Seasonal Influenza – Treatment and Prevention

The flu is a serious illness, having caused about 36,000 deaths per year between 1990 and 1999. Influenza outbreaks tend to occur in the winter months and peak over a two- to three-week period. Most people attacked by the virus do not become very sick, but some people, including the elderly and the chronically ill, are at high risk of illness, hospitalization and death.

Influenza viruses are spread between people by coughing and sneezing. Adults can spread the virus from the day before symptoms begin until about six days later. Very young children and people with poor immune systems can spread the virus for weeks or even months.

Flu symptoms typically include high fevers up to 105 degrees, aches and pains in joints and muscles, generalized weakness, dry cough and runny nose. Symptoms usually come on suddenly and go away after a few days, although many people continue to feel fatigued for up to two weeks. The most significant complication of influenza is pneumonia.

If you get influenza, rest and avoid physical exertion. Use over-the-counter medications for fever and aches. Children should not take aspirin. Wash your hands frequently and cough and sneeze into your sleeve or soft tissues. Contact a doctor if you have cold-like symptoms that last longer than 10 days; if you have a high fever; if you become short of breath or if symptoms last more than five days without improving.

In recent years, several medications have become available that can decrease the severity and duration of symptoms. These drugs need to be given within the first 48 hours of illness and can decrease the duration of influenza by about one day. Because influenza is caused by a virus rather than by bacteria, antibiotics are not helpful.

Although medications are available, vaccination against influenza is more effective in reducing illness in healthy adults and is particularly effective in reducing complications of pneumonia and death in the sick and elderly. The vaccine can be given before any symptoms develop and is widely available, inexpensive and safe. Because the virus changes its shape frequently, new influenza vaccines must be developed every year. Side effects of the vaccine are seen in fewer than 5 percent of patients and may mimic the flu with fever, headache and muscle aches. The flu vaccine is not a live virus and you cannot get influenza from the virus.

Protection against influenza occurs about two weeks after vaccination. The seasonal flu vaccine does not protect against H1N1 influenza. Although the H1N1 vaccine will not be available until later in the season, for full protection, you are urged to receive the seasonal flu vaccine as soon as possible. The vaccine should be given annually to all people who belong to a group at increased risk for influenza-related complications. These groups include people more than 65 years old, residents of nursing homes, people with chronic pulmonary or cardiovascular diseases, people with diabetes or kidney disease, and people with blood disorders or immunosuppression. Children between 6 months and 18 years of age who take regular aspirin and women who will be in the second or third trimester of pregnancy should also receive the vaccine. Otherwise, healthy children between 6 and 23 months, healthy people who may transmit the virus to those at risk (e.g., healthcare workers, parents of high-risk children) and the general public are also eligible to receive the vaccine.

This year, the H1N1 influenza A virus has been responsible for many illnesses and some deaths around the globe. What are the symptoms? Should you receive the vaccine? Next month, I will answer these questions in a special article on H1N1 influenza A.

Dr. Kelly McMahon, a graduate of Yale University and the University of Pittsburgh School of Medicine, is board-certified in Internal Medicine. She is a member of the American College of Physicians and the Allegheny County and Pennsylvania Medical Societies. She is in solo practice in the North Hills of Pittsburgh.