Now that cold and flu season is squarely upon us, it is time to focus on what constitutes flu and what can be done to prevent and/or treat its symptoms. On average, 5-20% of people in the US will get flu symptoms this year, with the highest percentage of these in young children. Over 200,000 cases will require hospitalization, with the majority of these being elderly patients. And sadly, over 36,000 deaths on average are attributable to the influenza virus and its subsequent debilitation each year. Yet some pharmacists, with all their clinical and practical experience, still have difficulty distinguishing between the mild symptoms of the common cold and potentially life threatening consequences of the influenza virus.

Influenza, commonly referred to as the "flu", is a very specific, medium- sized RNA viral infection which causes primary respiratory symptoms characterized by drainage, cough and sore throat. These respiratory symptoms are frequently accompanied by an abrupt onset of other constitutional symptoms such as; fever lasting 1-5 days, headache, malaise, chills, myalgias and sore throat.

There are actually three major types of flu viruses (A, B and C) and that it is the type A which can causes rare, but recurrent pandemic outbreaks. The specific type of influenza virus is determined by two antigenic surface glycoproteins, neuraminidase (N) and hemagglutinin (H). According to the World Health Organization (WHO), it was a specific H1N1 form of influenza A that was responsible for the 1918 "Spanish influenza" pandemic which killed an estimated 40-50 million people world wide.

In this month’s featured CE article "Influenza 2007-2008: What Pharmacists Should Know", author Darrell Hulisz, RPh., Pharm D., Associate Professor Department of Family Medicine Case Western Reserve University, describes the most important aspects of recognizing the symptoms of and treating influenza. Topics covered include:

• Epidemiology, virology and transmission of influenza
• Identifying individuals at risk
• Identifying the signs and symptoms associate with influenza and
• Discussing strategies for prophylaxis and treatment of Influenza

The flu can also lead to other rare, but serious, complications such as pneumonia, Reye syndrome, Guillian-Barre Syndrome, myosystitis/myocarditis and neurological complications.

Vaccines must be reformulated each year to ward off the various strains. It is the Center for Disease Control (CDC) that determines vaccination priorities and at-risk groups. There are numerous changes and updates in the 2007-2008 vaccine recommendations from the CDC and these are discussed in detail in this program. Specific recommendations are given regarding who should and should not receive the flu vaccine including changes in dosing schedules and amounts.

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