Influenza (Flu): Protect Yourself & Your Family

With a severe shortage of vaccine nationwide, the 2004/05 flu season will be difficult for everyone, and especially dangerous for older adults, young children, and those with certain health concerns. Unfortunately, some people who usually get flu shots (even those in high risk groups) may go without the vaccine this year.

To help make it easier to take charge of your health - and protect the health of your family - Preferred Care presents tips to help you prevent the flu, or cope with the illness and its symptoms.

Part 1: Flu Basics
Part 2: Prevent the Flu with Good Health Habits
Part 3: Preventing the Flu - Wash Your Hands!
Part 4: When You Have the Flu - Tips to Help You Cope
Part 5: Seeing You Through the Flu - Dehydration
Part 6: Seeing You Through the Flu - Diarrhea
Part 7: Seeing You Through the Flu - Fever
Part 8: Seeing You Through the Flu - Nausea and Vomiting

Flu/Flu Vaccine Update Resources 

• Monroe County, NY residents may call the County Health Department's Health Info Line at 234-9600 for a recording that offers good information about the current flu vaccine situation, updated regularly.
• Monroe County Public Health Department Flu Vaccine Update Web page
• Monroe County, NY Department of Health Flu FAQ (10/22/04)
• The Interim Influenza Vaccination Recommendations, 2004-05 Influenza Season weekly report Web page of the Centers for Disease Control and Prevention (CDC)
• The Centers for Disease Control & Prevention (CDC) Flu Information Web Page

Part 1: Flu Basics

What is the Flu?
Influenza (flu) is caused by a virus and comes on suddenly, causing fever, shaking chills, body aches, and other symptoms. The flu is not the same as the common cold. When you have the flu, you will often be sick longer than you would with other illnesses.

What causes the flu?
Influenza viruses A and B cause the classic flu. Type A is usually responsible for the outbreaks that occur annually. Strains of influenza virus that cause the flu may differ from year to year.

Although people often use the term "flu" to describe any kind of mild illness that has flu-like symptoms (such as the common cold or a stomach virus), the flu is a distinct viral illness with specific symptoms, and it tends to occur at a particular time of year-late fall and winter.

However, you should see a health professional for a fever if:

• An infant under age 3 months has a fever of 100.4°F or higher.
• A child age 3 months to 3 years has a fever of 104°F or higher that does not come down after 4 to 6 hours of home treatment.
• A person age 4 or older has a fever of 104°F or higher that does not come down after 2 hours of home treatment.
• Your fever does not begin to go down after 3 to 5 days.
• You have a fever that goes away and then returns. You could have a bacterial infection.
• You or your child also has shortness of breath or other breathing problems.
• You or your child has a fever and a severe headache or stiff neck, or seems confused or hard to wake.

(back to top)

Informational Source: Healthwise® Knowledgebase
Posted: October 2004

Preferred Care reminds you that when it comes to the flu, prevention is the best medicine. To help you take charge of your own health, and also keep the children and older adults in your life healthier, taking a few easy precautions to ward off the flu can make your whole life healthier.

• Avoid close contact. Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick, too.

• Stay home when you are sick. If possible, stay home from work, school, and errands when you are sick. You will help prevent others from catching your illness.

• Cover your mouth and nose. Cover your mouth and nose with a tissue when coughing or sneezing to help prevent those around you from getting sick (do not use your hands - germs cling to your bare skin and spread to the things you touch).

• Wash your hands. Washing your hands often will help protect you from germs.

• Avoid touching your eyes, nose or mouth. Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.

• Drink plenty of fluids. Water flushes your system as it rehydrates you. A typical, healthy adult needs eight 8-ounce glasses of fluids each day. How can you tell if you're getting enough liquid? If the color of your urine runs close to clear, you're getting enough. If it's deep yellow, you need more fluids.

• Eat foods containing phytochemicals. "Phyto" means plants, and the natural chemicals in plants give the vitamins in food a supercharged boost. So put away the vitamin pill, and eat dark green, red, and yellow vegetables and fruits.

• Eat yogurt. Some studies have shown that eating a daily cup of low-fat yogurt can reduce your chance of catching a cold by 25 percent. Researchers think that the beneficial bacteria in yogurt may stimulate production of immune system substances that fight disease.

(back to top)

Informational Sources: Centers for Disease Control and Prevention (CDC); WebMD
Posted: October 2004

Washing your hands is a simple and effective way to help prevent diseases, such as colds, flu, and food poisoning.

