The flu virus is mainly transmitted from person to person via droplets created by an infected person during coughing or sneezing.  Vaccination remains the best method of prevention against the flu.  However during the flu season, vaccines may not be readily available.  Furthermore, vaccination does not confer complete protection against the flu.  Some reasons for failure include a poor immune response to the vaccine, inappropriate viral antigens in the vaccine, an unstable or denatured vaccine due to poor handling and storage. During a flu pandemic it will take about 6 months before an appropriate pandemic vaccine can be produced.  In the meantime, we must rely on simple ways of preventing the transmission of the flu virus.  Here are a few suggestions:- 

Protecting Others

• Practise cough etiquette.  Cover the mouth and nose with tissue when coughing or sneezing.  When tissue is not available use the upper sleeve of the shirt or blouse instead but not the hands. Dispose off used tissues properly. Wear a mask if necessary, especially when visiting health care facilities.
• Practise frequent hand washing to prevent contamination of articles handled.  Wash adequately with ordinary soap and water.  Use alcohol based hand rubs when soiling is minimal and when water is not readily available
• Practise self isolation.  Do not go to work or school if one has the flu.

 Protecting Oneself

• Practise distancing.  Stay 3 feet away from anyone who is coughing and sneezing.  Expelled droplets normally settle within a distance of 3 feet.  Avoid crowded places.
• Practise frequent hand washing.  Wash carefully after contact with persons who have flu-like symptoms.
• Wear a mask particularly if one is in the high-risk group and cannot avoid getting up close with possible flu sufferers. High-risk groups include people aged 55 years and older, those who live in a long-term care facilities, children aged 6-23 months, pregnant women, and those with certain medical conditions (e.g. heart disease, lung disease and immuno-compromised individuals)
• Replace handshakes and hugs when greeting each other with a “wink and a nod” instead.
• Use anti-viral medication after contact especially if one is in the high risk group and during major flu outbreaks.
• Stay healthy by eating balanced meals and nutritional supplements.  Exercise regularly.  A healthy body will be able to fight the flu virus better.
• Stay healthy by eating balanced meals, taking nutritional supplements and drinking adequate amounts of fluids.  Exercise regularly.  A healthy body will be able to fight the flu virus better.

 Making Clinics Safer

• Post visual alerts at facility entrances instructing both patients and those accompanying, to alert the
  staff if they have symptoms of a respiratory infection.
• Signs should instruct those with symptoms to follow recommendations for respiratory hygiene and cough etiquette.
• Ensure there are adequate supplies of tissues, no touch waste receptacles, soap, water and alcohol based hand rubs in the clinic for doctors and patients to perform hand hygiene.
• Offer surgical masks to persons who are coughing.
• Coughing patients should be encouraged to sit at least 3 feet away from other patients.
• These measures should be implemented throughout the year.
• Healthcare personnel should observe Droplet Precautions in addition to Standard Precautions, when examining patients with symptoms of a respiratory infection, especially when fever is present.
• Droplet Precautions include the use of a surgical mask and eye protector for close patient contact.

     These simple flu prevention strategies are effective and should be enforced throughout the year.  These strategies should also apply during a flu pandemic.  WHO advises all health care personnel to practise Airborne Precautions during the initial stage of a flu pandemic until the mode of transmission of the pandemic flu virus is clearly established.