Vaccinations to prevent influenza is particulary important for person who are at increased risk for severe complications from influenza, or at higher risk for influenza related hospital visits. This document is a summary of the recommendations of the Advsory Commitee on immunization practices for 2013-2014.
When Does It Occurs?
Influenza (commonly called the flu) is a highly contagious illness that can occur in children or adults of any age. It occurs more often in the winter months because people spend more time in close contact with one another. The flu is spread easily from person-to-person by coughing, sneezing, or touching surfaces.
Influenza and the Flu
Every year, complications of the flu require more than 200,000 people in the United States to be hospitalized. Serious illness is more likely in the very young, older adults, pregnant women, and people who have certain health problems such as asthma or other forms of lung disease.
There have been several widespread flu outbreaks (called pandemics), which led to the deaths of many people worldwide. These outbreaks occurred when new strains of influenza viruses formed (often from pigs or birds) and humans became infected because they had no immunity to these viruses.
Symptoms of seasonal flu can vary from person to person, but usually include:
- Fever (temperature higher than 100ºF or 37.8ºC)
- Headache and muscle aches
- Cough and sore throat may also be present
People with the flu usually have a fever for two to five days. This is different than fever caused by other upper respiratory viruses, which usually resolve after 24 to 48 hours.
Most people with the flu have fever and muscle aches, and some people also have cold-like symptoms (runny nose, sore throat). Flu symptoms usually improve over two to five days, although the illness may last for a week or more. Weakness and fatigue may persist for several weeks
Influenza is usually diagnosed based on symptoms (fever, cough and muscle aches). Lab testing for influenza or flu is performed in certain cases, such as during a new influenza outbreak in a community and in patients who are at increased risk for complications.
Treat symptoms — Treating the symptoms of influenza can help you to feel better, but will not make the flu go away faster.
- Rest until the flu is fully resolved, especially if the illness has been severe
- Fluids — Drink enough fluids so that you do not become dehydrated. One way to judge if you are drinking enough is to look at the color of your urine. Normally, urine should be light yellow to nearly colorless. If you are drinking enough, you should pass urine every three to five hours.
- Acetaminophen (such as Tylenol® and other brands) can relieve fever, headache, and muscle aches. Aspirin, and medicines that include aspirin (eg, bismuth subsalicylate; PeptoBismol), are not recommended for children under 18 because aspirin can lead to a serious disease called Reye syndrome.
- Cough medicines are not usually helpful; cough usually resolves without treatment. We do not recommend cough or cold medicine for children under age six years
Antiviral treatment — Antiviral medicines can be used to treat or prevent influenza. When used as a treatment, the medicine does not eliminate flu symptoms, although it can reduce the severity and duration of symptoms by about one day. Not every person with influenza needs an antiviral medicine, but some people do; the decision is based upon several factors. If you are severely ill and/or have risk factors for developing complications of influenza, you will need an antiviral agent. People who are only mildly ill and have no risk factors for complications are usually treated with an antiviral medicine if they have had symptoms for 48 hours or less, but they are not treated if they have had symptoms for more than 48 hours.
Antiviral medicines that are used to treat or prevent the virus includes oseltamivir (Tamiflu®) and zanamivir (Relenza®). Two other antiviral medicines, rimantadine (Flumadine®) and amantadine (Symmetrel®), were used in the past but are generally no longer effective because most viruses are now resistant to them. Antiviral treatment is most effective for seasonal influenza when it is taken within the first 48 hours of symptoms.
The best antiviral medicine depends upon the type of influenza virus, if the virus could be resistant, and some individual factors. A doctor or nurse should make this decision
Remember always that vaccination is the best method of preventing the disease. Pregnant patients should vaccinate irrespective of trimester of pregnancy.
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