Cold and flu prevention

Colds and flus cause considerable illness, negatively affect our social life and cost us a lot of money in medical bills and time off work. Every year the average adult catches a common cold 2-4 times and children experience 6-8 colds. A cold typically lasts for 7-10 days, which adds up to a lot of time off work, in bed and feeling unwell. Influenza is less common, but more serious than a cold. Yet, up to one in five Australians catch the flu each winter and children are more than twice as likely to get the flu.

As there are no cures for common colds or the flu, prevention is the best strategy for minimising the disruptions to work and social life. There are many things you can do to reduce your chance of being exposed to these viruses. If you are exposed, you can still reduce the likelihood you’ll become infected and ill.

More people catch a common cold or the flu in winter months because of weather changes and they spend more time indoors where the viruses that cause these illnesses can spread easily.

You need to be especially careful about hygiene in cold and flu season, because when someone catches a cold or flu, they are contagious and can start spreading the virus causing their illness for about 24 before they start having symptoms which make them feel unwell.

1. Wash your hands

Maintaining good hand hygiene is vital during the cold and flu season. Colds and flus can be spread via aerosol droplets from coughing and sneezing, and by?touching surfaces that infected individuals may have been in contact with. The virus?commonly enters your body when you touch your nose, mouth or eyes with infected hands.

It is best to make a habit of washing hands for at least 10-15 seconds?in warm soapy water, especially after coughing or sneezing and before eating.?Teach children to?wash their hands?as well. If you do not have access to water, you can use an alcohol-based disinfectant hand gel with at least 60% alcohol content.

2. Avoid crowds and sick people

Sometimes it is difficult to?identify sick people, as people who are infectious may not have any symptoms in the early stages of their illness. Try to avoid people who you know have a cold or flu, and stay away from crowded areas during flu season to reduce your chance of infection. This is particularly important for babies in the first few months of life.

3. Disinfect surfaces

Keep household surfaces clean (e.g. door knobs, switches and telephones) as they can harbour viruses for several hours.?Wipe and disinfect these surfaces regularly. Individuals should use separate towels or paper towels in kitchens and bathrooms, especially for those who have a cold or flu. Throw tissues out immediately after use as they can spread the virus to surfaces.

4. Stay warm and dry

Staying warm and dry won’t prevent colds and flus which are caused by viruses. But when you are infected with a cold or flu virus, staying warm and dry might reduce the likelihood you’ll be affected by symptoms like coughing and sneezing. This occurs because getting cold causes the blood vessels in the nose to narrow, and when less blood is flowing in and out of the nose, cold and flu virus find it easier to multiply.

If you are healthy, your immune system is stronger and better able to fight infection. You can enhance your body’s natural resistance mechanisms by eating well, remaining physically active despite the cold weather, and getting enough sleep.

1. Boost the immune system to beat colds and flus

Healthy eating

Eating a balanced diet provides your body with the nutrients and vitamins it needs to help the immune system fight infection. Eat foods containing phytochemicals such as dark green, red and yellow fruit and vegetables. Eating a colourful diet (yellow, orange, purple, red and green vegetables) is a good way to ensure your diet includes all the micronutrients your immune system needs.

Foods containing healthy oils like salmon, kefir, tuna, flaxseeds and walnuts are also great for the immune system, as are Vitamin C rich food like oranges and tomatoes. Vitamin E and Selenium are two other immune boosting micronutrients you should include in your diet. Broccoli, brussel sprouts and almonds are all good sources of vitamin E and meat and poultry are rich in selenium. Eating a tub of yoghurt daily can reduce the chance of catching a cold by 25%.

Other healthy eating habits which can boost the immune system include:

Eat a healthy breakfast everyday;Grill, steam or bake foods instead of frying;Eat sugary foods in moderation;Limit alcohol consumption;Eat plenty of fruits and vegetables.

If you need to improve your diet, try to make changes gradually, for example by adding one healthy habit per day.

Rest

Getting plenty of sleep also helps boost the functioning of your immune system. Just resting and relaxing is also important.

Herbal remedies

Contrary to popular belief, herbal remedies like Vitamin C, echinacea and zinc do not prevent colds.

2. Reduce stress

People who are under stress tend to have weakened immune systems,?so are more likely to get sick?and experience more severe symptoms.

