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Dialogue: What you should know about the flu

Ken McIntosh, MD, Infectious Diseases

Diana Seufert, MSN, RN, NP, Occupational Health

hildren's Hospital Boston's top priority is the care and safety of our patients and staff, so we're taking measures to provide information about the flu and its treatment during the nationwide flu vaccine shortage.

How did the hospital determine which patients, staff and employees should be vaccinated?
Unfortunately, we have less than one-third of the supply that we used last flu season. After much discussion, Children's Infectious Diseases specialists decided that the most rational way to distribute the vaccine was to administer it first to high-risk patients and the employees who provide them with constant, hands-on care. We have to protect our most vulnerable patients, and in order to do so, we also have to protect the clinicians and other staff who care for them. It's possible that the shortage situation may change and more vaccine will be made available. If so, additional staff and employees will be vaccinated.

If I won't be getting a flu vaccine at Children's, where else can I look?
You can contact your primary care provider or your local public health department to check on the availability of the vaccine in your community.

What is FluMist, and who can use it?
FluMist is a nasal vaccine made of live virus. It can only be used for healthy children 5 years old and above, and for adults up to and including 49 years of age. Unlike the flu shot, FluMist can't be given to people who live in a household with anyone who has a weakened immune system. FluMist will protect you against the flu and is proven to be effective for those who are able to use it, but there are a lot of guidelines around its use. You should talk to your health care provider for more information.

What are antivirals?
Antivirals are prescription drugs used to prevent and/or treat the flu. There are four antivirals—amantadine, rimantadine, zanamavir and oseltamivir—and they are all different in terms of who can take them, how they are given, any dosing changes based on age or medical conditions, and side effects. Your health care provider can decide whether you should get an antiviral and which one you should get.

When is flu season, and how severe is this year's flu strain supposed to be?
The flu season lasts from November 1 to April 30, and this year's is expected to be moderate. There's no reason to expect that it will be any worse than previous years.

What's the difference between the flu and a cold?
Many people call all winter illnesses "the flu" (influenza). However, there are differences between a cold and the flu. The common cold is caused by over 200 types of viruses, specifically rhinoviruses and coronaviruses.

Starting two to three days after an infection with nose congestion, swelling in the sinuses, sneezing, sore throat, cough, headache and mild fever, colds usually creep up on you. These symptoms can last a couple of days to more than two weeks (most people recover in one week). The average adult gets two to four colds a year.

The flu is caused by influenza A and B viruses. The symptoms usually start suddenly with a headache, dry cough, fever/chills, muscle aches and a "knocked off your feet" feeling. The fever goes away after two to three days and then a sore throat and nasal congestion can start. The tired and weak feelings can last from days to weeks.

How are colds and flus spread?
Colds and flus are viral infections, spread from one person to another by a kiss, a handshake or by touching a contaminated surface, such as a doorknob, telephone or money.

How do I protect myself and my family from the flu?
Even though there's a limited supply of the flu vaccine this year, you can still protect yourself and others.

Most important, make sure you consistently wash your hands, or keep a gel sanitizer with you to use if you are unable to wash them with soap and water. Also, the cold weather and lack of humidity may make your nose lining drier and more susceptible to viral infections, so use plants (they release water back into the air as vapor), pans of water or a humidifier to counteract the dryness.

Beyond that, just be healthy. Get plenty of sleep and exercise, drink lots of fluids, take a multi-vitamin and eat healthy foods. Many people find these things hard to do around the winter holidays, so make a plan now to keep healthy.

How can I avoid spreading my cold or flu if I get sick?
The best thing you can do if you're sick is stay home from work. By being here, you are prolonging your recovery and putting others at risk for contracting your illness. If you must, make sure you constantly wash your hands and wear a mask around patients. You can also avoid spreading germs by coughing or sneezing into a tissue or your sleeve if a tissue is unavailable

How effective are over-the-counter medications in treating the flu?
Over-the-counter medications are effective in treating the symptoms of the flu, but are not effective in treating the flu itself. They will make you feel better, but it's up to prescribed medications and your body to kill the virus.