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'Tis the Season - Preventing Colds and Flu

Well, it’s that time of year again – time to begin thinking of the rapidly approaching holidays, of spending time with loved ones, and how to avoid one of the major risks that can put a damper on our celebrations – those nasty respiratory viruses that plague us in the late fall, winter and early spring. Our emergency room census predictably grows every year over the next few months, and much of this is related to the impact that influenza viruses and other respiratory viruses (such as those that cause the “common cold”) have on our population. It is estimated that every year between 5 and 20% of the population in the United States develops clinical illness from influenza (“the flu”), and the numbers are even greater with other upper respiratory viral infections.

So, how best to avoid these viral marauders? First, and foremost, get a flu shot. While this doesn’t provide 100% protection from influenza (it’s about 70-90% effective in healthy adults under the age of 65), it gives each of us the best chance of developing a level of immunity against the viruses that are predicted to be especially problematic over the next several months. Unfortunately, given the speed with which influenza viruses mutate and the amount of time it takes to develop and produce effective vaccines against them, we are left with vaccinating the population with the viruses that are predicted by the experts to be our biggest threat during the upcoming season. “Flu shots,” which contain inactivated (killed) viruses (and, therefore, CANNOT give you the flu!) can be obtained from your primary care physician and from various clinics in your area (including some local pharmacies and even grocery stores that offer the service). It’s best to get your shot sometime in late October to early November to allow your body the time it takes to develop immunity after the vaccination (approximately 2 weeks) before the flu makes its appearance in your area.

It is highly recommended that all immune-suppressed patients and their families get the vaccine as well as anyone at high risk of exposure to the virus (teachers, health care workers, etc.). It is, however, a good idea for all healthy adults who want to avoid the flu to get the vaccine unless they have some specific contraindication to doing so (for example, a history of egg allergy [eggs are used in the production of the vaccine], or a history of adverse reactions to prior vaccines).

The Centers for Disease Control and Prevention recommend that the following people should receive a flu shot:
- People at high risk for complications from the flu, such as:
- Children aged 6 months to 5 years
- Pregnant women
- People 50 years of age and older
- People of any age with certain chronic medical conditions (such as heart or lung disease)
- People who live in nursing homes and other long term care facilities
- People who live with or care for those at high risk for complications from flu, including:
- Household contacts of persons at high risk for complications from the flu (as above)
- Household contacts and out of home caregivers of children less than 6 months of age (i.e., children
too young to be vaccinated)
- Healthcare workers.

There is also a vaccine available for those who are truly “needle phobic” that is administered via a nasal spray. This vaccine is made from live, attenuated (weakened) viruses, and is recommended for healthy people between the ages of 5 and 49 years.

Everyday, sound preventive measures to avoid contracting a respiratory virus include:
- stay well hydrated (we all tend to walk around during our daily lives in a state of relative dehydration).
- get enough sleep (to allow our immune systems to “recharge”) - easier said than done!!
- eat a balanced, healthy diet.
- avoid folks who are spreading their “germs” through coughing, sneezing, etc. It’s perfectly acceptable to ask such individuals to cover their noses and mouths to avoid passing respiratory viruses into the air you are sharing with them.
- wash your hands (or use an alcohol-based hand sanitizer) frequently when out in public (especially after touching door knobs, public phones, shared keyboards, etc.).
- and, very importantly, keep your “unwashed” hands away from your eyes, nose or mouth when out in public. This is the way most respiratory viruses are passed – you get tiny infectious secretions from another person on your hands and then inoculate them into your own mucous membranes.

For more information about influenza and how to avoid it, check out the CDC website at: http://www.cdc.gov/flu/

So, with the approaching holidays, we owe it to ourselves and those loved ones who are looking forward to spending time with us to do all we can to stay healthy and avoid those nasty colds and flu!

Stay alert and stay safe.

- Dr. Bob
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About the Author

The Stanford Emergency Room is the center of emergency care at Stanford University.