Flu

Is this your symptom?

  • The flu is a viral infection of the nose, pharynx (throat), larynx (voice box), and airways of the lung.
  • The main symptoms are cough, fever, runny nose, and sore throat.
  • The medical term for the flu is influenza.

Symptoms

People often have symptoms 2 to 3 days after being exposed to the flu. Symptoms of the flu include:

  • Cough
  • Fatigue
  • Fever
  • Headache
  • Muscle aches
  • Runny nose
  • Sore throat
  • Vomiting or diarrhea

Symptoms often start quickly. Symptoms are much like the common cold. They include runny nose, sore throat, and a bad cough. However, the fever is usually higher (102 - 104° F; 38.9 - 40° C) with flu than with a cold. Headaches and muscle aches are also worse with the flu.

Cause

  • The flu is caused by the influenza virus.
  • Flu viruses change (mutate). Each year the flu virus is slightly different. This is why some people seem to get influenza every year. Flu season occurs every year, often during the fall and winter. During these months, about 5 to 40% of people get sick with the flu each year.

Diagnosis

  • Often people can diagnose this problem at home by asking themselves three questions. Is it flu season? Are other people getting the flu? Do the symptoms match the symptoms of flu?
  • A doctor (or other health-care provider) can diagnose the flu by taking a history (asking questions) and performing a physical exam. A flu test (nasal swab) is sometimes used to diagnose the flu.

How It Is Spread

  • The flu virus is in the nasal mucous or drainage.
  • Every time a person with the flu coughs or sneezes, germs are sprayed into the air.
  • Germs can be found on tissues and handkerchiefs. Germs often get on the hands after a person coughs or sneezes.

Prevention - How to Keep from Getting the Flu

The best way to prevent getting the flu is to get a yearly flu vaccine (nasal spray or shot).

Remember to also:

  • Wash your hands often with soap and water. This is especially important after shaking hands with a person who has the flu.
  • Avoid touching your own nose and face. The most likely way to get sick is to touch your nose after having touched something with the flu germs on it.
  • Avoid hugging or kissing people who are sick with the flu. Avoid shaking their hands.

Prevention - Stop the Spread of Germs to Others!

  • Cover your mouth and nose with a tissue or a cloth when you cough or sneeze.
  • Wash your hands often with soap and water, especially after you cough or sneeze. You can use an alcohol-based hand cleaner if soap and water are not available.
  • Don't shake hands when you are sick.

The CDC recommends that people with flu stay at home until their fever has been gone for a full 24 hours:

  • Do NOT go to work or school.
  • Do NOT go to church, child care centers, shopping, or other public places.
  • Do NOT shake hands.
  • Avoid close contact with others (hugging, kissing).

Complications

  • The flu is usually not serious in healthy adults. Most people with the flu do not need to be seen by a doctor. They can treat their flu at home.
  • However, sometimes the flu can move into the lungs and cause pneumonia. It can cause dehydration. It can make diabetes, heart failure, and lung problems (such as asthma) worse.

Adults at HIGH RISK for Complications

Experts at the Centers for Disease Control and Prevention (CDC) say that some adults are at HIGH RISK for more serious problems from the flu. These people include:

  • Persons 65 years and older
  • Persons younger than 19 years old who are taking aspirin long-term
  • Persons with a weak immune system, such as from cancer treatment, long-term steroid treatment, or HIV infection
  • Persons who are morbidly obese
  • Persons with lung, heart, kidney, and heart problems
  • Persons with sickle cell anemia
  • Persons with diabetes
  • Persons with nervous system problems such as stroke, seizures, and spinal cord injury
  • Persons living in nursing homes and other long-term care facilities
  • Women who are pregnant or who gave birth in the past two weeks
  • American Indians and Alaskan Natives

There are antiviral drugs that can be used to treat flu. The CDC recommends that these medicines be used in people who are at high risk for problems from the flu. They also recommend them for people with severe flu symptoms.

When to Call for Flu

Call 911 Now

  • Severe trouble breathing (struggling for each breath or cannot speak)
  • Lips or face are blue
  • Very weak (can't stand)
  • You think you have a life-threatening emergency

Call Doctor Now or Go to ER

  • Headache and stiff neck (can't touch chin to chest)
  • Chest pain (Exception: mild chest pain that lasts only a few seconds when coughing)
  • Fever over 103° F (39.4° C)
  • Fever over 100.4° F (38.0° C) and over 60 years old
  • Fever and have diabetes
  • Fever and have a weak immune system from:
    • HIV
    • Cancer chemo
    • Long-term steroid use
    • Splenectomy
  • Fever and are bedridden (nursing home patient, stroke, chronic illness, or recovering from surgery)
  • You are at HIGH RISK of problems from the flu (See List in Causes; such as age over 64, pregnant, chronic illness)
  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Fever and sinus pain (not just pressure or fullness)
  • Fever lasts more than 3 days
  • Fever returns after being gone for over 24 hours, and symptoms are worse or not better
  • Sore throat lasts more than 5 days
  • You think you need antiviral medicine and flu symptoms started less than 48 hours ago
  • You think you need to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Sinus pain (not just pressure or fullness) lasts more than 24 hours, after using nasal washes
  • Sinus pressure or fullness lasts more than 10 days
  • Runny nose lasts more than 10 days
  • Cough lasts more than 3 weeks
  • You have other questions or concerns

