Well, its official, the 2014-2015 influenza season is here. There have been documented cases in the Berlin area in the past couple weeks and the incidence is increasing rapidly. So let’s review what influenza is and what can be done about it.
Influenza is a respiratory illness caused by a virus. The virus is classified as an A or B type. The virus can be further identified by the H and N proteins that are attached to it. Vaccines were developed against specific strains that were expected for this year’s season. Unfortunately, there have been some reported cases this year of a strain that was not included in the vaccine. However, it is still a good idea to have had the vaccine since the illness generally is less severe for people who have been vaccinated.
The virus is spread from one person to another by contact with the virus in respiratory droplets from someone who is infected. These droplets can be spread by coughing or sneezing. The incubation period, or time from exposure to illness, is generally about two days (range of 1-4). People are felt to be contagious or shedding virus when the symptoms first develop and for several days into the illness.
The main symptoms of influenza are fever, sore throat, cough, muscle aches, headache and upset stomach. The symptoms generally come on abruptly and usually resolve in 5-7 days. Treatment of influenza is primarily supportive. The symptoms of headache and fever can be treated with Tylenol and ibuprofen. Sore throat and cough can be treated with throat lozenges, cough drops, and cough syrup. Hydration is important and oral hydration can be provided by water, broth soups, juice and sport drinks like Gatorade.
Traditional antibiotics are not effective against the influenza virus. However, there are antiviral medications that have some activity against influenza. The most commonly used antiviral agent is Tamiflu. It is most effective when started within 48 hours of the onset of symptoms. The medication may shorten the illness by 1-2 days. The people who benefit the most from the antiviral medication, and may be candidates to take it, are those who are at high risk for complications or who are ill enough to require hospitalization. Those who are considered high risk are people over the age of 65, women who are pregnant or within 2 weeks of delivery, people who live in a nursing home, patients who take medicine that suppress the immune system, the very young (less than five years old), people with lung disease, heart disease, diabetes, neuromuscular disease, kidney disease, and people who are very obese. There are thousands of deaths each year attributed to influenza. These occur primarily in people who are at high risk. Otherwise healthy people will generally recover in 5-7 days without antiviral medication. The diagnosis can be confirmed with a laboratory test but now that we know the flu is here the diagnosis can generally be made based on the symptoms.
If you think you have influenza and are otherwise healthy, it is not necessary to be seen at the emergency room. It is best to stay home and treat the symptoms. Try to avoid spreading the illness by covering your mouth when coughing or sneezing and wash hands frequently. If you have shortness of breath, severe weakness, or change in mental function you may be developing a complication of the flu and should be seen. The major complications include pneumonia and dehydration. Take precautions now that the flu season is here and stay healthy my friends.
By: P. Michael Shattuck, M.D. – Community Health Network Family Physician
