You’ve probably seen the headlines: “After a slow start in October, flu season in the United States is gaining speed, particularly in the South. Flu activity, which has been increasing since the start of November, is now higher than usual for this time of year.” 
As of December 5th, flu has been widespread in four states, including Georgia, Oklahoma, Louisiana, and Massachusetts, the CDC reports.
What’s more, this year’s flu shot may not be up to the task. It is the same formulation that was used during Australia’s most recent flu season — which typically sets a pattern for what the U.S. will face — and it was only 10 percent effective there. 
So what can you do?
First you should follow everyday preventive actions that include:
• Avoid close contact with sick people
• While sick, limit contact with others as much as possible to keep from infecting them
• If you are sick, stay home for at least 24 hours after your fever is gone, except to get medical care or other necessities
• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it
• Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub
• Avoid touching your eyes, nose, and mouth. Germs spread this way
• Clean and disinfect surfaces and objects that may be contaminated with flue like germs
Additionally, if you get sick with the flu, antiviral drugs can be used to treat your illness. Antiviral drugs are different from antibiotics. They include oseltamivir, zanamivir, and peramivir, and the good news is — if you start them within 24-48 hours they are pretty effective, but if you wait, then the benefit is significantly less. Contact your doctor as soon as you get sick!
If you would like to improve your chances of getting thru this season with minimal time lost, you can also look at natural therapies for treatment and prevention.
There is no cure for the common cold or flu, but there are effective strategies for proactive prevention and for the reduction of symptom severity and duration.
This is the latest update on the scientific evidence for some of the herbal and nutritional supplements for the common cold and flu:
Black Elderberry (Sambucus nigra) has a long history of use for the common cold and flu.
Extensive research confirms that it has antiviral activity against influenza A and B by reducing hemagglutination and inhibiting viral replication, and decreasing symptoms and duration by an average of 4 days. 
Black elderberry may offer the additional benefit of reducing the risk of complications from upper respiratory viral infections. It also has antibacterial effects against pathogenic microbes that could cause bacterial super-infection in susceptible patients.
Finally, black elderberry appears to offer some proactive prevention against the common cold. 
Echinacea refers to a group of plant species, which includes Echinacea purpurea, Echinacea angustifolia, and Echinacea pallida, that contain similar active compounds (such as echinacosides and alkylamides) and have similar therapeutic effects. Preparations of the root contain compounds that most directly support an acute immune response, and preparations of the aerial parts provide ongoing immune support.
Echinacea slightly reduces the risk of getting a cold in healthy individuals, but the evidence for Echinacea in treating colds is weak. More evidence suggests that Echinacea is most beneficial for treating acute viral infections, when combined with additional herbs, and could be equally effective at reducing duration of illness as the antiviral medication oseltamivir and more effective at reducing flu complications. A combination of Echinacea, Thuja occidentalis, and Baptisia tinctoria have antibacterial efficacy against bronchial infections and is commonly used in Europe for acute upper respiratory infections. 
Guaifenesin (glycerol guaiacolate) is a synthetic version of an active compound that naturally occurs in the resin of the Guaiac tree (Guaiacum officinale). Guaifenesin was FDA-approved
as an over-the-counter medication for its expectorant and antitussive properties.
Guaifenesin may reduce the severity of cough and phlegm symptoms in patients with acute upper respiratory tract infections. 
English Ivy (Hedera helix) leaf extract has historically been used as a remedy for productive coughs and bronchial inflammation.
Studies have shown ivy leaf extract to have expectorant, antitussive, anti-inflammatory, and antiviral properties that matched or exceeded other common therapies, such as ambroxol or n-acetyl cysteine (NAC).
Ivy leaf extract contains essential oils, flavonoids, and saponins that are responsible for its soothing effect on bronchial passages. One specific saponin, hederacoside C, works on β2-adrenergic receptors on bronchial and alveolar cells, resulting in bronchodilation (similar to prescription Albuterol) and increases secretion of surfactant.
It is particularly indicated in those with bronchial irritation or a productive cough. 
Lactoferrin is an iron-binding protein present in milk, secreted in the gastrointestinal tract, and produced by white blood cells at the site of infected tissue.
Studies show that lactoferrin inhibits viral attachment to targeted cells. Lactoferrin also promotes a systemic immune response, enhancing NK cell activity and TH1 cytokine activity. It is proven in reducing the risk of the common cold and has potential protective effects against the influenza A virus. 
