As winter approaches, many of us are looking ahead to the coming snow and a new season of skiing, boarding and hot chocolate around the fireplace. Of course, winter is not all fun and games — with the snow comes the cold, the ice and inevitably that old nemesis — the flu. Unfortunately, like the first snow, the start of the flu season and its severity can be hard to forecast, so it’s best to be prepared a little in advance.

Influenza, “The Flu,” historically has hit hardest in the months of December, January and February in this part of the country, but may come early or late during any given year. This miserable illness is the contagious handiwork of various strains of the influenza virus, typically infecting the nose, throat and lungs of millions of US residents annually. A typical bout of the flu may involve runny nose, sore throat, headache, cough, body aches, fevers and chills. It often lasts 1 to 2 weeks and is frequently described as the “worst cold in a long time.”  Some are less fortunate, with 114,000 people in the US admitted to hospital annually, often with more severe respiratory symptoms and pneumonia. Sadly, an average of 36,000 people die from flu-related illness annually, often from complications with severe pneumonia. Most serious illness and deaths tend to occur in people older than 65, however, influenza can cause serious illness in healthy people of all ages, particularly children below the age of 24 months. Many of those hospitalized are less than four years old, usually with respiratory illnesses such as wheezing, croup or pneumonia. During the 2003-04 season approximately 140 children died from influenza infection, and although those with significant medical problems were at greater risk, many of these were previously healthy children.

Like many viral illnesses, treatment for influenza is largely supportive care. Antibiotics are not helpful unless bacterial pneumonia sets in as a complication. For severe cases, and those at high risk, there are some antiviral medications that can help to stave off or modify the illness when given in a timely manner. With treatment options limited, the best approach is prevention, the cornerstone of which is the annual influenza vaccine. Other helpful measures include minimizing touching of your eyes, nose and mouth, and careful hand washing. As influenza is often spread directly through respiratory droplets, you can help limit the spread of  influenza by covering your nose and mouth to sneeze or cough, and staying home when sick.  

The flu vaccine is the most effective prevention and is made each year to protect against those strains of influenza forecasted to be prevalent in the coming season. Unfortunately, this means that having the vaccine or the flu in the past will not provide reliable protection from this year’s strains. The vaccine now comes in two forms, the “flu shot” and the nasal spray, each containing 3 representative strains of the virus. 

The flu shot is an inactivated vaccine made with killed virus and cannot give the recipient the flu. Although the vaccine is not always a perfect match it is usually quite effective. Fortunately, even when not fully effective, it often moderates the severity of illness, helping to protect the recipient from life threatening complications. Adverse reactions to this vaccine, if they occur, are usually limited to localized tenderness, fatigue, mild fever or muscle aches, with more serious reactions being extremely rare.

The nasal spray is a newer option made with attenuated (weakened) forms of the virus and is proving to be very effective. It is approved for healthy people ages 5 to 49, and is currently being tested in healthy children aged 6 months to 4 years. This form of the vaccine is not currently recommended for pregnant women, people with respiratory problems, chronic medical conditions, suppressed immune systems, or those in close contact with these groups. 

Anyone with a history of a severe allergic reaction to eggs (both forms of the vaccine are made from virus grown in eggs), a severe reaction to a previous influenza vaccine, or a history of Guillain-Barre syndrome should not receive the vaccine.

Once you have been vaccinated, the protective antibodies usually form within 2 weeks, making the months of October and November a good time to receive the vaccine.

Unfortunately, like the weather, forecasting the flu is speculative work that makes accurate prediction elusive. Good preparation is well worthwhile. So as winter approaches and you dust off the snow shovel once again, take a moment to consider the flu vaccine for yourself and your family. Along with snow tires and ski helmets, a “shot” or “sniff” of prevention can be an important part of a healthy and happy winter season.

For more information and updates about influenza and this years vaccines go to the Center for Disease Control website at www.cdc.gov/flu or call 1-800-232-2522 (English) or 1-800-232-0233 (Espanol)