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It Is Flu Season – Let’s deal With It!

The Difference Between the Flu and the Common Cold

Influenza (flu) is a contagious respiratory illness caused by influenza viruses, often resulting in mild to severe illness. Those more serious outcomes of flu infection can result in hospitalization or even death. Most people who get sick with flu will have mild illness. They usually do not require medical care and most often recover in less than two weeks. First, let’s make sure we differentiate between the flu and common cold. Below is a comparative chart defining the differences:

Signs and Symptoms Cold Influenza (Flu)
Symptom onset Gradual Abrupt
Fever Rare Usual; lasts 3-4 days
Aches Slight Usual; often severe
Chills Uncommon Fairly common
Fatigue, weakness Sometimes Usual
Sneezing Common Sometimes
Chest discomfort, cough Mild to moderate; hacking cough Common; can be severe
Stuffy nose Common Sometimes
Sore throat Common Sometimes
Headache Rare Common

Who is at Greater Risk

Most people who get sick with flu will have mild illness. They usually do not require medical care and most often recover in less than two weeks. There is a significant population who are more susceptible to the disease though and require more aggressive interventions. The populations at-risk are more likely to develop complications from the flu and may result in hospitalization or even death. Pneumonia, bronchitis, sinus infections and ear infections are examples of flu-related complications. Flu also can make chronic health problems worse. For example, people with asthma may experience asthma attacks while they have flu and people with chronic congestive heart failure may experience a worsening of this condition triggered by flu.

Below are the groups of people who are more likely to develop more serious flu-related complications:

  • Adults 65 Years and Older
  • Pregnant Women
  • Young Children
  • Asthmatics
  • Patients with a history of Heart Disease & Stroke
  • Diabetics
  • Individuals with HIV/AIDS
  • Cancer Patients
  • Children with Neurologic Conditions

Although not inclusive, those major early warning signs and symptoms which patients must pay particular attention to include:

Children:

  • Fast breathing or trouble breathing
  • Bluish lips or face
  • Ribs pulling in with each breath
  • Chest pain
  • Severe muscle pain (child refuses to walk)
  • Dehydration (no urine for 8 hours, dry mouth, no tears when crying)
  • Not alert or interacting when awake
  • Seizures
  • Fever above 104°F
  • In children less than 12 weeks, any fever
  • Fever or cough that improve but then return or worsen
  • Worsening of chronic medical conditions

Adults:

  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest or abdomen
  • Persistent dizziness, confusion, inability to arouse
  • Seizures
  • Not urinating
  • Severe muscle pain
  • Severe weakness or unsteadiness
  • Fever or cough that improve but then return or worsen
  • Worsening of chronic medical conditions

 

Sinus and ear infections are examples of moderate complications from flu, while pneumonia is a serious flu complication that can result from either influenza virus infection alone or from co-infection of flu virus and bacteria. Other possible serious complications triggered by flu can include inflammation of the heart (myocarditis), brain (encephalitis) or muscle (myositis, rhabdomyolysis) tissues, and multi-organ failure (for example, respiratory and kidney failure). Flu virus infection of the respiratory tract can trigger an extreme inflammatory response in the body and can lead to sepsis, the body’s life-threatening response to infection. Flu also can make chronic medical problems worse. For example, people with asthma may experience asthma attacks while they have flu, and people with chronic heart disease may experience a worsening of this condition triggered by flu.

High risk individuals who develop flu-like symptoms should obtain medical care immediately to avoid additional major consequences of the flu.

Three Methods Endorsed by the CDC to Manage Flu Season

According to the U.S. Centers for Disease Control and Infection (CDC) in Atlanta, the three most effective methods of managing flu are:

  1. Immunization
  2. Preventive Measures
  3. Treatment

I. CDC IMMUNIZATION RECOMMENDATIONS

Everyone 6 months of age and older should get a flu vaccine every season with rare exception (see below). Vaccination is particularly important for people who are at high risk of serious complications from influenza.

Flu vaccination has important benefits. It can reduce flu illnesses, doctors’ visits, and missed work and school due to flu, as well as prevent flu-related hospitalizations.

