Influenza

Influenza - The Flu

The flu is a serious respiratory infection that affects millions of people each year and spreads easily through the respiratory droplets of an infected person. Although recovery may take several days, most people recover from the flu (including H1N1 flu) with rest and proper self care strategies. UHS does not give class excuses for the flu.

Symptoms of the Flu

Fever (usually 100 degrees or greater) and cough and/or sore throat.

Other symptoms may include body aches, chills, mild headache, runny nose and /or nasal congestion, and occasionally vomiting or diarrhea.

What should I do if I’ve been diagnosed with the flu or have influenza-like symptoms?

People who are pregnant, have a chronic medical condition (such as asthma, diabetes, cystic fibrosis, or heart disease), or are immunocompromised, are at greater risk for developing severe illness from the flu. If you, or anyone you have been in close contact with while ill, have these conditions, contact UHS or a healthcare provider as soon as possible.

Anti-viral medications

These medications can help shorten the duration of influenza. They are most valuable for people at high risk of complications from influenza. While they may be helpful, they are not necessary for everyone.

Anti-viral medications are most effective when they are started as close to the onset of symptoms as possible. The effectiveness is reduced considerably after 48 hours of illness. There are two medications available:

• Tamiflu (Osteltamivir)- This medication has been available since 1999. It is taken twice daily for 5 days. Side effects can include: nausea, headache, and vomiting. Rarely this medicine can cause neurological or psychiatric problems like hallucinations, abnormal behavior, anxiety, or seizures.
• Xofluza (Baloxavir)- Approved by the FDA in late 2018, this medication is given as a single dose. There is little to no benefit of starting this medicine if symptoms have been present longer than 48 hours. Side effects are less common than with Tamiflu but can include diarrhea or rashes.This medicine is not available as a generic, it may be expensive and not well covered by insurance.

Treatment recommendations

Following these basic guidelines can help ease your discomfort and speed your recovery.

• Have personal care items available such as hand sanitizer, tissues, and over-the-counter medicines to treat flu symptoms, a thermometer, and fluids. It takes about a week to recover from the flu so make sure you have enough supplies available for this time period.
• Let someone know that you are sick. Ask a friend to check on you daily while you’re not feeling well.
• Increase your fluid intake. Drinking more fluids will help you stay hydrated and better control your temperature. Fluids such as water, sports drinks and clear broth soups are generally well tolerated.
• Get plenty of rest. Stay in bed and rest as much as possible.
• Wash your hands frequently. Use alcohol-based hand sanitizers after coughing, sneezing and wiping your nose to reduce the spread of the virus.
• Cover all coughs and sneezes with a disposable tissue and discard immediately into a trash can.
• Isolate yourself in your room or home until at least 24 hours after fever has cleared without the use of fever-reducing medications. This means that your temperature should be below 100 degrees for at least this time period.

Fever, Chills, and Body Aches

For fever, chills, and body aches, use an NSAID (non-steroidal anti-inflammatory medication, like ibuprofen (generic Motrin or Advil) or naproxen (generic Aleve). The major side effect of NSAIDs is irritation of the stomach, occasionally leading to gastrointestinal ulceration and bleeding. Stop themedication if you have stomach upset or pain. Consider taking acetaminophen (Tylenol), instead, for fever and pain if you have stomach upset.

DO NOT TAKE ASPIRIN.

Stuffy Nose and Congestion

For stuffy nose and congestion use a decongestant. The only effective oral decongestant currently available is pseudoephedrine. You must ask the pharmacist for this medication (regulated because of illegal use to make methamphetamine), although no prescription isrequired. Decongestants purchased off the shelf contain phenylephrine and are much less effective. Oral decongestants may produce rapid heart rate, blood pressure elevation, nervous stimulation, and restlessness which may interfere with sleep.

An alternative to the oral medication is a decongestant nose spray oxymetazoline hydrochloride(generic Afrin). This can rapidly relieve nasal obstruction. When the decongestant effect of the drug wears off, nasal obstruction rapidly returns. Therefore, this can be very effective, but limit use to 3 days (if used twice daily) or 5-6 nights (if only used at bedtime). Overuse by just a few days can result in “rebound” obstruction and mucosal damage.

Runny Nose, Sneezing, and Cough

For runny nose, sneezing, and cough, try an antihistamine. The most effective antihistamines are first generation, although they tend to cause drowsiness. Examples of first generation antihistamines are brompheniramine (generic for DimeTapp),chlorpheniramine (generic for Chlor-Trimeton and Singlet), diphenhydramine (generic for Benadryl), and doxylamine (generic for NyQuil and Alka-Seltzer Plus Night-Time Cold Medicine).

The newer (non-sedating) antihistamines do not appear to have the same degree of effectiveness for treating colds. Examples are Loratadine (Claritin), Fexofenadine (Allegra –prescription required), and Certirizine (Zyrtec).

Sore Throat and Nasal Congestion

For sore throat and nasal congestion, consider using a saline rinse. 

For the nose: Various nasal saline rinse kits are available commercially. Do not use tap water. Distilled or sterile water is preferred. The most convenient way to perform a sinus rinse is in the shower or over a sink.

For the throat: You can make your own saline by mixing ½ teaspoon of salt and 8 ounces of warm water in a clean container. Swish and spit.

Keeping a throat lozenge, cough drop, or hard candy in your mouth will stimulate your saliva and help soothe your throat

Cough

For cough, you can try a cough suppressant. Cough suppressants are natural narcotics, like codeine, and synthetic narcotics, like dextromethorphan (DM). They act on the brain to depress the cough reflex center. Their effectiveness inpatients with chronic cough has been demonstrated in controlled studies but there is little published information on their effectiveness in coughs associated with colds. Cough suppressants can produce gastrointestinal discomfort but otherwise have few side effects. In normal healthy people with good cough reflexes, cough suppressants are safe.

Drug interactions may occur with DM and certain anti-depressants.If you are on an antidepressant, discuss this with your provider.

When to Seek Medical Evaluation

If you have the flu or viral illness and any of the following symptoms or conditions you need to seek medical evaluation as soon as possible.

• Fever greater than 101° or increasing over 2-3 days
• Fever that does not improve with medication such as acetaminophen or ibuprofen
• Difficulty breathing or shortness of breath (not due to nasal congestion)
• Severe headache or neck stiffness or pain
• Pain or pressure in the chest or abdomen
• Dizziness or confusion
• Vomiting
• Rash
• Difficulty swallowing fluids
• Flu-like symptoms not improving after 2-3 days
• Flu-like symptoms that were improving, but now are getting worse

Emergencies

In an emergency go to Mount Nittany Medical Center or call 911 for an ambulance.

Test Results and Advice Nurse

Send a secure message to the advice nurse via myUHS or call 814-865-4UHS (4847) (Press 3). 

Appointments 

Schedule an appointment online or by calling the UHS.  

This content is reviewed periodically and is subject to change as new health information becomes available. This information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis, or treatment by a healthcare professional.

Approved by the UHS Patient Education Committee Revised 06/10/2020