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Every fall, flu season greets us with constant reminders to wash our hands and roll up our sleeve for a flu shot. The fear of not doing so is great: winter days spent huddled under blankets with a high fever and dwindling PTO days.
Technically, the Centers for Disease Control and Prevention (CDC) categorizes “flu season” as between October and February in the United States (but it can last as late as May some years). Right now, we’re in full flu season swing — which means it’s that time of the year when cases of the virus pop up from coast to coast.
But what exactly is the flu, how do you come down with it (for one: that subway rail), how do docs ID it, and how exactly is it treated? Emergency room doctors — who see countless cases of the condition walk in and out of hospital doors every day — know best. We touched base with a few of them to grab those answers and more (so you can avoid grabbing the tissues later this winter).
And yes: You should go get your flu shot.
What Exactly Is The Flu?
“People throw the term ‘flu’ around very loosely,” says Tom Waters, M.D., a physician in the Cleveland Clinic’s Center for Emergency Medicine in Cleveland, Ohio.
You’ve likely done it: I have a stomach flu, I feel flu-like.
“‘Flu’ has kind of become a term that is used to mean any sickness,” he says. “But that’d be like calling all tissue Kleenex.”
After all, “the flu” is the influenza virus—an airborne virus often passed through droplets, usually from your nose or mouth. That’s why cases pop up more in colder months, when our noses run.
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If the virus comes into contact with your nose or mouth, it can enter your body and replicate, leading your immune system to attack it, explains Erick Eiting, M.D., an emergency room doctor at Mount Sinai Beth Israel in New York. “Most of the symptoms you have with the flu are related to your body’s own immune response,” he says.
Those symptoms include classic signs of the common cold (a runny nose, nasal congestion), sinus pain or pressure, a sore throat, a cough, a fever, muscle aches, and sometimes GI issues like nausea and vomiting, says Eiting.
But because flu symptoms also line up with symptoms of the common cold (as well as a whole host of other health issues), it’s not always the easiest illness to ID. “Even doctors have a hard time knowing which patients are presenting with symptoms related to the flu or to some other viral infection,” admits Eiting.
That’s why, if you go to the doctor with symptoms, a physician might give you a flu swab (formally called a nasopharyngeal swab), says Eiting. The doctor sticks a sterile swab in your nose and sends it to a lab to test for evidence of the influenza virus.
How Do You Treat The Flu?
If it turns out that you are indeed one of the 9.2 to 35.6 million people who get the flu every year, there are a few different plans for treatment.
First, there are three main antiviral drugs that docs prescribe. They are:
- Oseltamivir (available as a generic version or under the trade name Tamiflu)
- Zanamivir (trade name Relenza)
- Peramivir (trade name Rapivab)
The thing is, these meds won’t exactly nip your symptoms in the bud. They’ll simply help to shorten the amount of time you are sick—usually just by a day or two, says Eiting. Also, they usually work best if you start taking them within one or two days of getting sick.
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Says Eiting: “If we have someone come in with five days of symptoms, it’s too late for us to be able to give the medications that cut down the amount of time you have symptoms.”
That’s when a doctor might tell you that you simply have to ride the illness out. To this extent, in healthy people with strong immune systems, flu treatment is often what Waters calls ‘supportive.’ It consists of rest, fluids (you lose a lot more water than you think sneezing and coughing and blowing your nose), and medications like acetaminophen and ibuprofen.
Ibuprofen—a pain reliever and fever reducer—is also anti-inflammatory in nature, working to calm the body’s inflammatory response to the flu. Largely, this bodily response is what contributes to the flu’s many unwanted symptoms. Taken regularly while you’re experiencing symptoms, Advil offers temporary relief from all of the head pounding.
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Acetaminophen can reduce your fever and help the aches and pains that come along with the flu. But Sudafed is also a powerful decongestant, working to tackle that stuffed up, can’t-quite-breathe-right feeling. It can alleviate sinus pressure and the build up in your nose. That’s important in terms of keeping things moving—something that can help prevent a build-up that could potentially grow into a full-blown sinus infection.
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And while you may have heard about the powers of foods like chicken noodle soup in helping make you feel better fast, Dana Hunnes, R.D., Ph.D., a senior dietitian at Ronald Regan-UCLA Medical Center says the benefits of the soup likely boil down to simply staying well hydrated. Soups, water, and electrolyte beverages can help with the thinning of mucus, she says. It’s also best to avoid dairy products as they can make you more stuffy, she notes.
Also, there is some evidence that—at least when it comes to the common cold—zinc can decrease the length of the illness by blocking the virus from multiplying, Hunnes notes. Remember, that’s when taking it at the first signs of sickness. While you shouldn’t bank on it as a treatment, adding oysters, wheat germ, pumpkin and squash seeds, cashews, and cocoa powder—all packed with zinc—into your diet, could offer some relief, Hunnes notes.
