Flu (Influenza)

The flu is an infection of the nose, throat, and lungs. It spreads easily.

This article discusses influenza types A and B. Another type of the flu is the swine flu (H1N1).

Influenza A; Influenza B; Oseltamivir (Tamiflu) – flu; Zanamivir (Relenza) – flu

The flu is caused by an influenza virus.

Most people get the flu when they breathe in tiny airborne droplets from the coughs or sneezes of someone who has the flu. You can also catch the flu if you touch something with the virus on it, and then touch your mouth, nose, or eyes.

People often confuse colds and flu. They are different, but you might have some of the same symptoms. Most people get a cold several times a year. On the contrary, people get the flu only once every few years.

Sometimes, you can get a virus that makes you throw up or have diarrhea. Some people call this the “stomach flu.” This is a misleading name because this virus is not the actual flu. The flu mostly affects your nose, throat, and lungs.

Flu symptoms will often start quickly. You can start to feel sick about 1 to 7 days after you come in contact with the virus. Most of the time symptoms appear within 2 to 3 days.

The flu spreads easily. It can affect a large group of people in a very short amount of time. For example, students and co-workers get sick within 2 or 3 weeks of the flu’s arrival in a school or workplace.

The first symptom is a fever between 102°F (39°C) and 106°F (41°C). An adult often has a lower fever than a child.

Other common symptoms include:

• Body aches
• Chills
• Dizziness
• Flushed face
• Headache
• Lack of energy
• Nausea and vomiting

The fever, aches, and pains begin to go away on days 2 through 4. But new symptoms occur, including:

• Dry cough
• Increased symptoms that affect breathing
• Runny nose (clear and watery)
• Sneezing
• Sore throat

Most symptoms go away in 4 to 7 days. The cough and tired feeling may last for weeks. Sometimes, the fever comes back.

Some people may not feel like eating.

The flu can make asthma, breathing problems, and other long-term (chronic) illnesses and conditions worse.

Most people do not need to see a health care provider when they have flu symptoms. This is because most people are not at risk for a severe case of the flu.

If you are very sick with the flu, you may want to see your provider. People who are at high risk for flu complications may also want to see a provider if they get the flu.

When many people in an area have flu, a provider can make a diagnosis after hearing about your symptoms. No further testing is needed.

There is a test to detect the flu. It is done by swabbing the nose or throat. Most of the time, test results are available very fast. The test can help your provider prescribe the best treatment.

HOME CARE

Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) help lower fever. Providers sometimes suggest you to use both types of medicine. DO NOT use aspirin.

A fever does not need to come all the way down to normal. Most people feel better when the temperature drops by 1 degree.

Over-the-counter cold medicines may make some of your symptoms better. Cough drops or throat sprays will help with your sore throat.

You will need a lot of rest. Drink plenty of liquids. DO NOT smoke or drink alcohol.

ANTIVIRAL DRUGS

Most people with milder symptoms feel better in 3 to 4 days. They do not need to see a provider or take antiviral medicines.

Providers may give antiviral drugs to people who get very sick with the flu. You may need these medicines if you are more likely to have flu complications The health problems below may increase your risk of getting sicker with the flu:

• Lung disease (including asthma)
• Heart conditions (except high blood pressure)
• Kidney, liver, nerve, and muscle conditions
• Blood disorders (including sickle cell disease)
• Diabetes
• A weakened immune system due to diseases (such as AIDS), radiation therapy, or certain medicines, including chemotherapy and corticosteroids
• Other long-term medical problem

These medicines may shorten the time you have symptoms by about 1 day. They work better if you start taking them within 2 days of your first symptoms.

Children at risk of a severe case of the flu may also need these medicines.

Millions of people in the United States get the flu each year. Most people get better within a week or two, but thousands of people with the flu develop pneumonia or a brain infection. They need to stay in the hospital. About 36,000 people in the United States die each year of problems from the flu.

Anyone at any age can have serious complications from the flu. Those at highest risk include:

• People over the age of 65
• Children younger than 2 years old
• Women who are more than 3 months pregnant
• Anyone living in a long-term care facility
• Anyone with chronic heart, lung, or kidney conditions, diabetes, or a weakened immune system

Complications may include:

• Pneumonia
• Encephalitis (infection of the brain)
• Meningitis
• Seizures

Call your provider if you get the flu and think you are at risk for having complications.

Also, call your provider if your flu symptoms are very bad and self-treatment is not working.

You can take steps to avoid catching or spreading the flu. The best step is to get a flu vaccine.

If you have the flu:

• Stay in your apartment, dorm room, or home for at least 24 hours after your fever has gone.
• Wear a mask if you leave your room.
• Avoid sharing food, utensils, cups, or bottles.
• Use hand sanitizer often during the day and always after touching your face.
• Cover your mouth with a tissue when coughing and throw it away after use.
• Cough into your sleeve if a tissue is not available. Avoid touching your eyes, nose, and mouth.

The Centers for Disease Control and Prevention (CDC) recommends that everyone 6 months and older should receive the influenza vaccine. For the 2016-2017 season, CDC recommends use of the flu shot (inactivated influenza vaccine or IIV) and the recombinant influenza vaccine (RIV). The nasal spray flu vaccine (live attenuated influenza vaccine or LAIV) should not be used during 2016-2017.

Aoki FY. Antiviral drugs for influenza and other respiratory virus infections. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 44.

Centers for Disease Control and Prevention. What you should know about flu antiviral drugs. Updated August 11, 2016. www.cdc.gov/flu/antivirals/whatyoushould.htm. Accessed August 31, 2016.

Havers FP, Campbell AJP. Influenza viruses. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 258.

Hayden FG. Influenza. In: Goldman L, Schafer AI, eds. Goldman’s Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 364.

Jefferson T, Jones M, Doshi P, et al. Neuraminidase inhibitors for preventing and treating influenza in healthy adults and children. Cochrane Database Syst Rev. 2014;(4):CD008965. PMID: 24718923 www.ncbi.nlm.nih.gov/pubmed/24718923.

Provider Information: Influenza VISs. Updated September 2015. www.cdc.gov/vaccines/hcp/vis/vis-statements/flu-hcp-info.pdf. Accessed April 18, 2016.