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Seasonal flu

Published by Bupa's health information team, March 2009.

This factsheet is for people who have seasonal flu, or who would like information about it.

Influenza - or flu - is caused by flu viruses. Flu has similar symptoms to a cold, when you have a runny nose, sore throat or a "bunged up" feeling, but flu tends to be more severe. Seasonal flu follows a pattern, and tends to occur at around the same time every year. Your body will usually fight off the infection on its own, without medical treatment.

About flu

In the UK, most cases of seasonal flu occur between December and March. There are two main types of influenza virus - type A and type B. Influenza type A is usually worse. Another type of flu virus called type C usually causes a mild infection similar to the common cold. The flu viruses infect your nose, throat, sinuses and airways.

Very rarely, a new flu virus emerges. When this happens, there is the possibility that the virus may spread very rapidly across the world causing a pandemic because no one has any immunity to the new flu virus, so more people get flu. See our factsheet on pandemic flu for more information.

If you are over 65 or have a lung disease, flu can lead to life-threatening complications. About 12,000 people in England and Wales die each year because of flu and this increases during a flu epidemic (when the flu is widespread and affects many individuals in the population).

Symptoms of flu

The flu viruses grow in the soft, warm surfaces of your nose, throat, sinuses and airways, so this is where you usually get the symptoms. Typically, you will:

  • have a fever - your normal temperature should be 37°C
  • have a blocked or runny nose
  • sneeze
  • have a headache
  • have a sore throat
  • cough
  • get chills
  • have aching muscles
  • feel tired

Symptoms usually last for about a week but coughs and tiredness may last for a few weeks. You may also lose your appetite, feel or be sick, or have diarrhoea.

Complications of flu

For most healthy adults, flu is just like an unpleasant cold. However, young children, the elderly and people with long-term illnesses are more likely to get complications.

Complications of flu include pneumonia, middle ear infections, and sinusitis. Children under six with flu can sometimes have seizures or fits - known as febrile convulsions - because of their high body temperature.

You are at greater risk of having complications if you are over 65, if you live in a care home, or you have:

  • asthma
  • chronic lung disease such as chronic obstructive pulmonary disease
  • diabetes and take medication for it
  • heart disease
  • kidney diseases and kidney failure
  • reduced immunity, for example if you have HIV/AIDS or have had your spleen removed

Causes of flu

Flu viruses are spread from person to person in droplets in the air. Sneezing or coughing produces more droplets and helps to spread the infection. Touching infected surfaces, such as door handles or when shaking hands, and then passing the virus from the hands to the mouth, nose or eyes is another route of infection. Close contact with someone with the virus, (such as kissing) can also pass the viruses.

You can spread flu viruses from a day before your symptoms start until up to five days afterwards. Children can pass the virus for up to two weeks. Children are especially important in spreading flu as they are less likely to have antibodies to fight most flu viruses and so are more likely to become infected.

Diagnosis of flu

Although flu can be nasty, your body will usually fight off the infection on its own, without medical treatment so you don't have to see your GP. If your symptoms get much worse or last longer than a week, you should go to your GP. If you have a medical condition which makes flu worse you should go to your GP.

You should see your GP, practice nurse or pharmacist for advice if you get any of the following symptoms with flu:

  • severe vomiting or diarrhoea
  • earache
  • difficulty breathing
  • skin rash
  • uncontrollable cough
  • cough with yellowy green or rust-coloured sputum (phlegm)
  • extreme lethargy or drowsiness

Your GP will ask you about your symptoms and examine you. He or she may also ask you about your medical history.

Your GP will base a diagnosis of flu on your symptoms rather than on results of laboratory tests. He or she may take a swab from your nose or ask you to provide a sample of mucus for further testing.

Treatment of flu

Self-help

There is no cure for flu. However, there are things you can do to help yourself feel better.

  • Drink enough fluids to prevent dehydration - but don't drink excessive amounts.
  • Steam inhalations with menthol, eucalyptus or camomile may be helpful. Take care with the hot water.
  • Vapour rubs can be soothing. Don't put this around your child's nose as it can block the airway.
  • Tissues with menthol or moisturisers may help clear noses or prevent sore skin around the nose.
  • Sucking sweets or lozenges with menthol or eucalyptus may help a sore throat.
  • Gargling with salt water may also help a sore throat.
  • Eating a balanced diet with plenty of fruit and vegetables.
  • Rest.
  • Don't smoke.

Medicines

Ask the pharmacist before taking any medicines. Always follow the instructions carefully and take care to stay within the safe daily doses.

For adults, use the painkiller that you would normally take for a headache to help relieve the fever and pain. Be aware of the doses you are taking of different medicines. It's easy to accidentally exceed the daily dose by using more than one product (eg tablets, capsules, a hot lemon/blackcurrant drink) containing the same active ingredient, such as paracetamol. Children can take liquid painkillers; your pharmacist will be able to discuss which products are available.

Ask your pharmacist for advice on products that contain a decongestant which can help to clear your blocked nose by reducing swelling. Nasal saline drops or nasal decongestants such as ephedrine sprays or drops may help with a bunged up nose. Nasal decongestants are not generally advised for children under 12.

Cough medicines may also be helpful. Glycerine, honey and lemon can be used for children under two years.

There are lozenges, mouth washes or sprays such as benzydamine hydrochloride (eg Difflam) which can be used to numb pain. They can be purchased from a pharmacist.

