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Avoid getting the flu

You probably didn't get a flu shot this year. Time to panic? Naah. A little knowledge and good hygiene, we always say, is mightier than the needle.

So here's help for surviving the season. Armed with chicken soup, the right blanket, some coping tips and an assortment of trivia about the flu, you may find that you don't need that old vaccine after all.

Read on. Prepare. And remember: We're all in this flu season together. So don't get too close.

Once flu season sets in, there's a whole new code of etiquette. Oh, you should still R.S.V.P. and send thank-you notes. But now there's an "extra" set of rules for staying away from germs - and keeping your germs away from other people.Carry tissues with you everywhere, especially if you're under the weather. Gross but true: The flu virus spreads through little virus-carrying droplets that spew from your mouth and nose. Every time you cough or sneeze, block those droplets with a tissue - and then throw the tissue away so no one else will come into contact with it. By the way - those new anti-viral tissues made by Kleenex? They can't hurt, but they're not going to solve your problems. Any tissue, anti-viral or not, will help contain those virus droplets- and any tissue will let them loose if you don't cover your mouth and nose completely.If you're caught without tissues, sneeze or cough into the crook of your arm, not into your hands. As you might guess, your hands are the worst place to have the flu virus.If you think you have the flu, stay home. No, really - even if you're tough, and even if the office needs you. Inevitably, six podmates will end up staying at home instead of just one.Don't shake hands during flu season. If you're introduced to someone new, just smile, then nod or wave. If people extend a hand to you, explain that it's flu season and you don't want them to get sick. That's less off-putting than, "Don't touch me!"If you're sick, carry some disinfectant wipes. It's beneficial to everyone to wipe off doorknobs, phones and computer keyboards.Don't share your air. If you're around someone who's sneezing or coughing, stay at least three feet away. Even if it sounds like a dry or shallow cough, it's still flinging those nasty droplets everywhere - and you could inhale one of them.You hear it so often, it has ceased to have meaning. But really: Wash your hands. A lot. If you can't wash your hands, carry an alcohol-based hand sanitizer. And don't touch your eyes, nose and mouth unless you absolutely have to - try to wash your hands first. You can't see a virus on your hands; just because they "feel" clean doesn't mean they aren't carrying the flu.If you're sick, don't prepare food for other people. If you're eating out and the person who serves your food is coughing or sneezing, "do not eat the food." Politely ask for a replacement or a refund. (Hint: This request will be better-received if you are self-deprecating and make fun of yourself for being paranoid and extra careful.)

Yeah, yeah - hand-washing helps prevent the flu. You know this. But are you washing your hands properly? Probably not.Here's what to do:Use warm water and soap. We've all come across public restrooms where soap is nowhere to be found. Prepare for this emergency: Carry alcohol-based hand sanitizer gel, foam or wipes. Or carry your own soap: The Container Store sells single-use soap sheets (paper-thin sheets that lather up and melt in water) in tiny, portable plastic boxes; get 50 sheets for $5.99.Don't just lather, rinse and leave. You have to spend some time scrubbing. Experts offer several guidelines for just how long you should scrub. Some say you should sing "Happy Birthday" twice; others say you should sing your way through the alphabet once. Either way, plan on about 20 seconds of scrubbing Don't ignore your fingertips, fingernails and cuticles. And please, keep the singing to yourself.After you've washed, you can undo all that scrubbing just by touching a dirty faucet or doorknob. Especially if you're in a public restroom, use a paper towel (or a tissue - you're carrying those with you, right?) to turn off the water. If you can't open the door with your arm or shoulder, keep that paper towel and use it to handle the doorknob when you leave.

Does chicken soup have healing powers?In 2000, Stephen Rennard, a pulmonary expert and professor of medicine at the University of Nebraska Medical Center, put it to the test.Rennard added his grandmother's chicken soup to samples of white blood cells called neutrophils. These are the cells that rush in to fight an invading virus, an act that stimulates the production of the mucus that causes congestion. Sure enough, the soup inhibited the neutrophils' movement, which - theoretically, at least - means it could eliminate some congestion.Rennard also tested 13 commercial brands of chicken soup - and some of them (he won't say which) worked better than homemade.The study is purely theoretical, of course. And Rennard has a Harvard bachelor's degree in folklore and mythology, too. So take this study - if not your chicken soup - with a grain of salt.Here's a classic chicken noodle soup recipe from "The Fannie Farmer Cookbook" by Marion Cunningham (Alfred A. Knopf, $30) to keep on hand during flu season.6 cups chicken broth1 stalk celery, finely chopped2 (dry) ounces flat egg noodles½ cup raw chicken meat, cut into bite-size piecesSalt and freshly ground pepper2 teaspoons chopped parsleySimmer the chicken broth and celery about five minutes. Add the noodles, and cook until tender. Add chicken pieces, and cook about two minutes or until done. Add salt and pepper to taste, and garnish with the parsley.Makes 6 servings.Nutritional analysis per serving: 116 calories, 5 grams fat, 8 grams carbohydrates, 10 grams protein, 23 milligrams cholesterol, 784 milligrams sodium, trace dietary fiber, 37 percent of calories from fat.But who really wants to cook when they're sick? Chicken noodle is now a soup du jour at many restaurants. Call your favorite restaurant to check listings and order takeout.

