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Flu (Adults)

 

Class
Respiratory system
Condition
Flu (Adults)
Description
Influenza or flu is an infectious disease caused by a virus that invades the lungs and upper respiratory tract (nose, nasal passages, sinuses and throat). Although often confused with a heavy cold, flu is caused by a different sort of virus than the one responsible for causing colds and the symptoms tend to be far more severe and last longer. Outbreaks of flu are seasonal, occurring most often in the winter in the UK between the months of October to April.
Causes
There are three types of influenza virus responsible for causing flu - influenza virus A, influenza virus B and influenza virus C.

The type A virus causes the severest form of flu in humans. It is further subdivided into different strains, the most important of which are H1N1 (responsible for the Spanish flu outbreak in 1918-1920 that killed an estimated 40 million people, and responsible for the Swine flu 2009-2010 pandemic that killed an estimated 18,000 people); H2N2 (responsible for the Asian Flu outbreak in 1957-1958 that killed 1-1.5 million people); H3N2 (responsible for the Hong Kong Flu outbreak in 1968-1969 that killed 0.75-1 million people); and H5N1 (possibly posing a threat of a major flu outbreak in the future).

The viruses are spread in the fine droplets of water released into the air when an infected person sneezes or coughs. This is the reason why the virus can spread so rapidly through offices, schools and other close communities, and reinforces the need for people to cover their nose and mouth with a tissue when sneezing or coughing.

The influenza virus can also be transmitted in saliva, faeces, blood and other bodily fluids either by direct contact or through contact with contaminated surfaces. Washing hands thoroughly after going to the toilet helps reduce the spread of the disease.
Symptoms
Flu symptoms begin quickly, usually within 24-48 hrs of being infected. They usually start with the sensation of a chill, which is soon followed by a fever, severe aches and pains especially in the muscles and joints, sore throat, headache, intermittent sweating and shivering, coughing, sneezing, blocked nose, runny eyes, weakness and fatigue. Flu keeps most people in bed and reduces appetite. Symptoms are usually at their worst after 2-3 days and gradually ease over the next 5-8 days, although a particularly bad bout of flu may leave a feeling of weakness that lasts for 2-3 weeks.

In severe cases, complications such as secondary chest infections and pneumonia may develop that can be fatal in the elderly, young children and the chronically sick.
Treatment
Vaccination against flu is the most effective way of tackling the disease. Each year the World Health Organisation predicts which strains of the various flu viruses are likely to cause the next season's outbreak of flu. Vaccines are manufactured containing inactivated material from three strains of these predicted influenza viruses, usually two of the influenza A strains and one of the influenza B strain. Unfortunately, because the influenza A virus changes so rapidly and other strains of flu virus become dominant, the vaccine produced for one year is not likely to be effective the next year. A new vaccine containing different strains of flu virus has to be produced for each flu season. Consequently, to remain protected against flu, people have to have a flu vaccination each year. This is particularly important for those with heart, chest or kidney problems, diabetes and those over the age of 65.

Antiviral drugs called neuraminidase inhibitors can be used against the flu virus. They do not cure flu, but they stop the flu virus from multiplying in the body and so reduce the severity and duration of flu symptoms. They must be taken before, or within 48 hours of being infected to be effective. There are two neuraminidase inhibitors available in the UK - oseltamavir and zanamavir. They can be prescribed on an NHS prescription, but their use is restricted to the treatment of flu (oseltamavir can also be used to prevent flu) in patients over 65 years of age, those with chronic asthma, chronic obstructive pulmonary disease, cardiovascular disease, chronic renal impairment, diabetes or an impaired immune system.

Paracetamol, ibuprofen or aspirin can all be used to reduce high temperatures and relieve headaches, muscle and joint pains. Aspirin must not be given to children under 16 years of age. Preparations containing codeine and dihydrocodeine should not be used as they are not considered appropriate and may cause addiction if taken for more than 3 days.

Decongestants, such as pseudoephedrine, phenylephrine, oxymetazole and xylometazoline, can help clear a blocked nose and sinuses but should not be used long-term as they can make the condition worse. Inhalations containing menthol and essential oils will also help ease nasal congestion. Other ways to relieve symptoms are steam inhalations, which can help relieve nasal congestion, and throat lozenges and gargles to soothe a sore throat.

