Influenza OR simply “The Flu” is caused by a viral illness that has outbreaks all across the globe, usually in the winter months. In the northern hemisphere (US and Canada), the flu season generally occurs between November and April.
It is an illness that is infectious and can be transmitted from person to person. One reason that is believed why It occurs more frequently in these months because people are in much closer contact with each other due to the cold.
Most importantly, it is a preventable illness. While the majority of people recover from the illness on their own in 7-10 days, some groups who are considered “high risk” - the illness can be fatal.
It Canada, it is estimated that influenza causes approximately 12,200 hospitalizations and 3,500 deaths in Canada each year.
Signs and Symptoms of the Flu:
The initial most common symptoms of The Flu are :
Fever (37.8-40.0 C)
After a day or two, one also may get symptoms of:
In the elderly, these symptoms can present differently. They may not experience a fever and instead have more pronounced weakness, chills, dizziness, and lack of appetite.
The flu virus is usually spread through sneezing and coughing and can be shared with close contact with an infected person. Usually, the more severe the illness in a person, the more contagious they can be.
It usually takes 2 days after catching the virus to start showing symptoms and become ill and for the average person, the illness tends to last 7-10 days in total.
Diagnosis & Testing:
In most cases, diagnosing the flu is done based on symptoms alone by your physician and no testing is needed.
There are certain cases where it is helpful to take a sample of the respiratory secretions using a swab and sending it to a laboratory to analyze and confirm a definitive diagnosis.
This mainly includes for individuals who are considered “high risk” OR for new travellers or residents from places where there might be a suspected outbreak.
High Risk individuals refers to people who have a higher likelihood of being severely impacted by the influenza virus and who will need additional monitoring and care from health care providers.
Here are some examples of those who are considered high risk:
Hospitalized patients and patients living in nursing homes and other similar facilities
Adults over age >65
decreased immune systems
Chronic medical diseases such as lung diseases (Asthma, etc.), heart disease, cancer, kidney and liver disease, HIV, obesity.
Chest X-ray - In most cases, an X-ray is not needed. However, in some cases, the flu can cause pneumonia, which is an infection in the lungs and an X-ray can help diagnose this. One sign that a flu may be converting into a pneumonia is experiencing difficulty breathing or shortness of breath.
Blood testing - blood samples and testing are usually not required and have little benefit in the majority of cases.
Prevention and Treatment:
Influenza infection is a preventable illness and here are some general good practices that can be used to help infection:
Good hand and overall hygiene
The Flu shot/vaccine - Flu vaccines are administered free of charge by most medical clinics and pharmacies. Our next week's post will detail more information on the Flu Shot
Avoiding and limiting contact with those that are sick
In certain cases with high risk individuals, antiviral medications can be given before the onset of flu symptoms to prevent the infection and spread of influenza. This role is generally given to public health departments to make these decisions but feel free to speak with your physician if you would like more information regarding this.
The majority of individuals will experience only mild symptoms that were mentioned above. In these cases, it will usually take 7-10 days for the illness to clear itself and no treatments are needed. In the meantime, If you are finding your symptoms too bothersome, here are some helpful strategies to consider and speak to your physician about:
1. General symptoms:
Rest - Take it easy until the illness is resolved. Take leave from work or school so that you can recover and also prevent the spread to others.
Fluids - Keep hydrated with fluids such as water and tea to avoid dehydration. Generally, the lighter your urine colour, the more hydrated you are.
Keep warm - the body uses heat to help fight off infection.
2. Fever and Pain - Tylenol and Advil over the counter are effective at treating fever and pain associated with the flu
3. Sore throat:
home remedies such as tea mixed with any OR all of honey, lemon, ginger and black seed (nigella sativa)
Lozenges - medicated lozenges such as cepacol, halls, fishermen’s friend etc.
