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In the Know - All About...Flu

Is the winter “influencing” you?   It influenced the medieval Italians, too—giving rise to “influenza da freddo,” or “influence of the winter.”


Before anyone knew that the illness known once as influenza da freddo was caused by a virus, they knew was that the symptoms associated with the flu—primarily, fever and chills for at least a good few days—struck regularly come each winter.


But caused by a virus it is—and several strains of the same virus, for that matter.


As it turns out, there are four types of flu: A, B, C and D.  A is the most common, followed by B.  Both cause seasonal epidemics.  Flu C is relatively rare and relatively invisible, generally causing mild respiratory illness (if any illness).  (Flu D primarily affects cattle.)


What’s more, most of the flu that goes around infecting people each year is Flu A—and that the Flu A virus itself is constantly mutating and presenting new strains.  (In other words, when people say, “Better watch out for that flu this season—I hear this year’s bug is rough!” they’re referring to Flu A.)


That’s why you need to get the flu shot every year—because last year’s vaccine won’t necessarily protect you from this year’s projected Flu A strain.  (It also won’t protect you from last year’s Flu B strain—the vaccine also protects against this year’s projected Flu B strain.)


Come freddo, catching the influenza is not inevitable.  Do read on!



The influenza virus is a common virus that attaches itself to the inside of your respiratory system (nose, mouth, throat and lungs), usually your nose.


Once there, it multiplies and spreads to the throat and lungs—triggering a strong response by your body’s immune system.  This response results in the fever, chills and muscle aches associated with flu.


Influenza is not the same as stomach “flu” viruses that cause diarrhea and vomiting.  The “stomach flu” is often just a case of what’s called gastroenteritis.


For most people, influenza resolves on its own.  If you’re young and healthy, seasonal influenza usually isn’t serious.  Although you may feel miserable while you have it, the flu usually goes away in a week or two with no lasting effects. 


What’s “Swine Flu”? And what about “Bird Flu”?

There are actually two viruses known as the Swine Flu.

One is simply just another strain of the Influenza A virus known as H1N1.  When it appeared in 2009, it was the first major new strain of Flu A in about 40 years, according to the CDC.  But the H1N1 Flu A strain already has a vaccine for it, which is now included in the annual flu shot.


The other Swine Flu is a flu virus that only infects pigs (swine), not humans—so you have no reason to be afraid of it, despite a plethora of sensationalistic reports about it.


Here’s why the other Swine Flu is not a threat: because it does not have the receptors, or arms, that are used to attach to the inside of the nose by regular flu viruses.  With no receptors, the Swine Flu virus can’t attach itself to the inside of human noses and thus infect humans.  And if this virus does get inhaled by a human, it typically ends up in the digestive system, where it is killed by natural acids.


The same is true for the Bird Flu—a flu virus that continues to be deadly for chickens, ducks and other flocks of commercial birds, but not for humans.  It has no receptors.



The flu may start off like a common cold—with ordinary symptoms like runny nose, sneezing and sore throat.  But colds usually develop slowly, while the flu tends to come on suddenly.  And while colds can be a nuisance, the patient will typically feel much worse with the flu.


The flu’s most common telltale signs are:

  • Fever over 100.4

  • Chills and sweats

  • Aching muscles, especially in the back, arms and legs

  • Fatigue and weakness


Other common flu symptoms include:

  • Headache

  • Dry, persistent cough

  • Nasal congestion

  • Sore throat


Risk of complications

Influenza and its complications can be deadly.  People at higher risk of developing flu complications include:

  • Young children under five, and especially those under two years

  • Adults older than 65

  • Residents of nursing homes and other long-term care facilities

  • Expectant women and women up to two weeks postpartum

  • People with weakened immune systems

  • People with chronic illnesses like asthma, heart disease, kidney disease or diabetes

  • People who are very obese, with a body mass index (BMI) of 40 or higher


Pneumonia is the most serious complication.  For older adults and people with a chronic illness, pneumonia can be deadly.



If you know it’s the flu and you’re not in one of the above at-risk categories, take comfort in the fact that most people with the flu can ride it out at home and often don’t need a doctor.  But anyone at risk for complications should see a doctor immediately.  A doctor can diagnose flu quickly and provide antiviral drugs within the first 48 hours after symptoms are first noticed.  This is important because flu antivirals like Tamiflu may reduce the length of the flu infection and help prevent more-serious problems.



