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Get Set for Winter Illness Season

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In much of the Northern Hemisphere, this is prime time for colds, influenza (flu), and other respiratory illnesses.

While contagious viruses are active year-round, fall and winter are when we're all most vulnerable to them. This is due in large part to people spending more time indoors with others when the weather gets cold.

The Food and Drug Administration (FDA) regulates medicines and vaccines that help fight winter illnesses.

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Colds and Flu

Most respiratory bugs come and go within a few days, with no lasting effects. However, some cause serious health problems. Although symptoms of colds and flu can be similar, the two are different.

Colds are usually distinguished by a stuffy or runny nose and sneezing. Other symptoms include coughing, a scratchy throat, and watery eyes. No vaccine against colds exists because they can be caused by many types of viruses. Often spread through contact with mucus, colds come on gradually.

Flu comes on suddenly, is more serious, and lasts longer than colds. The good news is that yearly vaccination can help protect you from getting the flu. Flu season in the United States generally runs from November to April.

Flu symptoms include fever, headache, chills, dry cough, body aches, fatigue, and general misery. Like colds, flu can cause a stuffy or runny nose, sneezing, and watery eyes. Young children may also experience nausea and vomiting with flu.

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Prevention Tips

Get vaccinated against flu. According to the Centers for Disease Control and Prevention (CDC):

  • More than 200,000 people in the United States are hospitalized from flu-related complications each year, including 20,000 children younger than age 5.
  • Flu-associated deaths number in the thousands each year. Between 1976 and 2006, the estimated number of flu-related deaths every year ranged from about 3,000 to about 49,000.

Flu vaccine, available as a shot or a nasal spray, remains the best way to prevent and control influenza. The best time to get a flu vaccination is from October through November, although getting it in December and January is not too late. A new flu shot is needed every year because the predominant flu viruses may change every year.

All people 6 months of age and older should be vaccinated. However, you should talk to your health care professional before getting vaccinated if you

  • have certain allergies, especially to eggs
  • have an illness, such as pneumonia
  • have a high fever
  • are pregnant

Flu vaccination for health care workers is urged because unvaccinated workers can be a primary cause of outbreaks in health care settings.

Certain people are more at risk for developing complications from flu; they should be immunized as soon as vaccine is available. These groups include:

  • people 65 and older
  • residents of nursing homes or other places that house people with chronic medical conditions such as diabetes, asthma, and heart disease
  • adults and children with heart or lung disorders, including asthma
  • adults and children who have required regular medical follow-up or hospitalization during the preceding year because of chronic metabolic diseases (including diabetes), kidney dysfunction, a weakened immune system, or disorders caused by abnormalities of hemoglobin (a protein in red blood cells that carries oxygen)
  • young people ages 6 months to 18 years receiving long-term aspirin therapy, and who as a result might be at risk for developing Reye's syndrome after being infected with influenza (See aspirin information in the section "Taking OTC Products.")

Note that only one vaccine is needed for the 2010-2011 influenza season.

During last flu season, two different vaccines were needed; one to prevent seasonal influenza and another to protect against the 2009 H1N1 flu virus. This year's seasonal flu vaccine protects against three strains of influenza, including the 2009 H1N1 flu virus.

Also, a vaccine specifically for people 65 years and older is available this year. Called Fluzone High-Dose, this vaccine induces a stronger immune response and is intended to better protect the elderly against seasonal influenza.

This vaccine—which was approved by FDA in 2009—was developed because the immune system typically becomes weaker with age, leaving people at increased risk of seasonal flu-related complications which may lead to hospitalization and death.

Wash your hands often. Teach children to do the same. Both colds and flu can be passed through coughing, sneezing, and contaminated surfaces, including the hands.

CDC recommends regular washing of your hands with warm, soapy water for about 15 seconds.

FDA says that while soap and water are undoubtedly the first choice for hand hygiene, alcohol-based hand rubs may be used if soap and water are not available. However, the agency cautions against using the alcohol-based rubs when hands are visibly dirty. This is because organic material such as dirt or blood can inactivate the alcohol, rendering it unable to kill bacteria.

Try to limit exposure to infected people. Keep infants away from crowds for the first few months of life. This is especially important for premature babies who may have underlying abnormalities such as lung or heart disease.

