(RNS) As the flu outbreak spreads across 48 states, some religious leaders are advising their flocks to take precautions, but others say avoiding infection is just a matter of common sense.
Several Catholic dioceses, including Manchester, N.H., Boston and New York, are advising priests to consider not offering the shared chalice of consecrated wine at Holy Communion at Masses. Communicants would only receive the consecrated wafer.
In addition, Manchester Bishop Peter Libasci had other suggestions, reported The Eagle Tribune of North Andover, Mass.
"The faithful should be encouraged to share the Sign of Peace without touching hands or kissing," he said. "This may be done with smiles and a bow of the head in reverence to one another."
In Boston this month Mayor Thomas Menino declared a public health emergency as hospital emergency rooms were overwhelmed with flu patients. The Episcopal Diocese of Massachusetts has recommended "reasonable precautions," such as avoiding "self-intinction" during Communion, during which congregants at the altar rail dip the wafer into the wine.
"Having hand washing and sanitizing supplies readily at hand in church facilities, and encouraging their use, is also a good idea," said the diocese.
The Centers for Disease Control and Prevention reported in the first week of January the flu had reached epidemic proportions. As of Jan. 12, it has killed 29 children under age 18 this season. Some school districts have closed for several days to prevent the spread of the virus and many hospitals are limiting visitors. The CDC said the flu season has peaked unusually early and the outbreak has led to shortages of vaccine.
"I told everybody to get the flu shot," said Rabbi Shmuel Herzfeld of Ohev Sholom synagogue, an Orthodox congregation in Washington, D.C.
Shaking hands is usually an essential part of an Orthodox service, after congregants come to the pulpit to read the Torah, or when the rabbi greets members, said Judah Isaacs, director of community engagement for the New York-based Orthodox Union. However, the OU, an umbrella group for Orthodox congregations, hasn't issued any flu-prevention guidelines, he said.
Rabbi Gershon C. Gewirtz, of the Young Israel of Brookline Orthodox congregation near Boston, said he made an announcement last weekend that "people might prefer not to shake hands." Among the alternatives he offered were nodding graciously, or wrapping part of a garment around the hand.
Some congregations are continuing practices put in place in 2009, when the outbreak of the H1N1 flu, or "swine flu," prompted changes in worship.
At St. John's Episcopal Church in Larchmont, N.Y., there have been several Communion stations since 2009, allowing congregants to choose whether to share the chalice or not, said the Rev. N. Chase Danford.
For Dr. Faheem Younus, a Muslim and infectious disease specialist, distributing free flu shots is a matter of faith as well as health.
"I gave out my first free flu shot 12 years ago at a mosque in Queens, New York, after the service," recalled Younus, now a clinical associate professor at the University of Maryland.
In the intervening years, he's asked for spare vaccine from hospitals and health organizations and he's distributed free flu shots at churches, mosques, homeless shelters and other institutions. At mosques, he said, there is often an immigrant population with little access to health care.
A member of the Ahmadiyya branch of Islam, Younus quotes the Quran as his inspiration: "God says,'You must exhort others to goodness and forbid that which is evil.' Goodness to mankind is the first thing."
Younus also noted that the ritual washing, called wudu, before Muslim services may help check the flu's spread, although it is usually a water rinse that doesn't use soap.
"Community and keeping the community safe is very important in Islam. Among the sayings of the Prophet Muhammad -- blessings and peace be upon him -- is that if there is an outbreak of infection,'stay in your place, don't go to another place,'" Younus said.
In other words, if you feel sick, stay home.
Fact: This myth just will not die. So let's clear this up: You cannot get the flu from your flu shot. Why? That vaccine is made from a dead or inactive virus that can no longer spread its fever-spiking properties. In rare cases, a person may experience a reaction to the shot that includes a low-grade fever, but these reactions are not The Flu, Everyday Health reported. Note: Even though the flu shot cannot cause the flu, there are a number of other reasons not to get the vaccine, including for some people with an allergy to eggs or a history of Guillain-Barre Syndrome.
Fact: Unfortunately, even after slapping a bandage on that injection site, you may only be about 60 percent protected, according to the CDC. That means, yes, you can still get the flu after your shot. Some people may be exposed to the flu in the two weeks it takes for the vaccine to take effect, reports NPR. Others might be exposed to a strain not covered in the vaccine, which is made each year based on the viruses experts predict will be the most common, according to Flu.gov. (This year's batch seems to have been matched well to what is actually going around, NPR reports.)
Fact: Plain and simply, antibiotics fight bacteria, not viruses. The flu -- and colds, for that matter -- are caused by viruses. In fact, antibiotics kill off the "good" bacteria that help to fight off infections, so that viral flu may only get worse.
Fact: Nausea, vomiting or diarrhea, while often dubbed the "stomach flu," are not typically symptoms of seasonal influenza, which, first and foremost, is a respiratory disease, according to Flu.gov. The flu can sometimes cause these issues, but they won't usually be the main symptoms -- and are more common signs of seasonal flu in children than adults.
Fact: Younger, healthy adults aren't among the people the CDC urges most strongly to get vaccinated, like pregnant women, people over 65 and those with certain chronic medical conditions. The young and healthy will more often than not recover just fine from the flu, with or without the shot. But protecting yourself even if you don't think you need protecting can actually be an act of good. The more people are vaccinated, the fewer cases of flu we all pass around, which in turn offers greater protection to those at-risk groups.
Fact: Mom or Grandma probably told you this one at some point, and while you might not feel so cozy if you head out the door straight from the shower, doing so doesn't exactly condemn you to bed. The only way to catch the flu is to come into contact with the virus that causes it. That might happen while you are outside in the cold, and flu season does certainly happen during cold weather, but it's not because you're cold that you catch the bug.
Fact: It's not antibiotics that cure-seekers should be looking for. While the two antiviral drugs available to fight the flu aren't a quick fix, they can reduce the length of your bout of the flu and make you less contagious to others, according to WebMD. This year's earlier-than-usual flu season has already led to shortages of one of the drugs, Tamiflu, in the children's liquid formulation, according to the medication's manufacturers. However, a number of experts in countries around the world have questioned Tamiflu's efficacy in fighting the flu, and some have even suggested a boycott until further data is published.