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Of course, sometimes flu symptoms can prove so intense that they require medical attention. “There are people who die from the flu and get severely ill from the flu,” says Eiting. “What I tell people is that if you’re not able to keep down food or drinks, if you’re light-headed when you stand up (or worse, pass out), or if you have symptoms you’re not able to manage (especially shortness of breath or pain in your chest), it’s time to see a doctor.”
Sometimes, he says, influenza can bring out chronic issues we already have or impact certain people (especially those with already compromised immune systems) more strongly than others.
Do You Really Need A Flu Shot?
Doctors will be the first to tell you that they’d rather prevent an illness than treat one. And in this case, that’s where the flu vaccine comes in.
Every year, the CDC conducts careful research based on epidemiological studies to predict which flus will be most common in coming months here in the United States. That season’s flu vaccine, then, protects against those strains.
The influenza vaccine of choice is an injectable. It’s what Eiting calls a “killed virus”—or little pieces of the virus that have been inactivated (and, thus, aren’t infectious).
So that means that no, you’re not going to get the flu from the flu shot. “There are a lot of myths about the flu shot—but the truth of the matter is that it prevents you from getting the flu. You’re not going to get sick from it,” confirms Waters. (You just might have a sore arm for a day or two, he admits.)
When injected into your muscle, different white blood cells go find those pieces of the killed virus, pick them up, recognize them as foreign, and plan to create an army of cells to destroy them if your body ever sees them again, Eiting exlpains.
And you pretty much have to get the shot. While there is a nasal spray flu vaccine out there, the CDC doesn’t recommend it’s use this season. The idea behind the nasal vaccine was that delivering the vaccine by way of the nose—the same way the actual flu might attack your body—would make it more effective than a traditional injection into the muscle, explains Eiting. But the findings so far are that the nasal vaccine simply hasn’t proved anywhere nearly as effective as the shot, he notes.
The CDC recommends everyone over the age of six months gets a flu vaccine every season (because remember, the vaccine changes every year). That’s a recommendation that’s been in place since 2010.
Generally, your best bet is to get vaccinated before the flu season starts, too (so: before right now). Ideally, you would have gotten vaccinated by the end of October. The reason is two-fold: Firstly, it’s less likely that there are as many flu cases in the early fall and secondly, it takes about two weeks for your body to develop those antibodies (the army) to protect against the flu.
But remember: It’s never too late to get vaccinated, says Waters—so if you haven’t gotten your shot, you still should.
Can You Prevent The Flu?
The flu shot, while entirely necessary and something everyone should add to their to-do list right this second, isn’t 100 percent effective. The CDC estimates that when the vaccine is well-matched with the flus of the season, it reduces the risk of getting sick by between 40 and 60 percent. So technically, yes, you can still get sick even if you get the shot.
If you’re traveling, it’s also important to note that the vaccine you’d get here in the United States doesn’t protect against less prevalent strains of the flu (that might be more prevalent in other countries).
That’s where hand-washing (with warm water and soap) proves über important. It’s one of the best ways to stay safe. Think about your day-to-day. “There’s not enough hand sanitizer in the world to clean off all of the germs you come into contact with just going into work,” says Eiting who rides the New York City subway every a.m.
Remember the way the flu is passed? Someone sneezes into their hand, they touch the subway seat, you touch the subway seat, you get the flu.
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Other preventive strategies center around building and maintaining a strong immune system—something your healthy habits (regular exercise, sleep, and stress-reduction techniques) can work to achieve.
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Drinking up (lots of water, tea, and unsweetened beverages) can also help keep mucus thin and therefore less likely to latch onto viruses as well as stickier, gooier mucus would, explains Hunnes.
And while certain foods certainly won’t prevent the flu, certain nutrients do play a role in immune strength, including vitamin C (think: citrus foods, bell peppers, strawberries, kiwi, papaya, and brussels sprouts), says Hunnes. “Vitamin C has less convincing data than zinc, but it may still be beneficial to take prophylactically.”
You can also try products like Airborne or Emergen-C. While there’s not tons of data behind their effectiveness, there’s something to be said about believing something works, notes Eiting who adds he usually tells patients that if they are doing something that they believe is making them better (and it certainly isn’t making anything worse), they should continue doing those things.
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But ultimately, while all of these preventative strategies are effective—in both building a body strong enough to fight the flu and in sidestepping it all together—we come back to the flu shot.
Only 41.7 percent of people over 18 got vaccinated last year (a figure that is 1.9 percent lower than coverage the years before). Even more: young people are guilty of skipping the shot. Only 37 percent of 18 to 49 year olds got vaccinated last year.
But even if you don’t get the flu and even if you hate shots, Reason Number 1,000 to get vaccinated is that it makes you a better citizen. “Even if you’re young and healthy and can fight the flu off and just get sick, if you get the flu, you’re a vector and you can spread it to other people,” says Waters. “You could give it to people who are more vulnerable to it—so from a societal standpoint, the vaccine is worthwhile to help the spread of the disease.”
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