The holiday's uninvited guest -- flu season

That situation has led the U. S. Centers for Disease Control and Prevention (CDC) to express concern that the 2003-04 flu season may be brutal. Now is the time to consider talking with your doctor about a prescription for pills that can serve as a back-up to the vaccine, and shield people who did not get vaccinated.

In a run-of-the-mill flu season, which lasts from November to March, about 1 in 4 people in the United Sates get influenza..

Influenza is more serious than the sniffles and sneezes of a common cold. Flu means days of headache, chills, body aches, fever, sore throat and other misery. Serious complications put 100,000 people in the hospital each year, and kill 50,000-70,000.

Flu vaccine is the main way to avoid that fate. If you haven't been vaccinated this year, do it now -- especially if you're in the high-risk category for flu's complications.

That includes people who are age 50 or over; have chronic diseases involving the heart, lungs, or kidneys; have diabetes; or will be more than 3 months pregnant during flu season.

People who live in households with high risk individuals also should make a point of getting vaccinated, to reduce the risk that they get flu and spread it.

You need a fresh vaccination every year because flu viruses mutate, or change their genes, a little over time, putting new flu viruses into circulation. Scientists usually start preparing the new vaccine in March, based on the flu viruses then circulating.

If new strains later appear, the vaccine won't be as effective as usual. The virus pulled such a surprise this year. The vaccine does not exactly match that strains that are causing illness in Texas and Colorado.

Four prescription anti-viral medicines are available as back-ups -- Tamiflu, Relenza, Flumadine, and Symmetrel. Each is a little different, and the doctor can decide which is best.

They can help prevent flu in healthy people who have not gotten flu vaccine, or when outbreaks involve flu strains not covered by the vaccine. They also work as a stop-gap measure in people vaccinated during an outbreak, protecting during the 14-28 day period needed for the vaccine to work.

In addition, the drugs are a treatment which ease symptoms in people who have flu, allowing a faster return to work or school.

The drugs work best if taken right after symptoms appear or right after a flu outbreak occurs in a community. Of course, that may be the worst time to seek a quick prescription, with doctors busy caring for seriously ill people.

Instead, CDC suggests discussing anti-flu drugs with the doctor in advance to see if they are right. If so, the doctor may pre-authorize a prescription that can be used quickly during community-wide flu outbreaks.