The flu is hitting early this year, and it's hitting hard. According to the Centers for Disease Control and Prevention, doctors are already seeing about twice as many cases of the flu as they usually do this time of year, which means that all the holiday shopping, parties, dinners out and traveling you're doing could leave you with a nasty, unwanted "present."
The flu strain that's circulating, H3N2, is particularly virulent and it's being called a new "swine flu" because it originated in pigs. Typically, flu season peaks after the start of the new year, according to officials with the CDC, but this year, the virus seems to have peaked around early December, the earliest since 2003.
But you can't stop your life just to avoid a nasty round of the flu. Here are ways to lower your risk of catching the illness so you won't spend your winter feeling sick as a dog.
In movie theaters.
The average big-screen movie theater has between 200 and 300 seats, and with today's megaplexes including as many as 26 theaters per venue, that could mean upwards of 8,000 people in one building on a crowded Saturday night, many of whom may be actively shedding the influenza virus without knowing it.
Strategy: Reschedule. First, ask yourself if seeing a blockbuster on opening night is worth the risk of contracting the flu. Should you decide that you can't stand another minute at home, head to the theater when you know crowds will be lightest. At the very least, you can maintain the optimum three to six feet—that’s the distance needed to prevent flu transmission—between you and other potentially sick moviegoers. And wash your hands for a full 15 seconds when you head to the bathroom, or take a hand sanitizer with you. Most people avoid or minimize hand washing in the rush to return to their seats so they don't miss anything.
On an airplane.
Unfortunately, if you wind up sitting next to an flu sufferer, options are limited, says David Ellington, MD, director of the American Academy of Family Physicians. "If you're sitting right next to someone who's coughing and hacking all over you, that's a very tough situation."
Strategy: Change seats. You can turn your head away from your seatmates so you're not directly inhaling their breath and the droplets from their coughing. But if you're lucky enough to be on an airplane that has a few empty seats, you can ask to move. If you can get at least six feet away from the offending individual, you stand a better chance. Wearing a flu mask during your flight may or may not shield you—outside of home or hospital, research on their effectiveness in real world situations is lacking. If you decide to go that route, you need to keep it tight on your face and wear it consistently to gain protection. Better yet, ask the cougher in question to wear the mask. Yeah, we know, good luck with that. But in home settings at least, research shows the infection is less likely to spread if the sick person wears a surgical-type mask.
While grocery shopping.
According to the CDC, the flu virus can live on surfaces for two to eight hours. So it would stand to reason that all those manhandled grocery carts would be prime vectors for spreading swine flu. Tests on those shopping carts have turned up everything from fecal bacteria from diapered baby bottoms to E. coli and Salmonella from raw meat, so it isn't a stretch to assume that they could be flu carriers as well.
Strategy: Wash and wipe. Your best defense is to keep your hands away from your face (and your children's faces) while you're at the store, and wash your hands immediately after getting home. (Keep your shopping list in your hands and you may be less likely to touch your face.) Alternatively, you can store a washcloth soaked in a weak solution of bleach and water inside a sandwich bag, and use that to wipe down the handle of your grocery cart. Note that some stores provide sanitizing wipes, but those may contain antibacterial solutions, not antiviral disinfectants, in which case they are useless against the flu virus (and toxic, to boot).
At a restaurant.
Most of the transmission of flu viruses occurs before someone gets sick, says William Schaffner, MD, president-elect of the National Foundation for Infectious Diseases and chair of the department of preventive medicine at the Vanderbilt Medical Center in Nashville, which means that any seemingly healthy chef, waiter, or fellow diner could be spreading the flu without realizing it.
Strategy: Dine in. Given all the unknowns and potential run-ins with sick employees or diners, and tables that may have been set with flu-contaminated hands, you're better off eating at home, especially if you haven't been vaccinated. Use this winter to learn how to cook. Plus, you'll cut out all the added sugar, fat, and salt. Worried that too many evenings in will make you crazy? Form a supper club with friends, so you can take turns dining at each other's homes (club members must vow to practice good flu-prevention tactics, and take themselves out of the rotation if family members come down with the virus). And when you just have to have that restaurant experience, choose a day and time when there are fewer diners. Wash hands diligently, so you don’t bring anything home besides leftovers.