Probiotic bacteria, including Lactobacillus acidophilus, L. rhamnosus, and Bifidobacterium longum, supports a healthy microbial balance in the digestive system and modulates immune function.
Daily probiotic drink users experience a significantly lower incidence of the flu and reduce the risk of fever, runny nose, cough.
Probiotics support immune function and provide proactive prevention against viral respiratory infections. 
Pelargonium sidoides is a native plant of South Africa.
Extracts of P. sidoides contain polyphenols and other compounds that increase phagocytosis, stimulate ciliary activity, and have mucolytic effects. It has showed significant benefit for acute bronchitis in adults and children, also for sinusitis and the common cold. 
Vitamin D insufficiency is common in the general population, particularly in the elderly, and peaks during the winter months. Researchers have proposed that vitamin D insufficiency may be one mechanism to explain the seasonality of the common cold and flu.
Vitamin D is considered an immune modulator, helping the innate immune response halt replication of infected cells, and lessen the severity of symptoms of the common cold and flu, like body aches, fever, headache.
Vitamin D offers the greatest benefit for proactive prevention of respiratory infections. 
And the most important: Immune-Enhancing Lifestyle:
- Proactive prevention relies on healthy immune function, and healthy immune function relies on a balanced lifestyle
- Smoking cigarettes increases risk for upper respiratory infections and can worsen symptoms when sick
- Excessive alcohol consumption can also compromise immunity
- Moderate and routine exercise has a beneficial effect on immune function, but intense or prolonged bouts of exercise have the opposite effect
- Sleep and stress also vital for our immune function. The National Institutes of Health recommends that children sleep 10 hours per night and adults sleep 7-8 hours per night
- Participating in activities that you enjoy, nurturing healthy relationships, staying positive, and laughing every day will help to reduce the physiologic impact of stress on immune health
- Healthy dietary habits go a long way to strengthen immunity against the common cold and flu. The US Dietary Guidelines recommend adults eat 5-9 servings of fruits and vegetables per day. Unlike exercise, which is best in moderation, more fruits and vegetables provide greater benefits. Green leafy vegetables, cruciferous vegetables, mushrooms, dark berries, garlic, onions, ginger, and fermented foods provide antioxidants, micronutrients, and probiotics to support strong immune function
Please see my post: ” Cold Remedies: Advil or Aleve vs. Safer Alternatives?” on the benefits of other natural remedies.
For more information on how to stay healthy thru the cold and flu season, please schedule and appointment with Dr. Koganski at 215-750-7000 or www.NewtownInternalMedicine.com
 Krawitz C, et al. Inhibitory activity of a standardized elderberry liquid extract against clinically-relevant human respiratory bacterial pathogens and influenza A and B viruses. BMC Complement Altern Med. 2011;1116.
 Tiralongo E, Wee SS, Lea RA. Elderberry Supplementation Reduces Cold Duration and Symptoms in Air-Travellers: A Randomized, Double-Blind Placebo-Controlled Clinical Trial. Nutrients. 2016;8(4):182.
 Ross SM. Echinacea Formula (Echinaforce® Hotdrink): Effects of a Proprietary Echinacea Formula Compared With Oseltamivir in the Early Treatment of Influenza. Holist Nurs Pract. 2016;30(2):122-125.
 Albrecht H, et al. Patient-reported outcomes to assess the efficacy of extended-release guaifenesin for the treatment of acute respiratory tract infection symptoms. Respir Res. 2012;13(1):108.
 Smith SM, et al. Over-the-counter (OTC) medications for acute cough in children and adults in community settings. Cochrane Database Syst Rev. 2014;(11):CD001831.
 Wakabayashi H, et al. Lactoferrin for prevention of common viral infections. J Infect Chemother. 2014;20(11):666-671.
 Waki N, et al. Effects of probiotic Lactobacillus brevis KB290 on incidence of influenza infection among schoolchildren: an open-label pilot study. Lett Appl Microbiol. 2014;59(6):565-571.
 Agbabiaka TB, et al. Pelargonium sidoides for acute bronchitis: a systematic review and meta-analysis. Phytomedicine. 2008;15(5):378-385.
 Martineau AR, et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ. 2017;356:i6583.
English Ivy Guaifenesin