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Exactly How Contagious Is the Flu?

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You've likely heard some scary stuff about the flu this year. That's because there's widespread influenza activity in all of the continental U.S. for the first time in 13 years, according to the Centers for Disease Control (CDC). Even if you got your flu shot (skipped it? It's not too late to get your flu shot), which the CDC says has been roughly 39 percent effective this year, you're still at risk of catching a different or mutated version of the virus. This also makes it possible to get the flu twice in one season. Influenza A, or H3N2, has been the most common form of influenza this season, reports the CDC. Overall, there were nearly 12,000 lab-confirmed flu-related hospitalizations across the United States between October 1, 2017, and January 20, 2018. And, sadly, even young and healthy people have died from the flu this season.

So just how high is your risk of catching the virus? Should you be scared to touch handrails, grocery cart handles, elevator buttons, doorknobs...?

"Flu viruses are spread mainly by droplets made when people with the flu cough, sneeze, or talk," says Angela Campbell, M.D., a medical officer in the CDC's influenza division. "These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. People with flu can spread it to others up to about 6 feet away. Less often, a person might get the flu by touching a surface or object that has flu virus on it and then touching his or her own mouth, nose, or eyes."

To put it simply, the flu is "quite contagious," says Julie Mangino, M.D., a professor of internal medicine in the infectious disease department at The Ohio State University Wexner Medical Center. One major thing you can do to protect yourself: Keep your hands off your face. "You should never touch your face, your eyes, your nose, and your mouth, because whatever is on your hands is now getting to the nose and the throat," says Dr. Mangino.

Regularly wash your hands, especially before preparing or eating food. Avoid sick people whenever possible. And if you are living in the same household as someone who has the flu, "do everything you possibly can to avoid swapping saliva," says Dr. Mangino.

If you do get the flu, there are ways to limit the likelihood of passing it on to others. If you are clearly sick with a fever and flu-like symptoms, you should not go to work, school, the gym, or other public places. If you live with other people, keep tissues around so you don't accidentally sneeze on someone and transmit the virus. Limit how much you touch other people. You can also try wearing a surgical mask around the house. And, crucially, wash your hands frequently with soap and water, or with an alcoholhand sanitizer. (Related: Is Hand Sanitizer Bad for Your Skin?)

"Linens, eating utensils, and dishes belonging to those who are sick should not be shared without washing thoroughly first," suggests Dr. Campbell. "Eating utensils can be washed either in a dishwasher or by hand with water and soap and do not need to be cleaned separately. Frequently touched surfaces should be cleaned and disinfected."

If you've been unfortunate enough to get the flu, how do you know when it's safe to head back to work or to your regularly scheduled gym routine? Well, the flu affects people in different ways, so there's no one-size-fits-all timeline regarding when the virus will pass through your system and stop being contagious. "You can probably expect to be out of commission for a number of days, and most people who get the flu won't need to go to the hospital or take antiviral drugs," says Dr. Campbell. If your symptoms are really bad or you're at high risk of complications, you can ask your doctor for a prescription for an antiviral drug like Tamiflu, but know that it works best if taken within 48 hours of the first sign of sickness.

High-risk people include children younger than age 2, adults ages 65 and over, pregnant women, and people with underlying medical conditions such as lung disease (including asthma), heart disease, diabetes, and other chronic medical conditions, says Dr. Campbell.

Dr. Mangino says that you should regularly check your temperature to see if your illness is progressing. "If you're still coughing like a crazy person, blowing your nose multiple times every hour, you're not ready to go back to work," says Dr. Mangino. But once you are at the point where you have not had a fever for 24 hours—and you are not taking aspirin or another medication that could be masking a fever—it's generally safe for you to get out and about again. That said, use your best judgment, and listen to your body.

When it comes to getting back into the gym after being sick, similar guidelines apply. Everyone is different, but, "in general, you will want to get plenty of sleep, drink plenty of fluids, and remember to wait until you are at least 24 hours free of fever before you work out around other people," says Dr. Campbell. "Not all workouts are the same, and your return to physical activity may depend on how sick you were with the flu."

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