Self Care at Home

  • No serious symptoms and you are NOT at HIGH RISK for problems from the flu

Care Advice

Home Care Treatment for the Flu

  1. What You Should Know:
    • For most healthy adults, the flu feels like a bad cold. People often confuse the flu and the common cold. People tend to get the flu only once every few years. It is common to have a couple of colds each year.
    • You do not have to see a doctor if you have the flu, unless you are very sick or at High Risk for problems.
    • Usually, you treat the flu in the same way you treat a common cold.
    • Here is some care advice that should help.
  2. For a Runny Nose - Blow the Nose:
    • Runny noses help to wash viruses and bacteria out of the nose.
    • Blowing the nose is all that is needed.
    • The skin around your nostrils may get irritated. You can rub a tiny amount of petroleum ointment on it 1 to 2 times a day.
  3. For a Stuffy Nose - Use Nasal Washes:
    • Salt water washes are a good way to treat a stuffy nose. You can pour, spray, or squirt salt water into your nose. Then let the water run back out.
    • How It Helps: The salt water rinses out mucus, dust, and allergens. It also keeps the nose moist.
    • Methods: There are a few ways to do nasal washes. You can use a:
      • Saline nasal spray bottle (sold over-the-counter)
      • Rubber ear syringe
      • Medical syringe without the needle
      • Neti Pot
  4. How to Do Nasal Washes:
    • Step 1: Lean over a sink.
    • Step 2: Gently squirt or spray warm salt water into one of your nostrils.
    • Step 3: Some of the water may run into the back of your throat. Spit this out. If you swallow the salt water it will not hurt you.
    • Step 4: Blow your nose to clean out the water and mucus.
    • Step 5: Repeat steps 1-4 for the other nostril. Do this 2 or 3 times a day if it helps you feel better.
  5. How to Make Salt Water Nasal Wash:
    • You can make your own salt water nasal wash.
    • Add ½ tsp of table salt to 1 cup (8 oz.; 240 ml) of warm water.
  6. Treatment of Other Flu Symptoms:
    • For muscle aches, headaches, or fever (over 101°F; over 38.9°C): Take acetaminophen (Tylenol) or ibuprofen (Advil, Motrin).
    • Sore throat: Try throat drops, hard candy, or warm chicken broth.
    • Cough: Use cough drops.
    • Feeling dry and thirsty: Drink liquids. Stay well-hydrated.
  7. Humidifier: If the air in your home is dry, use a cool mist humidifier.
  8. No Aspirin: Do not use aspirin to treat fever or pain.
  9. What to Expect:
    • Fever may last 2 to 3 days.
    • Runny nose may last 3 to 7 days.
    • Cough may last 2 to 3 weeks.
  10. Return to School or Work:
    • Do NOT go to work, school, church, child care centers, or other public places while you still have a fever. Avoid close contact with others (hugging, kissing).
    • You can return to school and work after your fever has been gone for 24 hours.
  11. Call Your Doctor If:
    • Trouble breathing
    • Fever lasts more than 3 days
    • Runny nose lasts more than 10 days
    • Cough lasts more than 3 weeks
    • You think you need to be seen
    • You get worse

