If you're like most Americans affected by this year's flu vaccine shortage, you haven't been able to get a flu shot. Fear not. There are other ways to protect yourself from the flu. And if you do catch it, you may be able to nip it in the bud, or prevent spreading the flu to your family.

Nasal Intelligence:
FluMist

Consider getting the nasal-spray flu vaccine if you're healthy, between 5 years to 49 years of age and are not pregnant. About 1 million doses of nasal-spray flu vaccine will be available in the United States this season.

The nasal spray vaccine, also known by the brand name FluMist, is made with live, attenuated (weakened, but alive) flu viruses that do not cause the flu. The body reacts to the inhaled vaccine by developing antibodies to the virus, just like it does to the shot.

In one large study among children aged 15 to 85 months, the nasal-spray flu vaccine reduced the chance of flu by 92 percent. In another study, adults who took the nasal spray vaccine were sick fewer days with the flu, missed fewer days at work, didn't take as many prescription or over-the-counter drugs for their symptoms, and didn't visit the doctor as much as participants in the placebo arm of the study.

The nasal spray vaccine takes two weeks before it is effective. Be sure not to take any flu antiviral medication during those two weeks. Antivirals will prevent the weakened flu virus from reproducing, rendering it ineffective. Wait 48 hours after finishing antiviral therapy before receiving the nasal spray vaccine.

Listen to Your Mother

She was right when she nagged you to wash your hands and cover your mouth when you cough. More than just being polite, her advice also protects you from catching the latest bug going around.

"Do all the things your mother told you to prevent the flu," says Dr. Mary desVignes-Kendrick, professor and deputy director of the Center for Biosecurity and Public Health Preparedness at The University of Texas School of Public Health at Houston. "Always cover your mouth or nose with a tissue when you cough or sneeze, and then throw it away."

If you don't have a tissue, the U.S. Centers for Disease Control and Prevention (CDC) also suggests coughing or sneezing into your sleeve, rather than into your hands. While Mom might have turned up her nose at such advice, it could save you from becoming the flu's next victim-or certainly save your friendships with those you might infect.

The flu spreads from person to person when you cough or sneeze out tiny droplets of moisture containing the virus. You can also catch the flu by touching something with the virus on it and then touching your eyes, mouth or nose.

"The single most important thing you can do to prevent the flu is to wash your hands often, " says Dr. Luis Ostrosky-Zeichner, an assistant professor of internal medicine specializing in infectious diseases at The UT Medical School at Houston . "I also recommend carrying alcohol gels, so you can sanitize your hands when you are not near water."

Since the flu vaccine is not approved for children under 6 months old, parents of young babies should take extra precautions to prevent them from catching the virus. Wash your hands and your child's hands frequently and thoroughly (at least 15 seconds). If your child is in daycare, do your best to wash her hands when you can. You might also ask your daycare provider about the provider's policy on hand washing and general cleanliness.

Stay Home

You don't have to become a hermit, but flu season might be a good time to rediscover the comforts of home.

"Stay away from large groups and crowds where people tend to be coughing and sneezing and spraying dropletts, like malls and movie theaters," desVignes-Kendrick says. Outdoor events such as festivals and football games should be fine, she adds, because the virus is more diluted in an open space.

If you do get the flu, stay home from work and have your children stay home from school or daycare. Adults may be able to infect others one day before getting symptoms and up to seven days after getting sick. Some children may be contagious for more than a week.

" While many employees may go to work ill because they worry about the amount of work they have to do, or what their bosses might think, it is essential that people with the flu stay home and not infect their co-workers with the virus," desVignes-Kendrick says. "This also applies to children in daycare and school settings, where one child with the flu could cause widespread illness."

Fight Back

If despite your best efforts, you still come down with the flu, see your doctor immediately. Your doctor can prescribe an antiviral drug that can help shorten the duration and blunt the severity of your symptoms.

The U.S. Food and Drug Administration has approved four different antiviral drugs -- amantadine, rimantadine, zanamivir, and oseltamivir - for treating the flu.

If you take antivirals within two days of getting the flu, the drugs can shorten the time you are sick by one to two days. Amantadine, rimantadine, and oseltamivir have also been approved to help prevent the flu. The drugs are about 70 - 90 percent effective for preventing illness in healthy adults, according to the CDC.

"Antivirals have been shown to prevent the flu in people with direct contact with someone who has the flu," Ostrosky-Zeichner says. "When you detect the flu in the family, chances are others in the family will get it, too. So see your doctor as soon as you think you, or a family member, has the flu."

UPDATED: 10-21-2004

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