When to wash your hands

• Often, especially during cold and flu season, can reduce your risk of catching or spreading a cold or the flu.
• Before and after preparing or serving food reduces your risk of catching or spreading bacteria that cause food poisoning. Be especially careful to wash before and after preparing poultry, raw eggs, meat, or seafood.
• After going to the bathroom or changing diapers reduces your risk of catching or spreading infectious diseases.

Wash your hands after:

• Eating a meal or snack
• Handling money
• Touching your ears, nose, or mouth
• Blowing your nose, coughing, or sneezing
• Touching your pets
• Any kind of cleaning or hand contact with dirty equipment or work surfaces
• Caring for someone who is sick or injured
• Taking out the garbage
• Using the bathroom
• Changing diapers

The best way to wash your hands

• Use warm or hot water when possible. Cold water is not as effective for killing bacteria on your hands.
• Wet your hands and wrists completely under the running water.
• Apply a small dab of liquid soap. If you use bar soap, rinse it off before you use it.
• Work up a good lather and wash all of the surfaces of your skin, including the wrist, palms, backs of your hands, fingers, and fingernails. Wash your hands for at least 15 to 20 seconds.
• Rinse your hands thoroughly.
• Dry your hands. Use your paper towel to turn off the water after you have finished.
• If soap and water are not available, use gel hand sanitizers or alcohol-based hand wipes. Most supermarkets and drugstores carry these products. Carry one or both with you when you travel, and keep them in your car or purse.
• If using the gel sanitizer, rub your hands until the gel is dry. You don't need to use water; the alcohol in the gel kills the germs on your hands.

(back to top)

Informational Source: Healthwise® Knowledgebase
Posted: October 2004

• Get extra rest. When you have the flu, you will most likely need no urging to stay home in bed for a few days. Bed rest will also help you avoid spreading the virus to others.
• Drink plenty of extra fluids to replace those lost from fever. Extra fluids also ease a scratchy throat and keep nasal mucus thin. Hot tea with lemon, water, fruit juice, and soup are all good choices.
• Avoid smoking and breathing other people's smoke. This is good advice anytime, but it is especially important when you have a respiratory infection like a cold or the flu.
• Breathe moist air from a hot shower or from a sink filled with hot water to help clear a stuffy nose.
• If the skin around your nose and lips becomes sore from repeated rubbing with tissues, apply a bit of petroleum jelly to the area. Disposable tissues containing lotion also may help.

Fever, headaches, and body aches are typical flu symptoms.

• If fever is uncomfortable, take acetaminophen or ibuprofen to lower it. You may also sponge your body with lukewarm water to reduce fever. Do not use cold water or ice. Lowering the fever will not make your symptoms go away faster, but it may make you more comfortable.
• If the fever is not causing discomfort, you may just want to watch for signs that it is going higher. A slight fever may help the body fight the virus.
• To relieve body aches and headache, take aspirin, acetaminophen, or ibuprofen. Do not give aspirin to anyone under age 20. Also, be aware that aspirin and ibuprofen can cause stomach upset, while acetaminophen does not.

(back to top)

Informational Source: Healthwise® Knowledgebase
Posted: October 2004

Dehydration occurs when your body loses too much fluid. When you stop drinking water or lose large amounts of fluids through diarrhea, vomiting, or sweating, your body's cells absorb fluid from the blood and other body tissues. Dehydration can occur at any age, but it is most dangerous for babies, small children, and older adults.

Signs of Dehydration

Early signs of dehydration include:

• Increased thirst.
• Dry mouth and sticky saliva.
• Reduced urine output with dark yellow urine.

Symptoms of moderate dehydration include:

• Extreme thirst.
• Dry appearance inside the mouth and the eyes don't tear.
• Decreased urination, or half the normal number of urinations in 24 hours (usually 3 or fewer urinations). Urine is dark amber or brown.
• Lightheadedness that is relieved by lying down.

Severe dehydration is life-threatening. Symptoms that require emergency care (even if only one of them is present) include:

• Altered behavior, such as severe anxiety, confusion, or not being able to stay awake.
• Faintness that is not relieved by lying down, or lightheadedness that continues after standing for 2 minutes.
• Weak, rapid pulse.
• Cold, clammy skin or hot, dry skin.
• Little or no urination.
• Loss of consciousness.

