The Centers for Disease Control and Prevention (CDC) recognizes that school administrators, teachers, staff, and parents are concerned about the flu, particularly its effects on children. Much attention has focused on the recent flu vaccine shortage, and how this may affect children and teachers in schools. Schools are instrumental in keeping their communities healthy by taking actions such as posting information about hand hygiene in restrooms, providing flu prevention messages in daily announcements, and being vigilant about cleaning and disinfecting classroom materials.

The following are some answers to questions commonly asked by school administrators, teachers, staff, and parents:

What is the current situation with flu vaccine?

On October 5, 2004, CDC learned that about half of the expected flu vaccine supply would not be available for the United States, due to manufacturing problems. The remaining supply of vaccine is being routed to serve individuals in "high priority" groups.

These people should get the flu shot:

• Children ages 6 months to 23 months.
• People who are 65 years of age and older.
• People 2 years old or older who have an underlying, long-term illness (heart or lung disease, metabolic disease [like diabetes], kidney disease, a blood disorder, or a weakened immune system (including people with HIV/AIDS)).
• Women who will be pregnant this season.
• People who live in nursing homes or other chronic-care places.
• People who are 6 months to 18 years of age, and take aspirin daily.
• Health-care workers who take care of patients.
• People who have or take care of a baby under 6 months old. (Do not give a flu shot to babies under 6 months.)

What is influenza (flu)?
Influenza, commonly called "the flu," is caused by the influenza virus, which infects the respiratory tract (nose, throat, lungs). It can cause mild to severe illness, and at times can lead to death.

How does the flu spread?
The main way that influenza viruses are spread is from person to person in respiratory droplets of coughs and sneezes. (This is called "droplet spread.") This can happen when droplets from a cough or sneeze of an infected person are propelled (generally up to 3 feet) through the air and deposited on the mouth or nose of people nearby. Though much less frequent, the viruses also can be spread when a person touches respiratory droplets on another person or an object and then touches their own mouth or nose (or someone else’s mouth or nose) before washing their hands.

What are the symptoms of the flu?
Influenza is a respiratory illness. Symptoms of flu include fever, headache, extreme tiredness, dry cough, sore throat, runny or stuffy nose, and muscle aches. Children can have additional gastrointestinal symptoms, such as nausea, vomiting, and diarrhea, but these symptoms are uncommon in adults. Although the term "stomach flu" is sometimes used to describe vomiting, nausea, or diarrhea, these illnesses are caused by certain other viruses, bacteria, or possibly parasites, and are rarely related to influenza. Please also see " Is it a Cold or the Flu".

How long is a person with flu virus contagious?
The period when an infected person is contagious depends on the age of the person. Adults may be contagious from one day prior to becoming sick and for three to seven days after they first develop symptoms. Some children may be contagious for longer than a week.

What is the difference between a cold and the flu?
The flu and the common cold are both respiratory illnesses but they are caused by different viruses. Because these two types of illnesses have similar flu-like symptoms, it can be difficult to tell the difference between them based on symptoms alone. In general, the flu is worse than the common cold, and symptoms such as fever, body aches, extreme tiredness, and dry cough are more common and intense. Colds are usually milder than the flu. People with colds are more likely to have a runny or stuffy nose. Colds generally do not result in serious health problems, such as pneumonia, bacterial infections, or hospitalizations.

How can you tell the difference between a cold and the flu?
Because colds and flu share many symptoms, it can be difficult (or even impossible) to tell the difference between them based on symptoms alone. Special tests that usually must be done within the first few days of illness can be carried out, when needed to tell if a person has the flu.

What are the symptoms of the flu versus the symptoms of a cold?
In general, the flu is worse than the common cold, and symptoms such as fever, body aches, extreme tiredness, and dry cough are more common and intense. Colds are usually milder than the flu. People with colds are more likely to have a runny or stuffy nose. Colds generally do not result in serious health problems, such as pneumonia, bacterial infections, or hospitalizations.

What are influenza antiviral medications?
Influenza antiviral medications are drugs that suppress the ability of influenza viruses to reproduce. When used correctly, they can reduce the duration of symptoms and some complications from influenza virus infection.

How are antiviral medications used for flu?
Antiviral medications are used along with vaccines to prevent and treat influenza. They most often are used to control flu outbreaks in institutions, such as nursing homes or hospitals, where people at high risk for complications from flu are in close contact with each other, see Antiviral Drugs and the Flu.

At what age should a child be vaccinated?
To protect their health, all children 6 months to 23 months old should be vaccinated against the flu. The flu shot is not approved for use in children less than 6 months old.

What can I do to protect myself against the flu?
By far, the single best way to prevent the flu is for individuals, especially people at high risk for serious complications from the flu, to get a vaccination each fall.   However, there are other good health habits that can help prevent the flu. These are:

• Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too.
• If possible, stay home from work, school, and errands when you are sick. You will help prevent others from catching your illness.
• Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick.
• Washing your hands often will help protect you from germs.
• Avoid touching your eyes, nose or mouth. Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.

Also, antiviral medications may be used to prevent the flu.  For more information, see Questions and Answers: Antiviral Medications and Antiviral Drugs and the Flu.

Where can I get more information about the flu, the vaccination shortage, and prevention?
For the most recent CDC updates on the flu vaccination shortage, go to http://www.cdc.gov/flu/protect/vaccineshortage.htm and/or call the CDC hotline:

CDC Flu Information Hotline (English and Spanish)
Public: 800-CDC (232)-INFO (4636)
Clinician: 877-554-4625

Also, CDC has developed a flu Web site where you can access:

• Information about preventing the spread of flu in schools;
• " Be a Germ Stopper" and " Cover Your Cough" posters formatted for printing;
• "It's a SNAP" toolkit, which includes activities that school administrators, teachers; and students and others can do to help stop the spread of germs in schools.

Flu Resources for Schools

To view Public Service Announcements for the 2004/2005 flu season, go to http://www.cdc.gov/flu/0405psas.htm

To find downloadable, print-ready flu prevention materials for schools, go to http://www.cdc.gov/flu/school/index.htm.

To find contact information for your state or local health department, go to http://www.cdc.gov/other.htm.

For "Key Facts About the Flu," a fact sheet including information about flu symptoms, how flu spreads, and how to prevent flu, go to http://www.cdc.gov/flu/keyfacts.htm.

For more information about both the injectable flu vaccine and the new, intranasal Flu Mist, go to http://www.cdc.gov/flu/about/qa/fluvaccine.htm.