Your Step-By-Step Guide to Getting Through This Year’s Flu Season

Photo credit: pepifoto - Getty Images
Photo credit: pepifoto - Getty Images

From Prevention

Table of Contents
Causes | Symptoms | Diagnosis | Treatment | Complications | Prevention

Flu overview

Influenza is a contagious respiratory infection caused by flu viruses that travel through the air and enter the body through the nose or mouth. On average, roughly 8% of Americans get the flu each year, ranging between 3 and 11%, and anyone is susceptible to the virus.[1]

From October 2019 through early April 2020, up to 62,000 people died due to flu complications, while up to 740,000 people were hospitalized, according to preliminary estimates from the Centers for Disease Control and Prevention (CDC). During the 2018-2019 flu season, an estimated 490,600 people were hospitalized and 34,200 people died due to flu complications.[2]

Flu symptoms range from mild to severe and can include fever, chills, achy muscles, sore throat, cough, and headache. The flu is often confused with the common cold, but flu symptoms develop more suddenly and severely.[3] Symptoms can also overlap with those of COVID-19, the respiratory illness caused by the novel coronavirus.

What causes the flu?

When someone with the flu coughs or sneezes, droplets carrying the virus enter the air. You can catch the flu if you inhale these droplets through your nose or mouth, or if you touch objects such as doorknobs or keyboards that are contaminated with the virus and then touch your nose, eyes, or mouth. If you have the flu, you can spread the virus a day before your symptoms develop and up to seven days after you become sick. People with the flu are most contagious during the first 3 to 4 days of their illness.[4]

Flu risk factors

Flu viruses are constantly changing, so if you’ve had influenza in the past, you may come down with it again. You are at greater risk of catching the flu and developing complications if you:

  • are younger than 4

  • are older than 65

  • live in a nursing home or long-term care facility

  • are pregnant or up to two weeks postpartum

  • have a weakened immune system

  • have a chronic illness

  • have a body mass index of 40 or higher

[5]

What are the symptoms of the flu?

Symptoms of influenza are often similar to those of a common cold and COVID-19. This can include some or all of the following:

  • Fever or feeling feverish

  • Achy muscles, especially in your back, arms, and legs

  • Runny or stuffy nose

  • Sore throat

  • Cough

  • Chills and sweats

  • Weakness and fatigue

  • Headaches

  • Vomiting or diarrhea

[6]

If it is flu season and you are generally healthy and experience symptoms, you don’t need to see a doctor right away, says Joseph Ladapo, M.D., Ph.D., professor of medicine at UCLA. Simply treat your symptoms with rest and over-the-counter medications, such as ibuprofen or acetaminophen.

However, anyone who is at high risk—that is, a child, older adult, pregnant woman, or someone with a chronic condition such as diabetes, heart disease, or stroke—should see their doctor. “He or she can follow up with you to confirm that things are going in the right direction,” Dr. Ladapo says, or advise on seeking more care if they feel it’s necessary.[7]

If you suspect your illness is due to COVID-19, click here for more information on when to see your doctor.

Cold vs. flu

Photo credit: Emily Schiff-Slater
Photo credit: Emily Schiff-Slater

Despite similar symptoms, a cold is milder than the flu and comes on more gradually. “If you don’t feel horrible, you probably don’t have flu,” Dr. Ladapo says. Most cold symptoms primarily show up above your neck (like swollen glands and a runny nose), while flu symptoms can impact your body above and below the neck. Ask yourself these questions:

How severe does this feel?

Cold: You feel a bit icky and things get worse slowly. The first signs to watch for include slight aches, a scratchy throat, headaches, and/or low-grade fever.

Flu: The flu hits you hard. You may first feel feverish at first, and quickly become too fatigued to do daily activities. Every inch of your body aches.

Can I get out of bed?

Cold: Yes, you can walk around. While you may not feel like going to work or getting your kids ready for school, you can still go about your day.

Flu: Absolutely not—you’re flat on your back and staying there. Extreme fatigue is going to incapacitate you for at least a few days.

How is the flu diagnosed?

To determine if you have the flu, a cold, or COVID-19, your doctor will do a physical exam, ask about your symptoms, and possibly do a lab test.

The most common test is the rapid influenza diagnostics test. Your doctor will swab the back of your nose or throat and check the sample for antigens, substances that cause your immune system to produce antibodies. It takes less than a half hour to get results. However, results aren’t always accurate, so your doctor may diagnose the flu without this test. “Trust your doctor and listen to your body,” Dr. Ladapo says.

Some specialized labs and hospitals use more accurate tests that look at the DNA or RNA of the virus.