The following tips may help you prevent dehydration:

• Drink 8 to 10 glasses of fluids, such as water or rehydration drinks (like Pedialyte for kids, Gatorade for adults) each day.
• Encourage your child to drink extra fluids or suck on popsicles. Children between the ages of 4 and 10 should drink at least 6 to 10 glasses of liquids to replace lost fluids.
• Avoid drinks that contain caffeine, such as coffee and colas. They increase urine output and make you dehydrate faster.
• Avoid high-protein diets. Diets that provide more than 1.8 grams of protein per kilogram of body weight per day increase urine output and lead to dehydration. If you are on a high-protein diet, make sure that you consume between 8 and 12 glasses of water each day.
• Avoid alcoholic drinks. They increase dehydration and make it difficult to make good decisions.
• Use the buddy system! During flu season, pair up with a friend and remind each other to drink fluids often.

(back to top)

Informational Source: Healthwise® Knowledgebase
Posted: October 2004

Part 6: Seeing You Through the Flu - Diarrhea

Home Treatment
Home treatment can help you treat your diarrhea and avoid other related problems, such as dehydration (the loss of body fluid that is most dangerous for babies, small children, and older adults).

• Take frequent, small sips of water or a rehydration drink (like Gatorade) and small bites of salty crackers.
• Try to increase your fluid intake to at least 1 quart per hour.
• Begin eating mild foods the next day or sooner, depending on how you feel.
• Avoid spicy foods, other fruits, alcohol, and caffeine until 48 hours after all symptoms have disappeared.
• Avoid chewing gum that contains the ingredient "sorbitol".
• Avoid dairy products, like milk or cheese, for 3 days after symptoms disappear.

Nonprescription medications for diarrhea
Nonprescription medication may be helpful in treating your diarrhea. Follow these tips when taking a nonprescription medication for diarrhea:

• Use nonprescription antidiarrheal medication if you have diarrhea for longer than 6 hours and you do not have other signs of illness, such as a fever, abdominal cramping or discomfort, or bloody stools.
• Read and follow all label directions on the nonprescription medication bottle or box. Be sure to take the recommended dose.
• To avoid constipation, stop taking antidiarrheal medications as soon as stools thicken.
• Long-term use of nonprescription antidiarrheal medication is not recommended.
• Do not use nonprescription antidiarrheal medications if you have bloody diarrhea or a high fever.

Diarrhea, Age 11 and Younger
Children, especially those younger than 6 months of age, need special attention when they have diarrhea because they can quickly become dehydrated (a loss of fluids in the body that can be dangerous for babies and small children). Pay careful attention to your child's appearance and how much fluid he or she is drinking can help prevent problems.

• Avoid giving your child apple juice, chicken broth, soda pop, sports drinks (such as Gatorade, All Sport, or PowerAde), ginger ale, or tea. These drinks do not contain the right mixture of minerals and sugar to replace lost fluids and may make the diarrhea worse.
• Do not offer diet soda pop because it lacks the calories and minerals your child needs.
• You may use plain water to replace lost fluids if your child is over the age of 1 year and is eating food.
• Do not withhold food from your child. Studies have shown that children who are fed easily digestible foods have shorter episodes of diarrhea.
• Avoid foods and drinks that contain a lot of sugar, such as juice, soda pop, ice cream, and candy.
• If your child drinks cow's milk, he or she may continue to drink cow's milk.
• Do not give your child prescription or nonprescription medicine to stop diarrhea unless you are told to do so by your child's doctor.
• Protect the diaper area with zinc oxide or another cream. Diaper rash is common after diarrhea.
• Wash your hands and your child's hands thoroughly after each diaper change and before each feeding.
• Until you have your doctor's OK, your child should not attend school or day care.

Home Treatment
As soon as you notice your child has diarrhea, begin to replace lost fluids to avoid dehydration.

• If you breast-feed your baby, continue at more frequent intervals to replace lost fluids. Give an oral rehydration solution (ORS), such as Pedialyte, between feedings only if signs of dehydration develop.
• If you use a bottle to feed your baby, increase the frequency of feedings to make up for lost fluids. Give an ORS between feedings only if signs of dehydration develop.
• If signs of mild or moderate dehydration develop, the amount of ORS your baby needs depends on his or her weight and the degree of dehydration present. You can give the ORS in a dropper, spoon, or bottle. Continue to give the ORS until your baby's stools return to normal.
• If your baby has started eating cereal, you may replace lost fluids with cereal. Offer the cereal mixture after each diarrhea stool. You may also offer rice cereal, strained bananas, and mashed potatoes if your child has had these foods before.