Strengthening your body's immune system may be the best way to help fight off the flu this winter, and established products to help do that range from garlic to green tea and echinacea to astragalus.The most common immune booster is vitamin C, found in lots of fruits and vegetables, especially oranges, berries and broccoli, as well as in some herbs, like rose hips.Research in recent years has also established the value of active zinc - that is, a form of the mineral that the body can readily absorb - as an anti-viral."The Herbal Drugstore/ (Rodale, $16.95) offers this traditional blend to help boost immunity and ease the discomfort of a cold or flu:2¼ teaspoons echinacea leaf2¼ teaspoons elder flowers2¼ teaspoons yarrow leaves and flowers1¼ teaspoons peppermint3 cups waterPlace all but the peppermint leaves in the water and simmer, covered, for 10 to 15 minutes. Remove from heat and add the peppermint. Steep, covered, for 10 more minutes. Strain herbs and discard. Drink up to three cups of tea a day as needed. Makes one serving.

Question: What's the difference between a cold and the flu?Answer: Both are upper-respiratory-system illnesses caused by viruses, but the flu - short for influenza - is more severe than a cold.Symptoms of a cold are a sore throat, runny or stuffy nose, and sometimes a headache caused by congestion. If there is a fever, it is mild.Flu symptoms are sore throat, runny nose, dry cough, headache, extreme tiredness, muscle aches and a high fever.Question: What causes the flu?Answer: Flu is caused by one of three types of influenza viruses. Influenza type A and influenza type B viruses are the ones that cause serious disease; the third, influenza type C, usually causes only a mild illness and is not considered a public health problem.Because flu is caused by a virus, antibiotics, such as erythromycin or amoxycillin, which are highly effective against bacterial infections, are of no use in fighting the flu.Question: Is the flu deadly?Answer: It can be for people in high-risk groups, which includes those 65 and older; people with weakened immune systems, such as people with AIDS; people with long-term diseases, such as heart disease or diabetes; and children under 2. Influenza can lead to complications, such as bacterial pneumonia and worsening of chronic conditions such as heart failure.Question: Why, then, is the flu vaccine offered to healthy people between ages 2 and 65 in most years?Answer: There are two reasons. The first is to prevent sick days and loss of productivity. Companies often offer flu shots to their employees as a way of keeping their work force on the job.The second reason is to create something called "herd immunity." Flu is a highly contagious disease, but you can't get it if you haven't been exposed. And if lots of people have been immunized, there are fewer sick people to whom you could be exposed.Question: Is there any danger in getting a flu vaccination?Answer: Unwanted side effects from the flu vaccine are extremely rare.Question: What can people who aren't going to be getting a shot do to reduce the likelihood of getting the flu?Answer: For healthy people between the ages of 5 and 49 who are not pregnant, the FluMist nasal spray is another way of building immunity to the flu virus. Unlike the injection, which uses a killed virus to stimulate the production of antibodies, FluMist uses a live virus that has been weakened. For this reason, it is not recommended for people with compromised immune systems or any serious disease.Another thing someone can do, particularly an elderly person or a person with a serious chronic disease, is to get vaccinated for pneumococcal pneumonia. Although that won't help prevent the flu, it can prevent one of the serious complications.Question: Why has there been so much talk about lines for the flu vaccine?Answer: Because it's human nature to react to a shortage by hoarding. When the government announced last month that there would be fewer doses of influenza vaccine available than planned, many people suddenly were in a rush to get immunized, including, most likely, some who wouldn't have gone to the effort to get a shot otherwise.Question: Why doesn't the flu vaccine create immunity for many years like others do, such as the measles vaccine?Answer: Unlike the measles virus, the influenza virus is continually changing. It changes in two ways. One is called "antigenic drift," which is small changes that take place in the virus. Antigenic drift occurs each year. The other is "antigenic shift." Antigenic shift is a major change, but it doesn't happen every year. When there is an antigenic shift, the disease will affect many more people, generally causing a pandemic (worldwide flu epidemic).Question: Why do pandemics so often seem to start in Asia?Answer: The answer isn't known, but the concentration of people who live in close quarters with other people and in close quarters with animals is the likely reason, said Dr. Arnold Monto, an epidemiologist with the University of Michigan and a leading researcher on influenza.Versions of the influenza type A viruses circulate among birds, pigs, horses and other animals, as well as among humans. An antigenic shift often involves mixing of viruses in an animal host.Question: What should people do if they get the flu?Answer: Although the penicillin-type antibiotics are of no help, some anti-virals have been created in recent years.One such product is Tamiflu, a pill that is taken for 10 days. To be effective, anti-viral medicines must be started within two days of the onset of symptoms, says Monto.Anti-virals, which are available by prescription only, may also be effective in preventing the development of flu in people who have been exposed to the disease but have not yet come down with it. They have most frequently been used in this way in nursing homes.Other than anti-virals, the way to deal with the flu is to follow mother's orders: Stay in bed, drink lots of fluids and treat the symptoms with over-the-counter or prescription medications. Just remember not to give aspirin to children who have the flu, because it could cause Reyes syndrome.Sources: www.cdc.gov; "Wall Street Journal" and "New York Times"

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