Symptoms of Flu

Taking Care of Yourself If You Are Sick

If you have been diagnosed with H1N1 flu, you should stay home, follow your doctor’s orders, and watch for signs that you need immediate medical attention.

• CDC recommends that you stay home for at least 24 hours after your fever (100°F or 37.8°C) is gone except to get medical care or for other things you have to do and no one else can do for you. (Your fever should be gone without the use of a fever-reducing medicine, such as Tylenol®.) You should stay home from work, school, travel, shopping, social events, and public gatherings.
• Avoid close contact with others, especially those who might easily get the flu, such as people age 65 years and older, people of any age with chronic medical conditions (such as asthma, diabetes, or heart disease), pregnant women, young children, and infants.
• Clean hands with soap and water or an alcohol-based hand rub often, especially after using tissues or coughing/sneezing into your hands.
• Cover coughs and sneezes.
• Wear a facemask when sharing common spaces with other household members to help prevent spreading the virus to others. This is especially important if other household members are at high risk for complications from influenza. See Interim Recommendations for Facemask and Respirator Use to Reduce Novel Influenza A (H1N1) Virus Transmission.
• Drink clear fluids such as water, broth, sports drinks, or electrolyte beverages made for infants to prevent becoming dehydrated.
• Get plenty of rest.
• Get medical attention right away if you:
  • Have difficulty breathing or chest pain
  • Have purple or blue discoloration of your lips
  • Are vomiting and unable to keep liquids down, or
  • Show signs of dehydration, such as feeling dizzy when standing or being unable to urinate

Caring for a Sick Person at Home

If you are taking care of someone at home who has novel H1N1 flu, you should protect yourself and other people in the household.

• Avoid being face-to-face with the sick person. When holding small children who are sick, place their chin on your shoulder so that they will not cough in your face.
• If close contact with a sick individual is unavoidable, consider wearing a facemask or respirator, if available and tolerable. .
• Ask the person’s health care provider about any special care that might be needed, especially if the person is pregnant or has a health condition such as diabetes, heart disease, asthma, or emphysema.
• Ask the patient’s health care provider whether the patient or you, as the caregiver, should take antiviral medications.
• Keep the sick person away from other people as much as possible, especially others who are at high risk of complications from influenza.
• Make sure everyone in the household cleans their hands often, using soap and water or an alcohol-based hand rub.
• Ask your healthcare provider if household contacts of the sick person—particularly those contacts who may have chronic health conditions—should take antiviral medications such as oseltamivir (Tamiflu®) or zanamivir (Relenza®) to prevent getting the flu.
• Get medical care right away if the patient
  • Has difficult breathing or chest pain
  • Has purple or blue discoloration of the lips
  • Is vomiting and unable to keep liquids down
  • Shows signs of dehydration, such as feeling dizzy when standing, being unable to urinate, or (in infants) crying without shedding tears
  • Has seizures (for example, uncontrolled convulsions), or
  • Is less responsive than normal or becomes confused.

“Bundle Up or You’ll Catch Your Death”

Contrary to what your mother told you, and what you may have told your own kids, chilling and dampness have nothing to do with susceptibility to the common cold. Back in the 1950′s, at the Common Cold Research Unit in England, then-director Christopher Andrewes, M.D., made volunteers stand nearly naked in frigid meat lockers and drafty gyms wearing little but wet socks for hours on end, and in no experiment did those who got chilled catch more colds, or worse colds, than people who spent the same amount of time happily ensconced in warm cozy rooms.

The contemporary twist on the “chill” myth is that people who live in centrally air-conditioned homes or work in modern office buildings often blame their colds on over-active air-conditioners. The problem is not the air’s low temperature, Dr. Cooper says, but rather it’s low relative humidity. Air conditioning dries air, often to the point where it may dehydrate the protective mucus in the nasopharynx and allow cold viruses to do their worst.

Don’t Kiss Me. I Have a Cold

Dr. Dick infected one member of 16 couples with a cold virus, and had them to plant an extended kiss on their partners’ mouths. Only one partner (6 percent) caught the cold. During colds, the virus generally stays in the nose and throat. The mouth remains remarkably virus-free. Then Dick infected one member of 24 married couples and tracked them as they lived their daily lives together for more than a week. Only nine of the spouses (38 percent) caught the cold, and risk was unrelated to their kissing or lovemaking. The only risk factor was the total amount of time they spent together. There’s no reason to refrain from kissing cold sufferers, especially if the kiss is a peck on the cheek. “Just don’t rub noses with them,” Dick advises, “or you risk passing the cold by nose-to-nose transmission.”

