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The Virginia Department of Health reported last week that the flu activity level in the state had increased to “widespread” for the first time this season. Many questions sprang to The List’s mind, including is this an epidemic; does this mean she actually has to get a flu shot; and, the one that’s plagued her for years, why is flu season automatically in the winter? Why can’t it come in the spring once in a while? For answers to these and other pressing influenza matters, The List consulted Dr. Stephen Haering, director of the Alexandria Health Department.

1. What does “widespread” mean?

   There are five designations for the flu in a state: no activity, sporadic, local, regional, and widespread. The terms refer to the number of confirmed reports of flu per region. When at least half of a state’s health planning regions report high enough numbers, the state of the flu is designated widespread.

2. Where do the numbers come from?

   Doctors’ offices and hospitals, which electronically report confirmed cases of the flu to the state.

3. Why is Virginia’s flu activity at widespread and Maryland and D.C. are still at “sporadic”?

   “Part of that can be that, well, it just hasn’t affected the other [states] yet,” Haering says. “But why did it affect one area sooner than another? It’s hard to really track that.” In other words, no one really knows, but Maryland and D.C. are probably next.

4. Is there anything especially bad about this season’s flu?

   “Mm, nothing that strikes me in terms of being unusual,” he says. Last year, though, was bad: two and a half times more pediatric patients died compared to the average year.

5. Why do people get the flu in the winter, anyway?

   Haering says there are a number of reasons, including the way the virus circulates around the planet, the make-up of the virus, and the nature of life during the winter. “One of the suggestions is that people tend to be indoors more,” he says. “Your windows are closed, you’re not getting out and about, your kids are still in school.” He notes that the southern hemisphere also experiences flu season during their winter months, opposite of ours.

6. Will public transportation increase my odds of getting the flu?

   “I’ve never seen any public health evidence of that,” Haering says. “Typically, say, on Metro, there’s pretty good air flow with the doors opening and closing so much.” Concerns over touching handrails can be alleviated by frequent hand-washing.

7. Isn't the flu airborne?

   “It spreads through the air, but then we get it hand to mouth,” he explains. “What happens is if someone were to cough or sneeze, you could get it from them in the air, but less commonly.” People usually touch infected things like doorknobs and phones and then touch their faces. “If you go to a meeting sometime and watch a few people, you’ll notice that people are always touching their face,” he says. Scratching your nose, rubbing eyes, touching your mouth, and applying make-up are all ways to transfer the germs.

8. Then do I need to replace my make-up if I had the flu?

   Haering says there’s no need; you can’t re-infect yourself with make-up that’s been exposed to the flu.

9. Can’t I get the flu from the flu shot?

   Haering calls this the biggest flu myth. “It’s simply not possible to get the flu from the flu vaccination,” he says. “If they end of getting a cold or something…they got it from somewhere else.”

10. Does the flu mist really work?

    Haering hears this question a lot and isn’t sure where all the skepticism over the nasal flu vaccination comes from. “In fact, it does work,” he says.

11. But how do we know it works??

    Before being approved by the FDA, all medications must be proven effective through trials. Haering adds that the CDC and other institutions continue to periodically test the effectiveness of things like the flu shot. “The thing I find interesting [about the flu] is that this is a preventable disease,” Haering says. “Get vaccinated, and get your family vaccinated.”