The Flu and You

Fall brings with it two certainties: a new school year and a new flu season. This year, families are on the lookout for two different kinds of flu: the seasonal flu that arrives in October or November and winds down in March, and the H1N1 (swine flu) that hit this country last April and is still circulating.


Swine flu has received the most press and perhaps raised the most alarm bells among parents. As of early September, this flu had killed 593 people in the United States and hospitalized 9,079. It’s considered most dangerous for ages 5 to 24 and very young children, which is why it makes parents so nervous. People over age 64 seem to have some immunity, perhaps because they’ve encountered similar viruses in the past.


Still, health experts urge parents not to panic about H1N1, assuring them that most children and adults will probably suffer from typical flu symptoms, spend a few days at home recuperating and then be back on their feet.


All said, here are four things you need to know about H1N1 and the seasonal flu:


  1. Seasonal influenza is actually more deadly than H1N1. (It kills 36,000 people in the United States each year and hospitalizes 226,000.) It’s most dangerous for the elderly, the very young and those with underlying medical conditions.
  2.  Regularly washing your hands is the best way to stay healthy.
  3.  An H1N1 vaccine won’t protect you against seasonal flu or vice versa.
  4.  If you get sick, stay home.


What Is the Flu?


Influenza virus is a piece of genetic material, surrounded by a coat of protein, which invades our bodies’ cells. You are most likely to be infected by touching someone who is ill or touching something they recently touched, and then touching your eyes, nose or mouth. You can also inhale the virus that someone else coughed or sneezed out.


The flu viruses’ protein coats, which function as their “armor,” are described with letters and numbers:


  • H1N1 is “swine” flu,
  • H5N1 is “avian” flu
  • H3N2 is the most common type of seasonal flu.


When our bodies encounter a virus, they try to fight it off. This is called our “immune response.” The problem with influenza viruses is that they tend to change their armor.


Minor changes produce each year’s crop of seasonal influenza, which is similar to viruses our bodies have battled before. “It’s because of those small, incremental movements over time that we need a new vaccine every year,” explains Maureen Lichtveld, M.D., a former researcher with the national Centers for Disease Control (CDC) who now heads up the Flu Emergency Task Force at Tulane University.


Big, abrupt changes in those protein coats produce brand-new viruses like H1N1, which our bodies don’t yet know how to fight. “We don’t recognize the armor that it is wearing, so we don’t know how to make antibodies against it,” Lichtveld says.


Our “flu” symptoms – the fever, aches, chills, cough, sore throat and runny nose – are the result of our bodies trying to fight off the virus.


“It’s kind of overkill,” says Jim Sears, M.D., a pediatrician from the renowned Sears medical family and a co-host of The Doctors television program, shown in cities nationwide. “The body’s immune system tends to overreact to the virus.” Usually the result is several days of discomfort, but in some cases infection with flu virus paves the way for serious – even deadly – complications such as pneumonia.


How Do You Keep from Getting Sick?


There’s a lot that you and your family can do to stay healthy.


Wash your hands. “The power is really with us,” says Lichtveld. “Hand washing reduces 95 percent of transmissions.” Teach your kids to sing the ABCs while they lather and rinse, for example. “Then you have done hand-washing well,” she says.


Sleep, exercise and eat well. All of these can make a big difference in the body’s immune system. Sears says that when he’s not feeling well, he bumps up his fruit and vegetable consumption. “Now’s the time to start that, before the flu season hits,” he says.


As the flu begins to circulate, try to avoid crowds and keep your family’s exposure to a minimum. Infectious disease specialist Pia Pannaraj, M.D., of Childrens Hospital Los Angeles reminds parents to take steps to protect themselves if their child comes down with the flu. “I think it’s hard to stay out of their line of cough,” she says. But holding little ones with their head on your shoulder or against your chest will keep your face out of the way.


What About Flu Shots?


To keep from getting sick, everyone can also get a flu shot. Or, rather, two, because a seasonal flu shot won’t protect against H1N1, and H1N1 vaccination won’t protect against seasonal flu. “I don’t want the panic of H1N1 to overshadow the need for the regular flu vaccine,” says Sears.


Seasonal flu vaccine should already be available, and H1N1 vaccine is scheduled to start coming in by the middle or end of October. In fact, expect a massive nationwide effort to encourage people to get vaccinated once the H1N1 shot becomes available.


If you’re wondering whether the H1N1 vaccine will be safe, Pannaraj points out that the manufacturers making vaccines against H1N1 are using the same methods that they have used for years to create seasonal flu vaccines. They’ll be producing versions of the vaccine that do not include the controversial mercury-containing preservative thimerosal. H1N1 vaccine is also going through the usual clinical trials process to determine safety, and health officials will monitor reports of any side effects once the vaccine is available.


What if You Get Sick?


If you or someone in your family gets sick, priority No. 1 is to stay home.


“If you do get mild symptoms, the last thing you want to do is run out and spread it to everybody,” says Sears. “If you are feeling ill, even if it’s just a cold, do your co-workers and your classmates a favor by just staying home for a little while.”


That means until any fever has been gone – without the aid of Tylenol or any other medication – for at least 24 hours.


Influenza tends to bring on a higher fever than a cold, earlier in the illness. This should prompt a call to your doctor for advice. “Don’t go in, but give a call,” Lichtveld says. You could save yourself an office visit (and exposure to other sick people).


Laboratory tests for H1N1, and doses of the antiretroviral drug TamiFlu, will be reserved for the most severe cases. “Parents come in and say, ‘My child might have been exposed, and I can’t really afford for them to get sick right now. Can’t I just give them TamiFlu for 10 days?’” says Dennis Woo, M.D., former chair of the department of pediatrics at UCLA Medical Center. TamiFlu is effective in treating H1N1, but doctors are worried about creating resistant strains by overusing it.


Instead, most who get sick will be told to rest and drink lots of liquids. As long as the patient is breathing comfortably, hydrated, and acting normal, things are fine, says Pannaraj. If any of that changes, or if someone who seemed to be recovering from the flu suddenly gets sick again, talk to the doctor. It could be a sign of secondary infection.


Finally, Lichtveld advises, stay informed. Follow developments and expert advice from credible sources like the CDC. It will help keep fear at bay and better equip you to keep your family well.


Christina Elston is a senior editor and health writer for Dominion Parenting Media. To keep up with family health news, check out her “HealthE” blog at




Online Resources


National Centers for Disease Control or – Follow the Web site for this health-monitoring and research organization for information on the spread of flu, prevention, and vaccine guidelines. – This U.S. Department of Health and Human Services Web site bills itself as a one-stop source of information on H1N1, avian and pandemic flu. Here you’ll find prevention tips, including for pregnant women, flu monitoring information state by state and more.


Flu – Find flu vaccination clinics in your area.

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