Many people think the flu is nothing more than a bad cold -- until they come down with it. When your entire body aches, your energy vanishes, and a fever, dry cough, sore throat, and headaches set in, it's impossible to mistake the flu for a mild illness.

The flu can hit anybody hard, but it's especially dangerous for people over 65 and others with weak immune systems. If you're older, it's particularly dangerous because the viral infection can exhaust your body, making it easy for life-threatening complications such as bacterial pneumonia to take hold. It can also worsen the symptoms of conditions like heart disease, asthma, and chronic obstructive pulmonary disease. The Centers for Disease Control and Prevention (CDC) reports that every year the flu sends on average more than 200,000 to the hospital. Flu and pneumonia combined kill over 36,000 Americans, making the deadly duo the eighth leading cause of death in the country. A whopping 90 percent of these deaths are among people over 65.

It's a really good idea. For years, the CDC urged every person 65 and over to get an annual flu shot. The latest CDC guidelines recommend that every person 50 and over get an annual flu shot.

The CDC also recommends flu shots for the following groups at high risk for flu-related complications:

•People with chronic lung or heart disease such as asthma and high blood pressure

•People who need regular medical care (or needed hospitalization in the past year) for diabetes, kidney problems, blood cell diseases, or immune disorders

•All adults and children who live or work with anyone over 65 or otherwise at risk for flu-related complications. This is to make sure those who have contact with seniors (or other high-risk people) don't inadvertently pass the infection on to them.

In addition, it's a good idea to be vaccinated against pneumococcal pneumonia (the pneumonia caused by strep bacteria) if you're over 65 or in one of the high-risk groups above. You can get this shot anytime, including the day you go in for your flu shot.

Although it's a common fear, it's impossible to catch the flu from a flu shot. The vaccination contains a killed virus that stimulates your immune system to make antibodies but can't cause disease. The most common side effect (in a third of all people) is a little soreness and swelling at the site of the shot. About 5 to 10 percent of people, especially children who have never been exposed to influenza viruses, develop mild fever, fatigue, and body aches immediately after the vaccination.

There are certain people who should not get vaccinated. If you have a severe allergy to eggs, the shot could trigger a dangerous reaction because the virus for the vaccine is grown in chicken eggs. Talk with your doctor if you think you have an allergy to hens' eggs, if you've had a severe reaction to a flu shot in the past, or if you've developed Guillain Barre Syndrome within 6 weeks of a flu shot.

A flu shot is your best defense against the wily virus -- people over 65 who get vaccinated every year lower their odds of being hospitalized for pneumonia and the flu by about 70 percent and their risk of dying by about 85 percent. For people living in nursing homes, vaccinations cut the risk of flu-related hospitalizations by 50 percent and deaths by 75 to 80 percent.

Keep in mind that the shot isn't as effective when you get older for the same reason you can't fight off the flu as easily -- your immune system isn't as good as making antibodies to fight off bacteria, viruses, and other intruders. A flu shot will protect about 50 percent of people over 65 (but 70 to 90 percent of healthy young adults). So even if you get vaccinated, it helps to be careful. Wash your hands often when you're around people who may have the flu, and if possible, avoid spending a lot of time in crowded buildings -- the flu virus spreads when infected people cough or sneeze.

Yes. Unlike many other vaccinations, a flu shot does not give you lifelong protection. The flu virus comes in many different strains that change from one year to the next, and the shots are only designed to protect you from the few major strains that are expected to be a problem in a certain year. Even if the same strain comes back a year later, your immunity can weaken between flu seasons.

The best time to get a flu shot is from early October to mid-November, well before the start of the flu season. Within one to two weeks, your body will develop antibodies against the disease. Since the flu season generally runs through March, getting vaccinated as late as February may still save you some misery, but it's best not to wait until the last minute. You'll want protection for the duration of the yearly epidemic; in addition, supplies of the vaccine often run out towards the end of the flu season.

Low cost flu shots (about $10) are available at many clinics and pharmacies at the beginning of flu season. If you have Medicare Part B, your flu shot is free every year (there's no co-pay and it doesn't apply towards your deductible) no matter where you get it, as long as your doctor orders it and the provider accepts Medicare and doesn't charge more than what Medicare will pay. Members of Medicare HMOs need to ask their health plan for details. If you have Medicare Part B, the pneumonia shot is also free when your physician orders it.

If you think you have the flu, schedule an appointment with your doctor promptly. He or she can prescribe drugs that fight the flu virus, but they'll only help if you take them within 48 hours of the onset of symptoms. Your doctor can also determine if you really have the flu or if your symptoms indicate one of several other illnesses -- such as viral bronchitis or rhinovirus infections -- that also make the rounds every winter.

You can take several steps on your own to ease the misery of the flu: Get plenty of rest, eat nutritious meals, and drink lots of fluids. Ibuprofen can help to relieve your fever and muscle aches. (Never take aspirin if you think you have a virus, because the combination can trigger Reye's syndrome, a potentially life-threatening ailment). However, if you have asthma, or are allergic to nonsteroidal anti-inflammatory agents (NSAIDs), acetaminophen or another nonaspirin pain reliever is a better choice. Over-the-counter cough relievers should quiet your cough.

-- Chris Woolston, M.S., is a health and medical writer with a master's degree in biology. He is a contributing editor at Consumer Health Interactive, and was the staff writer at Hippocrates, a magazine for physicians. He has also covered science issues for Time Inc. Health, WebMD, and the Chronicle of Higher Education. His reporting on occupational health earned him an award from the northern California Society of Professional Journalists.

References

First published June 14, 2000
Last updated March 13, 2008
Copyright © 2000 Consumer Health Interactive

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