A number of flu tests can detect flu viruses.  The most common are called “rapid influenza diagnostic tests” and can provide results in 30 minutes or less.  Unfortunately, the ability of these tests to detect the flu can vary greatly—you could even test negative and still have the flu.  Also, rapid tests appear to be better at detecting flu in children than adults.


There are several other flu tests that are much more accurate, but these must be done in specialized laboratories at hospitals or state public health facilities.  These tests require the swabbing of the inside of the nose or the back of the throat for a sample which is then tested.  They not require a blood sample.



The flu is caused by infection with the flu virus.  But how do you get that flu virus?  Contaminated droplets, that’s how!


When you cough, sneeze or even talk, your mouth and/or nose expels droplets of water or moisture that drift through the air.  If you have the flu, your expelled water droplets will have the flu, too—and if someone (without the flu shot) inhales those droplets, they’ll get the flu, too.


People can also catch the flu if they touch their hand to a surface—for example, a desk, keyboard or cell phone—with infected droplets on them, and then touch their eyes, nose or mouth. 


People with the virus are likely contagious from the day or so before symptoms first appear until about five days after symptoms begin—and can be contagious for up to ten days after symptoms appear.  Kids and people with weakened immune systems may be contagious for slightly longer.



Flu usually needs nothing more than bed rest and plenty of fluids.  But in some cases, your doctor may prescribe antiviral drugs like Tamiflu or Relenza.  They may shorten the flu’s run by a day or so and help prevent serious complications, but can produce side effects including nausea and vomiting (which may be lessened if taken with food).


Tamiflu has also been associated with delirium and self-harm behaviors in teenagers, so it’s not recommended for youths.  An additional concern is that some flu strains have become resistant to Tamiflu and the older Flumadine antiviral drug.


Home treatment

  • Drink plenty of liquids.  Choose water, juice and warm soups to prevent dehydration

  • Rest.  Get more sleep to help your immune system fight infection

  • Take pain relievers like acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others) to combat the flu’s muscle aches and pains.  Don’t give aspirin to children or teens because of the risk of Reye’s syndrome



The CDC recommends annual flu vaccination for everyone over the age of six months.


Each year’s seasonal flu vaccine contains protection from the three or four influenza viruses projected to be the most common during in the upcoming season.  The CDC no longer recommends nasal spray vaccinations because they have been relatively ineffective in recent seasons.


For seniors, recent studies find that the high-dose flu shot protects better than the standard dose.


Controlling the spread of infection

Here are the critical basics to break the chain of viruses passing from one person to another:

  • Elbow your face!  Flu-rich water droplets will bounce right off your hands into the air to float around and possibly infect people—so sneezing or coughing into your elbow, NOT your hands, will keep those water droplets far more contained, especially if they’re absorbed by your sleeve.  If your elbow is not “sleeved,” cough or sneeze into anything absorbent—a tissue, napkin or even towel.  Very important: Teach your kids this habit!

  • Soap hands regularly.  Whether or not you’ve just sneezed or coughed a handful of bug-laden water droplets onto your hands, washing your hands regularly with soap and hot water during the flu season is a great way to kill any bugs that may have ended up on your hands—where they can infect you or others.  Kids should sing the “A-B-C Song” while soaping hands to ensure effectiveness.  Use alcohol-based hand sanitizers if soap and water aren’t available.

  • Avoid close-quarters areas.  One of the most common myths is that flu is associated with winter.  It’s not!  It only strikes more during winter because more people are indoors—and in closer proximity to more people—during winter.  So avoid places where people congregate, like child care centers, schools, office buildings, auditoriums and public transportation,  because that’s where the flu spreads the most.

  • Infected?  Don’t expose others!  If you’ve got the flu, stay home for at least 24 hours after your fever fades out so that you lessen your chance of infecting others.

  • Ventilate your house.  It can seem counterintuitive—but the fact is that stale and unchanged indoor air can be a veritable virus soup, especially when someone in the house has the flu (or any other viral infection).  Isolate the infected person in a bedroom for a few hours while leaving open all the other windows and doors in the house—allowing fresh outside air to blow in, flush out and replace stale inside air.  Then isolate the infected person in a freshly ventilated room for a few hours while you ventilate his/her bedroom, leaving the whole house with fresh air!



The flu virus can leave one feeling rather uncomfortable for a good few days.  But with proper rest and fluid intake should one get it, never mind getting the flu shot and taking other precautions so as to never get it, fall and winter need not be seasons of flu-induced suffering.