Just as seasons change, there are seasonal variations to the illnesses that we care for in the emergency department. Influenza, or “flu,” is a contagious seasonal respiratory virus. The exact timing and duration of flu seasons can vary but influenza activity often begins to increase in October, peaking between December and February. Activity can last as late as May.
The virus can live on surfaces for two to eight hours, a stealthy way to attack the unsuspecting victim. It is spread by coughing, sneezing and even talking to those within six feet of us. People will be contagious from one day before showing symptoms and up to seven days after becoming sick.
There are four types of influenza virus: A, B, C and D. Human Influenza A and B cause seasonal epidemics. Type C influenza causes mild respiratory symptoms and does not cause epidemics. Type D influenza primarily affects cattle and is not known to cause illness to humans.
Let me set the record straight: the influenza vaccine does NOT give you the flu. There are several vaccine types available. All the injections on the market use an inactivated, or dead, form of the virus.
Influenza viruses are constantly changing and this is the reason why a new vaccine is necessary each year. The most common side effects from the influenza shot are soreness, redness, tenderness or swelling at the site of the shot. Low-grade fever, headache and muscle aches also may occur. The vaccine can either prevent the flu or, in the event you get ill, lessen the severity of your symptoms.
Flu usually comes on suddenly. People who are sick with flu often feel some or all of the following symptoms:
· Sore throat
· Runny or stuffy nose
· Muscle or body aches
· Fatigue (tiredness)
Some people may have vomiting and diarrhea, though this is more common in children than adults.
Most people who get flu will recover in a few days to less than two weeks but some people will develop complications (such as pneumonia) because of flu, some of which can be life-threatening and result in death.
People who are high risk of developing very serious influenza-related complications include people 65 years and older; people of any age with certain chronic medical conditions, such as asthma, diabetes, or heart disease; pregnant women and children younger than five years but especially those younger than two years old. Please refer to CDC.gov for a complete list of medical illnesses that may place you at high risk.
A clinician makes a flu diagnosis based on symptoms and sometimes by rapid diagnostic tests, although these can provide false negatives. Patients with a simple case of the flu who are not in a high risk category or who don’t have underlying medical illnesses can be treated at home.
What are the emergency warning signs of flu sickness that mean you should come to the emergency department? In children, these include:
· Fast breathing or trouble breathing
· Bluish skin color
· Not drinking enough fluids
· Not waking up or not interacting
· Being so irritable that the child does not want to be held
· Flu-like symptoms improve but then return with fever and worse cough
· Fever with a rash
In adults, these include:
· Difficulty breathing or shortness of breath
· Pain or pressure in the chest or abdomen
· Sudden dizziness
· Severe or persistent vomiting
· Flu-like symptoms that improve but then return with fever and worse cough
In addition to the signs above, get medical help right away for any infant who:
· Is unable to eat
· Has trouble breathing
· Has no tears when crying
· Produces significantly fewer wet diapers than normal
A common question from parents and local school systems is when should children return to the classroom. It is safe to go back to school 24 hours after the fever has resolved.
Remember some simple rules and practice common sense. If you have a fever you are contagious. Cover your mouth when you cough or sneeze and don’t forget to wash your hands with soap and water. Hand sanitizers are a short fix and option until you find running water. Don’t forget to clean your work station and computer terminal and phones. You would be amazed to what is growing there right now. Stay healthy – go get your flu shot today! As Benjamin Franklin said, an ounce of prevention is worth a pound of cure.
Dr. Willette is a residency trained, board certified emergency medicine specialist with 27 years of experience. He is a clinical professor at Ohio University and works for US-Acute Care Solutions at Mercy Health.