“Feed a Fever, Starve a Cold.”

Or is it: “Starve a fever, stuff a cold”? You hear it both ways, but don’t starve or stuff either one. Drown colds in plenty of fluids, Dr. Simons says. As for feeding and starving, colds often suppress appetite, and some people say that eating lightly or drinking only vegetable juices speeds their recovery. Listen to your body. Eat well if you feel hungry. Refrain if you don’t.

I have a Cold, Doc. I need an Antibiotic

Not so fast. Antibiotics treat only bacteria. They are powerless against viruses, including the viruses that cause colds. Antibiotics can help only when you have a bacterial infection, for example, sinusitis, on top of your cold. Such secondary bacterial infections occur in only about 10 percent of colds, according to a study by Ralph Gonzalez, M.D., of the University of Colorado Health Sciences Center in Denver. Doctors know this, but come under pressure for antibiotics from their patients—and wind up writing some 12 million antibiotic prescriptions a year for colds and other viral infections. These unnecessary prescritpion add to health care costs and contribute the development of antibiotic-resistant micro-organisms.

In addition, once or twice each century, a particularly lethal flu strikes. The 1918-19 epidemic killed 20 million people worldwide (700,000 in the U.S). No one knows when the next killer flu will strike, but the experts agree we’re about due.

If you’re like most Americans, you call any bad cold “the flu.” Like the common cold, the flu is an upper respiratory viral infection. But that’s where the similarities end. The flu, short for “influenza,” is often much more severe.

“Most people under 65 still see the flu as no big deal,” says flu specialist Steven Mostow, M.D., chairman of the department of medicine at the University of Colorado Health Sciences Center in Denver. “That’s a big mistake. Even if you’re healthy and in the prime of life, flu can knock you flat on your back for a week. And if you’re elderly or have chronic health problems, it can kill you.”

In the U.S., the annual flu season runs from Thanksgiving to Easter, though the worst outbreaks typically occur from late December to early March.

Flu is caused by three viruses, identified as A, B, and C. Type-A flu (also called influenza A) causes the worst symptoms and the most complications, says Nancy Arden, R.N, a senior official at the Influenza Branch of the Centers for Disease Control and Prevention (CDC) in Atlanta. Type-B flu can also cause severe illness, but it’s symptoms tend to be less severe and don’t linger as long. Type C flu is hardly even an illness. When public health officials say “flu,” they mean Type A and B.

Then there’s “stomach flu.” “It’s not flu at all,” Dr. Mostow explains, “It’s a common misnomer for viral infections of the digestive tract, medically known as gastroenteritis.”

Flu spreads through the air. You inhale the virus Colds can also spread through the air, but flu spreads much more easily. “If you put a cold sufferer in a room full of people who are susceptible, several will catch the cold,” the CDC’s Arden says. “But if you put a person with influenza A in that same room, within one to three days, most of them will get the flu.”

One famous study of flu transmission involved 54 passengers on a commercial jet. One boarded the five-hour flight infected with influenza A, and within three days, 72 percent of the other passengers came down with flu. Another involved a tour group traveling to Alaska. One had influenza A, and within a few days, more than half the group had caught it.

If you do come down with the flu, you feel better faster by taking care of yourself by trying some of these home remedies.

• Rest. With flu, you have little choice. The illness sends you to bed. “There’s a clear message in that need for bed rest,” says Anne Simons, M.D., an assistant professor of family and community medicine at the University of California’s San Francisco Medical Center. “It’s your body’s way of investing all its energy in making you well.”

• Drink plenty of fluids. The maker of one over-the-counter flu formula surveyed a large number of family doctors, asking which home remedies they considered most important when treating flu. Seventy-nine percent called fluids “very important.” Why? Because fever is dehydrating, and even minor dehydration adds to flu misery. In addition, hot fluids help relieve such flu symptoms as sore throat, nasal congestion, and cough.

Diet

• Fight back with mushroom soup. Speaking of hot fluids, one of the best is mushroom soup. But you can’t use any old mushrooms, says Boulder, Colorado herbalist Mindy Green, who teaches at the Rocky Mountain Center for Botanical Studies. You need shiitake, maitake, and reishi mushrooms, which many studies show help strengthen the immune response to viral infections.