Flu vaccine also has been shown to be life-saving in children. A CDC Study published in Pediatrics in 2017 revealed that flu vaccination significantly reduced a child’s risk of dying from influenza. The study, which examined data from four flu seasons between 2010 and 2014, found that flu vaccination reduced the risk of flu-associated death by half (51 percent) among children with underlying high-risk medical conditions and by nearly two-thirds (65 percent) among healthy children. The study findings underscore the importance of the recommendation by CDC and the American Academy of Pediatrics that all children 6 months and older get an annual flu vaccine.

Different flu vaccines are approved for use in different groups of people. There are flu shots approved for use in children as young as 6 months of age and flu shots approved for use in adults 65 years and older. Flu shots also are recommended for use in pregnant women and people with certain chronic health conditions.  The nasal spray flu vaccine is approved for use in non-pregnant individuals, 2 years through 49 years of age. People with some certain medical conditions should not receive the nasal spray flu vaccine.

There are many vaccine options to choose from, although the CDC does not recommend one flu vaccine over another. Of greatest importance – almost all people 6 months of age and older to get a flu vaccine every year.

Who Should Not Receive a Flu Shot:  There are some members of the population who should not consider flu immunization, though. Factors that can determine a person’s suitability for vaccination, or vaccination with a particular vaccine, include a person’s age, health (current and past) and any relevant allergies.

  • People with Guillain-Barre syndrome – The CDC says some people with a history of Guillain-Barre syndrome (GBS) should not get a flu vaccine. GBS is a neurologic condition that attacks the peripheral nervous system, causing muscle weakness and, in severe cases, paralysis.
  • Infants under 6 months old – The flu vaccine is not approved for babies under 6 months of age. Thus, the rationale exists for pregnant women to get vaccinated to enhance the potential for the infant to have circulating maternal antibodies.
  • People who are extremely ill – Those with a very high fever and/or pneumonia should only consider a flu shot after they recover. However, once recovered, a flu shot is appropriate and beneficial. Patients should always consult their physician if these circumstances exist.
  • Populations that should avoid the nasal flu vaccine – The nasal spray-mist type of flu vaccine is an option for some people ages 2 to 49 years old, as long as they’re healthy. It contains live virus and is not recommended for certain people, including:
    • Children younger than 2
    • Adults 50 and older
    • Pregnant women
    • People with a history of severe allergic reaction to a previous flu vaccine or any vaccine ingredient
    • Children 2 to 17 receiving aspirin or medicines containing salicylate (an aspirin ingredient used for relieving pain or inflammation)
    • People with weakened immune systems, such as those with cancer
    • Children 2 to 4 years old with asthma or a history of wheezing in the past year
    • People who have taken antiviral drugs for the flu within the past 48 hours
    • People who care for extremely immune-compromised patients (unless they avoid any contact with these people for 7 days after getting the nasal flu vaccine)
  • Special Consideration Regarding Egg Allergy – People with egg allergies can receive any licensed, recommended age-appropriate influenza (flu) vaccine (IIV, RIV4, or LAIV4) that is otherwise appropriate. Although, people who have a history of severe egg allergy (those who have had any symptom other than hives after exposure to egg) should be vaccinated in a medical setting, supervised by a health care provider who is able to recognize and manage severe allergic reactions.

Scheduling Vaccinations

A flu vaccine should be administered before flu viruses begins spreading in the community, since it takes about two weeks after vaccination for antibodies to develop in the body and provide protection against flu. Individuals should plan vaccination early in fall, before flu season begins. CDC recommends that people get a flu vaccine by the end of October. Getting vaccinated later, however, can still be beneficial and vaccination should continue to be offered throughout the flu season, even into January or later. Getting vaccinated early (for example, in July or August) is likely to be associated with reduced protection against flu infection later in the flu season, particularly among older adults. Children who need two doses of vaccine to be protected should start the vaccination process sooner, because the two doses must be given at least four weeks apart.

II. CDC-RECOMMENDED PREVENTIVE MEASURES

As we have already discussed, the single best way to prevent seasonal flu is to get vaccinated each year. But there are other good health habits that should be employed as well.

