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THE FLU ARRIVES EARLY GOOD HYGIENE IS THE BEST PREVENTION

THE BAD news is that anyone can get the flu.
The worse news is that it's here.

The good news, if we can call it that, is that a case of the flu should run its course in three to seven days. Without complications, people can expect to be back on their feet within a week.

Influenza is caused by a virus that comes in many different strains, named after the places where they were first found. This year, we're battling A-Taiwan, A-Shanghai and B-Yamagata, according to Kathy Petko, coordinator of adult health at the American Lung Association. The influenza virus belongs to one of three different families -- A, B or C. Influenza A has the most virulent strains.

Generally, the flu is not life-threatening to healthy people. But it kills an average of 20,000 people every year in this country, usually by turning into pneumonia.

Though flu can appear any time between early December and early April, this year it appeared a bit earlier than it has for the past few years, said Dr. Richard G. Judelsohn, Erie County Health Department medical director.

Recently, eight cases of Influenza A were confirmed at Children's Hospital and three at a local nursing home, Judelsohn said.

Though the county keeps no statistics on the flu because it isn't a reportable disease like measles and hepatitis, some pediatricians, family practitioners and nursing homes report cases to the health department.

"All have been reporting that since the last week in December, there is a marked increase in the number of ill people," Judelsohn said. "Compared to other years, this seems to be an active year."

Influenza is spread when a sick person sneezes, coughs or talks and expels droplets that may be inhaled by others.

Even someone who is just coming down with the flu, and doesn't yet feel sick, can pass it along. The flu is most contagious from two days before symptoms first show up until about four days after they appear.

Good hygiene is good prevention. "Those who are ill should wash their hands frequently, cover their mouths when they cough or sneeze, and dispose of tissues properly," Judelsohn said.

"It sounds so simple, but that's often the most effective."

If the flu catches up with you, you'll recognize these typical symptoms: fever, sore throat, headache, muscle aches, fatigue, respiratory symptoms, congestion and coughing and nausea.

And the treatment is straightforward:

Aspirin for adults; acetaminophen for children for pain and fever (unless the patient can't tolerate these; if that's the case, call your doctor);

Cough and cold medication for those symptoms;

Bed rest;

Plenty of liquids.

"Mostly, you're looking at the relief of symptoms until the body kills the virus," Judelsohn said. Also, a drug called amantadine is sometimes prescribed to relieve symptoms or even prevent the flu -- but only type A. It has some side effects, such as nausea, insomnia and impaired concentration, and it is not widely prescribed outside of nursing homes.

The Food and Drug Administration is looking at another drug, rimantadine, which is said to be as effective as amantadine, but causes fewer side effects.

Twenty to 30 percent of the population typically will get the flu during any given season, the experts say.

Though most people can treat their symptoms at home, anyone with a chronic illness should consult a physician, Ms. Petko said.

"For people who are fairly healthy it can be a moderate illness, but for people who are not well to begin with it can be severe or even fatal."

The American Lung Association recommends that people in high-risk categories get a flu vaccination each year. The optimum time is in November, according to the Centers for Disease Control.

Experts say it's still possible to get a shot, but it takes two weeks for the vaccine to become effective.

Groups at risk include:

Any adult or child with a chronic lung disease, such as asthma, emphysema, chronic bronchitis, bronchiectasis, tuberculosis or cystic fibrosis;

Anyone with diabetes, heart or chronic kidney disease or a metabolic disorder;

People over age 65.

Around this time of year, people blame the flu for any and all ailments.

The ailments commonly mistaken for the flu are colds and stomach virus, which cause nausea, vomiting or diarrhea. Though influenza sometimes causes stomach problems or diarrhea, its classic symptoms (fever, chills, sore throat, headache, muscle aches and pains, dry cough, malaise) come on quickly.

And even after the symptoms are gone, some flu victims have that weak, run-down feeling for weeks.

A complication that may show up following a bout with the flu is something doctors call "hidden asthma."

"After the flu, the damage done to the trachea and other air tubes usually takes up to six weeks to improve," said Dr. Alan Aquilina, associate professor of medicine at the University at Buffalo.

"Even though the patient feels well, they may still have a slight cough, vague chest discomfort and just not feel right. But an examination of the chest is normal, the breathing test is normal, and the person doesn't wheeze. This is why we call it hidden asthma."

Aquilina, director of respiratory care services at Erie County Medical Center, said patients who continue to have respiratory symptoms weeks after the flu should have subsided may have hidden asthma, which can be confirmed by a breathing test.

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