Well, our beautiful North Carolina summer is over and autumn is here. The kids are back in school, there is football on TV and pumpkins are turning up at roadside stands. Fall is the time that we need to start thinking about winter illnesses like influenza, usually known as flu.

Flu can occur at any time of year, especially type B flu, but winter is the time for epidemics of Type A flu. Most of us think of flu as a minor illness that is more of a nuisance than a danger, but flu is actually responsible for large numbers of deaths every year.

When young healthy people with normal immunity get the flu it causes several days to a week of fever, dry cough and body aches. It is miserable but usually self limited. On the other hand people who are old, very young, or who have underlying medical problems like asthma, heart disease or chronic obstructive pulmonary disease already have reduced immunity. When they get flu their immunity is even more compromised and they can develop serious complications like bacterial pneumonia. These complications result in a steep increase in fatal illness among the elderly and immune compromised population every winter.

Flu is caused by a virus. There are numerous strains of flu, so it is not like Chicken Pox or Measles. These are illnesses that usually occur only once in childhood, and immunization for these illnesses lasts many years. The flu virus is always changing and mutating, finding ways to evade the immunity we have built against the strains we have had in the past.

This is why flu vaccine is recommended every year. The World Health Organization and the CDC look at the strains of flu virus that are circulating and decide which strains to include in the next year’s vaccine. It takes several months for the drug companies to produce the vaccine. Each dose of vaccine provides immunity against three different strains of flu virus and differs from the vaccine given the year before. Sometimes new strains of flu can emerge after the decision is made. This apparently happened last year, and some people who had the vaccine still developed flu.

Over the past few years the CDC has expanded it recommendations of people who should get the flu vaccine. These are the current recommendations taken from the CDC website:

1.) People at high risk for complications from the flu;

• People 65 years and older;
• People who live in nursing homes and other long-term care facilities that house those with long-term illnesses;
• Adults and children 6 months and older with chronic heart or lung conditions, including asthma;
• Adults and children 6 months and older who needed regular medical care or were in a hospital during the previous year because of a metabolic disease (like diabetes), chronic kidney disease, or weakened immune system (including immune system problems caused by medicines or by infection with human immunodeficiency virus [HIV/AIDS]);
• Children 6 months to 18 years of age who are on long-term aspirin therapy. (If given aspirin while they have influenza, they are at risk of Reye syndrome.);
• Women who will be pregnant during the influenza season; and
• All children 6 to 23 months of age.

2.) People 50 to 64 years of age; ( Nearly one-third of people 50 to 64 years of age in the United States have one or more medical conditions that place them at increased risk for serious complications from influenza.)

3.) People who can transmit influenza to others at high risk for complications . (This means that if you have contact with anyone in a high risk group (see listing above), you should get vaccinated. This includes health-care workers and parents or other close contacts of children 6 to 23 months of age and close contacts of seniors.)

There are some people who should not be vaccinated. This includes:

• People who have a severe allergy to chicken eggs.
• People who have had a severe reaction to an influenza vaccination in the past.
• People who developed Guillain-Barré syndrome (GBS) within 6 weeks of getting an influenza vaccine previously.
• Children less than 6 months of age.
• People who are sick with a fever. (These people can get vaccinated once their symptoms lessen.)

For further information go to the CDC website and review the information on flu and flu vaccine they make available: www.cdc.gov/flu/keyfacts.htm