Antihistamines may help to reduce some symptoms such as a runny nose and sneezing but can make you feel more tired and cause headaches.

Antibiotics are not prescribed but can treat secondary infections caused by bacteria, such as a chest infection or infections of the ear, nose or throat. GPs don't usually prescribe antibiotics for seasonal flu. Your GP will tell you if you need to take them.

Antiviral medicines

If you are in general good health and are not over 65, you probably won't need any specific medical treatment for flu, apart from the self-help and medicines suggested. However, if you are likely to get complications or spread the virus – for example if you have asthma or live in a care home – you might be prescribed antiviral medicines to treat flu.

Antiviral medicines can reduce the duration of flu by around one day, but only if you start the treatment within two days of getting the flu. These medicines can be taken as tablets or as an inhaler (similar to the ones used for asthma).

GPs don’t usually prescribe antiviral medicines for flu.

Complementary medicines

Supplements of vitamin C, zinc and the herbal remedy echinacea are popular for preventing and treating colds. However, there is no good evidence that they are effective for colds and there is no evidence linking their effectiveness to flu.

There is some evidence that taking vitamin C supplements may slightly reduce the length of time you have symptoms of a cold but not flu. Further evidence has highlighted that if you are under high physical stress, such as running a marathon, or experience extreme cold, for example if you are skiing, your risk of getting a cold may be reduced if you take vitamin C but there is no evidence that it helps flu.

Zinc products, which can be purchased as a gel that you put in your nose or lozenges that you suck, may be helpful for colds but there is limited evidence that they help treat flu.

Echinacea may help to reduce the symptoms of a cold if you take it early enough before your symptoms get worse, but again there is limited evidence for this and it hasn't been shown to help treat flu. Echinacea can be purchased in different preparations such as a powder or tablets. It's not suitable for everyone. Always check the label and follow your GP's or pharmacist's advice.

There is no medical evidence to support the use of Chinese herbal medicines for flu.

Always check the label and follow your GP or pharmacist's advice.

If you are pregnant

If you are a healthy pregnant woman with uncomplicated flu, you should rest, drink plenty of fluids and take paracetamol, if needed. If you are likely to get flu complications, you should ask your GP for advice. You shouldn't use antivirals unless the risk of getting flu is high.

Prevention of flu

There are a few steps that you can take to help prevent catching flu:

  • eat a balanced diet that is rich in fruit and vegetables
  • take regular (preferably daily) exercise
  • don't smoke - or if you do, try to stop - because smokers are more likely to catch flu

To help prevent spreading flu:

  • try to stay away from other people
  • wash your hands regularly
  • throw away tissues as soon as you have used them

Immunisation

The flu jab will provide you with protection against the seasonal flu virus for one year. It only protects from some human strains of the influenza virus (not avian or swine flu).

It's freely available to everyone over 65 and is recommended for people at risk from the complications of flu. Your GP will give you more advice. Flu jabs may also be offered to some employees by their company. Alternatively, they are available from private health clinics. The usual time to get a flu vaccination is between September and early November, which is generally before the flu season starts.

Further information

Related topics

Sources

  • Advising patients to increase fluid intake for treating acute respiratory infections. The Cochrane Collaboration. www.cochrane.org
  • Antibiotics for the common cold and acute purulent rhinitis. The Cochrane Collaboration. www.cochrane.org
  • Chinese medicinal herbs for the common cold. The Cochrane Collaboration. www.cochrane.org
  • Common cold. Clinical Knowledge Summaries. http://cks.library.nhs.uk, accessed 2 June 2008
  • Common cold BMJ Clinical Evidence. www.clinicalevidence.com, accessed 2 June 2008
  • Echinacea for preventing and treating the common cold. The Cochrane Collaboration. www.cochrane.org
  • Febrile convulsions. Clinical Knowledge Summaries. http://cks.library.nhs.uk, accessed 16 June 2008
  • Flu treatment - zanamivir (review), amantadine and oseltamivir. National Institute for Health and Clinical Excellence (NICE), 2003. www.nice.org.uk
  • Frequently asked questions on influenza. Health Protection Agency (HPA). www.hpa.org.uk, accessed 17 June 2008
  • Influenza. BMJ Clinical Evidence. www.clinicalevidence.com, accessed 4 June 2008
  • Seasonal flu. Health Protection Agency (HPA). www.hpa.org.uk, accessed 4 June 2008
  • Influenza. Clinical Knowledge Summaries. http://cks.library.nhs.uk, accessed 4 June 2008
  • Iribarren C FG, Klatsky AL, Eisner MD, Exposure to environmental tobacco smoke: association with personal characteristics and self reported health conditions. J Epidemiol Community Health, 2001(55):721-8
  • Joint Formulary Committee, British National Formulary (BNF) March 2008, 55th ed. London: British Medical Association and Royal Pharmaceutical Society of Great Britain
  • Nasal decongestants for the common cold. The Cochrane Collaboration. www.cochrane.org
  • Planning for pandemic influenza in adult social care. The Department of Health (DH), 2007. www.dh.gov.uk
  • The Green Book. The Department of Health (DH). www.dh.gov.uk, accessed 4 June 2008
  • Vitamin C for preventing and treating the common cold. The Cochrane Collaboration. www.cochrane.org

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: March 2009

 

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