Practice healthy habits.

  • Eat a balanced diet.
  • Get enough sleep.
  • Exercise. It can help the immune system better fight off the germs that cause illness.
  • Do your best to keep stress in check.

Also, people who use tobacco or who are exposed to secondhand smoke are more prone to respiratory illnesses and more severe complications than nonsmokers.

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Already Sick?

Usually, colds and flu simply have to be allowed to run their course. You can try to relieve symptoms without taking medicine. Gargling with salt water may relieve a sore throat. And a cool-mist humidifier may help relieve stuffy noses.

Here are other steps to consider:

  • First, call your doctor. This will ensure that the best course of treatment can be started early.
  • If you are sick, try not to make others sick too. Limit your exposure to other people. Also, cover your mouth with a tissue when you cough or sneeze, and throw used tissues into the trash immediately.
  • Stay hydrated and rested. Fluids can help loosen mucus and make you feel better, especially if you have a fever. Avoid alcohol and caffeinated products. These may dehydrate you.
  • Know your medicine options. If you choose to use medicine, there are over-the-counter (OTC) options that can help relieve the symptoms of colds and flu.

    If you want to unclog a stuffy nose, then nasal decongestants may help. Cough suppressants quiet coughs; expectorants loosen mucus so you can cough it up; antihistamines help stop a runny nose and sneezing; and pain relievers can ease fever, headaches, and minor aches.
    In addition, there are prescription antiviral medications approved by FDA that are indicated for treating the flu. Talk to your health care professional to find out what will work best for you.

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Taking OTCProducts

Be wary of unproven treatments. It's best to use treatments that have been approved by FDA. Many people believe that products with certain ingredients—vitamin C or Echinacea, for example—can treat winter illnesses.

Unless FDA has approved a product for treatment of specific symptoms, you cannot assume that the product will treat those symptoms. Tell your health care professionals about any supplements or herbal remedies you use.

Read medicine labels carefully and follow directions. People with certain health conditions, such as high blood pressure, should check with a health care professional or pharmacist before taking a new cough and cold medicine. Some medicines can worsen underlying health problems.

Choose appropriate OTC medicines. Choose OTC medicines specifically for your symptoms. If all you have is a runny nose, only use a medicine that treats a runny nose. This can keep you from unnecessarily doubling up on ingredients, a practice that can prove harmful.

Check the medicine's side effects. Certain medications such as antihistamines can cause drowsiness. Medications can interact with food, alcohol, dietary supplements, and each other.

The safest strategy is to make sure your health care professional and pharmacist know about every product you are taking, including nonprescription drugs and any dietary supplements such as vitamins, minerals, and herbals.

Check with a doctor before giving medicine to children. Get medical advice before treating children suffering from cold and flu symptoms. Do not give children medication that is labeled only for adults.

Don't give aspirin or aspirin-containing medicines to children and teenagers. Children and teenagers suffering from flu-like symptoms, chickenpox, and other viral illnesses shouldn't take aspirin.

Reye's syndrome, a rare and potentially fatal disease found mainly in children, has been associated with using aspirin to treat flu or chickenpox in kids. Reye's syndrome can affect the blood, liver, and brain.

Some medicine labels may refer to aspirin as salicylate or salicylic acid. Be sure to educate teenagers, who may take OTC medicines without their parents' knowledge.

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When to See a Doctor

See a health care professional if you aren't getting any better or if your symptoms worsen. Mucus buildup from a viral infection can lead to a bacterial infection.

With children, be alert for high fevers and for abnormal behavior such as unusual drowsiness, refusal to eat, crying a lot, holding the ears or stomach, and wheezing.

Signs of trouble for all people can include

  • a cough that disrupts sleep
  • a fever that won't go down
  • increased shortness of breath
  • face pain caused by a sinus infection
  • worsening of symptoms, high fever, chest pain, or a difference in the mucus you're producing, all after feeling better for a short time

Cold and flu complications may include bacterial infections (e.g., bronchitis, sinusitis, ear infections, and pneumonia) that could require antibiotics.

Remember: While antibiotics are effective against bacterial infections, they don't help against viral infections such as the cold or flu.

This article appears on FDA's Consumer Updates page, which features the latest on all FDA-regulated products.

Revised October 29, 2010

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