• Liquids Only Fasting Diet. Try a liquids-only fast for a day or two, just water, juices, teas, and soups, says Alan Brauer, M.D., director of TotalCare Medical Center in Palo Alto, California, one of the nation’s oldest clinics to combine mainstream and complementary medicine. “It takes a lot less energy to digest liquids than solid food,” he explains. “A liquid diet allows your body to invest more energy in fighting your flu.”

• Flu Shot. If you’re under 65, the annual flu shot, available every fall, is the best preventive method, and is 70 percent effective in preventing flu. If you’re elderly, the shot is less effective because most older people’s immune systems are not as robust, so the vaccine does not stimulate as powerful a defensive response. “But at any age,” the CDC’s Nancy Arden says, “if you get the flu after you’ve had a flu shot, it’s usually mild.”

The CDC recommends getting immunized in October or November. It takes a week or two after vaccination to develop effective immunity, Arden says.

You have to get vaccinated every year because flu viruses change constantly. The CDC tracks flu outbreaks around the world, and each spring, directs vaccine makers to produce a vaccine to protect against the Type A and B strains expected to strike the U.S. the following winter.

Anyone can get a flu shot—including pregnant women after their first trimester. The only people who should not get vaccinated are those with serious allergies to eggs, which are used to manufacture the vaccine.

Many health departments make flu shots available at low cost or for free every October and November. Call yours. In addition, some pharmacy chains also offer low-cost flu shots in their stores each fall. Check the ones near you.

Unfortunately, several myths keep many people from getting immunized:

• “I can’t be bothered.” It takes maybe an hour and a few bucks to get a flu shot. If you don’t get one, and catch the flu, you’re out of commission for at least a week. Think about it.

• “Flu shots cause the flu.” Absolutely not. A flu shot is your best protection against the flu. The reason some people believe this myth, Dr. Mostow explains, is that, coincidentally, they catch colds after getting vaccinated and mistakenly blame the illness on the shot. Or they catch the flu immediately after getting vaccinated, before the shot has had a chance to immunize them.

• “Flu shots cause side effects.” Side effects, if any, are usually mild—soreness at the injection site for a day or so, with perhaps a little achiness or hives. Children sometimes develop a brief low-grade fever. But these side effects are trivial compared with a case of flu, Arden says.

• “Flu shots can cause paralysis.” No. Way back in 1976, a few of the millions of people who received that year’s shot developed a rare, paralytic disorder, Guillain-Barré syndrome. The episode tarnished the flu shot’s reputation for years. Today, experts consider that incident a freak accident, and point out that since 1976, more than 150 million flu shots have been administered with no serious side effects.

Stress Management

• Stress shoots flu shots. At Ohio State University College of Medicine, Janice Kiecolt-Glaser, Ph.D., a professor of psychology and psychiatry, gave flu shots to 64 elderly people, half of whom were caregivers for spouses with Alzheimer’s disease, a responsibility that causes severe stress. A month later, she used standard blood tests to measure the participants’ immune response to the vaccine. Non-caregivers showed strong immune responses, meaning good protection from flu. The caregivers, however, showed significantly less robust responses. The chronic stress of caregiving impaired their immune systems’ ability to respond to the vaccine, leaving them more vulnerable to flu.

Immune Enhancement

• Rev your resistance. Your body’s ability to fight any illness depends on the vitality of your immune system.

Prescriptions Medications to Prevent Flu

In addition to treating flu, prescription amantadine and rimantadine also help prevent it. For prevention of Type A, they are about as effective as vaccination, but they are less effective than a flu shot for prevention of influenza B. However, for decent protection, these drugs must be taken daily for the duration of any flu outbreak in your community. This can turn into an expensive hassle, which is why the CDC promotes flu shots and considers antivirals a last resort if you didn’t get one.

Flu symptoms include:

• fever
• headache
• extreme tiredness
• dry cough
• sore throat
• runny or stuffy nose
• muscle aches

In children, there may be additional symptoms such as:

• nausea
• vomiting
• diarrhea

Difference Between Flu and Common Cold

While both the flu and common cold are respiratory illnesses that share many of the same symptoms, they are caused by different viruses. It can be difficult to tell the difference between flu and common cold based on the symptoms alone.

To know for sure if an illness is the flu or a common cold, special tests that usually must be done within the first few days of illness can be carried out.