People who are more sociable are?less likely to get sick. Researchers believe this is because people who have more social contacts and support are less likely to feel stressed than people who keep to themselves. So if you are run down or stressed, try to incorporate some relaxation techniques into your life. If you remain relaxed, your?immune system produces more of the chemicals needed to fight infection (interleukins).

3. Stop smoking

Smokers are more prone to respiratory illness than non-smokers, and experience more severe and frequent colds. This is because cigarette smoke dries out nasal passages and paralyses the hairs that line the mucous membranes, which normally act to sweep viruses out of the nasal passages. Non-smokers should take care to avoid second-hand smoke.

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?To learn more about the negative effects of smoking on your health, see Smoking.

4. Exercise regularly

Regular exercise, particularly cardiovascular exercise, helps keeps you fit and gives your immune system a boost, enabling it to function more effectively. Exercise can increase the number of virus-killing cells in your body. It may not prevent all infections, but it can speed up recovery and reduce the intensity of symptoms. Exercise also helps you distress which is an important part of staying healthy.

5. Regulate humidity

Other ways to avoid catching a cold?are to ensure your house is not overheated, and to increase the humidity by?using cool mist humidifiers or vaporisers. The low humidity created by heating dries out the mucous membranes of the nasal passages, making you more vulnerable to?infection. Low humidity also provides an environment that encourages viruses to survive and thrive.?Make sure?you?go out and get fresh air to counteract the drying effects of indoor heating.

The flu vaccine provides one of the best ways to protect against the flu and is particularly important for people who are at high risk of developing flu-related complications (e.g.?infants, pregnant women, people over 65, or people with chronic health conditions such as asthma, diabetes or heart disease). ?The large number of viruses capable of causing colds means that there are no vaccines for the common cold. Vaccines only protect against a single virus, however there are more than 200 viruses which can cause colds. However, there are flu vaccines available including Agrippal (inactivated influenza vaccine), Fluarix (inactivated influenza vaccine), Influvac (inactivated influenza vaccine), Vaxigrip (inactivated influenza vaccine) Fluvax (inactivated influenza vaccine) and Intanza (inactivated influenza vaccine).

The flu vaccine is between 70-90% effective, depending on the intensity and length of the flu season. In Australia, the flu season begins around May and continues until September (Autumn and winter). The flu vaccine is best administered in March/April (or even as early as February) to provide full protection.

Who should get a flu shot?

Most people are able to obtain a flu shot.?There are certain groups of people who are highly susceptible to complications and?are therefore strongly?advised to?get vaccinated. In Australia, the?flu vaccine is free of charge for people aged over 65, and for Aboriginal and Torres Strait Islanders (ATSIs) aged over 50 years or aged 15-49 years with a chronic illness.

New vaccines are produced every year and supplies are sometimes limited. If you need a flu shot it is a good idea to talk to your doctor early to make sure you can get vaccinated before the flu season starts. ?

In Australia, immunisation is recommended for:

All adults aged over 65 years;Infants and children aged from 6 months to 4 years;Children on long term aspirin therapy;Pregnant women (especially those who are in their second or third trimester between June and October);Anyone with a chronic medical condition (e.g.?asthma, diabetes or?heart, kidney or lung disease);Anyone with a weakened immune system or who is undergoing immunosuppressive treatments;Residents of nursing homes or long term care facilities;Child care workers, health care workers, or anyone living with or looking after someone at high risk of developing flu-related complications; andAnyone visiting parts of the world where influenza is circulating.

Who should not be vaccinated

People who have had an allergic reaction to a flu vaccine in the past;People with allergies to chicken eggs (the vaccine is cultivated in chicken eggs);Anyone who has developed Guillain-Barre syndrome within six weeks of receiving the vaccine in the past;Children under 6 months of age; andPeople suffering from an illness with a fever.
For more information on the common cold and influenza, types of influenza and treatments and tips?for preventing influenza, see Cold and Flu.
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Food Poisoning Prevention and Food Safety

Food-borne diseases are diseases that are transmitted by food. Food that has been contaminated with pathogens?– including micro-organisms like bacteria or toxic substances like lead or mercury – can cause infection and/or toxicity if a person eats the food. Eating contaminated food causes the micro-organisms or other contaminants to enter your body.

