Dr. Jawad Saade is a family medicine physician at the University of Maryland Baltimore Washington Medical Center.
Dr. Jawad Saade is a family medicine physician at the University of Maryland Baltimore Washington Medical Center. (Handout)

The flu already has hit Maryland, killing two people so far this season. Nearly a dozen more have been hospitalized. Doctors are urging people to take precautions, such as getting vaccinated, so they don’t end up as one of those statistics.

Dr. Jawad Saade, a family medicine physician at the University of Maryland Baltimore Washington Medical Center, tells you all you need to know about the flu.


What is the flu and how do people get it?

Influenza, commonly known as the “flu,” is a respiratory contagious illness caused most commonly by Influenza A or B viruses. It is transmitted via air droplets released by the infected person when sneezing, coughing or talking that end up being communicated via inhalation either directly or indirectly to another person’s mouth, nose, eyes or lungs.

What are the symptoms of the flu?

The Maryland Department of Health announced the first confirmed cases of the flu Tuesday, an adult and child in Central Maryland and the Eastern Shore.

People who catch the flu may develop some or all of the following symptoms: fever, headaches, muscle or body aches, tiredness, cough, sore throat, runny nose. Some people may develop vomiting and diarrhea, though this is more common in children than adults.

How does a person know they have the flu and not a common cold?

The manifestation of the flu, in contrast to the common cold, is more abrupt and fast. Fever, chills, body aches, tiredness, weakness and headache usually are more common with people who get the flu. Nasal congestion and a sore throat are more prevalent with people experiencing a common cold.

What precautions can people take to prevent from getting the flu?

The most important preventive step is to receive an annual flu vaccine. Another preventative measure is to avoid close contact with people who already have the flu. If you are around people who have been infected with the flu virus, wear a mask if possible. Also, avoid touching your eyes, nose and mouth and wash your hands frequently with soap and water or alcohol-based hand rub. The Centers for Disease Control and Prevention recommends that people who are sick with flu-like illness stay home for at least 24 hours after the fever is gone without being on a fever-reducing medicine.

Who should get the flu vaccine? Are there any patient populations who can’t be vaccinated?

Influenza vaccine, according to the Advisory Committee on Immunization Practices, is recommended to all persons aged six months and older, including pregnant women.

The flu vaccine is especially important for some people who are at higher risk of developing serious flu-related complications than others if they get sick, including children between six months and four years of age; people aged 50 years and older; residents of nursing homes and other chronic-care facilities; pregnant women; and people with chronic heart, lung, liver, kidney, endocrine diseases as well people taking drugs that decrease their immunity such as steroids, immunosuppressants and chemotherapeutic drugs.

People who are not advised to take the flu vaccine include children younger than six months old and people with severe, life-threatening allergies to the flu vaccine or any ingredient in the vaccine.

People are advised to consult their physician prior to receiving a flu vaccination if they had or have Guillain-Barre Syndrome (a severe paralyzing illness, also called GBS), are sick and/or have a fever while receiving the vaccination, or have an allergy to eggs (mild allergy reaction such as hives is not considered a contraindication to have the flu vaccine).

How is the flu treated? When should someone see the doctor?


Most often, the flu virus is best treated conservatively with bed rest and plenty of fluids along with over-the-counter fever-reducing medications.

If the flu symptoms are severe, a person is at high risk of developing serious flu-related complications and/or the person has underlying chronic medical conditions, it is advised to see a doctor who might prescribe an antiviral medication such as osetamivir (Tamiflu) or zanamavir (Relenza). If those medications are taken within the first 48 hours of the onset of symptoms, they may shorten the illness by a day or so and help prevent further serious complications.

It is always important to seek immediate medical attention if the following symptoms occur: rapid breathing, difficulty breathing or shortness of breath, change in skin color, fever with a rash, pain or pressure in the chest or abdomen, sudden dizziness, confusion, severe or persistent vomiting, and flu-like symptoms that improve then return with fever and a more severe cough.

When can the flu be dangerous?

Baltimore City records show 5,400 people perished in the 1918 pandemic. For the month of October 1918, there were 334 burials at Baltimore Cemetery at East North Avenue and Rose Street. “That’s more than 10 a day,” said Tim Burke, the cemetery’s current manager.

The flu virus can become dangerous when complications such as pneumonia, bronchitis, ear infections, severe dehydration and sepsis occur. Other complications also include muscle inflammation, heart attacks, inflammation of the heart and problems with the central nervous system.

How accurate is the vaccine expected to be this year?

It is not possible to predict if the flu vaccine will be effective this year or not. Circulating flu viruses can change from one season to the next or even during the course of the same season and thus matching with the flu vaccine can become a challenge.

Why did so many people die from the flu last year?

Last year’s flu season was considered a high-severity season, according to the CDC, and was one of the worst seasons we have had in the past four decades. The CDC recorded high rates of outpatient clinic and emergency department visits as well as high rates of hospital admissions and deaths. The population group that was the most affected by the flu was the elderly, 65 years old and above.

One of the major causes of the high severity of the flu season last year was related to the fact that a new Influenza B strain virus (H3N2) was circulating, which the vaccine produced did not match. As a result, the vaccine last season overall had low effectiveness against that particular viral strain.

This year, flu vaccines have been updated again, as it is every year, to better match the circulating viruses.

Can people get the flu from the vaccine or is that a common myth?

There are many misconceptions about the flu vaccine among people. One of them being that you can catch the flu from the flu vaccine itself. This is simply a wrong assumption. The flu vaccine is made, depending on the kind, of the killed or weakened form of the flu virus, or from a single gene of the flu virus. Therefore it is not infectious. The flu vaccine has side effects such as soreness, swelling and redness at the site of the injection or body aches and headaches; however, those symptoms are mild and short in duration and are not considered to be related to the flu virus.

It is possible to get the flu shortly before getting vaccinated or during the period that it takes the body to gain protection after getting vaccinated, but it is not considered to be from the flu vaccine itself. Catching the flu in this instance is due to the exposure to the circulating flu virus before the vaccine has time to protect the person immunized, usually two weeks.

Another possibility would be to catch another virus that can cause upper respiratory symptoms such as the rhinovirus (common cold), which is not related to the flu virus. Unfortunately we can always be exposed to a circulating flu virus that is not included in the seasonal flu vaccine and develop flu symptoms. Some people, despite being vaccinated, do not develop proper immunity to fight the flu virus in case they catch it and this may be due to their advanced age and other health factors.