Fight the Flu Q&A

We’ve been fielding a lot of calls about the flu this fall—and understandably so! The flu was big news last year due to worry over the H1N1 virus (also known as “swine flu”). While the threat of contracting H1N1 is no longer a universal public concern, the seasonal flu is still a widespread health threat.

Among those most at risk for infection and complications from the seasonal flu virus: people with lupus and other chronic or systemic inflammatory illnesses, or who take medicines such as prednisone that dampen (lower) immune system activity.

Get the Seasonal Flu Vaccine!

Vaccination is the best protection against getting the flu.

According to the Centers for Disease Control and Prevention, while people were advised to get two vaccines last year—the 2009 H1N1 and the seasonal vaccine—this flu season people only need the seasonal vaccine. This 2010-2011 flu vaccine protects against an influenza A H3N2 virus, an influenza B virus, and the 2009 H1N1 virus.

We asked leading lupus doctor Richard Furie, MD, to answer some of the most common questions about lupus and the flu. Dr. Furie is chief of the Division of Rheumatology and Allergy-Clinical Immunology at the North Shore–LIJ Health System in New York.

Q. I have lupus. Should I get the seasonal flu shot?

A. If you have lupus, you should strongly consider getting the seasonal flu vaccination—as long as it is not in the form of a “live attenuated nasal vaccine.”

The flu shot is administered by a relatively painless injection into the arm muscle. (Note that since the vaccine is made in chicken eggs, you shouldn't get it if you are by chance allergic to eggs.) In rare cases, a person develops a localized injection site reaction (redness, pain, and/or swelling) as well as fever or muscle aches for a day or two. These types of reactions are not the result of contracting the flu; it is biologically impossible to develop the flu from the injected vaccine.

It’s also a good time to ask your doctor about getting the pneumonia (pneumococcal) vaccine to protect against this dangerous type of bacterial infection—I suggest this vaccine to my patients with lupus.

Q. What else should I do if I have lupus to protect myself from getting the flu?

A. Experts believe that flu viruses are spread primarily from person to person through coughing and sneezing. Sometimes a person can get infected by touching a surface or object that has the droplets of the virus on it, and then touching their nose or mouth. So follow the basics of prevention—wash your hands thoroughly with soap and water (or an alcohol-based hand rub) before touching these areas of your body (or eating), and keep your distance from people who may be infected!

Q. What should I do if I think I have the flu?

A. Since antiviral medicines should be taken within 48 hours in people who are at high risk for complications—which includes people with lupus, or who are taking medicines that suppress the immune system—call your doctor right away if you start to feel sick with some or all of the following flu symptoms: fever, cough, sore throat, runny or stuffy nose, body aches, headache, fatigue, chills, diarrhea and vomiting. Then wait for 24 hours to pass after your fever has stopped (on its own, without medicines) before going to work or school, or traveling.

For more information on the flu shot, visit