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Flu
(Influenza)

The flu is a common respiratory illness you get from the influenza
virus. Symptoms often include fever, head and body aches, coughing and a
stuffy or runny nose. You’re at risk for serious complications if you
have an underlying health condition or are pregnant. Getting vaccinated
every year is the best way to avoid getting sick with the flu.
Overview
What is the flu (influenza)?
The flu is an illness you get from the influenza virus. It causes
symptoms like head and body aches, sore throat, fever and respiratory
symptoms, which can be severe. Flu is most common in winter months, when
many people can get sick at once (an epidemic).
When is flu season?
Flu season — when cases of the flu go up dramatically — in the Northern
Hemisphere (which includes the U.S.) is October through May. The highest
number of cases (peak) usually happen between December and February.
How common is the flu?
The flu is one of the most common infectious diseases. Every flu season,
about 20 to 40 million people in the U.S. catch the flu.
What is the difference between the flu and the common cold?
The flu and the common cold can have similar symptoms, like runny nose
and cough. But cold symptoms are usually mild and flu symptoms can be
severe and lead to serious complications. Different viruses cause colds
and the flu.
How do I know if I have the flu or COVID-19?
Since they have similar symptoms, the only way to know for sure if you
have the flu or COVID-19 is to get tested. They both have a risk of
serious illness. But different viruses cause these infections, and
providers treat them with different medications.
Who is at higher risk for complications from the flu?
Certain health conditions can put you at higher risk for severe illness
from the flu. This includes life-threatening complications that require
hospitalization. You’re at higher risk for serious illness if you:
- Have asthma, COPD or
another chronic lung disease.
- Have a history of kidney, liver, neurological, heart or blood
vessels disease, including stroke.
- Have a condition that causes issues with muscle function or makes it
difficult to cough, swallow or clear fluids from your airways.
- Have diabetes.
- Have a weakened immune system (from HIV/AIDS, cancer or immunosuppressive
medications).
- Have a blood disorder, like sickle
cell disease.
- Have a BMI greater than 30 (have obesity).
- Are under 5 years old or over 65 years old.
- Are pregnant.
- Are under 19 years old and take aspirin regularly.
- Live in a long-term care facility.
Non-Hispanic Black people, non-Hispanic American Indians, Alaska Native
people and Hispanic or Latino people have the highest rates of severe
illness from the flu compared to non-Hispanic White people and
non-Hispanic Asian people.
Symptoms and Causes
What are the symptoms of the flu?
Symptoms of the flu usually come on quickly, and can include:
- Fever.
- Chills.
- Body aches.
- Cough.
- Headache.
- Sore throat.
- Runny or stuffy nose (congestion).
- Tiredness or feeling run down.
- Diarrhea or vomiting (usually only in kids).
You may not have all of these symptoms.
What causes the flu?
The influenza virus causes flu. Influenza A, B and C are the most common
types that infect people. Influenza A and B are seasonal (most people
get them in the winter) and have more severe symptoms. Influenza C
doesn’t cause severe symptoms and it’s not seasonal — the number of
cases stays about the same throughout the year.
H1N1 (“swine flu”) and bird
flu are both subtypes of influenza A.
Is the flu contagious?
Yes, the flu is contagious (it spreads from person to person). For every
person infected, they spread the flu to one to two more people.
How does the flu spread?
The influenza virus spreads from direct or indirect contact with someone
else who’s infected. Common ways to get the flu include:
- From someone nearby coughing, sneezing or talking. Droplets can
either get onto your hands or move through the air to get into your
nose or mouth. The flu then moves into your lungs.
- By touching a surface that’s contaminated by the flu virus, then
touching your face, nose, mouth or eyes. This includes things like
door knobs, desks, computers and phones.
- By touching the hands or face of someone who has the flu, then
touching your face, nose, mouth or eyes.
How long after exposure will I get the flu?
If infected, you’ll usually get symptoms of the flu one to four days
after exposure (incubation period).
Diagnosis and Tests
How is the flu diagnosed?
Your provider diagnoses the flu by listening to your
symptoms and testing a sample of mucus from your nose.
They’ll put a long stick with a soft tip (swab) in your nose
to test
for influenza. Results may take a few minutes or your
provider may send the sample to a lab, where you’ll get
results in a day or two.
Management and Treatment
How is the flu treated?
Providers can treat the flu with antiviral medications under
certain circumstances. Antivirals can
reduce your risk of severe illness and shorten the amount of
time you’re sick. Many people can treat the flu without
prescription medications. Providers prescribe antivirals if
you:
- Have had symptoms for under 48 hours. Antivirals are
less likely to work if you start them after two days of
symptoms. The virus has already made more copies of
itself and your body has started to fight it off with
its own antibodies.
- Have an underlying condition or are at risk for severe
illness. Providers may prescribe antivirals even if
you’ve had symptoms for longer than 48 hours.
- Have severe symptoms, even if you’ve been sick for
longer than 48 hours.
- Live with or care for people who are at risk for severe
complications of the flu.
What medications treat the flu?
Antiviral drugs for influenza include:
-
Oseltamivir phosphate (Tamiflu®). You take
oseltamivir by mouth as a pill or a liquid. You usually
take it for several days.
-
Zanamivir (Relenza®). You breathe zanamivir in
through your mouth with an inhaler.
You usually have to take it for several days. Zanamivir
isn’t recommended for people with breathing issues, like
asthma or COPD.
-
Peramivir (Rapivap®). Your provider gives you
peramivir directly into your veins using an IV. You
usually only need one dose of peramivir.