Water may also contain disease-causing micro-organisms or toxic substances (sometimes the same micro-organisms as contaminated food), which can enter your body and make you ill if you drink the water. These are known as water-borne diseases. Contaminated water may also cause water-borne disease if it is used for washing food, especially raw food like salad.

Food- and water-borne diseases are a considerable cause of illness. Around the world, an estimated 1.8 million people die each year from diarrhoeal diseases caused by food- or water-borne pathogens. Although most of these deaths occur in developing countries, food-borne illnesses are also a considerable cause of illness and death in developed countries.

Determining the exact number of food poisoning cases that occur each year is difficult because it is estimated that only 20% of people affected by food poisoning visit a doctor for treatment. Thus the vast majority of food poisoning cases go unreported. It is also difficult to definitively attribute the cause of food poisoning symptoms (e.g. vomiting, diarrhoea) to eating contaminated food.

Available evidence indicates that there are 5.4 million cases of food poisoning each year. Over 1.2 million visits to the doctor each year are because of food poisoning, and over 300,000 prescriptions are written each year for medicines to treat food poisoning. On average, 120 Australians die each year as a result of food poisoning, and 2.1 million days of work are lost because of food poisoning. The cost of food poisoning to the Australian economy is $1.25 billion each year.

Food poisoning is also a significant cause of morbidity and mortality in other developed countries. In England and Wales, an estimated 850,000 cases of food poisoning occur each year, and about 500 result in death. In the United States, approximately 5,000 food poisoning-related deaths occur each year.

Food poisoning occurs when someone eats food or drinks water that has been contaminated with disease-causing micro-organisms.

Food often gets contaminated by bacteria from human hands. Contamination can occur during food processing, packaging, storage or preparation in the home or a restaurant. Bacteria may also be present in foods, especially raw meats, when they are purchased.

Food can also be contaminated if it comes into contact with or is produced from an animal that carries a disease-causing pathogen. Contact with contaminated water can also transfer disease-causing pathogens to food, such as when fruit is washed in contaminated water.

Soil can contaminate food when vegetables and fruit are not adequately washed prior to consumption. Soil and water may also contain heavy metals such as lead, murcury and cadmium, which can be transferred to food while it is growing (e.g. fish or vegetables).

In Australia, food poisoning is most commonly caused by the bacteria Campylobacter (bacteria which infects the intestine) and Salmonella typhimurium (which causes salmonellosis).

Toxin-mediated food poisoning is mainly caused by Clostridium perfringens (bacteria commonly found in low concentrations in meat), Bacillus cereus (bacteria commonly found in soil) and Staphylococcus aureus (bacteria that inhabits skin, hair follicles and mucous membranes in humans). Listeria (the bacteria that causes listeriosis) and Escherichia coli (which commonly causes severe diarrhoea and gastrointestinal bleeding) infections are relatively rare causes of food poisoning but can be very serious. For example, they can cause intestinal bleeding and death.

Other toxins can occur naturally in food such as mycotoxins (toxins produced by tiny fungi) and toxins in fish such as ciguatera (caused by eating fish that have consumed toxin-producing algae). Other disease-causing agents that can contaminate food include prions (a type of protein) such as those that cause bovine spongiform encephalopathy (mad cow disease), persistent organic pollutants (POPs), and heavy metals such as mercury and lead.

Many foods can harbour bacteria that causes food poisoning. Disease outbreaks are often associated with food dishes containing eggs, including whole eggs, desserts and sauces. Outbreaks of food poisoning are also commonly associated with buffets and dishes containing meat such as chicken, beef and fish. Pasta- and rice-based dishes have also been known as sources of food-borne pathogens, as have milk and cheese.

Some foods are particularly likely to house bacteria. They include:

Unpasteurised milk and dairy products. Soft cheeses carry a particularly high risk;Raw or undercooked meat or poultry;Raw or undercooked eggs and foods that contain them, such as mayonnaise, salad dressings and cookie dough;Raw or undercooked shellfish;Improperly processed foods such as canned goods or salted meats;Unwashed fruits and vegetables.

Symptoms of food poisoning vary depending on the type of infection, but may include:

The severity of symptoms varies depending on the individual's health and the type of bacteria causing the infection. They may appear up to several days after the contaminated food was eaten.

