Fall brings cooler temperatures, colorful leaves, and football games. It also means another flu season is upon us. Last year’s was rough. The CDC classified 2017-2018 a high severity season with high levels of outpatient clinic and emergency department visits for influenza-like illness, high influenza-related hospitalization rates, and widespread influenza activity across the United States for an extended period. The CDC estimates the flu caused between 140,000 and 710,000 hospitalizations and between 12,000 and 56,000 deaths annually in the U.S. since 2010. While estimates for last season won’t be available until later this fall, it’s likely that last season was record-breaking.

While It’s not possible to predict how severe the upcoming season will be, it’s important to start taking steps NOW to protect yourself and your loved from getting the flu.  Although complete immunity can’t be guaranteed, below is a list of 10 tips that might just protect you from getting sick this flu season:

  1. Get a flu shot

Getting a flu shot is the single best thing that you can do each flu season to protect yourself from severe illness. Seasonal flu shots — created to protect against three or four flu viruses that are believed to be the most common during a specific flu season — are vaccines that are usually injected into the arm with a needle. Flu vaccines trigger antibodies to develop in the body, usually within 2 weeks of having the shot. The antibodies provide protection against the strains of flu infection contained in the vaccine. Although the flu shot may have side effects in some people, it cannot cause flu illness.

The flu vaccine saved 40,000 lives in the U.S. between 2005 and 2014 and can even decrease the likelihood of complications and death — even when infection fails to be prevented. So who should get the flu shot? According to the CDC, it is recommended that everybody over the age of 6 months get an annual flu vaccination. Several flu shots are available depending on age, whether you are pregnant or if have a chronic health condition.

  1. Practice good health habits

As well as getting vaccinated, good health habits also act as a line of defense against the flu. Flu is extremely contagious, able to spread from one person to another standing within 6 feet via droplets produced when coughing, sneezing, or talking or by touching contaminated surfaces. A study that was conducted by the University of Maryland in Balitmore found that those with flu contaminate the air around them simply by breathing. Other research demonstrated that one single doorknob or tabletop could spread a virus to 40–60 percent of workers and visitors within just 2–4 hours of contamination. The findings highlight the importance of good hygiene practices in the workplace and public places plus the need to go home as soon as possible when symptoms of flu begin.

Following a few simple steps can minimize the spread of flu viruses:

  • Avoid close contact with those who are sick or other people if you are sick.
  • If you have flu-like symptoms, stay home from school or work for at least 24 hours after your fever has disappeared.
  • Use a tissue to cover your nose and mouth when sneezing and coughing. Dispose of the tissue immediately after use.
  • Regularly wash your hands with soap and water or an alcohol-based hand rub.
  • Try not to touch your eyes, nose, or mouth without first washing your hands to ensure they are germ-free.
  • Clean and disinfect surfaces that people come into contact with at work, school, or home.

Research conducted by the University of Michigan in Ann Arbor indicated that hand hygiene and wearing surgical masks reduced the spread of flu-like symptoms by up to 75 percent in university residence halls.

  1. Keep the windows closed

Although cracking a window next to your sneezing office neighbor might give you peace of mind — since theoretically, it would help circulate out infected air — chances are it won’t do much to protect you. According to Dr. Amesh Adalja, MD, an infectious disease physician, spokesperson for the Infectious Diseases Society of America, and senior scholar at Johns Hopkins University for Health Security,”unless someone literally sticks their head out the window or moves out to the fire escape, opening the window won’t have any measurable benefits once the flu virus is in the air.” FWIW, the flu virus’s outer coating hardens in cold, which helps it remain viable while passing between people, according to researchers of a 2008 study published in Nature Chemical Biology.

  1. Maintain your immune system

The immune system protects your body from infection. When it is in tiptop shape and functioning properly, the immune system launches an attack on threats — such as flu viruses. For most individuals, the immune system does a good job of regulating itself. But immune system disorders, allergies, asthma, medications, and autoimmune diseases can all impact how well the immune system works.

You can benefit your whole body, including your immune system, by implementing healthy living strategies, such as: (1) consuming a fruit- and vegetable-rich diet, (2) exercising frequently, (3) aiming for a healthy BMI, (4) sleeping for 7–9 hours each night and (5) reducing stress.

Studies have also produced some interesting findings surrounding the immune system and flu:

Vitamin D supplements have been demonstrated to halve the risk of respiratory infections such as flu in people with low baseline vitamin D levels. Vitamin D plays a vital role in the functioning of the immune system.

