Preventing Flu

Flu and outbreaks of flu

Each winter there is usually an outbreak of flu (influenza) which affects many people. An outbreak is called an epidemic if the number of cases is very high. If you are normally well, then you are likely to recover fully if you develop flu. See leaflet called 'Flu and Flu-like Illnesses'. However, some people are at increased risk of developing serious complications (such as pneumonia) if they have flu. Note: bird flu (avian influenza) is different to the usual 'human' flu and is more serious. See separate leaflet called Bird Flu for details.

Who is at increased risk of developing complications from flu?

• If you are aged 65 or over.
• If you have a chronic (ongoing) lung disease. For example: chronic obstructive pulmonary disease (COPD), emphysema, asthma which requires regular use of inhaled steroids or steroid tablets (or if you have previously been admitted to hospital because of asthma), cystic fibrosis, interstitial lung fibrosis, pneumoconiosis, etc.
• If you have a chronic heart disease. For example: if you require regular medication or follow-up for ischemic heart disease (angina, heart attacks, etc), congenital heart disease, chronic heart failure, or heart disease caused by high blood pressure.
• If you have a serious kidney disease. For example: nephrotic syndrome, kidney failure, if you have had a kidney transplant.
• If you have a serious liver disease such as cirrhosis.
• If you have diabetes which requires insulin or tablets to control it.
• If you have a poor immune system. For example, if you have no spleen, are taking chemotherapy or steroid treatment, if you have HIV/AIDS, etc.
• If you have certain serious diseases of the nervous system such as multiple sclerosis.
• If you live in a nursing home or other long stay residential care accommodation.

Who should be immunised against the influenza virus?

The aim is to protect people who are more likely to develop complications from flu. Current advice is that:

• All people at increased risk (in the above groups) should be immunised.
• You should be immunised if you are the main carer of an elderly or disabled person whose welfare may be at risk if you fall ill with flu.
• If you work in close contact with poultry you should be immunised. This is a precautionary public health measure advised by the Department of Health.

If you are healthy and under 65, you do not need to be immunised against the influenza virus as you are unlikely to develop complications if you get flu. However, staff involved in direct patient care may be offered immunisation from their employer.

The influenza vaccine gives good protection against the influenza virus, and lasts for one year. The vaccine is normally ready by the autumn each year. It is made from the strain of influenza virus that is expected in the coming winter.

See separate leaflet called 'Influenza Immunisation' for more details.

Antiviral medication to prevent flu

During outbreaks of flu, a drug called oseltamivir may be advised for some people to help protect against flu. Oseltamivir works by interfering with the way the virus multiplies. If you take oseltamivir, it may not stop flu completely, but it may reduce the severity and duration of the illness. The usual course is for 7-10 days. Oseltamivir is not advised if you are usually healthy and are under the age of 65. It may be advised in the following circumstances.

If you are at increased risk

Current guidelines advise that oseltamivir may be prescribed if you are at increased risk of developing complications if you were to develop flu (see above), and...

• You are in close contact with someone with flu (this usually means someone who lives in the same house or home as you), and...
• You have not been immunised against flu in the current autumn/winter (or were immunised within the previous two weeks and so it has not had time to work), and...
• You can start taking oseltamivir within 48 hours of coming into contact with the person who has flu.

If you live in residential care home such as a nursing home

If a resident or member of staff develops flu, then oseltamivir may be advised for other residents who are at increased risk of complications from flu, even if they have been immunised against the influenza virus.

In addition, if an outbreak of flu occurs in a residential care home, other ways to prevent spread of the virus may be advised. For example:

• If possible, separating people with flu from people without it.
• Offering influenza immunisation to staff and residents who have not been immunised.
• Restricting movements of staff, residents and visitors between wards, sections of buildings, etc, until the outbreak is over.

Further sources of information

Government immunisation website

Web: www.immunisation.nhs.uk