  • Avoid close contact with people who are sick – Keeping an effective distance will help prevent the spread of infection.
  • Staying home when sick – If possible, stay home from work, school, and errands when you are sick. This will help prevent spreading your illness to others.
  • Cover mouth and nose when coughing or sneezing – Flu and other serious respiratory illnesses, like respiratory syncytial virus (RSV), whooping cough, and severe acute respiratory syndrome (SARS), become airborne and may spread when coughs and sneezes are unobstructed.
  • Hand Hygiene – Washing hands often will help protect individuals from infection. If soap and water are not available, an alcohol-based hand rub is a suitable alternative.
  • Avoid touching eyes, nose and/or mouth – Organisms are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.
  • Practice other good health habits – Clean and disinfect frequently touched surfaces at home, work or school, especially when someone is ill. Additionally, effective sleep, physical activity, stress management, fluid intake and effective nutrition will al assist in preventing flu.

Nonpharmaceutical Interventions (NPIs)Everyday preventive actions, like nonpharmaceutical interventions (NPIs), are actions – apart from getting vaccinated or taking medicine – that people and communities can take to help slow the spread of illnesses like influenza (flu). Some of those more common measures include:

At School:

  • Parents can determine if there is a childcare program that is activated in the event of an outbreak of flu or another illness occurs, and whether flu vaccinations are offered on-site.
  • Parents should determine if the school routinely cleans frequently touched objects and surfaces, and whether they have an adequate supply of tissues, soap, paper towels, alcohol-based hand rubs, and disposable wipes on-site.
  • Determine whether students and staff are separated from others and who will care for them until they can go home.

At Work

  • Determine the employer’s plans if an outbreak of flu or another illness occurs, and whether flu vaccinations are offered on-site.
  • Routinely clean frequently touched objects and surfaces, including doorknobs, keyboards, and phones, to help remove germs.
  • Make sure the workplace has an adequate supply of tissues, soap, paper towels, alcohol-based hand rubs, and disposable wipes.
  • Assure there is adequate staff backup in the event employees are absent due to illness.
  • When individuals become ill, they must go home as soon as possible.

III. CDC-RECOMMENDED TREATMENT MEASURES

Antiviral drugs – Most people with flu have mild illness and do not need medical care or antiviral drugs, but if flu symptoms persist or persons are in a high-risk group, they should contact a health care provider immediately. CDC recommends prompt treatment for people who have flu infection or suspected flu infection and who are at high risk of serious flu complications, such as people with asthma, diabetes or heart disease. Antiviral medications may be prescribed to treat symptoms, although the following considerations should be heeded:

  • Antiviral drugs can treat flu illness
  • Antiviral drugs are different from antibiotics. Flu antivirals are prescription medications (pills, liquid, intravenous solution, or an inhaled powder) and are not available over-the-counter
  • Antiviral drugs can make illness milder and shorten time of illness.
  • Antivirals also can prevent serious complications of flu like pneumonia or others described above.
  • Antiviral drugs must be used early.
  • Most otherwise-healthy people who get flu may not need to be treated with antiviral drugs.

Studies show that flu antiviral drugs work best for treatments when they are started within 2 days of getting sick. However, starting them later can still be helpful, especially if the sick person has a high-risk health condition or is very sick from flu (for example, hospitalized patients). Follow your doctor’s instructions for taking these drugs.

Other Interventions

According to the CDC, additional measures can be taken to limit the course of the disease in individuals as well as prevent the spread of infection.

  • While sick, limit contact with others as much as possible to keep from infecting them.
  • Cover nose and mouth with a tissue during a cough or sneeze. Discard the tissue properly in the trash.
  • Wash hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.
  • Clean and disinfect surfaces and objects that may be contaminated with germs like flu.
  • If flu-like illness persists, CDC recommends that individuals remain home for at least 24 hours after the fever subsides, except to get medical care or for other necessities. The fever should subside without the use of fever-reducing medication.

SUMMARY

Good health habits will often help prevent the infection of the flu virus in individuals. Effective sleep, nutrition and exercise are a few of those measures discussed above. If flu does occur, medications and other interventions are appropriate, although we must understand that the flu cannot be cured – but the length of tine infected as well as the control of symptoms CAN be managed. As always, good common sense will help prevent and treat such a common occurrence in our society today.

 

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