In Canada, this time of year is often greeted with sounds of coughing and runny noses in the hallways of our schools and from behind every cubicle and counter in our workplaces. This isn't reason to throw up your hands in defeat, but an important opportunity to keep you and your family safe from potentially serious strains of the Flu. This article is designed to help you find answers to questions like:

Why should I worry about the Flu?

You may be asking yourself, what's all the fuss about? After all, a little runny nose is common enough. Indeed, if it were simply the matter of a few days of a sore throat, cough or low grade fever, there would be much less to be concerned about. Whereas you may already be comfortable handling the common cold, an infection with the Influenza virus is more likely to knock you off your feet, and can be life-threatening to children, elderly patients, pregnant women, and even adolescents and other adults with asthma, immune compromise, diabetes or a history of heart disease. Upto 1500 Canadians die each year from this preventable infection. From early autumn to the end of spring, emergency department visits and hospitalizations due to complications from the Flu are a common occurence. One of every five Canadians will get sick with a case of Influenza each winter. Keeping not only yourself, but also your friends and family members, safe from the Flu is a responsibility that begins with you.

How can I keep myself from catching the Flu?

There are many steps that you can take to protect yourself and your family from the Flu. Some involve treatments from your doctor, and other require small changes in regular habits or behaviours.

1. get the Flu-shot

One of the most effective means of preventing serious infection, complications, and transmission of the Flu is by getting the Flu-shot. This is a vaccine intended to stregthen and train your body's own natural immune system to fight the Flu. That way, if you are exposed to the Flu anytime through the winter or spring, you will have trained your own immune army to protect your body from the Influenza virus, and reduce the chance of carrying it home to your loved ones. Give your body a head start by teaching it how to fight off the Flu virus. Your body will learn this best before it gets bogged down fighting the common winter colds, so get the Flu-shot as soon as it is available in the early fall of each year.

Some individuals, such as young children, pregnant women or the elderly, are more susceptible to potentially dangerous complications from the Flu. Even if you are healthy and not otherwise at a higher risk yourself, you can help to build a circle of protection from the Flu around them, by minimizing the chance of your bringing the Flu to them if you get infected. Whereas you may be healthy enough to fight off the Flu, they may have a more difficult time of it.

If either you or someone close you has any risk factors for complications from the Flu, you should get the Flu-shot to keep both yourself and them safe.

2. wash your hands frequently

During flu and cold season, it is generally prudent to assume your hands are contaminated with viruses, unless you've just washed them and haven't touched any other objects yet. So, washing your hands carefully, front and back, between the fingers and under the nails will help stop you from being infected with the Flu, even you come into contact with the virus. If running water and soap are not available, using an alcohol-based hand-sanitizer is good alternative that can easily be carried around in your bag or purse.

Whereas adults can make a point of remembering such self-care habits more easily, it can be a challenge for younger children who have been touching and swapping contaminated toys and other objects all day at daycares and schools. The World Health Organization (WHO), along with numerous concerned agencies and individuals around the world, have made it easier to promote safe and effective hand-washing behaviour in young children. The "hand-washing song" is one such effort, and can be found by following the link below.

3. avoid touching your eyes, nose or mouth

It is a common misconception that if you caught the Flu, it must be because you inhaled the viruses coughed or sneezed into the air by someone else. While that is definitely one way to be infected, you can reduce your chance of infection dramatically by washing your hands carefully several times during the day. This is because we often infect ourselves by picking up viruses on door handles, shaking hands and handling shared objects, and then bringing that virus into contact with vulnerable parts of our body such as our eyes, nose or mouth. Touching these exposed mucous membranes with our contaminated hands is how we infect ourselves with the Flu as well as cold viruses. It's a risk that can be entirely eliminated by better hygeine practices.

How can I make sure I don't give the Flu to others?

If you were unfortunate enough to catch the Flu before you had a chance to get the Flu-shot, all is not lost. Alongside of taking care of yourself, you can take steps on the road to recovery to prevent transmitting the Flu to others around you. Some small and simple changes in habit will keep your loved ones and colleagues safer while you recuperate.

1. cover your cough or sneeze

The Flu is often transmitted through droplets in the air from your coughs and sneezes, which are either inhaled by others, or else land on surfaces around the home or workplace. Keep the virus contained by carrying tissues to catch your coughs and sneezes, and keep the air cleaner and safer for those around you. It's a good idea to dispose of the tissue as soon as you've used it, so that virus contamination doesn't spread onto your hands or other objects. If you don't have a tissue handy, cough into your sleeve, which will at least prevent most of the virus from becoming airborne.

2. wash your hands frequently

If you're sick yourself, it is much more likely that you will be carrying the Flu virus on your hands, whether from rubbing an itchy nose or wiping away a sniffle. Help keep everyone around you from getting sick by washing your hands well and regularly. A good rule of thumbs is to wash your hands with soap and water for the time it takes to sing "Happy Birthday" twice. Prepare by keeping a bottle of an alcohol-based hand-sanitizer in your office desk drawer, in the car's cup-holder, and in your bag if you're on the go.

For added protection, particularly when dealing with children, wiping down surfaces and toys with disinfectant sprays after usage can prevent the spread of the Flu virus to others who later come into contact with these things.

