Cold and Flu Guidelines

The Flu is an infectious illness which affects the whole body and the lungs and is caused by the influenza virus.

There are three types of influenza virus: A, B, and C.

  • Types A and B are the most severe. The viruses change constantly and different strains circulate around the world every year. The body's natural defenses cannot keep up with these changes. Therefore, a person should get a flu shot each year.
  • Type C causes either a very mild illness, or has no symptoms at all. It does not cause epidemics and does not have the severe public health impact that influenza types A and B do.

Avian influenza, or bird flu, is an emerging subtype of the A strain virus. While highly contagious in birds, it does not usually infect humans. Several cases of human infection with bird flu viruses have occurred since 1997, primarily in Asia, parts of Europe, the Near East and Africa. The death rate for these reported cases has been about 60 percent. The virus is mainly transmitted to humans by direct contact with infected live, sick or dead poultry. However, it is thought that a few cases of human-to-human spread have occurred. 

While human-to-human spread has been rare and has not spread beyond one person, scientists are concerned that the virus could one day be able to be spread by human contact causing a worldwide outbreak of disease. Experts from around the world are watching the situation in Asia very closely and are preparing for the possibility that the virus may begin to spread more easily and widely from person to person.

Flu symptoms …

  • are more severe than those of colds.
  • come on abruptly.
  • include high fever, cough, and body and muscle aches.

Flu illness impacts your daily life by …

  • leading to school absenteeism.
  • leading to days off from work.
  • leading to complications such as pneumonia requiring hospitalization.
  • affecting all other aspects of normal daily activity.

The Flu Can Be Fatal In ... 

  • elderly people;
  • people with chronic diseases; and
  • anyone with a weak immune system.

Many people who become sick with the flu say it is like being hit by a truck. This decrease in quality of life, the shifting nature of the virus, and the danger of life-threatening complications, combine to make the flu a major public health problem.

Catching the Flu

Flu Symptoms In Adults…

If a person has a mild case, the flu may seem a lot like an ordinary cold. But more often, symptoms appear suddenly, and may include:

  • temperature of 101°F or above
  • cough
  • muscle ache
  • headache
  • sore throat
  • chills
  • tiredness
  • include high fever, headache, extreme tiredness, cough, sore throat, runny or stuffy nose, and body and muscle aches. Stomach symptoms such as nausea, vomiting or diarrhea may occur, but are more common in children than adults.

Most people recover from the flu within one or two weeks, but others, especially the elderly, may feel weak for a long time even after other symptoms go away.

SARS, a potentially more serious illness may start like the flu. Check with a health care provider immediately if complications such as difficulty breathing occur in areas where SARS is present.

Flu Symptoms In Children…

Flu symptoms in school-age children and adolescents are similar to those in adults. Children tend to have higher temperatures than adults, ranging from 103°F to 105°F. Flu in preschool children and infants is hard to pinpoint, since its symptoms are so similar to infections caused by other viruses.

If the symptoms mentioned above are present and the flu is in one's area, please contact a healthcare provider immediately.

What Can Be Done if You Get the Flu?

Treatment
There are effective treatments that can reduce the duration of the suffering caused by the flu and improve quality of life. See a healthcare provider as soon as flu symptoms appear to find out if these and other treatments are right for you.

The following antiviral medications are available to treat the influenza virus:

  • Oseltamivir (brand name: Tamiflu®)
  • Zanamivir (brand name: Relenza®)

These two medications, oseltamivir (Tamiflu®) and zanamivir (Relenza®) are members of a new class of drugs that act against both influenza types A and B, while the older medications amantadine (Symmetrel®) and rimantadine (Flumadine®) may be used to treat influenza type A only. Amantadine and rimantadine are not recommended for use during the 2008–2009 flu season due to high drug resistance to them in the circulating influenza virus strains.

Time is of the essence! Starting treatment with these medications within 2 days after flu symptoms appear will reduce the length of the illness and the severity of symptoms by at least 1 day. Early treatment can lead to faster results, enabling one to resume daily activities in a shorter amount of time.

NOTE: Be sure to tell a health care provider if one has a chronic lung disease such as asthma, because some precautions may be necessary if zanamivir (Relenza®) is prescribed. A person may need to have a fast-acting reliever bronchodilator on hand in case he or she has difficulty breathing; if that happens, call a health care provider and stop taking zanamivir (Relenza®).

NOTE: Some of the antiviral medications can be prescribed for children over one year of age. Consult a health care provider as soon as possible after flu symptoms appear, or whenever a child has a fever.

Symptom Relief

Over-the-counter medications can minimize discomfort associated with flu symptoms, but these medications do not treat the viral infection.

