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Glenn D. Braunstein, M.D. Headshot

Roll Up Your Sleeves for Flu Season

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Los Angeles has had interesting weather in the last few weeks, going from biting temperatures in the 50s to a sweltering record-high temperature of 113 degrees downtown. According to an old medical myth, these kinds of temperature swings can make you sick.

They can't. But the flu can.

In fact, about 200,000 people are hospitalized with influenza each year. As for the number of deaths, the numbers vary widely from year to year due to a variety of factors including the virulence of the flu strain, the Centers for Disease Control (CDC) estimates the death rate to be between 3,000 and 49,000 a year.

Any way you count it, that's a lot of deaths for an illness that many brush off as little more than a harmless annoyance. But the flu is not just a bad cold. If the fever, chills, cough, sore throat, congestion, muscle and body aches, headaches and fatigue weren't misery-making enough on their own, the illness can spark some nasty complications. Pneumonia, bronchitis, sinus infections and ear infections are a few common examples, but it can also make chronic health problems worse. Those with asthma may experience more attacks, and the flu can worsen preexisting heart disease such as chronic congestive heart failure. While anyone - even healthy adults - can encounter complications, some are at higher risk of serious complications including anyone 65 or older, anyone with chronic medical conditions like asthma, diabetes or heart disease, as well as pregnant women and young children.

A shot in the arm
The CDC recommends yearly flu vaccines as the most important step in protecting against flu viruses and recommends that starting with this influenza season everyone 6 months old and older should get a flu vaccine - especially those at high risk of serious flu-related complications or who live with or care for those individuals. Flu vaccines protect against the viruses that research suggests will be most common.

There are two types of flu vaccines available. One is what's commonly referred to as the flu shot - which is given by injection into the muscle as an inactive vaccine; that is, the virus is dead. The other option is the nasal spray, in which a live, attenuated, or weakened, vaccine is sprayed into the nostrils. Healthy adults and children between the ages of 2 and 49 can get either version. Pregnant women, infants, people with chronic conditions and older adults and seniors should get the inactive vaccine.

This year's dose includes protection against influenza H3N2, an influenza B virus and the 2009 H1N1 virus. While experts don't expect H1N1 to be as widespread this year, it took a toll on children last year. About 40 percent of the cases affected young people ages 10 to 18. Among children in California who were hospitalized due to this strain of influenza, more than a quarter of them were treated in intensive care units or died, according to a California Department of Public Health report. In total, by the end of August this year, there had been a total of 2,114 serious cases, 596 of which resulted in deaths.

It cannot be said enough: The flu shot does not cause the flu. The viruses used in the making of the vaccine are killed in the process. Randomized, blinded studies confirmed that the only symptom those who received the flu shot rather than salt water were more likely to develop was increased soreness in the arm and redness at the injection site.

Allergic reactions to the flu shot - or any vaccine - may occur. They are very rare with the influenza vaccine, but if you do develop breathing problems, hoarseness or wheezing, hives, paleness, fast heartbeat, weakness or dizziness, immediately contact your physician. Also, about one in 100,000 per year develop Guillain-Barré syndrome, an illness characterized by fever, nerve damage and muscle weakness.

Complications from the flu shot are far rarer than complications from the flu. The vaccine serves to protect not only you, but those around you who may be more vulnerable to the illness and its serious complications.

Other prevention
The flu shot - while quite effective, preventing influenza in 70 to 90 percent of healthy adults - isn't enough on its own to completely dodge the flu. Practicing basic good health habits is also crucial. These practices are very common, but bear repeating and will help you avoid other illness as well.

-- Wash your hands frequently with soap and water or an alcohol-based hand rub.
-- Avoid close contact with those who are sick.
-- When you're sick, help others avoid close contact with you by staying home when you are sick. Skip work, school and errands. They can wait until you're well, and others will thank you.
-- Cover your mouth when you cough or sneeze - then wash your hands again, or cover your mouth and nose with your coat or shirt sleeve.
-- Avoid touching your eyes, nose and mouth. Germs are often spread when you touch a contaminated item or surface, then ones of these areas on your face.
-- Take care of yourself. You know, do all those things doctors keep reminding us to do: Get enough rest and exercise. Drink plenty of water and eat healthy foods. Manage your stress. In addition to all the other reasons we should adopt these habits - they'll help you dodge illnesses, too.

If all else fails ...
Another flu myth is that there is no treatment for it. That's not true. While otherwise healthy adults do not need to be treated with them, antiviral medications are available. These are viewed as a second line of defense after taking all of the above preventative measures. They're available by prescription, and are generally used to treat those who are very sick or who are at high risk of serious complications. Antiviral medicines can shorten the length of the illness, help avoid complications and alleviate symptoms.

In children and infants, watch for these signs which indicate they need immediate medical help: fast breathing or trouble breathing; bluish skin color; not drinking enough fluids; not waking up or not interacting; excessive irritability, such as not wanting to be held; symptoms that improve then return with fever and worsening cough; rash; being unable to eat; no tears when crying; or significantly fewer wet diapers. Likewise, adults should seek immediate medical care if they experience shortness of breath or difficulty breathing; pain or pressure in the chest or abdomen; sudden dizziness; confusion; severe or persistent vomiting; or flu-like symptoms that improve then return with fever and more severe cough.

If you experience typical flu symptoms, stay home until at least 24 hours after your fever is gone. Stay as comfortable as you can, and consider another favorite medical myth of mine: the healing properties of chicken soup. Go ahead and indulge in this one if you find yourself home sick this flu season. Turns out, there may be something to its healing properties after all: In addition to being soothing and delicious, scientists found that it acts as an anti-inflammatory and temporarily speeds the flow of mucus, potentially easing congestion and limiting the amount of time viruses are in contact with the nose lining.