More severe symptoms can be treated with prescription for anesthetic agent like Tantum OR one dose of dexamethasone 10mg
Home remedies: The above mentioned home remedies can help also help with cough
Over the counter cough suppressants may also help with cough. There are numerous different brands and types - look for extra-strength ones which include the highest doses of “DM” or Dextromethorphan
Inhalers - in some cases, especially those with wheezing, shortness of breath and chest discomfort, short term use of an inhaled medications can help to widen the airways and can help with relief of symptoms. These are prescription medications
Opioids - The final level of support for cough is using opioids. Opioids are very sedating and cause many side effects such as constipation, decreased level of consciousness, and addictions. However for very short periods and in very severe cases, they can be helpful
A note about Antibiotics: Antibiotics are NOT helpful in treating the Flu since they are effective against bacterial bugs and the Flu is caused by a viral bug. Antibiotics are ONLY used if there is a secondary bacterial infection on top of the flu virus such as a bacterial pneumonia, a bacterial ear infection or a bacterial sinusitis infection.
Antibiotics are generally harmful in cases where they are not needed as they kill a lot of the good bacteria in your gut flora and can cause side effects such as stomach upset, nausea, vomiting, diarrhea, yeast infections. The use of Antibiotics can also cause bacterial resistance which will cause the growth of superbugs that become stronger and stronger and may not be able to be killed.
Moderate to Severe Illness:
In patients who are considered high risk and who may have severe symptoms, additional levels of therapy may be needed:
Antiviral medication - this includes pills that one takes and usually only works if it is taken within 48 hours of experiencing symptoms. These medications can help lower the severity of the illness and improve recovery time.
Hospitalization and Oxygen support - in some severe cases, oxygen and other advanced levels of care may be needed to help those with the flu infection overcome their illness.
When to seek help:
Most people with the flu recover within one to two weeks without treatment. Feel free to speak to your physician if you require symptomatic management. Also in case of serious complications of the flu can occur - See a doctor immediately if:
●You feel short of breath or have trouble breathing
●You have pain or pressure in your chest or stomach
●You have signs of being dehydrated, such as dizziness when standing or not passing urine
●You feel confused
●You cannot stop vomiting or you cannot drink enough fluids
In children, you should seek help if the child has any of the above or if the child:
●Has blue or purplish skin color
●Is so irritable that he or she does not want to be held
●Does not have tears when crying (in infants)
●Has a fever with a rash
●Does not wake up easily
●Fever is not improving with tylenol/advil
In this Your Health Matters we’ve covered some key pieces of information to know about how to recognize influenza infection and how to prevent and treat this illness. One of the key pieces about any disease is prevention and one of the key tools used in prevention of influenza is the flu vaccine.
Please stay tuned to next Week’s Edition of our “Your Health Matters” Series which will be on the Influenza Vaccine.
From all of us at Town Care Medical Clinic, we wish you a healthy and productive winter season.
The following does not constitute medical advice. If you have a medical question or symptoms of illness, you should consult a physician. This information here is being shared for informational purposes only. Town Care Medical Clinic makes no representation or warranty of any kind as to the accuracy, completeness or currency of the information provided. The information is subject to change at any time and without prior notice.
The following does not constitute medical advice. If you have a medical question or symptoms of illness, you should consult a physician. This information here is being shared for information purposes only. Town Care Medical Clinic makes no representation or warranty of any kind as to the accuracy, completeness or currency of the information provided. The information is subject to change at any time and without prior notice.
Up-to-date: www.uptodate.com topic: Treatment of seasonal influenza in adults & Clinical manifestations of seasonal influenza in adults
Government of Canada Website: canada.ca/en/public-health/services/diseases/flu-influenza/health-professionals-flu-influenza.html
-Dr. Suleiman Furmli is a staff physician at the Town Care Medical Clinic. Dr. Furmli attended the University of Toronto for his medical training (MD) and proceeded to also complete his residency training in family medicine. He is passionate about translational medicine, health promotion and patient empowerment.