What's up with the flu?

February 2, 2018 Elizabeth Meade, MD

What is “the flu”?

When doctors refer to “flu” we mean influenza, which is a specific type of virus. Other things referred to as “the flu”, like “the stomach flu” are different – these aren’t actually influenza-related. Colds are also different and are caused by other types of viruses. It’s important to distinguish influenza infections from other viral illnesses because the treatment and the prognosis can be different. Influenza infections may cause symptoms similar to a common cold (cough, runny nose, headache) but often also comes with high fevers, fatigue, muscle aches, or “malaise.”

Why is it dangerous?

Influenza is miserable for most people, but most recover without long-term effects. However, every year tens of thousands of people (including hundreds of children) die from the flu or complications of the flu. Certain groups of people are at higher risk of serious illness and complications – young infants, older adults, pregnant women, anyone with a chronic illness or compromised immune system – but many, many of the people who become seriously ill or die every year are healthy kids and younger adults. People can develop pneumonia, , respiratory failure, and sepsis (an overwhelming infection) because of influenza – and we can’t always predict who this will happen to. One of the scariest things is how fast flu can kill – it might be just a day or two from the onset of symptoms to being seriously ill.

Do I need to see the doctor if I think I have the flu?

Anyone who has suspected influenza and is in one of the high-risk groups described above should be seen by a doctor right away. For otherwise healthy adults, those with mild-to-moderate symptoms can often get away with staying home and recovering, but make sure that you have someone to check on you frequently, and consider talking with your doctor at least by phone. People with severe symptoms – dehydration, confusion or altered mental status, repetitive vomiting, chest pain or pressure, or trouble breathing – should always be seen by a physician. Even if you are seen and discharged home, if you feel you are getting worse and need to be seen again, go back! You know your body best.

Where should I be seen?

For people with milder symptoms, start with calling your primary care doctor. Alternative options like “virtual visits” which take place remotely through your smartphone or computer, or in-home visits where a provider comes to your home, are other good options and can avoid crowded waiting rooms where you might spread germs around. For people with moderate symptoms or if you aren’t able to be seen by your primary care doctor, urgent care may be a good choice and often has shorter wait times than emergency rooms. But for anyone in a high risk category, with severe symptoms, or who is getting worse quickly – the ER is the best place to go.

How is the flu treated?

Most of the time, it’s what we call “supportive care” – keeping people comfortable and hydrated. Anti-viral medications like Tamiflu do have some role in shortening symptoms by a day or two, but work best if they are started within 24-48 hours of getting sick. These medications are usually recommended for children, other high risk groups, or hospitalized patients – but may be an option for others also if started early. Some people can get nausea, vomiting, and headache as side effects. If you are dehydrated, we may give you intravenous (IV) fluids to help you. For those who get sicker, they may need more intensive care like breathing tubs or other support.

I’ve heard the flu shot isn’t very effective this year – should I still get it?

The flu shot has different variability each season because the virus strains mutate every year. We do our best to anticipate which strains will be most prevalent but things sometimes change at the last minute. This year experts are estimating that it’s about 30% effective – but that doesn’t tell the whole story. Although the vaccine does not prevent 100% of people who get it from getting the flu, we do know that it decreases the severity of illness and risk of death. So even if you get the flu – if you’ve been vaccinated, you have a significantly lower chance of getting really, really sick and ending up in the ICU – or dying from the flu.

How else can I prevent the spread of flu?

If you think you have the flu – STAY HOME! Don’t go to work, don’t go to the grocery store, don’t go to the movies. Unless you are doing something essential like getting to the doctor, stay home and away from other people as much as possible. If you do have to go out, wash your hands, wear a mask, and cough into your elbow. Avoid any contact with people at high risk of complications or people who can’t be vaccinated for medical reasons.

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