EAGLE COUNTY, COLORADO — Have you seen the FLU walking down the street? I have not either, although it has been reported throughout the United States this season. Colorado in particular is reporting sporadic activity as of this week. If we could see the flu, I suspect it would look like an out of control 18-wheeler truck barreling down the road. We just better be lucky to avoid getting hit.

Dear Doc,

How much should my family worry about the coming flu season? Heard it might be a rough one. Should we get shots? How much do those help anyway? Does one-shot work for all flu viruses? Or do we risk getting shots for one kind of flu and getting another. How do health officials figure out which virus will be the worst one?

— Staying healthy in Eagle

Prevention is often the best medicine. We talked about the flu vaccine last week and who should receive it. With plenty of time remaining, and enough vaccine to go around let us review the recommendations for those who should receive the flu vaccine:

n All persons, including school-aged children, who want to reduce the risk of becoming ill with influenza or of transmitting influenza to others.

n All children aged 6 months to 4 years.

n All persons aged 50 years and older.

n Children and adolescents (aged 6 months to 18 years) receiving long-term aspirin therapy who therefore might be at risk for experiencing Reye syndrome after influenza virus infection.

n Women who will be pregnant during the influenza season.

n Adults and children who have chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, hematological or metabolic disorders (including diabetes mellitus).

n Adults and children who have immunosuppression (including immunosuppression caused by medications or by human immunodeficiency virus.

n Adults and children who have any condition (e.g., cognitive dysfunction, spinal cord injuries, seizure disorders, or other neuromuscular disorders) that can compromise respiratory function or the handling of respiratory secretions or that can increase the risk for aspiration.

n Residents of nursing homes and other chronic-care facilities.

n Health-care personnel.

n Healthy household contacts (including children) and caregivers of children aged <5 years and adults aged 50 years and older, with particular emphasis on vaccinating contacts of children aged <6 months.

n Healthy household contacts (including children) and caregivers of persons with medical conditions that put them at higher risk for severe complications from influenza.

There is more to prevention than just a shot though. Keeping your immune system healthy is important. Getting adequate sleep, eating healthy and managing stress are all essential. Beyond that there are some over the counter remedies. Vitamin C in doses of 200 to 6000 mg daily can help. Dr Linus Pauling fervently advocated the use of high dose vitamin C. His work showed about 50 percent of those who took large doses of the supplement benefited with fewer colds.

The NIH (National Institute of Health) recently increased their recommendation of dietary vitamin C intake to 200 mg daily. The FDA recommendations for adults are 60 to 75 mg daily. Other antioxidants such as vitamin E may help, too. While the scientific data is still limited on any of these treatments, Echinacea, and zinc may offer benefits as well. These supplements are safe and early use is probably essential.

Now if the flu hits hard there are two prescription medications that have been shown to decrease both the duration and severity of the illness. The older medications amantadine (brand name Symmetrel) and rimantadine (brand name Flumadine) have unfortunately been left relatively ineffective due to growing resistance by the current flu strains. The recently introduced zanamivir (brand name Relenza) and oseltamivir (brand name Tamiflu) however show benefit when used properly. The key to the use of any of these medications is early treatment. Starting treatment in the first 24 hours is preferred and the benefit rapidly decreases after 48 hours. Equally important, both medications work against Influenza type A, and Influenza type B. Zanamivir is the only medication which is inhaled and shouldn’t be used if you have asthma or emphysema.

So how do we know it is the flu and not a cold? The following will help.

n The flu hits us fast, while colds develop over days.

n With the flu, muscle aches are usually severe while a cold brings nary an ache.

n Your appetite will most likely disappear with the flu, while it might drop only a bit or not at all with a cold.

n Fatigue and malaise (feeling run down) are hallmarks of the flu and are typically severe while they are mild and transient with a cold.

n Expect the flu to bring a severe dry cough, while the common cold brings little or none.

n Sneezing may be uncommon with the flu, but is common with a cold.

n If your throat is very sore, it is more likely you have a cold than the flu.

So, stay healthy, exercise, eat right, drink plenty of fluids and get plenty of sleep. If you’re unlucky enough to get the flu get in to see your doctor because medication might be right for you. Over the counter supplements are probably better at preventing the flu than actually treating it, so there is no better time than now to get started.

I want to thank all my readers for your questions and support. Please keep your questions coming in! The only bad question is the unanswered one! Let me know what’s on your mind at editor@vaildaily.com.

Remember your health is your responsibility! Health is our greatest asset and it doesn’t happen by accident. If something doesn’t seem right, or questions are left unanswered don’t wait, call your doctor.