People who are sick with suspected food poisoning should not handle food during preparation. Ideally, they should not be involved in food preparation for 48 hours following recovery, because during this time there is a risk that they can contaminate food and pass the infection on to someone else.

Medical attention should be sought if:

Blood is seen in vomit or faeces;Diarrhoea persists after 2–3 days;A fever is present over 38.3oC; There is dehydration (indicated by thirst, light-headedness or dizziness) and fluids cannot be consumed due to vomiting or nausea; orThe person with food poisoning is confused or has difficulty reasoning.

Urgent medical attention should be sought if:

There is a lot of blood in faeces or vomit;Faeces appear black or maroon;The food poisoning is suspected to be from fish or?mushrooms, or to be?botulism (caused by Clostridium botulinum, a bacteria that most commonly infects improperly processed foods such as canned foods); orThe heart rate is abnormal (e.g.?beating too fast, too slowly, or irregularly).

Usually food-borne diseases are not serious or life-threatening and the body's immune system is strong enough to fight the disease. In these cases, symptoms usually go away within hours or days of the person getting sick, and there may be no need to visit a doctor or take medicine.

However, sometimes food-borne illness is more serious and requires medical treatment. Some people have a greater risk of becoming severely or fatally ill with food-borne illness. These people should always visit their doctor when they experience symptoms of food poisoning, including:

Pregnant women;Young children and infants;Older people; and People who have diseases or take medicines that compromise their immune system, including those with cancer or AIDS.

Individual variation also occurs, so that some people may not get sick after eating a significant amount of bacteria, while others may develop severe illness after eating a very small amount of bacteria.

Food-borne illness can lead to a wide range of chronic diseases. These include:

In Australia, all States and Territories conduct surveillance of communicable (contagious) diseases, including diseases that cause food poisoning. Doctors and laboratories report individual cases of illness to the appropriate state or territory health department, which in turn pass on a summary of all cases reported by doctors to national health authorities. The OzFoodNet Network collates data about cases of food poisoning for the whole of Australia.

Doctors and laboratories are required by law to report cases of certain diseases to health authorities. The information provided to health authorities helps to monitor disease and prevent outbreaks. For example, if several cases of food poisoning involving the same pathogen are reported in the same area, this might alert health authorities to the possibility of a source of contamination in that area (e.g. a restaurant or?contaminated water source). The authorities can then investigate and take measures to prevent further contamination from the same source.

Some types of food poisoning are more dangerous than others, such as those where there is a high risk of severe illness or death. These cases must be urgently reported to health authorities, within 24 hours of diagnosis. There are slight variations between states, but generally the urgent cases of food-borne disease which must be reported within 24 hours include:

Those involving: Two or more related cases of food poisoning caused by any pathogen (e.g. cases in two individuals from the same area, who have eaten the same food); orFood poisoning in a food handler (e.g. a person who works in a kitchen or food processing area).

If you are sick with food poisoning, the doctor will notify the relevant health authority of your case. You do not have to do anything. The doctor may, however, tell you that?information about your illness will be passed on to health authorities.?

Food may contain very small quantities of harmful bacteria, although in small quantities many bacteria will not cause illness in a human. However, small quantities of bacteria can multiply rapidly when they are in warm environments that contain nutrients and water. Multiplication can result in enough bacteria growing in the food to cause illness in a human who consumes the food.

It is important to be aware that food contaminated with bacteria often appears normal. Bacteria do not produce a bad smell when they multiply, nor do they change the appearance of food. This makes it difficult to identify potentially contaminated food.

The exact time it takes bacteria to multiply depends on the species and environmental conditions. However, many bacteria begin to multiply rapidly after as little as two hours at room temperature. Refrigerating or freezing food can slow the multiplication of bacteria, but it does not destroy the bacteria – this can only be achieved by thorough cooking.

All bacteria multiply by dividing and replicating their cells, meaning that the number of bacteria in a particular environment (e.g. a piece of food) double within a given timeframe. The time it takes one particular bacterium to replicate is referred to as the generation time. If the generation time is 20 minutes, the number of bacteria contained in the food will double every 20 minutes. The more bacteria contained in the food, the more new bacteria will grow.

If food is handled safely, most food-borne illness can be prevented. The following points can help you avoid food poisoning.

