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The Flu: What You Need to Know

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CHILDREN are dying - 20 to 30 so far, and we don't know what the final total will be. Still, the danger to any of us or our kids remains far less than it would seem.

Influenza kills 36,000 in an average year, but this year looks to be a bad one. Early estimates predict possibly twice as many deaths as usual.

Here in New York, we wait. There are only a sporadic number of cases here so far, with more in the offing. My patients want to know if they should vaccinate their children, they want to know if this year's vaccine works, they even want to know if they should keep their kids out of school for fear of catching the dreaded bug.

Here is what I tell them:

First, schools close for blizzards, not flurries. So far, our flu is a flurry, not a storm or epidemic.

Second, since death from flu occurs mainly from accompanying infections like pneumonia, the best thing you can do is call your doctor more quickly if your child is sick.

Since we are on a heightened flu alert, we are likely to think every cough or sneeze is that bad bug, but your doctors can usually tell you if you are overreacting or actually require immediate attention.

The vaccine? You've probably heard it doesn't "cover" this year's strain - but you should also know the vaccine still provides "cross protection," which may well make the difference between severe infection and a more moderate course of the flu.

Consider also that with more than 80 million doses already out there, a "herd" immunity has developed by now, and will delay the flow, as the flu virus makes its way across neighboring states and approaches New York.

Know, too, that there is still vaccine available (manufacturers are out, but many doctors still have supplies) for the very young, the very old, those who are chronically ill, asthmatics and pregnant women.

Previously, I had thought of flu as an underappreciated ho-hum killer. No longer. The good news is that today's worries may lead more people who need the vaccine to get it now and in years to come. In fact, most of us should probably get the vaccine next year (if enough is available), just as we are routinely immunized against many other viruses.

In the meantime, the bad news is that virulent panic - the SARS, West Nile, sniper kind of panic - fills us with the unrealistic sense that we are about to be the killer bug's next victim.

Dr. Marc Siegel is an internist in New York City.

Copyright 2003 NYP Holdings, Inc. All rights reserved.

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