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Many experts, and most moms, are bracing for a more-difficult-than-usual cold and flu season this winter, thanks to swine flu, or the H1N1 virus. As of early October, visits to doctors for influenza-like illnesses were increasing at a rate that is "very unusual for this time of year," according to the Centers for Disease Control and Prevention -- and 76 pediatric deaths attributed to H1N1 had been reported.
Despite all the scary news coverage, there's no reason to panic. There are simple steps you can take to protect your family. While no one can predict how widespread or severe swine flu may become, it's important to follow these preventive measures. After all, they can help you fight regular flu and colds, too. We asked experts for the latest news on what you can do to strengthen your immune system, limit your exposure to germs, and stay healthy.
1. Wash up at least five times a day.
There's a good reason why washing your hands is at the top of our list: It's one of the easiest and best ways to prevent colds and flu. In one study, Navy recruits who scrubbed up five times a day had 45 percent fewer respiratory ailments than recruits who didn't. How best to rinse those germs away? Use warm water and regular bar or liquid soap (not antibiotic formulas, which may make bacteria more resistant to antibiotics). Rub your hands together for at least 20 seconds, the time it takes to sing your ABCs. And be thorough: Clean under your nails, the backs of your hands, and between your fingers. Rinse and dry with a clean cloth or paper towel; then, if you're in a public place, use the towel to turn off the faucet and open the door as you exit. Make sure your kids wash their hands throughout the day, too.
Carry hand sanitizer containing at least 65 percent alcohol for times when soap and water aren't available. A pea-size dollop will destroy many (but not all) germs instantly and is better than nothing, says Birgit Winther, MD, associate professor at the University of Virginia's department of otolaryngology.
2. Go for a flu shot -- or two.
Although a vaccination doesn't protect against every variation or new mutation of flu virus that comes along each season, getting immunized is still the smart choice for most people. Flu vaccinations can't guarantee that you and your family won't get sick, but they offer the best protection right now, says Shmuel Shoham, MD, scientific director for the MedStar Clinical Research Center at Washington Hospital Center, in Washington, D.C.
This year, in addition to the regular flu vaccine, one for swine flu has also been developed by manufacturers. Your family may need both. The CDC strongly recommends the regular flu vaccine for children 6 months to 19 years old, pregnant women, infant caregivers, adults 50 and older, healthcare workers, and those with certain chronic medical conditions.
The swine flu vaccine is recommended for pregnant women, caregivers of infants, kids 6 months to 24 years old, people under 65 with existing medical conditions, and healthcare workers. (As alternatives to shots, ask your doctor about the availability of nasal-spray vaccines for both types of flu.)
3. Keep all surfaces clean.
If you had special goggles that would let you see how many cold and flu germs lurk around you, you might be tempted to wear surgical gloves all the time. Dr. Winther led a team of scientists that tested surfaces in the homes of people with colds. They found that viral germs on refrigerator door handles, light switches, phones, TV remotes, and elsewhere survived for two days or longer. In fact, if someone at home has a cold, commonly touched areas like door handles test positive for the cold virus 40 percent of the time. So if you, your spouse, or your children are sick, frequently wipe down the things you all touch. No need to use heavy cleaning agents, says Dr. Winther -- plain old dishwashing detergent and water will do the trick. And remind whoever is sick to sneeze into his or her elbow, not the hand, to further limit the easy transfer of germs.
4. Be careful what you touch.
When you rub your eyes or scratch your nose you can usher viruses into your tear ducts and nasal passages, which work like a conveyor belt to deliver germs into your body. Viruses can also enter through open wounds or dry, cracked skin, especially on your hands (often made worse by washing). So keep your skin moisturized and cuts and scrapes covered with a bandage to protect yourself.
At work it may be prudent to avoid shaking hands during flu season, says Dr. Shoham. And don't hang out in a sniffling coworker's cubicle. If someone with a respiratory infection sneezes, Dr. Shoham says, secretions can travel in a fine mist, like hair spray.
To keep her fingers less germy, Dr. Winther turns on light switches or pushes elevator buttons with the backs of her fingers or knuckles. She also suggests opening door handles in public places after first covering your hand with your sleeve or a scarf; having your own pen handy to sign receipts at the pharmacy and the doctor's office as well as at stores; and carrying hand sanitizer for your child to use at the pediatrician's (communal toys and books may carry germs). In one study done in Switzerland, the flu virus survived on bank notes for up to 17 days, so wash your hands after handling money. Give your kids a squirt of hand sanitizer the second they get in the car after daycare or school, and have them wash their hands when they come in the house.