Before handling food

Wash your hands properly with soap for 15–20 seconds;Clean surfaces that come into contact with food thoroughly before and after processing each separate food item. Utensils such as knives, cutting boards and bench tops should also be cleaned before, during and after food preparation;Rinse all fruit and vegetables with running water before cooking or eating them;Do not rinse raw poultry and meat before cooking it. Rinsing raw meat under running water can cause the juices from the meat to splash and contaminate benches, utensils or other food.

Whilst handling food

Don't allow people who are sick with food poisoning to handle food. They may contaminate the food and pass their illness onto someone else. Ideally, someone who has had food poisoning should not handle food until 48 hours after symptoms subside;Use one cutting board for meat products, and a separate one for foods that can be eaten raw such as fruits and vegetables;Do not allow meat and meat juices to come into contact with food that can be eaten raw;Wash your hands thoroughly again if you have touched raw meat, been to the toilet, touched a pet or blown your nose;Wash all utensils between use on different food items. This is particularly important when a knife or cutting board is being used for meat or cheeses and raw food;If wearing disposable gloves, they should only be used for one task. When changing or commencing a new task, put on new gloves.

Cooking

Bacteria that cause food poisoning can reproduce rapidly if they are left at room temperature for more than two hours. Make sure foods are refrigerated before cooking and as soon as possible afterwards;Keep raw meat separate from other food to prevent cross-contamination;If possible, use a meat thermometer to check the internal temperature of cooked meat. Once food is cooked, it should be kept below 5oC or above 60oC to prevent bacteria growing. Christmas meats such as turkey and ham should be cooked so that the internal temperature reaches 75oC;When properly cooked, the juices of turkey, chicken and mince should be clear and not cloudy or milky in appearance.

Reheating

Soups, marinades, gravies and sauces should be well cooked or boiled when reheating them;Food should be reheated to steaming hot (a mimimum of 60oC) as quickly as possible and within two hours of being taken from the refrigerator;Never reheat leftovers more than once. Take only the amount you intend to eat out of the refrigerator for reheating.

Serving food

Do not leave food unrefrigerated on a serving table for long periods of time. Bacteria begin to multiply rapidly after two hours at room temperature. Ideally, cold food should not be left out of the refrigerator for more than an hour.Be wary at buffets, as it can be challenging to maintain proper food hygiene at a buffet. Potential issues include: Food being stored at the wrong temperature, either cold food becoming too hot or hot food becoming too cold;Food becoming contaminated because serving utensils are shared between dishes, or utensils are not used and food comes into contact with contaminated hands;Utensil handles might contaminate food if they drop into the dish. Handles have generally been touched by many people and may harbour many types of bacteria;Many people serve food from the same dishes and some may not practise good food hygiene. For example, they may eat from the serving dish or spoon, or they may use their hands to serve food;People standing in line to serve food may sneeze or cough, and this can contaminate the food.

Food storage

Store raw meat in a rigid container that will prevent contact between it and other food. Store it at the bottom of the fridge to prevent cross-contamination from any drips that spill from the container;Food items that will not be cooked or reheated should never be defrosted at room temperature. Always defrost them in the fridge;Do not overfill your refrigerator. Cool air must be able to circulate to keep food cold;Eat all leftover cooked food within 48 hours;Check products for an expiry date. Foods with a 'use by' date should be frozen or disposed of on or before the use by date.

Utensils

Keep cutting boards only if they are in good condition without scratches on their surface;Plastic and glass cutting boards are best for raw meat, although plastic boards should be replaced as soon as they become scratched;Scrub all utensils with hot water and detergent after they have been used on raw food, and before they are used again on cooked food.

General guidelines

If you are in any doubt about whether the food is safe or not, throw it away;Be aware of how environmental conditions affect food, and throw away food that may have been contaminated because of exposure to environments that enable bacteria to grow, including: Cross-contamination, when a raw food has come into contact with a cooked food;Temperature, when food has been at room temperature for more than two hours or has been reheated on a previous occasion; Be prepared and organised: Ensure there is sufficient food preparation space to enable safe preparation, particularly the separate preparation of raw and cooked food;Ensure you have enough containers to store raw and cooked foods separately; Make sure you have enough room in the refrigerator to enable cold foods to be refrigerated.
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