If you decide to see your health care provider, be ready to answer questions about your symptoms, how long you’ve had them, and how severe they are. Also let them know of any medical conditions, if you are pregnant, and if you live with anyone at high risk of influenza or COVID-19 complications, Dr. Ladapo says.

How is the flu treated?

If you promptly see your doctor upon noticing symptoms, he or she may give you an antiviral such as oseltamivir (Tamiflu) or zanamivir (Relenza). Tamiflu comes in capsule form,[8] while Relenza is a powder you inhale.[9] If taken within two days of the onset of symptoms, these can lessen symptoms and shorten the length of time you are sick by about a day.

However, “it’s far from a slam dunk,” Dr. Ladapo says. “By the time you can schedule a doctor’s appointment, you may be outside the window where it’s effective.”

Whether or not you take an antiviral, the best way to treat the flu is to rest, drink fluids, and use any other remedies that best alleviate your symptoms such as pain reliever for headaches and achy muscles. “Whatever you are used to and know works for you, that is the appropriate treatment for flu,” says Michael P. Angarone, D.O., professor of infectious diseases at Northwestern Memorial Hospital.[10]

Flu complications to know

Healthy people typically recover from the flu once the virus passes. However, those at high risk of complications may develop complications, which can be deadly. These include:[11]

  • Sinus and ear infections

  • Pneumonia

  • Bronchitis

  • Asthma flare-ups

  • Inflammation of the heart, brain, or muscle tissues

  • Multi-organ failure

  • Sepsis, a life-threatening response to infection

  • Worsening of conditions such as heart disease

If you have a health condition and come down with the flu, talk to your doctor, who can help monitor your symptoms. If you have the flu and the fever persists for more than a few days or you experience difficulty breathing, chest pain, persistent cough, lots of sputum (mucus), or feel weak or lightheaded, seek medical attention immediately. “These are signs the virus is not getting better or you may be developing a complication,” Dr. Angarone explains.

How to prevent the flu

You can reduce your risk of contracting influenza with some common-sense health practices.

Experts widely agree that the single best way to protect against the flu is getting the flu vaccine. The vaccine is appropriate for anyone 6 months and older, and it’s important to get the flu shot each year.[12]

It’s also especially crucial to get the flu shot as COVID-19 continues to circulate, says infectious disease expert Amesh A. Adalja, M.D., a senior scholar at the Johns Hopkins Center for Health Security. Flu cases “compete with the same resources,” like ICU beds and medical personnel, he explains. “The more room we have in our hospitals to take care of COVID-19 patients, the better.”

The injection protects against the three or four flu viruses that research indicates will be most common that year.[13] You can get the flu vaccine at your health care provider’s office or at many pharmacies.

And despite what you may have heard, the vaccine cannot give you the flu. “It is true that the vaccine can lead to flu-like symptoms when the body responds to the proteins in the vaccine. But even then, it’s still protective, and those symptoms are not as severe as the flu,” Dr. Ladapo says.

In addition to the vaccine, practicing good hygiene can prevent flu germs from spreading:

✔️Wash your hands. Use soap and water, scrubbing for at least 20 seconds (or as long as the Happy Birthday song). When soap isn’t available, use alcohol-based hand sanitizer.

✔️Cough or sneeze into a tissue and discard the tissue. If you don’t have a tissue, cough or sneeze into your elbow.

✔️Avoid crowded areas. The flu spreads more easily in heavily trafficked places such as public transportation, schools, and offices. If you are sick, stay home for at least 24 hours after any fever subsides.

✔️Avoid touching your eyes, nose, and mouth to avoid germs entering your body.

✔️Clean and disinfect surfaces and objects such as keyboards, doorknobs, and telephones that may be contaminated with germs.

✔️Follow state orders that are in place to prevent the spread of the novel coronavirus, which may include wearing a face mask in public and maintaining a six-foot distance from others.

Additional reporting by Jessica Migala and Korin Miller


Sources

[1] https://www.cdc.gov/flu/about/keyfacts.htm

[2] https://www.cdc.gov/flu/about/burden/2018-2019.html

[3] https://medlineplus.gov/flu.html, https://www.cdc.gov/flu/consumer/symptoms.htm

[4] https://www.cdc.gov/flu/keyfacts.htm

[5] https://www.cdc.gov/flu/about/disease/high_risk.htm

[6] https://www.cdc.gov/flu/consumer/symptoms.htm

[7] Joseph Ladapo, MD, PhD, professor of medicine at UCLA

[8] https://www.gene.com/download/pdf/tamiflu_prescribing.pdf

[9] https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/021036s027lbl.pdf

[10] https://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=18170

[11] https://www.cdc.gov/flu/consumer/symptoms.htm

[12] https://www.cdc.gov/flu/protect/keyfacts.htm

[13] https://www.cdc.gov/flu/about/season/vaccine-selection.htm

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