There's a little burning at first, and soreness can last a few days.
But the shot in the arm is nothing compared with the misery of the flu, says Janet Howard, a certified medical assistant at Concentra Medical Center in downtown Baltimore. Nicknamed a "sticker," she can't count how many inoculations she's given since the beginning of last month when influenza season began.
The flu shots are the best preventive measure against the worst of the winter viruses. But not everyone can or will get them. There also is no vaccine for the flu's less severe cousin, the common cold. So, health professionals say there are other steps everyone should take to keep themselves and those around them healthy.
"Mom was right, getting the proper amount of sleep, exercise and nutrition really do go a long way to keeping your immune system healthy," said Gregory Poland, director of the vaccine research group at the Mayo Clinic in Rochester, Minn., and a professor of medicine and infectious disease.
Americans typically get three upper respiratory infections a year, including colds and the flu, he said. A healthy system might mean fewer infections for some or less severe symptoms when avoiding a bug is not possible.
Infections spread when someone sneezes or coughs droplets full of virus into the air and others breathe them in through their nose or mouth. Viruses can also be picked up from surfaces. People touch a handrail or doorknob coated in germs and then touch their faces.
Steps to protect yourself and others include sneezing into a tissue or the crook of your arm and not your hand, moving away from someone who is sneezing or coughing, washing hands frequently with soap and using a paper towel to open bathroom doors after you've washed your hands.
Those infected with a virus are typically contagious a day before and several days after they show symptoms, so they could be unintentionally spreading their cold or flu.
The flu is typically distinguished from the common cold by a fever. Other flu symptoms are extreme fatigue and body aches. A cough is also typical, but not a runny nose. Conversely, someone with a cold usually has sniffles, congestion and less severe achiness and no fever.
A cold is not often deadly and usually passes in several days.
The flu, however, can be dangerous for the old, the young and those with compromised immune systems or chronic diseases such as asthma or heart disease.
Thousands die of flu
About one-fifth of Americans are exposed to flu viruses each year and about half of them - one in 10 Americans - come down with symptoms. About 36,000 people die from the flu in a typical season, mostly the very young and old.
There aren't yet reports of mass flu outbreaks this year, according to the Centers for Disease Control and Prevention, although a nasty cold virus has been spreading into several states and has killed at least 10 people. To stop the flu, many people began getting shots in November. With 132 million doses of vaccine expected to be produced in the 2007-2008 flu season, there is still plenty to go around.
Doctors say it's not too late to get a shot to fend off the virus that peaks in the early months of the year and is present through May.
The CDC recommends most people get a flu shot. It's injected into the arm muscle and, contrary to popular belief, cannot cause the flu. Some people experience some mild symptoms, including mild soreness and fatigue. (Concentra's Howard injects the arm that the person uses most because, she said, the increased activity helps it heal faster.)
Those with a sensitivity to eggs can't get a shot because the vaccines are made in eggs. And Flu Mist, an alternative vaccine made by Gaithersburg-based MedImmune Inc. for those who are needle-adverse, can't be given to those younger than 2 or older than 50.
Dr. Edward Seidel, regional medical director for Concentra, a large national provider of shots to the general public and to businesses in the area, said the shots and mists are effective. The company administers hundreds of thousands of shots over the year, including up to 10,000 shots in the Baltimore area. The inoculation takes effect in a week or two.
"The flu is quite preventable," he said. "But once we see it, it can spread fairly rapidly."
Seidel said that there are probably hundreds of home remedies, including vitamins and herbs people believe can prevent colds and the flu. He said, however, there isn't good scientific research to prove any really works.
That's true for vitamin C, echinacea and zinc. Ditto for berries, tea, oregano and mushrooms.
Chicken soup helps
Chicken soup, on the other hand, does appear to lessen the length and severity of an illness, but researchers don't know exactly why.
This doesn't mean the other remedies don't work. It means doctors such as Seidel can't say for sure they do. Most probably won't hurt, and he doesn't tell people not to take supplements they believe help.
Seidel said he could make other recommendations for recovery.
Those with infections should stay home from work, and not spread their virus. They should rest rather than exercise. The importance of sleep in general wellness has been proven in studies, he said.
They should eat and drink plenty of fluids to avoid getting run down. Tylenol and Motrin are recommended for pain, but aspirin can be harmful to sick people, especially children.
Leonita Barber thinks it's just better not to get sick. She's a human resources assistant at Bacchus Importers Ltd., a Baltimore area wine and spirits distributor. Her company has been looking for ways to help workers achieve and maintain their health.
Barber was put in charge of an in-house flu shot clinic this year after a lackluster showing of employees last year. This year's effort was held on a day the salespeople were scheduled to be in the office for a meeting, and it was later in the day so the night crew could participate without using their own time.
Turnout grew to 37 of 65 workers from just about 20. The company footed the bill for all the shots supplied by Concentra.
Barber said the company executives were not so much concerned about lost productivity - though U.S. companies lose billions of dollars' worth of worker time a year to the flu, according to the National Institutes of Health. Bacchus officials couldn't say how many hours were lost there. Barber said the effort was to prevent suffering.
"Our goal is just to make sure no one gets the flu," she said. "It's so miserable."
meredith.cohn@baltsun.com
AVOIDING COLDS AND THE FLU
Those infected with a respiratory virus are contagious a day before they first show symptoms and for few days after, so they frequently are unknowingly spreading germs. You can catch a bug when someone sneezes or coughs a droplet full of virus into the air you breathe through your nose or mouth. You could also get one when you touch a germy railing or doorknob and touch your face. But there are a few things you can do to improve your chances of staying well:
Get a flu shot. Flu season lasts through the winter, and the inoculations are still recommended for just about everyone, especially the elderly and those who work with sick people or children.
Wash your hands. It's estimated that only 20 percent of Americans wash at all or properly after using the restroom. "Properly" means use soap and scrub for 20 seconds.
Avoid touching your nose or mouth. You risk transmitting germs from your hands into your body.
Don't sit next to the sick guy at work, on the plane or elsewhere if you have a choice.
Carry hand sanitizer for when handwashing isn't an option.
Get enough sleep, eat right and exercise. Studies show that healthy, rested people get sick less and recover faster.
Don't expect magic from alternative medicines, such as vitamin C, zinc and echinacea. Studies are inconclusive, though some suggest such products may shorten the duration of a cold or flu and reduce the severity of symptoms.
A COLD VERSUS THE FLU
Symptoms of the flu include fever, fatigue and body aches. Frequently there is a cough, but not a runny nose. Symptoms of the common cold usually include sniffles, congestion and less severe achiness and no fever. Those with the flu should see a doctor within 48 hours to receive a prescription for an anti-viral medication.
[Sources: Allison Janse, co-author of The Germ Freak's Guide to Outwitting Colds and Flu; The Mayo Clinic; Centers for Disease Control and Prevention]