-
Baloxavir marboxil (Xofluza®). You take
baloxavir marboxil by mouth as a pill or a liquid. You
only take one dose. Baloxavir isn’t recommended if
you’re pregnant, breastfeeding, hospitalized or have
certain medical conditions.
Tell your provider about any health conditions you have
before starting an antiviral medication.
Side effects of treatment
Each antiviral medication has different side effects, but
common ones include nausea and diarrhea. Inhaled medications
can cause spasms that tighten and narrow your airways (bronchospasm).
How do I manage symptoms of the flu?
Many people can manage the symptoms of flu at home with
over-the-counter (OTC) medications and other therapies,
including:
- Getting plenty of rest.
- Drinking fluids like water or broth to help prevent
dehydration.
- Applying heat packs or hot water bottles can help with
aching muscles.
- Taking acetaminophen (Tylenol®) or NSAIDs (Advil®,
Motrin®, Aleve®) can help lower your fever and relieve
head and body aches.
- Using spray or oral decongestants like phenylephrine or
pseudoephedrine can help with a runny or stuffy nose.
- Taking cough suppressants (antitussives) like
dextromethorphan can help calm a nagging cough.
- Using expectorants like guaifenesin make it easier to
clear mucus out of your lungs.
Not everyone should take certain OTCs, so check with your
provider before you use them. It’s also a good idea to make
sure certain medications are okay to use together or with
supplements. Don’t give aspirin to children under the age of
16 unless their provider says it’s okay.
Outlook
What can I expect if I have the flu?
Most people are able to manage flu symptoms at home and
recover within a few days to a week. Because it can cause
severe illness, it’s important to keep an eye on your
symptoms and get medical attention if you need it. This is
especially important if you have an underlying health
condition.
If you’re sick with the flu, you should avoid being around
others, except to seek medical care.
How long does the flu last?
Flu can last from a few days to two weeks. Symptoms like
fever and body aches can come on suddenly but usually go
away faster than other symptoms. A cough or runny nose can
last longer.
How long is the flu contagious?
You can be contagious with the flu from a day before your
symptoms start to up to a week after. You’re most contagious
for three to four days after your symptoms start. People
with weakened immune systems and infants may be contagious
for longer.
When can I go back to work/school?
To avoid spreading the flu to others, you shouldn’t go back
to work or school until it’s been at least 24 hours since
you’ve had a fever (without taking fever-reducing
medications). Your employer or school may have different
requirements for returning.
Complications
The flu virus itself can cause complications or it can
weaken your immune system and allow bacteria to infect
different parts of your body (secondary infection).
Complications and secondary infections include:
- Ear infections.
- Sinus infections.
- Severe lung infection (pneumonia).
Pneumonia can lead to acute
respiratory distress syndrome (ARDS) and other
life-threatening conditions.
- Pregnancy loss (miscarriage).
- Neural tube defects (NTDs) in the developing fetus
of a pregnant woman.
How many people die from the flu each year?
In a typical flu season in the U.S., it’s estimated that
between 20,000 and 50,000 people die from the flu. Another
300,000 to 500,000 require hospitalization for serious
illness.
Prevention
How can I prevent the flu?
The best way to reduce your risk is to get the flu vaccine yearly.
You can get it as a shot or a mist sprayed into your nose.
The influenza virus can change (mutate) over time, so you
need to get vaccinated every year.
Other ways to reduce your risk of getting the flu include:
- Wash your hands often with soap and water. If you can’t
use soap and water, use an alcohol-based hand sanitizer.
- Cover your nose and mouth when you sneeze or cough.
Cough or sneeze into your elbow or a tissue rather than
your bare hand.
- Avoid being around other people when you or they are
sick with the flu or other infectious diseases.
- Consider wearing a mask if you’re sick and can’t avoid
being around others.
- Avoid touching your face, eyes, nose and mouth.
- Don’t share food or eating utensils (forks, spoons,
cups) with others.
Living With.
When should I see my healthcare provider?
If you think you have the flu, it’s important to get tested
early on so that antiviral medications are most effective if
your provider prescribes them. Contact a healthcare provider
right away if:
- You have flu symptoms and an underlying condition that
puts you at higher risk for severe illness.
- Your symptoms don’t start to improve after seven to 10
days or if you have a fever lasting longer than three
days.
- You’re pregnant and have a fever or other flu symptoms.
When should I go to ER?
Go to the ER or seek immediate medical attention if you have
symptoms of severe illness, including:
- High fever (over 103 F/40 C).
- Difficulty breathing.
- Not peeing or peeing very little.
Pain in your chest or stomach (abdomen) that doesn’t go
away.- Persistent dizziness.
- Confusion.
- Severe muscle pain or weakness.
- Seizures.
- Bluish skin, lips or nails (cyanosis, which can be a
sign of low
oxygen levels in your blood or tissues).
- Fever or cough that gets better or goes away but then
get worse.
- Worsening of other health conditions.
What questions should I ask my doctor?
- How do I take my medication?
- What over-the-counter medications can I use?
- How do I treat my symptoms at home?
- What severe symptoms should I look out for?
- When should I go to the ER?
- When should I follow up with you?
- How long might it take to feel better?
Additional Common Questions
Is the stomach flu influenza?
No, gastroenteritis, commonly called “stomach flu,” isn’t caused by
the influenza virus. It’s not related to the seasonal flu.
One Final Note..
While the flu is very common, it’s also important to remember that
it can lead to life-threatening complications. Getting your flu shot
is the best way to avoid getting sick and protect your loved ones
and neighbors, too. If you have underlying health conditions or are
pregnant, talk to your provider about reducing your risk of flu.
Having the flu isn’t fun for anyone, but most people can get through
with some movies and chicken soup at home.
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