Children 1 year through 11 years of age

• For older children with diarrhea, an oral rehydration solution (ORS) such as Pedialyte, half-strength orange juice, or plain water (if the child is eating food) may be used to replace fluids lost from diarrhea.
• Offer your child 1/2 cups to 1 cup of fluids after each diarrhea stool.
• Allow your child to drink as much fluid as he or she wants.
• If diarrhea is persistent or if your child is dehydrated, using an ORS as the main source of replacement fluids is the safest approach.
• The amount of ORS your child needs depends on his or her weight and the degree of dehydration present.
• Keep giving the ORS until your child's stools return to normal.
• Cereal may also be used to replace lost fluids. Offer 1/2 cups to 1 cup of the cereal mixture after each diarrhea stool.
• Give your child frequent small meals, at least 6 a day, while he or she is having diarrhea.
• The best foods for your child are easily digestible foods, such as rice cereal, pasta, breads, cooked beans, mashed potatoes, cooked carrots, applesauce, and bananas.
• Pretzels or salty crackers can help your child replace the salt lost from diarrhea.

(back to top)

Informational Source: Healthwise® Knowledgebase
Posted: October 2004

Part 7: Seeing You Through the Flu - Fever

Fever, Age 4 and Older
Fever is the body's normal and healthy reaction to infection and other illnesses, both minor and serious. Fevers cause the body to increase the production of white blood cells and other substances that help fight infection. Fever is a symptom, not a disease. In most cases fever means you have a minor illness. Most infections with a fever are caused by viral infections, such as colds and flu.

Normal body temperature - Average normal body temperature is 98.6°F orally. It usually varies during the day from a low of 97.4°F in the morning to a high of 99.6°F in the late afternoon. Exercising, wearing too many clothes, taking a hot bath, or being out in hot weather can cause an increase in your temperature.

Fever temperatures - A fever is a high body temperature. A temperature of up to 102°F actually can be helpful, because it helps the body react to an infection. Most healthy children and adults can tolerate a fever as high as 103°F to 104°F for short periods of time without problems.

Children tend to run higher fevers than adults. The degree of fever may not indicate how serious the illness is. With a minor illness, such as a cold, you may have a temperature, while a very serious infection may cause little or no fever. It is important to look for other symptoms along with the fever.

A fever without other symptoms that lasts 3 to 4 days, comes and goes, and gradually reduces over time is usually not a cause for concern. When you have a fever, you may feel tired, lack energy, and may not eat as much as usual. High fevers are not comfortable, but they rarely cause serious problems.

Home Treatment
It is important to prevent dehydration (when the body loses too much fluid) from a fever:

• Drink extra fluids, especially water. Adults should drink at least 10 glasses of liquid a day to replenish lost fluids. Children between the ages of 4 and 10 should drink at least 6 to 10 glasses.
• Watch for early signs of dehydration (increased thirst, dry mouth and sticky saliva, reduced urine output with dark yellow urine).
• Eat light, easily digested foods, such as soup.
• For fevers that cause discomfort, try a warm (not cold) shower or sponge bath and dress lightly to allow your body to cool down.

Prevention
The best way to prevent fevers is to reduce your exposure to infectious diseases. Washing your hands often is the single most important prevention measure - for people of all ages!

Fever, Age 3 and Younger
In most cases, fever means your child has a minor illness. Most infections with a fever are caused by viral infections, such as colds and flu.

Home Treatment
It can be hard to know whether you should call your doctor when your child has a fever, especially during the cold and flu season. The way your child looks and acts is a better guide than the thermometer. Most children will be less active when they have a fever.

If your child is comfortable and alert, eating well, drinking enough fluids, urinating normal amounts, and seems to be improving, home treatment without medication is all that is needed for a fever of 100°F to 102°F. If you are unable to measure your child's temperature, you need to look for other symptoms of illness every hour while your child has a fever and follow these home treatment measures:

• Encourage your child to drink extra fluids or suck on popsicles. Your child should be urinating at least every 6 to 8 hours.
• Dress your child lightly, and do not wrap him or her in blankets. Dressing lightly will help your child's body cool down.

Prevention
The best way to prevent fevers is to reduce your child's exposure to infectious diseases. Hand washing is the single most important prevention measure - for people of all ages.

(back to top)

Informational Source: Healthwise® Knowledgebase
Posted: October 2004

Nausea and Vomiting, Age 4 and Older
Nausea is an unpleasant feeling in the pit of the stomach. When you are nauseated, you may feel weak and sweaty and produce a lot of saliva. Intense nausea often leads to vomiting. Nausea and vomiting can be a sign of another illness. Nausea and vomiting may be caused by viral infections, like the flu.