Aspirin should not be used in children under eighteen years old because it may play a role in causing Reye's Syndrome, a rare but severe liver and central nervous system condition.

Congestion, cough and nasal discharge are best treated with a decongestant, antihistamine or in combination. Many over-the-counter flu remedies contain both of these ingredients. (See Table 2 for more information on available products.) Check with a health care provider if one has chronic medical conditions such as thyroid disease or high blood pressure.

Adequate liquids and nutrition are necessary for rapid recovery and to prevent dehydration. Bed rest is also a good idea. Until symptoms are gone, it is not advisable to go back to full activity.

What Can You Do to Prevent Getting the Flu?

Prevention: FLU VACCINES
There are currently two vaccine options, the flu shot and the nasal spray vaccine. The shot gives more reliable protection and the spray is recommended only for non-high risk groups.

The best tool for preventing the flu is the flu vaccine, and the best time to get a flu vaccine is in September or October, or as soon as it is available. However, it's never "too late" to get a flu shot as it only takes about two weeks for the body to develop immunity to influenza. The flu season lasts through March and vaccination is offered and recommended throughout the season. A flu vaccine is recommended every year because the virus is constantly changing and new vaccines are developed annually to protect against new circulating strains.

Who Should Get a Flu Shot?

  •  All persons aged 6 months or older, including school children, who want to reduce the risk of becoming ill with influenza or of transmitting influenza to others and are not allergic to eggs.
  •  Adults 50 years or older.
  •  All children aged 6 months through 18 years.
  •  Adults and children with chronic medical conditions, especially asthma, other lung diseases, diabetes and heart disease.
  •  Adults and children with a suppressed immune system.
  •  All women who will be pregnant during the influenza season.
  •  Residents of nursing homes and other chronic care facilities.
  •  Health-care workers involved in direct patient care.
  •  Out-of-home caregivers and household contacts of children less than 6 months old.

Who Should NOT Get a Flu Shot?

You should NOT get the flu shot this year if …

  • you are allergic to eggs or any component of the vaccine. The viral material in flu vaccines is grown in eggs.
  • you are younger than 6 months.
  • you have a history of Guillain-Barre Syndrome.
  • you have an acute illness and a fever. You should not get a flu shot until you are feeling better.

Side Effects and Adverse Reactions to Flu Shots

  • The flu vaccine is made from a virus that is no longer active. Therefore, no one can catch the flu from a flu shot.
  • Less than one out of three people will develop soreness around the injection site for one or two days.
  • Fever, aches and pains are not common and more severe reactions are rare.
  • A recent American Lung Association study has proven that the flu shot does not increase asthma attacks.

Nasal Spray Vaccine

In June 2003, the FDA approved FluMist, an influenza vaccine that is the first nasally administered vaccine in the US. It is being billed as the painless alternative to the traditional flu shot. The FDA has approved FluMist only for healthy people between the ages of 2 and 49. The safety of FluMist has not been established in the elderly and people with chronic underlying medical conditions, such as asthma. These high-risk groups should avoid the nasal spray vaccine and receive the flu shot.

NOTE: No vaccine is 100% protective and the flu vaccine is no exception. Sometimes a person who has been vaccinated will still come down with the flu.

Prevention: ANTIVIRAL MEDICATIONS

Antiviral medications are not a substitute for vaccination, although physicians may prescribe them for people who cannot or have not taken the flu shot. Two of the antivirals have been approved for preventing the flu during the flu season.

Oseltamivir (Tamiflu®) and Zanamivir (Relenza®) can be used to prevent influenza A and B if it is taken before exposure to the virus. Both medications can also shorten the amount of time spent suffering from flu symptoms if started within two days of influenza onset. (See Table 1 for more information on available products).

Flu Complications

Pneumonia can be caused by the flu virus or by bacteria that get into the lungs when the body's defense system is weakened by the flu. See a doctor if you…

  •  have difficulty breathing;
  •  experience chest pain as a result of coughing; or
  •  are coughing up yellow green or bloody phlegm.

Other infections that may be associated with the flu include sinusitis, bronchitis and ear infections.

Post-infectious cough, usually without phlegm, may last for weeks to months after the flu symptoms go away and may keep a person up at night. This cough has been associated with asthma-like symptoms, and can be treated with asthma medications. Consult a healthcare provider if one has this kind of cough.

NOTE: If a person or his or her child has a complication such as pneumonia or a sinus or ear infection, a healthcare provider may prescribe antibiotics. While antibiotics are not useful in treating the flu, they may be necessary to clear up a related sinus or ear infection. Additionally, nasal decongestants and antihistamines can be used to briefly relieve nasal symptoms.

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