Dr. John Ruskey, senior medical director at AtlantiCare Urgent Care, believes people can avoid winter illnesses, for the most part, by following some simple, common sense rules mothers routinely set down for their children.

Ruskey recommends: hand washing, especially when in contact with people; staying away from people who are sick; and receiving a flu shot.

"The flu season lasts from October to May. But January and February is the peak season," said Ruskey, a doctor of osteopathic medicine, who added it's not too late to arrange for a flu shot this winter. "The people who generally need flu shots the most are the very young and the very old."

A flu shot is recommended for anyone older than

6 months. The very young, whose parents would have to arrange their flu shots, are preschoolers and the elementary-school age children, Ruskey said. On the other end of the age spectrum, it is just as important those age 65 and older receive a flu shot as it is for the youngsters, Ruskey said. Also, those whose immune system is compromised through diabetes, heart or lung disease should make the extra effort to schedule a flu shot, the doctor said.

Unpleasant consequences can follow people who skip receiving a flu shot.

A person can come down with a severe case of bronchitis, pneumonia and in rare cases, death. You may lose income because you missed work to stay home to recover from the flu. You also may spread the illness to other people, Ruskey said.

Ruskey and other AtlantiCare representatives have heard all the excuses why people avoid receiving flu shots, including "I do not get the flu, so I do not need the vaccine."

The vaccine not only keeps people from becoming ill, but it also helps keep individuals' viral load down when exposed to the flu. Being vaccinated keeps the flu virus from replicating within individuals, which decreases their ability to spread the virus to co-workers, loved ones and others.

When it comes to washing hands, five seconds with water only will not cut it, said Dr. Jenny Cook of Cape Regional Physician Associates' Seaville office.

"Patients should be aware that the best thing to wash their hands with is soapy water for at least 15 seconds, but if unavailable, then, a hand sanitizer may be used," said Cook, who added the flu vaccine is still available in the Cape Regional Physician Associates offices.

Karen Byerly, of Ocean City, receives a flu shot annually.

Byerly works with Easter Seals, a nonprofit charitable organization that assists children and adults with autism, other disabilities and special needs. Byerly also has two teenage children - Ian, 17, and Erin, 15. Mom doesn't want to pass on or receive illnesses from either the people she works with or her children.

"I try to stay at least 6 feet away from someone who's coughing," said Byerly, who drinks four cups of water daily, sleeps eight hours per night and exercises daily.

Medical advice to avoid winter illnesses breaks into two categories. There are specific things a person can do that are more applicable during cold and flu season, and there are overall wellness practices that are useful during the winter months because they boost a person's immune system.

Alexis Brown, of Vineland, doesn't think she ever had the flu.

Even though Brown doesn't bother with flu shots, she does other things that keep her from being ill often. Brown washes her hands all the time. Brown carries hand sanitizer with her. She eats balanced meals that include vegetables. For exercise, Brown walks a great deal around the very hilly campus of Fairleigh Dickinson University, College at Florham in Madison, Passaic County, where she is a junior studying radiology technology.

"I try to avoid sick people. I cover my mouth when I cough," said Brown, 20.

Gregory Carson, medical director of Shore Urgent Care in Northfield, said if a healthy person is exposed to the flu, they will come down with the flu. There is no genetic disposition that can keep a person from contracting the flu.

"If you have been lucky because you are young and healthy (and have avoided the flu), that doesn't stop them from getting it," Carson said.

Doctors tell patients not to smoke and following that advice also helps people avoid winter illness, Carson said. Tobacco decreases the mobility of the nose and lung cilia - slender, microscopic, hair-like structures that extend from the surface of nearly all cells in mammals. The lung cilia sweeps dirt and disease-causing organisms towards the mouth. Smoke slows the beating of the cilia at first, then paralyzes it and eventually makes it disappear.

Dr. Mavola Tench, a family medicine doctor who practices in Minotola and is a part of the Inspira Health Network, said some people take either a Vitamin C supplement before winter starts or Zinc drops to shorten the time they have a cold, and there have been some studies on this, Tench said.

"The most important thing is handwashing," said Tench, who added if you sneeze or cough into your hands, it's important not to touch your face until your wash your hands.

For people who already have a sore throat, gargling with saltwater for 30 seconds is very helpful, Tench said. If a person can set aside enough time in a day to sleep for eight hours per night, a well-rested body also will boost the immune system and help fight off winter illnesses, Tench said.

Contact Vincent Jackson:

609-272-7202

Is it the flu?

Flu symptoms the Centers for Disease Control warn about include:

•Fever or feeling feverish/experiencing chills (although not all who have the flu have a fever)

•Sore throat

•Runny or stuffy nose

•Muscle or body aches

•Headaches

•Fatigue

•Some people may have vomiting and diarrhea, although this is more common in children than adults.

If you experience these symptoms, stay away from other people as much as possible. Remain home for at least 24 hours after your fever is gone.