Home Treatment

• Watch for and treat early signs of dehydration (when the body loses too many fluids). These are increased thirst, dry mouth and sticky saliva, and reduced urine output with dark yellow urine. Older adults and young children can quickly become dehydrated from vomiting.
• After vomiting has stopped for one hour, drink 1 fl oz of a clear liquid every 20 minutes for one hour. Clear liquids include apple or grape juice mixed to half strength with water, weak tea with sugar, clear broth, and gelatin dessert. Avoid orange juice, grapefruit juice, tomato juice, or lemonade.
• If vomiting lasts longer than 24 hours, sip a rehydration drink (like Pedialyte for kids or Gatorade for adults) to restore lost fluids and nutrients.
• Rest in bed until you are feeling better.
• When you are feeling better, begin eating clear soups, mild foods, and liquids until all symptoms are gone for 12 to 48 hours. Gelatin dessert, dry toast, crackers, and cooked cereal are good choices.
• Suck on peppermint candy or chew a stick of peppermint gum. Peppermint is an antispasmodic that will help decrease the stomach contractions that may be causing your nausea.

Vomiting, Age 3 and Younger
Vomiting occurs when a child's stomach contents are forced up from the stomach and out the mouth. Most of the time vomiting is not serious. Home treatment will often help your child feel better.

• Most vomiting in children age 3 and younger is caused by a viral illness, like the flu. A child with stomach flu also may have other symptoms, such as diarrhea, and fever. With home treatment, the vomiting usually will stop within 12 hours. Diarrhea may last for a few days or more.
• Vomiting in babies should not be confused with spitting up. Vomiting is forceful and repeated. Spitting up may seem forceful but usually occurs shortly after feeding and causes no discomfort. A baby may spit up for no reason at all. Overfeeding, not burping your baby after feeding, intolerance to milk or formula, or exposure to tobacco smoke are other reasons why your baby may spit up.
• Babies and children less than one year old need special attention if they continue to vomit. They can quickly become dehydrated (when the body loses too much fluid, which can be dangerous to babies and young children). Watch your child carefully and pay close attention to the amount of fluid he or she is able to drink. Look for these early signs of dehydration:
  • Less frequent and more concentrated urine or fewer diaper changes needed. Your child's urine will have a stronger odor or darker yellow color.
  • Fussiness
  • Acting hungry most of the time

Newborns and babies through 6 months

• Do not feed your baby for about 30 to 60 minutes after he or she has vomited. Be sure to watch your baby carefully for signs of dehydration (less frequent and more concentrated urine or fewer diaper changes needed, urine with a stronger odor or darker yellow color, fussiness, acting hungry most of the time.)
• If your baby is breast-fed, continue breast-feeding. Offer each breast to your baby for 1 to 2 minutes every 10 minutes.
• Do not give your baby plain water.
• If your baby is formula-fed, switch to an oral rehydration solution (ORS), like Pedialyte.
• Offer 1 Tbsp of the drink every 10 minutes for the first hour.
• After the first hour, gradually increase the amount of ORS that you offer your baby.
• When 6 hours have passed without vomiting, you may resume your child's regular formula feedings.
• Do not give your child a prescription medication to stop vomiting unless your health professional specifically tells you to do so.

Children 7 months through 3 years

• When there has been no vomiting for 1 hour, give 1 fl oz of a clear liquid every 20 minutes for 1 hour. Be sure to watch your child carefully for signs of dehydration. Increase the volume of clear liquids that you give by 3 fl oz per hour for each hour that your child does not vomit.
• Clear liquids include fruit juice mixed to half strength with water, oral redydration solution (ORS) like Pedialyte, clear broth, and gelatin dessert.
• Do not give your child plain water, undiluted fruit juice, or soda pop. These drinks contain too much sugar and not enough of the essential minerals (electrolytes) that are being lost. Do not offer diet soda pop or plain water because they lack calories and essential minerals that your child needs.
• Gradually start to offer your child regular foods after 6 hours with no vomiting.
• Offer your child solid foods if he or she was eating solids before.
• Allow your child to eat what he or she prefers; the type of food is not important.
• Avoid high-fiber foods, such as beans, and foods with a lot of sugar, such as candy or ice cream.
• Do not give your child a prescription medication to stop vomiting unless your health professional specifically tells you to do so.

(back to top)

Informational Source: Healthwise® Knowledgebase
Posted: October 2004

This medical information does not take the place of professional medical advice, diagnosis, or treatment. Always seek your doctor's advice if you have questions about a medical condition.