Don't let the flu cause misery for you

Published Oct. 21, 2009
By Maj. (Dr.) Jessica Cowden
81st Medical Operations Squadron

KEESLER AIR FORCE BASE, Miss. -- The Gulf Coast has had increased numbers of flu-related visits to health-care providers' offices and hospitals since mid-August.

The Mississippi State Department of Health and the Centers for Disease Control and Prevention are not tracking every person who gets sick with a flu-like illness because there are too many and many people never get seen by a doctor and even fewer get tested. However, they are tracking how many people are hospitalized. They are also testing viruses (taken from hospitalized people and from people at surveillance sites) to see what types of influenza viruses are circulating. So far, nearly all the influenza viruses being detected by the Mississippi State Department of Health laboratory are the 2009 H1N1 strain; this, however, may change as the flu season continues as seasonal flu strains may re-emerge.

For most otherwise healthy people, the 2009 H1N1 flu is a relatively mild (but uncomfortable) illness similar to seasonal flu. Symptoms include fever, chills, cough, sore throat, runny or stuffy nose, body aches, headache, fatigue, and sometimes diarrhea and vomiting. Pregnant women, people with chronic medical problems, and children under the age of 5 (especially those under 2) are at extra risk for complications; these individuals should be careful about taking action quickly and should call their health-care provider for advice.

People with uncomplicated flu illness who are not considered "high-risk," based on age or medical condition, do not need to be seen by a health-care provider and do not need to be tested for H1N1. People with influenza-like illness who are not high risk should stay home until they have been without fever for at least 24 hours (without the use of fever-reducing medication).

High-Risk Individuals for Seasonal and H1N1 Influenza

Individuals who are at higher risk for complications for H1N1 and seasonal flu and may need to see a health care provider include the following:
- infants and young children
- pregnant women
- people 65 years of age and older
- people of any age with lung disease (including asthma), heart disease or weakened immune systems from cancer, HIV or immunosuppressive medications
- people with kidney disease, diabetes or neurological and neuromuscular diseases
- people younger than 19 years with diseases requiring long-term aspirin therapy
- individuals with other chronic diseases

Signs that Individuals may need to see a health-care provider

Signs that a child may be sicker and should be seen by a health-care provider include the following
- difficulty breathing or fast breathing
- bluish or gray skin color
- fever lasting more than three days
- dehydration (no urination in 12 hours)
- severe or persistent vomiting
- not waking up or not interacting
- very irritable and not wanting to be held
- flu-like symptoms improve but then return with fever and worse cough

Signs that an adult may be sicker and should be seen by a health-care provider include the following
- difficulty breathing or shortness of breath
- pain or pressure in the chest
- confusion or increasing lethargy (sluggishness)
- severe or persistent vomiting
- persistent fever and cough

Use of antivirals such as Tamiflu for flu treatment .

Antiviral medications such as Tamiflu are recommended for all people hospitalized with a flu-related illness and for individuals who fall into one of the high-risk categories above. They have been shown to prevent complications and side effects of influenza illness. Antiviral medications, like all medications, can be associated with adverse effects, including allergic reactions, gastrointestinal side effects (vomiting and diarrhea in 13 percent of people), and strange behavior. For antiviral medications to be most beneficial in treating flu illnesses, they should be started within 48 hours of illness onset.

Tamiflu treatment is not recommended for individuals without chronic conditions or who are not in a high-risk age group, and who are otherwise tolerating the flu without the warning signs listed above. When ill with the flu, these people should keep away from others as much as possible, stay home for at least 24 hours after fever is gone (except to seek medical care, if needed), get plenty of rest, drink clear fluids like water and soup to keep from getting dehydrated, cover coughs and sneezes, wash hands often with soap and water or an alcohol-based hand rub and be watchful for emergency warning signs (listed above) that might indicate the need to seek medical attention.

Individuals are encouraged to avoid the flu by getting seasonal flu and H1N1 vaccinations when the vaccines are available and to practice good hygiene by:
- frequently washing hands;
- coughing and sneezing into the crook of your arm, rather than uncovered or in your hand;
- avoiding people with respiratory illness;
- staying home from work or school when sick, returning only after fever has subsided for
24 hours without the use of a fever-reducing medication.

For information about seasonal or 2009 H1N1 influenza, visit the CDC Web site at http://www.cdc.gov/h1n1flu or http://www.flu.gov/.

Don’t let the flu cause misery for you