Over-the-Counter Medicines for Cough, Runny Nose, and Stuffy Nose

  1. Runny and Stuffy Nose Medicines:
    • Most cold drugs that are sold over-the-counter (OTC) are not helpful.
    • Antihistamines are only helpful if you also have nasal allergies.
    • If you still think you need medicine, try using a nasal decongestant.
  2. Nasal Decongestants for a Very Stuffy or Runny Nose:
    • Nasal decongestants can help you breathe better. They reduce the amount of nasal drainage. They may be taken as pills by mouth or as a nasal spray.
    • Most people do NOT need to use these medicines.
    • Pseudoephedrine (Sudafed): This is sold OTC, but it is kept behind the drug store counter. You will need to ask the pharmacist or clerk for it. Normal adult dose is two 30 mg tablets every 6 hours.
    • Phenylephrine (Sudafed PE): This is sold OTC in pill form. Normal adult dose is one 10 mg tablet every 4 hours.
    • Oxymetazoline Nasal Drops (Afrin): These are sold OTC. Blow your nose to clean out the mucus before using. Spray each nostril once. Wait one minute, and then spray a second time.
    • Phenylephrine Nasal Drops (Neo-Synephrine): These are sold OTC. Blow your nose to clean out the mucus before using. Spray each nostril once. Wait one minute, and then spray a second time.
    • Read the instructions on the package insert for all medicines you take.
  3. Warning - Nasal Decongestants:
    • Do not take these drugs if you are pregnant.
    • Do not take these drugs if you have high blood pressure, heart disease, an enlarged prostate, or an overactive thyroid.
    • Do not take these drugs if you have taken a MAO inhibitor drug in the past 2 weeks. Very serious, harmful side effects can occur. Examples of MAO drugs include isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate).
    • Do not use nasal decongestants for more than 3 days.
    • Read the warnings on the package insert for all medicines that you take.
  4. Cough Medicines:
    • Over-the-Counter (OTC) Cough Syrups: Some people find that cough syrups help decrease coughing. Dextromethorphan is the most common cough suppressant in OTC cough syrups. Often the letters "DM" appear in the name.
    • OTC Cough Drops: Cough drops can help a lot. They work best for mild coughs. They soothe the tickling feeling in the back of the throat. Cough drops are easy to carry with you.
    • Home Remedy - Hard Candy: Hard candy works just as well as OTC cough drops. Diabetics should use sugar-free candy.
    • Home Remedy - Honey: Honey has been shown to help decrease coughing at night. The adult dose is 2 teaspoons (10 ml) at bedtime.
  5. OTC Cough Syrup - Dextromethorphan (DM):
    • Cough syrups with DM in them may help your cough. Cough syrups work best for coughs that keep you awake at night. They can help with a dry, hacky cough at the end of a cold or flu. They can be used along with cough drops.
    • Examples: Benylin, Robitussin DM, Vicks 44 Cough Relief
    • Read the instructions on the package insert for all medicines that you take.
  6. Caution - Dextromethorphan (DM):
    • Do not try to stop coughs if you are coughing up phlegm. Coughing is helpful in bringing up mucus from the lungs. This helps keep you from getting pneumonia.
    • Research Notes: Some research shows DM helps a cough get better. Other research shows it has little to no effect.
    • Drug Abuse: DM has become a drug of abuse.
    • Do not take DM if you have taken a MAO inhibitor in the past 2 weeks. These include: isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate).
    • Do not take this drug if you are taking venlafaxine (Effexor).
  7. Call Your Doctor If:
    • You have more questions
    • You think you need to be seen
    • You get worse

Over-the-Counter Medicines for Fever and Pain (Headache, Muscle Aches)

  1. Fever and Pain Medicine:
    • For fever above 101° F (38.3° C) or pain you can take acetaminophen (Tylenol) or ibuprofen (Advil, Motrin).
    • They are over-the-counter (OTC) drugs. You can buy them at the drugstore.
    • The goal for treating fever is to bring it down to a comfortable level.
    • Fever medicine usually lowers fevers by 2° F (1 - 1.5° C).
    • Use the lowest amount of a drug that makes your fever or pain feel better.
    • Acetaminophen is safer than ibuprofen in people over 65 years old.
    • Read the instructions and warnings on the package insert for all medicines you take.
  2. Call Your Doctor If:
    • You have more questions
    • You think you need to be seen
    • You get worse

Prescription Antiviral Medicines for the Flu

  1. What You Should Know:
    • There are antiviral drugs that can be used to treat influenza. The two most commonly prescribed drugs are oseltamivir (Tamiflu) or zanamivir (Relenza).
    • To get the most benefit, these drugs must be started within 48 hours of when flu symptoms start.
    • The benefit of these drugs are limited in healthy adults. The may decrease the time you are sick by 1 to 2 days. They help reduce the symptoms, but do not make them go away.
    • The CDC recommends that antiviral drugs be used for people at High Risk for flu problems. They also recommend them for people with severe flu symptoms.
  2. Call Your Doctor If:
    • You have more questions
    • You think you need to be seen
    • You get worse

The Flu Vaccine

  1. What You Should Know:
    • All adults should get a flu vaccine (nasal spray or shot) every year. Protect yourself and your family!
    • You should get it in the fall before the start of flu season. However, it is never too late.
    • It is especially important for people over 65 years old and people at High Risk for getting severe problems from the flu.
    • A Vaccine Information Statement (VIS) for the flu vaccine shot is available from the CDC.
    • A Vaccine Information Statement (VIS) for the flu nasal spray vaccine is available from the CDC.
  2. Call Your Doctor If:
    • You have more questions
    • You think you need to be seen
    • You get worse

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Last Reviewed: 8/18/2017 1:15:41 AM
Last Updated: 5/7/2017 1:36:06 PM

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