Frost and even snow in parts of Minnesota are not-so-gentle reminders that winter is coming. Know what to do to ward off a bout with flu and to keep from contracting a virus while out and about. Flu is a huge potential health threat for the people with disabilities and the elderly.

In October state officials had two reports of elderly Minnesotans dying of complications of the A/H3 strain of flu. The victims were women, one from southwestern Minnesota and the other from the Twin Cities. Both were in their 80s. The A/H3 strain of influenza virus has caused sporadic outbreaks in long-term care facilities in Minnesota and other states over the summer and early fall.

“This may be a difficult year in terms of severe influenza infections in the elderly,” said Dr. Ruth Lynfield, state epidemiologist with MDH. “In years when there has been primarily H3 influenza A circulating, we’ve seen higher rates of serious illness, particularly in the elderly.”

Health officials said that they have not yet seen increased influenza activity among the general population. It is not unusual to see sporadic cases and outbreaks among those in institutional settings in early fall. A cluster of A/H3 cases was reported in September in a long-term care facility in Minnesota. Clusters were also reported in a day care and a college in Iowa in July.

Lynfield said it is extremely important for those who care for, live with or frequently visit the elderly to be vaccinated for influenza as a measure to protect the elderly.

That concern was shared by Kristen Ehresmann, director of the infectious disease division at MDH. “While Minnesotans over 65 have among the highest rates of influenza vaccination in the nation, and we do recommend vaccination for the elderly, it is important to remember that they may not respond as readily as younger individuals to the vaccine,” she said. “So we need to protect them by making sure that all those around them are vaccinated, just as we protect babies less than six months by vaccinating those around them.”

In addition, Lynfield said, “All health care workers in Minnesota should be vaccinated for influenza.” This includes health care workers in clinics, hospitals and long-term care facilities. Health care workers and others should limit contacts with others when they have symptoms of influenza.

A recent survey indicated that overall about 70 percent of Minnesota’s health care workers get vaccinated for influenza. “But we can and we must do better,” Ehresmann said. This most recent influenza case serves as a reminder to all Minnesotans that vaccination is the best way to protect yourself and others against influenza—and now is a good time to get vaccinated. “There are adequate supplies of vaccine this year.”

Flu seasons are unpredictable and can be severe. CDC estimates of annual flu-associated deaths in the U.S. between 1976 and 2006 range from a low of about 3,000 to a high of about 49,000 people. Each year, according to CDC estimates, more than 200,000 people are hospitalized due to influenza.

More information on influenza and vaccination can be found on the MDH website at www. health.state.mn.us. This site also has a listing of public flu vaccination clinics. To find the influenza vaccination clinic nearest you, go to www.mdhflu.com and click on “Find a flu shot clinic.” Or you may call your city or county public health agency. Many pharmacies also offer flu shots. There are two types of vaccines:

• The “flu shot”–an inactivated vaccine (containing killed virus) that is given with a needle. The seasonal flu shot is approved for use in people 6 months of age and older, including healthy people, people with chronic medical conditions and pregnant women.
• The nasal–spray flu vaccine –a vaccine made with live, weakened flu viruses that do not cause the flu (sometimes called LAIV for “Live Attenuated Influenza Vaccine”). LAIV is approved for use in healthy people 2-49 years of age who are not pregnant.

About two weeks after vaccination, antibodies develop that protect against influenza virus infection. Flu vaccines will not protect against flu-like illnesses caused by non-influenza viruses.

Each year, the strains of influenza virus circulating around the world change just enough that the influenza vaccine needs to change. Influenza vaccines always contain three strains of antigens that provide protection against the three strains most likely to be circulating in the US.

Influenza vaccination is now recommended for everyone six months and older unless they cannot be vaccinated for medical reasons. It is especially important that those at high risk for serious complications from influenza be vaccinated. These include pregnant women, seniors, young children and those with chronic medical conditions.

Children under six months of age cannot receive flu vaccine, so household contacts and caretakers should be vaccinated to protect the very young.

The symptoms of influenza which tend to come on suddenly, can include a sore throat, coughing, fever, headache, muscle aches and fatigue. People who become severely ill with influenza-like symptoms should see a physician. Influenza is caused by a virus and antibiotics are not effective against it.

During flu season, it is important for everyone, shots or not, to do his or her part to avoid spreading influenza by following these guidelines:

Do your best to stay healthy. Get plenty of rest, physical activity and healthy eating.

Stay home from school or work if you have a respiratory infection. Avoid exposing yourself to others who are sick with flu-like illness.

Cover your nose and mouth with a tissue whenever you cough or sneeze, and then throw the tissue away. If you don’t have a tissue, cough or sneeze into your sleeve.

Clean surfaces you touch frequently, such as doorknobs, water faucets, refrigerator handles and telephones.
Wash your hands often with soap and water or with an alcohol based, waterless hand sanitizer.

Access Press staff added information from the Centers for Disease Control to this article.