Flu (Influenza)

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Prevention

Influenza cannot be prevented in all cases. To help prevent the flu, avoid close contact with people who are sick. Wash your hands frequently and avoid touching your eyes, nose, and mouth. Cover your mouth and nose with a tissue when coughing or sneezing.

The best way to prevent the flu is to receive a flu vaccine each year, usually in the fall. There are two types of vaccines available to help prevent the flu: the flu shot and the nasal-spray flu vaccine.

The flu shot is an inactivated vaccine (i.e., it contains killed viruses) that is usually administered as a shot in the upper arm. The flu shot is approved for use in people over 6 months of age. It can be given to healthy people as well as people who have chronic medical conditions and are at increased risk for developing complications from the flu.

According to the Centers for Disease Control and Prevention (CDC), current recommendations for flu vaccination include the following:

• Children between the ages of 6 months and 19 years
• Women who are or who will be pregnant during flu season
• People 50 years of age and older
• Adults and children 6 months of age and older who have chronic medical conditions (e.g., asthma, diabetes, kidney disease, epilepsy) or who have a weakened immune system
• People who live in long-term care facilities, such as nursing homes
• Caregivers and household contacts of children less than 6 months of age and people who are at increased risk for flu complications (e.g., health care workers)

The nasal-spray flu vaccine (e.g., FluMist®), which is sometimes called LAIV (Live Attenuated Influenza Vaccine), is made with live, weakened flu viruses. This vaccine is approved for use in healthy people aged 5–49 who are not pregnant. In September 2007, the Food and Drug Administration (FDA) expanded approval for FluMist to include children 2–5 years of age.

Each flu vaccine contains 3 different flu viruses, based on scientific estimates about which types and strains of flu will circulate in the upcoming flu season. Antibodies to protect against influenza viruses develop in the body about 2 weeks after vaccination.

The flu vaccine is not used in children younger than 6 months of age. To help reduce the risk for flu in children who are too young to be immunized, some health care providers recommend that family members, caregivers, and others who have regular contact with infants should receive the flu vaccine.

Others who should not receive the flu vaccine without consulting a physician include the following:

• People who have a severe allergy to eggs
• People who have had a past severe reaction to the flu vaccine
• People who developed Guillain-Barre syndrome (GBS) following a flu vaccine
• People who currently have an illness with fever

Side effects of the flu shot include soreness, redness, and swelling at the site of the injection; low-grade fever; and muscle aches. These side effects usually last 1 or 2 days. Rarely, the flu vaccine can cause severe allergic reactions.

The nasal-spray flu vaccine also may cause side effects (e.g., runny nose, headache). In children, side effects can include vomiting, muscle aches, and fever, and in adults, it can also cause cough and sore throat.

Antiviral medications may be used to help prevent the flu in patients who are at high risk for complications (e.g., people 65 years of age and older, children between 12 and 23 months of age, and people who have chronic medical conditions). Antivirals approved by the Food and Drug Administration to prevent influenza A infection include amantadine (Symmetrel®), rimantadine (Flumadine®), and oseltamivir (Tamiflu®). Oseltamivir and zanamivir (Relenza®) also are effective against influenza B viruses.

In healthy adults, antiviral drugs can prevent influenza infection in about 70–90% of cases. They often are prescribed to control flu outbreaks in places where people at high risk for complications are in close contact with one another (e.g., nursing home, hospital).

Side effects of antiviral medications include the following:

• Anxiety
• Difficulty concentrating
• Insomnia
• Lightheadedness
• Loss of appetite
• Nausea and vomiting
• Nervousness

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