Sleep eight hours or more.
Being sleep-deprived increases your chances of catching a respiratory infection, says Sheldon Cohen, PhD, professor of psychology at Carnegie Mellon University, so make sure everyone in the family gets enough rest. A recent study showed that people exposed to a cold virus were three times more likely to catch it if they slept fewer than seven hours a night compared with those who slept eight hours or more. And the less people slept, the more likely they were to get sick. Why? It could be that the lack of sleep interferes with the production of key chemicals your immune system needs in order to fight infections.
6. Meditate to de-stress.
You've probably noticed: The more stressed you are, the likelier you are to come down with a cold or flu. Dr. Cohen found that people dealing with chronic stress, such as financial, relationship, or work troubles, were two and a half times more likely to develop a cold.
There's a technique that seems to help, says Charles Raison, MD, clinical director of Emory University's Mind-Body Program. He and his colleagues gave healthy young adults a six-week course in a relaxation method known as compassion meditation, which teaches you how to deal with stress calmly. Those who practiced this meditation for 30 minutes three to four times a week had lower levels of the stress chemical interleukin-6, which may make you more vulnerable to infection, says Dr. Raison. When you are under chronic stress, interleukin-6 remains elevated in the body and stimulates inflammation, which, if too high, can interfere with the part of the immune system that fights infection. Any kind of relaxation training, meditation, yoga, or focused breathing can help you feel more balanced and may help lower the levels of this bad chemical in your body.
7. Stay warm.
Could Mom's advice to "bundle up or you'll catch your death of cold" actually have some truth to it? Yes, says Ronald Eccles, PhD, director of the Common Cold Centre at the School of Biological Sciences at Cardiff University, in Wales. Dr. Eccles and his colleagues had half of a group of healthy people chill their feet in buckets of ice water during cold season. The subjects who'd had the icy dunk were twice as likely to develop colds as the ones who stayed warm and dry. Chilling causes blood vessels to constrict, and when your nasal blood vessels become constricted, your immune system's white blood cells can't travel to your nose as easily to fight off a viral infection.
This is one of the reasons colds and flu skyrocket when temperatures drop. So when you're outside, dress warmly and stay active to keep your circulation going and be sure your kids do, too. Wrapping a scarf around your face to keep your nose toasty can also help. And the moment you or your kids come inside, Dr. Eccles says, "get out of your wet, chilled clothes and put on something warm and dry." Then sip a hot drink or soup to help warm up your nasal passages.
8. Increase your vitamin D.
Vitamin D does more than help your body absorb calcium. It also assists your immune system. Some 77 percent of all Americans, and 97 percent of African-Americans, have lower-than-ideal levels. Adit Ginde, MD, assistant professor in the Division of Emergency Medicine at the University of Colorado, Denver, and his colleagues studied 19,000 adults and adolescents and found that those with the lowest levels of D were 40 percent more likely to have had a respiratory infection recently than those who had adequate levels. Although the current vitamin D RDA ranges from 200 to 600 IU, Dr. Ginde (and some other experts) recommends 1,000 IU per day for better immune functioning. The most efficient way to get D is with just a few minutes a day of un-sunscreened sun exposure. That can be difficult in winter, so get more D from dairy foods, fatty fish, and supplements.
9. Hit the gym.
Exercise boosts the immune system's ability to fight infection, according to a growing body of research. Recent studies done in postmenopausal women show that 45 minutes of moderate exercise such as a brisk walk five times a week make you three times less likely to get a cold. This should hold true for all age groups because exercise increases the circulation of the body's white blood cells, which help fight infection.
10. Try a surgical mask.
It may seem extreme, but hear us out: If someone is sick at home, consider having the healthy members of the family wear surgical masks. One recent study found that adults who wear a mask when someone in the house has a respiratory illness are four times less likely to contract the virus. This may be particularly important for moms. "Women get more colds than men because of their greater exposure to sick children," says Dr. Eccles.
Originally published in Ladies' Home Journal, December/January 2010.