During the winter months influenza occurs in explosive outbreaks lasting six to eight weeks. The illness, which is heralded by the sudden onset of symptoms such as fever, muscle aches and generalised weakness, headache, sore throat and dry cough, can progress to respiratory complications such as sinusitis, bronchitis, pneumonia and otitis media. It can also lead to myocarditis and encephalitis. The 2 most important features of influenza are its epidemic nature, with attack rates often reaching 10-40% of the population, over a 5 to 6 week period. An average of 34 people die of influenza in New Zealand each year. In fact an estimated 435 deaths occur annually that can be directly or indirectly attributed to influenza. This is one of the reasons our Ministry of Health has made influenza vaccines free to specific groups.
What is the flu?
The flu, or influenza, is a viral infection caused by type A and type B influenza viruses. It is most common in the autumn and winter and is highly contagious; the virus usually enters the body through mucous membranes in the mouth, nose or eyes. When a person with the flu coughs or sneezes, the virus becomes airborne and can be inhaled by anyone nearby. In most communities, it is school-age children who are the first to get the flu, and then they carry it home and to other group activities. In a mild flu season, about 10% to 15% of the population becomes infected. In a more severe flu season, 20% or more of the population can suffer from the flu.
How do I know if I have the flu?
Flu generally strikes 1 to 3 days after exposure to the virus. The onset of flu often seems sudden - people describe feeling like they've 'been hit by a truck.' Common flu symptoms include sudden onset, fever and chills, cough, muscle and joint pain, headache, tiredness and weakness. Some people also get a stuffy nose and sore throat.
What's the difference between the flu and a cold?
Both the flu and a cold are viral infections and can cause symptoms such as coughing and sore throat. A cold is a minor viral infection of the nose and throat. The flu, however, is usually more severe, with a high fever (rare with a cold) and the addition of muscle and joint aches and pains. People often suffer extreme tiredness and weakness with the flu, along with a headache. (If headache is present with a cold it is usually much more mild than with flu.) Nasal symptoms such as blocked or runny nose and sneezing are not usually present with the flu.
Preventive Medicine
Vaccines against the flu are available from your doctor. The vaccine is made from disrupted (killed) influenza virus which means it cannot cause flu. It take 10 to 14 days for the vaccine to provide protection, so you need to have the vaccine before the influenza season starts. Because influenza viruses are constantly changing, a new vaccine is produced each year to keep up with the latest viruses. In New Zealand the Government funds flu vaccine for those over 65 years of age or those with certain chronic medical conditions which may make them more susceptible to influenza.
Buccaline Berna Viral and influenza-like illnesses are frequently made worse by additional bacterial infections which delay recovery. Buccaline Berna tablets contain tiny, inactivated amounts of the bacteria which can cause these complications associated with colds and flu eg Haemophilus influenzae. A three day course can help the body build an immunity towards these bugs, the course can be repeated every 4 weeks if required. Protection may last for up to three months.
What should I do if I get the flu?
Influenza usually lasts about a week. It is a good idea to stay in bed for a few days to give the body a chance to recover. Keep fluid intake high, and because it is contagious it is advisable to stay away from work or school to limit its spread. Flu continues to be contagious for 3 or 4 days after symptoms appear.
There are many treatment options which will treat the symptoms of flu. They include:
Analgesic/Antipyretics such as paracetamol (Panadol, Pamol, Lemsip Cold and Flu Sachets) and ibuprofen (Nurofen). They should be taken regularly to help reduce fever; and aches and pains. Aspirin is similar to ibuprofen in its action, but should not be given to children under 12 years of age, and it should be discontinued if indigestion or increased bruising or prolonged bleeding occurs.
Cough suppressants are useful if cough is a problem. They are available as products such as Durotuss (pholcodine) and Robitussin Cough Control (dextromethorphan). They are often included in combination products.
Combination products are useful for relieving many of the symptoms of flu such as headache, muscular aches and pains, fever, congestion and cough. They contain various combinations of analgesics, decongestants, antihistamines and cough suppresants and are available over the counter as Codral Day and Night Tablets , Codral Cold and Flu Tablets, Coldrex Flu Strength Capsules and Day and Night Cold and Flu Capsules. For a full list of cold and flu preparations available from CyberChemist click here.
Lozenges have the advantage of a longer contact time with the throat and they have a demulcent (soothing) effect. Some, such as Strepsils Cough have antiseptic and cough suppressant properties, while Difflam are analgesic and anti-inflammatory. Click here for a full list of lozenges available form CyberChemist.
Antivirals
The new antiviral drugs are the latest development in the treatment of influenza. They are available only on prescription from your doctor, and you must start them within 48 hours of developing flu symptoms. They act by preventing the flu virus from multiplying. One product is an oral tablet called Tamiflu; the other is an inhaled powder called Relenza. Both products taken as a 5-day course of treatment. As soon as you feel the sudden onset of flu symptoms, visit your doctor (within 2 days) and ask if either of these products is right for you.
Should I call my doctor if I think I have the flu?
If you feel seriously ill, you should always call your doctor. Only your doctor will be able to tell you if you have a condition that requires treatment. If you think you have the flu, call your doctor as soon as symptoms start (within 2 days) and ask for more information about the new antivirals.
People over the age of 50 years and those of all ages with chronic health problems are at a greater risk and should always seek professional health care when infected with the flu. Also, people with the flu sometimes develop other serious infections such as pneumonia, bronchitis, sinusitis or ear infection. You should consult your doctor promptly if:
- You are coughing up thick, discoloured or bloody mucus.
- You have symptoms such as recurring fever, chest pain, facial swelling, earache or severe pain in the face or forehead
Can the flu be cured with antibiotics?
No. Because flu is a viral infection, it should be treated with an antiviral medication - if your doctor feels it's appropriate - not antibiotics. Antibiotics are medicines that kill bacteria and are, therefore, not effective against viral infections. If your doctor does not think that you need antibiotics to treat your infection, do not insist. Inappropriate use of antibiotics contributes to the development of antibiotic-resistant strains of bacteria, which is a major public health problem. Antibiotics may be appropriate if you have a secondary bacterial infection.