In the doctor's office.
Most likely, if you're at the doctor's office, you're sick already, but those who are there for non-flu-related health problems can ask to be placed in a separate waiting room, or even wait outside, if weather permits.
Strategy: Watch your hands. There are lots of surfaces you have to touch between entering the office—the doorknob—to checking in for your appointment—the pen—to waiting to be called back—books, magazines, and chair armrests, just to name a few. Ultimately, "your major defense is washing your hands and trying not to rub your nose and eyes," says Dr. Ellington. Pack a small bottle of hand sanitizer that contains at least 60 percent alcohol, and use it liberally. Bring your own books and magazines—at least they won't be from 2006—and toys for your kids. Sign in with your own pen. If your doctor doesn't have waiting rooms for flu patients, maintain six feet of space between you and the other people in the waiting room.
At the gym.
Moderate exercise can do wonders to boost your immunity. While a crowded gym may not be the best place to be during flu season, it's not good to give up exercise, either.
Strategy: Clean, then sweat. Switch to outdoor exercise as much as you can, and make sure your fitness center carries sanitation wipes so you can wipe down equipment before and after use (check that they're antiviral, not just antibacterial). If they don't, bring your own alcohol-based hand sanitizer with you, and then apply lotion when you get home so your skin doesn't dry out. If you have the flu, don't exercise, rest.
At sporting events.
We're in the thick of the NFL season, and your local colleges and high school teams are likely keeping busy, too. Despite the crowds, outdoor sports venues are less likely to expose you to flu germs than you might think. "Yes, there are lots of people in a football stadium, but they're outside, breezes are blowing, and they're not in an enclosed space," explains Dr. Schaffner.
Strategy: Practice viral blocking. Still, if someone is hacking near you, it's best to move, or watch the game from a standing-room only spot. If it's cold, wear a scarf—it can double as a neck warmer and a face shield, if someone starts sneezing around you, suggests Pat Rosenbaum, RN, CIC, spokesperson for the Association for Professionals in Infection Control and Epidemiology.
On public transportation.
You've probably seen it before. Someone on the bus or train is sick as a dog, hoodie up, face smooshed against the window, sneezing all over the place.
Strategy: Board with a Kleenex. "If it's a good, juicy sneeze or cough, turn your head," says Rosenbaum. "If you have a Kleenex, put it up to your nose and mouth for a second, that's another way to try and block it." She also says don't be afraid to ask someone challenged in the respiratory-etiquette department to cover his or her mouth. Holding your breath when someone near you sneezes isn't likely to help much, unfortunately. "If you hold your breathe for a few seconds and then inhale, you'll inhale strongly," she says, urging people to adopt three generic principles in any situation to prevent the spread of flu: Practice good hand hygiene, keep your hands away from your face, and try to stay three to six feet away from people.
While you're at college.
Schools are breeding grounds for germs, and close living quarters on college campuses make it tough to protect yourself if your roommate gets sick.
Strategy: Lighten your social calendar. Since flu is transmitted through droplets, try to make sure your bed is at least six feet away from your sniffling roomie's. Avoid drinking a lot of alcohol (it can weaken your immune system), and steer clear of crowded campus parties if there's an outbreak at your school. Use Facebook, or whatever social-networking tool has replaced it among college hipsters, to keep in touch with your buds. And if your campus is offering any remote learning options as a flu-control measure, take advantage.
At the workplace.
Cubicles do provide some protection against sniffling coworkers. "But you have to wonder why they're at work in the first place," says Dr. Schaffner.
Strategy: Eat like a loner. If someone at work is clearly ill, talk to your supervisor and ask for the coughing coworker to be sent home. It will keep healthy workers safe and keep productivity running smoothly at the office. If people are still showing up to work sick, consider packing your own lunch and eating solo at your workspace until the outbreak eases. If many are sick at the office, you can also ask your boss if you can work from home until the outbreak subsides. Perhaps unimportant meetings can be put on hold (increasing productivity as a side benefit!).
If layoffs have hit your company hard, opt to use bathrooms located in areas with fewer workers, to lower your chances of running into a sniffling colleague. And make sure you wash your hands to stop the spread of flu in 15 seconds.