 6 months to 18 years who take aspirin every day
• Healthcare workers

If there is enough flu vaccine for everyone this flu season, the following groups also should be vaccinated:

• Out-of-home caregivers and household contacts of people in a high-risk group
• Adults aged 50 to 64 years

People who should not get a flu shot include babies younger than 6 months and people who are allergic to chicken eggs, have a fever, or previously had Guillain-Barré syndrome within 6 weeks of vaccination.

Most people don't experience side effects from the shot, but some report soreness in the arm, redness, swelling, an achy feeling, and fever.

In the 2003 and 2004 flu seasons, there was a shortage of the vaccine due to a problem at the plant where much of it is made. Only people at high risk for the flu were allowed to get it until more supplies were available. The US government estimates that about 58 million flu shots will be available this season compared with the 96 million shots that are usually produced. But more may become available as the season goes on.

Am I a candidate for the nasal flu vaccine?
The flu vaccine is available as a nasal spray, although there are differing opinions about whether it's as effective as the flu shot. About 3 million doses are expected to be available this flu season.

Healthy people aged 5 to 49 years can spray the vaccine in their nose instead of getting a shot. Side effects of the spray in children may include a runny nose, muscle aches, fever, headache, and vomiting. Adults may experience a runny nose, headache, sore throat, and cough. Pregnant women and people who live with or take care of someone with a weakened immune system should not use the nasal vaccine.

Are antiviral drugs an option for me?
Antiviral drugs are another option for preventing the flu or for shortening the length of illness if you take the drug within 2 days of becoming ill. These drugs, of which three are available, are most often used in people at high risk of complications of the flu and are estimated to be 70% to 90% effective in preventing the flu. These three antiviral drugs, as well as a fourth medication, are available for treatment of the flu. However, they can cause trouble sleeping, shakiness, and depression. One of these drugs has worsened asthma in some people. If you're interested in antiviral drugs for the flu, talk to your doctor about whether one might be right for you.

What else can I do to prevent the flu?
Good hygiene can help keep the flu at bay. Cover your nose and mouth when coughing or sneezing, stay home if you get the flu, and wash your hands often with soap and water. Stay away from people who are sick and avoid touching your eyes, nose, and mouth.

For more information on the flu American Lung Association 61 Broadway, 6th Floor New York, NY 10006 800-548-8252 http://lungusa.org/diseases/luninfluenz.shtml Centers for Disease Control and Prevention http://www.cdc.gov/ncidod/diseases/flu/fluinfo.shtml MEDLINEplus http://www.nlm.nih.gov/medlineplus/influenza.shtml World Health Organization http://www.who.int/health_topics/influenza/en

This information is not a substitute for medical treatment.

Please send technical questions related to the Web site to Ann Harste