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Protection from the Flu

FluInfluenza (the flu) is a serious viral infection. Ten to 20 percent of Americans develop it every year, and some — typically the elderly and those with underlying diseases — may die of the infection and its complications.

The influenza vaccine, or the flu shot, is the most effective means of preventing influenza. The flu vaccine can prevent up to 80 percent of influenza cases. In the elderly, it is not quite as effective in preventing disease, but it can lessen the severity of the infection, preventing many deaths and other complications. The actual effectiveness of a given year's vaccine depends on how closely the strains (varieties) of virus in the vaccine match the strains responsible for diseases that year. There are three strains in each year's vaccine, and they are chosen months before flu season in an attempt to predict which strains will cause disease that year.

There is a lot of talk about influenza this season, and I have heard many patients and co-workers state that the influenza strain this year was not represented in the vaccine. That is not really true. According to the U.S. Centers for Disease Control in Atlanta, as of January 8, 2000, 92 percent of all flu strains found in the U.S. population were very similar to the strains in the vaccine. Therefore, the vaccine should have been effective in preventing influenza. Why is there a perception that this year's vaccine is not effective? Even when there is a close match between a vaccine strain and an infecting strain, as there is this year, the vaccine cannot prevent every case of influenza. Most important, however, is that many people who say "I got the flu shot and got the flu anyway" did not actually get the flu. Many viruses can cause illnesses similar to the flu, and there is no way to be sure without further testing.

Now, what else can one do to prevent the flu? The virus is transmitted by contact with respiratory secretions. A simple cough, a sneeze or even talking near another person can transmit the virus. And a person who had the flu can spread the virus up to several days after the major symptoms of infection have disappeared. If you could avoid all contact with people who have or recently had the flu, you will not get it. That, of course, is impossible. However, washing your hands frequently will help prevent infection with many respiratory viruses, as some can be transmitted by contact with hands.

There is little, if any, compelling evidence that vitamins can prevent infection. On the other hand, two prescription antiviral medications have been proven to prevent influenza — amantadine (trade name Symmetrel) and rimantadine (Flumadine). To prevent diseases for the entire flu season, you would need to take these expensive drugs (which may cause side effects) for more than three months. Their best use in preventing illness is in nursing homes or other such facilities when there is an outbreak of influenza among residents. Everyone else in the institution can take the medicine for a short period until the outbreak is over. It is simply not worthwhile to give these drugs to most people in the community.

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