The wisdom mothers have been dispensing for ages — wash your hands, eat your vegetables, go to bed earlier — turns out to be great advice for avoiding the flu.
Doctors and nutritionists say careful hygiene, a balanced diet and plenty of rest and fluids can go a long way toward keeping people healthy during the influenza season, especially considering this year's vaccine shortage.
"Taking care of yourself from a health standpoint is probably the best thing you can do," said Dr. R. Michael Gallagher, a family physician and dean of the University of Medicine and Dentistry of New Jersey's School of Osteopathic Medicine.
"People who are run down, they're overworked, not getting proper rest or proper nutrition, these people increase their risk" of illness, he said.
Besides getting enough sleep — at least seven hours a night for adults and more for youngsters — managing stress is important, Gallagher said, because too much can weaken one's immune system.
Frequent hand-washing, using soap and hot water and rubbing vigorously for about half a minute, also is crucial.
"What you want to do it is try to interrupt transmission of disease with the kinds of things our mothers taught us," said Dr. Mitchell Cohen of the federal Centers for Disease Control and Prevention.
Avoid touching your eyes, nose or mouth, because germs on your hand could infect you, he said. And, if you do get the flu, stay home from work or school so you don't infect others.
The United States will get only half its expected supply of flu vaccine this year because British health authorities suspended the license of vaccine producer Chiron Corp. at the company's Liverpool, England, factory because of contamination.
Cohen said the CDC is planning two public education campaigns, first to explain the shortage and who should or shouldn't get vaccinated, and second to teach people how to protect themselves through hygiene and "cough etiquette."
The old advice was to cough or sneeze into your hands, then wash them, but children and many adults don't wash up immediately. That means they can spread the flu virus or other germs via a handshake or touching a doorknob, computer keyboard or other surface, where those germs can live for hours. Now doctors are urging that, if a tissue isn't at hand, people — especially children — should sneeze into their sleeve.
"Doctors have been emphasizing this in the last several years," said Dr. Ron Davis, an American Medical Association trustee and preventive medicine specialist.
Davis said hand sanitizers are a good option when soap and water aren't available, but anti-bacterial soaps offer little benefit.
Another new piece of advice is to stop refilling the bottles of water so many of us carry.
The bottles accumulate germs and shouldn't be reused or shared, said American Dietetic Association spokeswoman Gail Frank, a professor of nutrition at California State University-Long Beach. But don't skip the water, because eight glasses of fluid a day is essential to health, aiding in almost every process in the body.
People, especially the elderly and those in poor health, also should avoid crowds and people who are coughing or sneezing, said Dr. Michele Bachhuber, an internal medicine specialist at Marshfield Clinic in Marshfield, Wis.
"Regular exercise helps boost our immune system, so that's important, too," she said.
Then there's the role of diet. Frank said it's crucial to eat a healthy and substantial breakfast, about one-fourth of the day's calories.
Variety in the diet is important, but people should emphasize plant foods, including whole grains and at least five servings of fruits and vegetables a day, said Elisa Zied, another American Dietetic Association spokeswoman and a registered dietitian in New York.
She said people can help keep their immune system strong by eating foods rich in vitamins A, C and E: milk, eggs and fish oil; citrus fruits, melons and red peppers; and nuts, spinach, peanut butter and corn oil.
Moms, doctors and health officials have been dispensing most of this advice for decades, but many people clearly forget or ignore it.
"We always worry about the healthy behavior fading over time as the crisis subsides, so we have to keep reminding people about the benefits of good hygiene and vaccination and taking care of themselves," said Davis, of the AMA. "I expect that people will listen more carefully ... because many people are going to have a hard time getting their flu shot."