3. avoid close contact and public gatherings

We often have to interact in groups and with other people, either at work or in our social lives. If you or your child is sick with the Flu, staying away from those environments, particularly in the early and more contagious stages, can help reduce the transmission of the virus to others. This is particularly important with young children, who have more difficulty remembering to shield their coughs and sneezes, and are less careful about what they touch and share with other children at school.

Since runny noses and coughs are common throughout this season, seeing your doctor can help you figure out when to stay home, and when it's alright to go back to your regular activities. Particularly if you will require a note for work or school, make sure you are assessed by your physician so that they can examine you and confirm the diagnosis that required your absence from work.

Your doctor will help you decide how long it is necessary to stay away. This will generally be just a few days, within reason, since most people have already been sharing the virus for 1-2 days prior to recognizing their illness. The deicision will also depend on the degree of contact with the public entailed by your job, and the particular susceptibility and risk factors of those you're dealing with (ie. young children or elderly individuals).

4. get the Flu-shot

Once you've recovered from this Flu infection, see your doctor to get the Flu-shot. This is because the vaccine covers several different strains of the virus that are circulating through our cities this season. Whereas you've managed to recover from an infection with one strain of the Flu, you're still susceptible to the other strains still out there. Having just gotten through the Flu, the last thing you want is another round of it next month. So once you're well, get the Flu-shot, if you haven't already had it, and keep yourself and your family safer for the remainder of the season.

Who should get the Flu-shot?

Nearly everyone over the age of 6 months will benefit from and should get the Flu-shot. This is based on numerous studies from around the world, and is recommended by Health Canada and Toronto Public Health, as well as their American counterparts. The Flu-shot has been shown to significantly improve the health and safety of individuals vulnerable to serious complications from the Flu, especially:

  • pregnant women
  • children over the age of 6 months
  • adolescents or adults with asthma, lung or heart disease, diabetes or compromised immune system
  • anyone 65 years or older

Those on this list should get the Flu-shot as soon as it is available. In fact, giving the Flu-shot to pregnant women has been shown to protect not only the mother, but also the new baby for the first few months of life, when he or she is too young to get the Flu-shot directly. This proof of the Flu-shot's safety and efficacy, even for an unborn child, gives an even greater meassure of reassurance to the rest of us.

In addition, anyone who works in healthcare, or is exposed to or lives with someone with any of the risk factors listed above, should get the Flu-shot to keep not only themselves but those around them safe this season. Since most individuals will visit or live with children or elderly relatives, the Flu-shot is recommended for nearly every one. Whereas those without risk factors will usually recover, the lost productivity and suffering from illness are added reason to consider prevention using the vaccine.

The only people who shouldn't get the Flu-shot are those who've had a previous allergic reaction to any component of the Flu vaccine (eg. eggs, neomycin or thimersol), or with active neurological disorders such as Guillan-Barré Syndrome. It is generally felt to be safe to re-vaccinate those individuals who may have experienced the mild 'oculorespiratory syndrome' reaction to a previous Flu vaccine.

Where can I get the Flu-shot?

You can get the Flu-shot with your regularly scheduled appointments, or on a walk-in basis. To make the process faster and easier for you, each year, we run a walk-in Flu-shot Clinic, where we try to save you time by "getting you in and out quickly" if all you need is the Flu-shot that day. The Flu-shot is usually available at our clinic in mid-autumn of each year, though the exact date can vary, depending on supply from Toronto Public Health. Alternatively, you can also get the Flu-shot through programs run at some workplaces, or in certain locations set-up by Toronto Public Health throughout the city.

To keep you up to date about arrival, availability, and up-to-the-minute "walk-in Flu-shot Clinic" hours, we're trying a pilot project in 2010. Click on the link below to follow us on the Twitter.com notification service to get timely updates and information about the "walk-in Flu-shot clinic".

    references
  1. Niroshan Siriwardena A, Gwini SM, Coupland CAC. "Influenza vaccination, pneumococcal vaccination and risk of acute myocardial infarction: matched case-control study" CMAJ, 182(15), Ocotober 19,2010.
  2. Canada Communicable Disease Report: Statement on Seasonal Inactivated Influenza Vaccine (TIV) for 2010-2011. NACI, Health Canada. 36(6), August 2010.
  3. Influenza Fact Sheet. Toronto Public Health, October 2008.
  4. Jefferson T, Rivetti A, Harnden A, Di Pietrantonj C, Demicheli V (2008). "Vaccines for preventing influenza in healthy children". Cochrane Database Syst Rev (2): CD004879. doi:10.1002/14651858.CD004879.pub3. PMID 18425905.
  5. US Centre for Disease Control. "Children, the Flu, and the Flu Vaccine" http://www.cdc.gov/flu/protect/children.htm
  6. Demicheli, V.; Di Pietrantonj, C.; Jefferson, T.; Rivetti, A.; Rivetti, D.; Rivetti, D. (2007). "Vaccines for preventing influenza in healthy adults". Cochrane database of systematic reviews (Online) (2): CD001269. doi:10.1002/14651858.CD001269.pub3. PMID 17443504.
  7. Global Alert and Response: Recommended viruses for influenza vaccines for use in the 2010-2011 northern hemisphere influenza season. World Health Organization, August 2010.