Lactobacillus brevis — a type of lactic acid bacteria — from a pickled turnip that is popular in Japan was found to be protective against flu infection in mice by increasing immune system molecules in the body.

Flavonoids, which are found in blueberries, red wine, and black tea, may help to control immune response by working with gut microbes to protect against severe flu infections.

Regular moderate exercise could cut respiratory infections by one third, while strenuous exercise may cause a two- to sixfold increase in the risk of infection. These findings show that physical activity can have either a positive or negative effect on the function of the immune system.

  1. Give sick sleeping partners their own pillow, and have them sleep on their own side

Like other communal surfaces, blankets and pillows, particularly in shared beds, can host the flu virus for about 24 hours. Although it’s best to avoid sharing a bed with an infected partner — particularly when he or she is coughing or sneezing — you can avoid infection by keeping to yourself once in bed, and changing the linens if your partner steals your pillow. In the same vein, if flu-infected roommates take up residence on the couch, have them use their own pillows and blankets, or avoid snuggling up in the same spot for 24 hours.

  1. REST

Yes, the flu can make you sick, but guess what? Stress can, too: People who report psychological stress are less likely to develop protective antibodies in response to the flu vaccine, according to a 2009 review of 13 existing studies, which was published in Brain, Behavior, and Immunity. “It’s important not to become completely obsessed and compulsive,” Dr. Adalja says. “During a flu season like this, when the virus is spreading among humans in every type of environment and community, you’re going to be exposed to it — even if you live in an overly sterile environment.”

  1. Clean your home

Flu germs and viruses love to lurk on items you touch every day. Some hot spots for germs are: kitchen sponges, dishcloths, cutting boards, home desks, floors, sinks and toilets.  Clean and disinfect these hot spots regularly. You can microwave your kitchen sponge for one minute on a high setting to zap germs. Better yet, throw it out.

If someone in your household has the flu, take special care when washing their things. Wash dishes and silverware thoroughly by hand or in the dishwasher. You don’t have to do a sick person’s laundry separately, but try to avoid scooping up an armload of items and holding them close before washing them. Use laundry soap and dry on a hot setting. Always wash your hands immediately after handling dirty laundry

  1. Quit smoking

Quitting smoking could be a useful preventative measure against flu — not only for you but also for your children, family, or anyone else who lives with you. People who smoke have a more exaggerated response to viruses, including the flu. Flu virus symptoms that are often mild in those who do not smoke could have a severe effect on people who do. For example, smokers are more likely to die than non-smokers during flu epidemics.

Researchers at the Yale School of Medicine in New Haven, CT, conducted an experiment that revealed that exposure to cigarette smoke from two cigarettes per day for 2 weeks triggered an overreaction in the immune system of mice when exposed to the flu virus. Although the mice’s immune systems cleared the flu virus normally, there was inflated inflammation and higher levels of tissue damaged than would be expected. These findings suggest that flu severely affects people who smoke not because they can’t fight it off, but because their immune system overreacts to the virus.

Lead author Dr. Jack A. Elias, the chair of internal medicine at Yale School of Medicine, compared the reaction of smokers with using a sledgehammer rather than a fly swatter to get rid of a fly. The University of Rochester Medical Center in New York also discovered that “children who are exposed to secondhand smoke” have a higher chance of needing intensive care and longer hospital stays when hospitalized with flu.

  1. Clean communal surfaces at least once a day

The flu virus can remain viable without a host for about 24 hours, according to Dr. Adalja. “In general, all household surfaces are going to be contaminated with the flu virus if you’re living with someone who has the flu,” he says, adding that about 25 percent of people who become infected experience no symptoms but can still be contagious. It’s why you should wipe down commonly-touched surfaces — think phone chargers, fridge handles, and light switches — at least once a day using any standard household cleaner, regardless of whether anyone in your household is sick. Before you drop a paycheck on cleaning supplies, remember that “going above and beyond to clean surfaces still isn’t an iron-clad way to avoid the flu, because there are so many opportunities for the virus to spread directly between humans in a shared environment,” Dr. Adalja says.

  1. Limit contact with family members who are ill

If someone in your family does get the flu, take these steps to prevent the flu from spreading:

  • Keep the sick person at home.
  • Limit close contact between the sick person and other family members as much as you can while they’re contagious. In general, this is up to a week after they show symptoms.
  • Change sleeping arrangements, if possible.

You should also avoid sharing the following items from the sick person: washcloths, towels, dishes, toys and utensils