Q&A: Time to test your flu IQ

By Bruce S. Auerbach, M.D.

Even as infectious diseases like West Nile virus, Lyme disease and EEE still command our attention, we're now on the edge of the flu season, and it's not too early to remind ourselves about this annual public health threat. Test your flu IQ with these questions and answers.

How serious is the flu?

Seasonal flu affects five to 20 percent of the population and accounts for some 36,000 deaths and 200,000 hospitalizations annually. In the last five years, the Centers for Disease Control and Prevention (CDC) has recorded more than 400 flu-related deaths of children, one of the most vulnerable groups. Lost work time and added hospital and health care costs add to the impact of this disease.

How is the flu spread?

Contagion is principally by coughing and sneezing, as respiratory droplets spread from person to person. It may also be spread by touching droplets on another person or object and then touching one's mouth or nose. Note these cautions: A person can also infect someone else before feeling sick, as the virus can spread one day before symptoms develop, and it can spread up to five days after getting sick.

What kinds of complications can arise?

Bacterial pneumonia, ear and sinus infections and dehydration are common complications. People with chronic medical conditions, such as diabetes, asthma, and congestive heart failure, will see those conditions aggravated, posing serious threats to health. CDC estimates that during flu epidemics, for example, death rates among people with diabetes jump by five to 15 percent.

Who should get vaccinated?

CDC recommends annual vaccinations for children age six months to 19 years; pregnant women; people 50 years and older; anyone with chronic medical conditions; people in nursing homes and long-term care facilities; and those who live with or care for those at high risk. But anyone wanting to reduce their chances of getting sick should get a shot.

Who should not be vaccinated?

Vaccination is not recommended for people with allergies to chicken eggs (the source of vaccines), those who've had a severe reaction to prior vaccinations, people who developed Guillain-Barr syndrome (an immune system disorder) within six weeks of a previous flu vaccine, and children less than six months of age.

What are the best preventive measures?

The best protection is vaccination. The flu shot with a needle is approved for people six months and older. Nasal-spray vaccines are approved for healthy people age two to 49 who are not pregnant. Habits are critically important, too. Practice good hygiene by washing your hands often or using hand sanitizers. Control your coughing and sneezing by covering your mouth. Keep children home if they're sick, don't go to work if you're sick.

When should I get a flu shot?

Get one as soon as vaccine is available, generally in September or October. But as the flu season can last into April or May, vaccination in December and January is still effective. Getting vaccinated quickly is best for children who are being protected for the first time, because they need two doses at least four weeks apart.

How long does a shot last?

A flu shot lasts for about year, and while it offers protection through the flu season, you should get a shot every year because the virus changes every year. And no, you won't get the flu by getting a flu shot.

Will there be enough vaccine this year and where can I get a shot?

Manufacturers estimate that a record 146 million doses will be available in the U.S. for the 2008-2009 season. Check with your physician or local board of health to see when and where flu vaccine and clinics will be available.

The Mass. Department of Public Health (www.mass.gov/dph/flu) and the CDC (www.cdc.gov/flu) have lots of information on seasonal flu, including recommendations on what to do if you get sick, emergency warnings signs for children and adults, and the use of antiviral drugs in fighting the flu. You can download free information from both sites.

Bruce S. Auerbach, M.D., is president of the Massachusetts Medical Society and Vice President of Emergency and Ambulatory Services at Sturdy Memorial Hospital in Attleboro. Physician Focus is a public service of the Massachusetts Medical Society. Readers should use their own judgment when seeking medical care and consult with their physician for treatment. Send comments to PhysicianFocus@mms.org.