Robert N. Hunold Robert N. Hunold, D.O., a family practitioner at Miles Medical Group in Wiscasset, could teach Tedy Bruschi a thing or two about defense, at least when it comes to blocking the flu. (Photo Barbara Martin)

Just because the snow banks are melting, the sun now shines after 6 p.m. and the first day of spring is circled on your calendar, don't think the flu has made its last run at you this season. The flu is flexing its muscles in Maine and creating its own version of March Madness along the Midcoast.

"It's prime time for the flu," said Dr. Robert N. Hunold, "But there is still time to get a flu shot."

Dr. Hunold is a Family Practitioner, and a member of the Miles Medical Group in Wiscasset. He's also a good guy to have on your side when facing a fight. Before earning his medical degree from the University of New England in Biddeford, he served as a U.S. Navy pilot. Defense is his game.

He shared a copy of a Maine Public Health Alert that was sent to many health care providers in the state from Dora Anne Mills, M.D., and Public Health Director for the Maine Center for Disease Control. It was short but emphatic.

• Subject: Widespread Influenza Activity in Maine

• Priority: High

Dr. Hunold explained that the Maine CDC sends updates regularly so there's no need to pack up the kids and head for Canada. However, it does make sense to take any of those unwanted "bugs" that come calling seriously.

He explained that Maine is under attack from Influenza A and B, with Influenza A bringing a sub-strain along for back up. In a press release dated February 26, the Maine CDC announced that this year's vaccine has not been as effective against all three of the flu types trying to make our acquaintance as they had hoped. Yet, they agreed with Dr. Hunold, recommending vaccination for all. The release also "strongly encouraged those persons at risk of more severe disease" to get the point… so to speak.

The press release listed the following groups as needing the most attention:

• Children from the ages of six months to four years.

• Adults over age 50.

• Women who will be pregnant during the flu season.

• Persons with health conditions that place them at risk from complications of the influenza.

• Residents of long term care facilities

• Health care workers and those who have contact with people at risk of complications.

According to Dr. Hunold, the Center for Disease Control in Washington D. C. has the annual assignment of "teasing out the virus" that will be most likely win the best achiever award in the next flu season. The CDC starts this process early in the year in preparation of the coming storm of symptoms.

One important telltale is the type of virus that is active in the South Pacific prior to the start of our flu season. Viruses often begin their migration to our shores from that area of the world. So taking an early peek at what is alive and well there can be a good prognosticator of what we'll be facing in the fall of the year. The CDC then develops and distributes the vaccine that all of us flu-phobics will be clambering for as the threat nears, and those of us who procrastinate will be searching for as friends and family begin to succumb.

Even though this year the CDC didn't hit the bulls-eye with their antiflu recipe, Dr. Hunold said that there is a 70 to 90 percent chance of immunity within 30 days of receiving the vaccine, and he agrees that even a bad defense is better than none.

He was also willing to field questions that could be attributed to all those "old wives" and their never-ending tales. When asked what is the difference between a cold and the flu, he actually said, "That's a good question," pleasing this old wife.

"The main difference between a cold and the flu is how quickly the virus attacks the system," Hunold said. A cold comes on at a slower pace with less severity. People with a cold often continue to keep to their schedules, not felled, just slowed down a bit.

"With the flu, you experience a rapid on-set of fever, cough, headaches and the need to get to bed," he said. However, Dr. Hunold urges patients to come in as quickly as possible for help. "Medication is most effective during the first 24 to 48 hours," he said.

O.K., then what about those tales we hear that there is nothing the medical system can do to cure the flu, once we have it, and that antibiotics, are powerless against a virus?

Good news Mainers - Dr. Hunold said that doctors can prescribe anti-viral drugs that will shorten and diminish the symptoms of the flu. They may also help patients avoid developing more serious conditions that can result from a bout with the flu, such as pneumonia or bronchitis. And don't worry, antibiotics still have their place and often serve as treatments for those post-flu problems.

The bad news is that there really is no good reason not to haul yourself out of bed when you feel the worst to visit the doctor, and it's not a bad idea to consider bringing family members who are at risk of more serious complications for a flu shot. Dr. Hunold also put to rest another misconception that the flu is usually identified by the dreaded gastro-intestinal symptoms that brings the mighty among us to their knees.

"GI symptoms are caused by a virus but are not generally a part of the symptoms we see from influenza," he said. "Shorter in duration, the GI symptoms usually last for between 24 and 48 hours but can also be treated with other anti-viral drugs."

When it comes to prevention, Dr. Hunold, the Maine CDC and its national counterpart echo the same precautions, and sorry mom, none of the experts listed wearing a hat as an important deterrent"

• Wash your hands frequently.

• Cover your cough and sneezes.

• Drink fluids regularly and stay rested to maintain a strong immune system.

• Get a flu shot.

The national CDC also provides ongoing updates about the success of the flu in various parts of the country as the season progresses, starting in the month of September. This year they reported that "influenza activity" was low through the month of December and peaked nationwide by February 16, with the following week showing a decrease in the number of reported cases.

However being the independent Mainers that we are, we've been just too stubborn to be beaten by a full frontal flu attack. Leave it to a virus to sneak up on us unannounced, while we had already started planning for spring planting and summer sailing.

For more information, go to www. mainepublichealth.gov and www. cdc.gov.