Cough remedies containing an expectorant such as guaifenesin may help remove mucus from the airways, or those containing an antitussive such as dextromethorphan may help relieve a dry tickling cough.
When to consult your pharmacist
As flu can strike so suddenly, it is best to be prepared each autumn before the flu season starts. Many of the traditional cough and cold medicines will no longer be supplied from supermarkets or other non-pharmacy outlets and will only be available from your local pharmacy. Visit your pharmacist for advice about flu and to stock up with medicines that will help ease the symptoms should you or members of the family be unlucky enough to get flu in the winter. Pain killers to ease aches and pains and to reduce high temperature, decongestants and inhalations to ease nasal congestion, pastilles and lozenges to ease sore throats and cough medicines can all be obtained from your local pharmacy without a prescription.

Cough and cold remedies containing antihistamines, antitussives, expectorants or decongestants are not suitable for children under 6 years of age. Children under 6 years of age suffering from a cough or a cold may be given medicines containing paracetamol or ibuprofen to lower a raised temperature, or if they have a cough may be given soothing cough medicines containing glycerol, honey or lemon.

Cold remedies containing antihistamines, antitussives, expectorants or decongestants can be used in children age 6 to 12 years, but they should only be used after soothing preparations have been tried and they should not be used for more than 5 days. Never give your child more than the recommended dose or other cough and cold medicines containing similar ingredients at the same time.

Describe your symptoms to the pharmacist and, if your child is affected always tell your pharmacist your child's age, so the pharmacist may be able to recommend the most suitable product.

Some pharmacies also provide a flu vaccination service. If you are not entitled to a free flu vaccination, but are worried about catching flu, you can pay for the flu vaccination to be given at your local pharmacy.
When to consult your doctor
People who are considered to be particularly at risk of developing complications as a result of flu are entitled to free flu vaccinations each year. If you are aged 65 years or over, or if you have diabetes, heart, chest, liver or kidney problems, or an impaired immune system you should make an appointment to see your doctor each October to receive your flu vaccination.

If you are one of those people considered to be at risk of developing complications but have not been vaccinated against flu and you have been in contact with someone who has flu, or you become aware that there is an outbreak of flu in the community, visit your doctor as soon as possible. If your doctor thinks it appropriate an antiviral drug may be prescribed for you.

If you are caring for an elderly or disabled person, you are also entitled to a free flu vaccination and so you should also make an appointment to receive your vaccination in October. If you have a relative living in a residential or nursing home, check with the head of the home to make sure that someone will visit the home to give the residents the flu vaccine as flu can spread very quickly through close communities.

If you suffer from frequent chest infections, or were frail or ill before contracting flu you should see your doctor as there is a risk of your developing complications, in particular secondary bacterial chest infections.

If you have had flu symptoms for more than a week and do not seem to be improving you should also seek medical advice. Babies and children with a very high temperature should see their doctor. If your child or baby is refusing to drink or showing signs of meningitis seek medical attention immediately.
Living with flu
If you do get flu and you are otherwise fit and healthy, the best option is to stay at home and treat the symptoms yourself. There is no point asking your doctor to prescribe antibiotics as they do not work against the flu virus. Also, if it is more than 48 hours since your flu symptoms developed, antiviral drugs will no longer be effective.

If you do get flu, the best thing to do is to stay at home and rest for 2-3 days. This helps your body fight the virus, and also reduces the risk of your spreading the infection to colleagues and friends. A visit to your doctor's surgery risks spreading flu to other, less healthy people.

When flu symptoms are at their worst it is import to rest to help your body's immune system fight the virus. Avoid strenuous exercise and try to get as much rest and sleep as possible. If you can, stay in a room that has a constant temperature and keep warm. If you have to go out, wrap up warmly. Drink plenty of fluids to replace body fluids lost by sweating. Do not smoke or drink alcohol.

Use tissues, rather than handkerchiefs, for blowing your nose and for trapping coughs and sneezes to reduce the risk of spreading the flu virus to others. Dispose of the tissues in a waste paper bin. Wash your hands frequently throughout the day to reduce the spread of the virus by contact with surfaces.

If necessary, treat symptoms with the medicines described above. If you develop signs of a bacterial infection, see your doctor.
Useful Tips
  • Try to keep warm, stay in bed and get plenty of rest
  • Drink plenty of fluids
  • Always read the label on medicines and never exceed the recommended dose
  • Sponge your forehead with tepid water, it is soothing and helps reduce a high temperature
  • Do not smoke


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