Influenza or the “Flu”

By Roland Larrabee, M.D.

Influenza, or the flu, is a virus infection of the air passages. Significant outbreaks of the flu occur almost every year, usually in the early winter.

Each season a different strain of flu virus may be responsible for an outbreak. In some years, the flu strain may be particularly severe and cause many deaths, particularly if pneumonia develops. There are two types of influenza: Type A and Type B. Type A flu tends to be more severe than Type B.

Flu is spread from person to person by virus-infected droplets that are coughed or sneezed into the air. In some people, a bacterial infection that causes pneumonia may also occur. This is particularly common in people who have chronic conditions, such as heart disease, asthma, chronic bronchitis, kidney disease, or diabetes. These are known as “comorbid conditions.” Pneumonia is one of the leading causes of death in people over the age of 65 and often occurs during and after flu outbreaks.

Flu symptoms usually last seven to 10 days and may include: chills and fever (100 to 102 degrees F, 37.8 to 38.9 degrees C); sore eyes and throat; runny nose; weakness, tiredness, and muscle aches; headache, which may be severe; cough and loss of appetite.

The symptoms of flu are easy to recognize, particularly during a seasonal outbreak. Many people tend to diagnose and treat themselves. However, you should always see your healthcare provider if:

• you are over the age of 65
• you suffer from heart disease, asthma, chronic bronchitis, kidney disease, or diabetes.
• your symptoms become more severe, or if you begin to cough up phlegm. This may indicate you have pneumonia.

Most people with influenza respond well to rest, fluids, and nonprescription medications to ease symptoms. Ibuprofen or acetaminophen is useful for fever, headache, and muscle aches. Cough medicine may help your cough. If you develop pneumonia, your health care provider will prescribe antibiotic medication. If started within 48 hours of onset of your symptoms (seventy-two hours at the latest), there are anti-viral medications that can dramatically reduce symptoms and duration of the flu. To receive this treatment benefit, you must visit your physician within this time frame. These medications include amantidine, rimantidine, Tamiflu®, and Relenza®.

For prevention, it is recommended that you have a flu shot in the early fall (except if you are allergic to eggs). Because the flu virus strain may vary from year to year, you need to get a new flu shot each year. Since influenza can last into the spring, it is never too late to receive the vaccine. It takes two weeks to develop at least some protection. Vaccination against pneumococcal pneumonia is also important after age 65, but unlike influenza vaccine, this only needs to be given once or twice after age 65.

The Center for Disease Control recommends the following receive their flu shot beginning October 1, 2005:

• Persons aged 65 years and older with or without comorbid conditions
• Persons aged 2-64 years with comorbid conditions
• Children aged 6-23 months
• Pregnant women
• Residents of long-term care facilities
• Health care workers providing direct patient care
• Out-of-home caregivers and household contacts of children aged <6 months
• Displaced hurricane persons aged 6 months or older living in crowded group settings

All other persons can start receiving their flu shot beginning October 24, 2005.

You can help yourself by doing the following:

• Protect your lungs by not smoking. If you smoke, quit.
• Ask your health care provider about getting your flu and pneumococcal pneumonia shots.
• If your flu symptoms become more severe, or if you begin to cough up phlegm, call your health care provider. This may indicate you have pneumonia. Stay in bed and drink plenty of fluids.
• Use nonprescription medication, such as ibuprofen, acetaminophen, and cough medicine, to relieve symptoms.
• Follow the treatment prescribed by your provider. Finish all your medication.