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There's no shortage of the vaccine this year, so get ready to roll up your sleeve
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You may not consider yourself to be at much risk of coming down with the flu. But if you are a parent, a co-worker or part of a household where someone has a chronic disease, you may be more vulnerable to its complications than you realize.

Unlike some past years, flu vaccine supplies this year are plentiful. And regional health care experts are urging people to take advantage of it, preferably in the next few weeks.

"Not only do you not lose as many days of work or school, but we know that schoolchildren are more likely to spread it among themselves and bring it home to younger siblings," said Joyce Allers, manager of school health for child health promotion at Children's Healthcare of Atlanta, Georgia, in the United States.

"We also know that when you have a flu vaccine, you can decrease the incidence of even ear infections by 30 percent."

Particularly troubling to health experts is that last year fewer than half the 218 million people considered at higher risk - primarily infants and small children, seniors, people with chronic conditions and their caregivers - actually received the flu vaccine. As a result, more than 200,000 people were hospitalized with the flu, and 36,000 people died of complications from the virus.

Some of the people who are most lax about getting vaccinated are the very ones who should know best: health care providers. Last year, only about 41 percent were vaccinated, even though they are at greater risk of being exposed to flu and passing it on to their patients and colleagues. As a result, there is a major push this year among health care organizations to make sure that their employees are vaccinated.

"We don't need to have any of our staff absent during the flu season because we need everybody present and accounted for to take care of our patients," Allers said.

Who should not get vaccinated?

People who are allergic to chicken eggs or egg products.

People who have had a severe reaction to the vaccine in the past.

People who have developed Guillain-Barre syndrome, an inflammatory disorder that affects the peripheral nerves, within six weeks of getting the flu vaccine in the past.

Children younger than six months of age.

Anyone who is sick with a fever should wait until his or her symptoms clear up before getting the flu vaccine.

Who needs the vaccine the most?

People at higher risk of being exposed to the flu or of developing complications from the virus should definitely be vaccinated, according to health officials. And this recommendation applies to a large group of people including:

Children ages six months to five years of age

People older than 50

Women who will be pregnant during the flu season

Adults and children with chronic conditions or immune deficiencies

Caregivers of young children or adults older than 50

Household contacts of any person who is at heightened risk of complications from flu

Residents of nursing homes or other chronic-care facilities.

Cold or flu?

It can be tricky to tell the difference between a severe cold and the flu because both are respiratory illnesses and many of the symptoms are similar. A cold tends to impact the nose, throat or chest. The flu affects the entire body and tends to be more severe than a cold. Flu can lead to more serious illnesses such as pneumonia or bronchitis. A typical case of the flu will run its course in five to seven days. A cold can last for three weeks or longer, but people usually begin to feel better in seven to 10 days.

Treatment options

Antiviral agents. There are prescription drugs that can potentially speed recovery from the flu if they are taken within two days of the appearance of symptoms. They also can be used to prevent the flu in the case of a recent outbreak or exposure to the flu.

There are two antiviral medications recommended by the US Centers for Disease Control and Prevention:

Oseltamivir (Tamiflu), which is recommended for people ages one and older, and zanamivir (Relenza), recommended for people ages seven and older. These medications are appropriate for individuals who cannot receive the flu vaccine because of an allergy or other reasons, and people who are particularly vulnerable to complications from the flu, said Mitchel Rothholz, chief of staff of the American Pharmacists Association in Washington, DC.

However, Rothholz cautioned that you should not take an antiviral medication if you plan to receive the LAIV vaccine (FluMist) in the next 48 hours. Also, he said people should stay away from antiviral medications for at least two weeks after they have received the LAIV vaccine. LAIV is made from weakened virus and does not cause influenza.

Analgesics. A number of other medications can provide relief from symptoms of the flu. For example, analgesics such as acetaminophen and ibuprofen will reduce fever and ease the pain associated with headaches, body aches and sore throat. Make sure the dosages you use are appropriate, particularly with respect to children. Also, children should not be given aspirin because of its association with Reye's syndrome. Be careful about the use of some stomach-coating medicines because many of them contain aspirin.

Other cold/flu remedies. Decongestants can be used for a stuffy nose or congestion, and antihistamines are appropriate for sneezing or a runny nose. However, Children's Healthcare of Atlanta does not recommend the use of these medications in children, especially kids younger than two. In fact, just weeks ago, manufacturers voluntarily pulled cough and cold medications aimed at infants and toddlers off the market. A Food and Drug Administration advisory panel voted to ban scores of over-the-counter cough and cold products intended for children younger than age six. The FDA has not yet made a final decision.

As an alternative, a steamy bathroom or a warm bath can provide children with some relief from congestion. A humidifier can be helpful as well.

Combination products. Be careful about the use of any multisymptom cold and flu remedies. "The important thing is to look at the ingredients on whatever product the patient is taking," stressedĀ Rothholz, noting that many people take products that have combinations of different classes of drugs, and then will take a second medication not realizing that they already have taken the maximum recommended dose in the combination product. "Particularly with a younger child ... talk to your pharmacist or physician about what best meets your needs rather than taking the gunshot approach."

Sources: Centers for Disease Control and Prevention, the American Pharmacists Association, Children's Healthcare of Atlanta

(Shanghai Daily November 14, 2007)

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