This week Dr Ciaran Roarty of Scally McDaid Medical Practice Letterkenny shares an insight into the recent winter flu outbreak.
What are flu and flu-like illnesses?
The recent flu outbreak has hit the headlines causing mayhem in our hospitals and GP surgeries up and down the country. The strain is similar to that which caused significant disease during the Summer in Australia (their Winter) so it is good to be well versed on what it is and how to deal with it.
Keep an eye on elderly and at risk neighbours. Numbers are not expected to peak for another 3-4 weeks. Remember it is not too late to get vaccinated and even if you have had the flu, you should get vaccinated if you are in an at risk group.
What is influenza?
The flu is caused by the influenza virus. Other viruses can cause “flu like illnesses” and it is often very difficult to say which exact virus is causing your symptoms. Doctors often will give a diagnosis of a flu-like illness – or quite commonly – “You have a dose.”
Each winter there is a seasonal flu outbreak and most cases occur within an 8 week period. There are 3 types of influenza virus –A, B and C and most cases are caused by either A or B.
The most common flu symptoms in adults and older children include:
- Fever (High temperature)
- General aches and pains in muscles and joints.
- A cough (usually dry).
- Sore throat.
- Sick tummy (nausea).
The actual influenza virus makes us feel worse than the other viruses which cause flu like illnesses. Even the young and healthy often have to go to bed.
In young children the flu may also cause difficulty breathing or feeding and sometimes febrile convulsions (fits)
Symptoms of the flu come on quite quickly, are worst for the first few days and then ease gradually. The cough may persist for longer. Most people recover after a week or so.
Is it contagious?
The flu virus is spread by little droplets created when we sneeze or cough. Touching a surface where the virus has been deposited can be enough to spread it.
Could it be something else Doctor?
Certain other serious illnesses, such as meningitis, pneumonia or malaria may have symptoms similar to the flu but generally you would expect to develop other symptoms also which would point towards these rarer conditions.
For example a rash that does not fade (or blanch) when pressed, a very stiff neck which may prohibit you bending your neck forward, or an aversion to bright lights may point towards more significant disease. Drowsiness, chest pain or coughing up blood or blood stained sputum should also be checked out. A headache which comes on suddenly and just keeps getting worse and worse or repeated vomiting are also significant symptoms.
If you have recently visited a country with malaria and develop the flu you should let your doctor know.
Once again we depend on our immune system to clear the flu virus. Treatment is really aimed at easing the symptoms until this happens. The good news is that in the vast majority of cases we can treat ourselves. Also see the excellent HSE website undertheweather.ie
Stay indoors and try to prevent spreading the infection. Recent HSE advice has advised parents not to send children to school or creche if they have flu like symptoms.
Paracetamol and/or ibuprofen eases aches and pains and helps lower high temperatures. Fluids are particularly important when running a temperature in order to prevent dehydration which makes us feel worse. Decongestant drops, throat lozenges and saline nasal sprays are also helpful.
It is important to be aware that over the counter cough and cold medicines should not be given to children under 6. There is no evidence that they work and indeed they may cause side effects such as allergic reactions or effects on sleep.
Antiviral medicines are sometimes prescribed by doctors to people who are at an increased risk of developing complications. They do not kill the flu or act like a vaccination and even without them you are still likely to make a full recovery. They are only prescribed when there is a significant burden of flu in the community and are usually only used within 48 hours of developing symptoms.
Will an antibiotic help me get rid of the flu quicker ?
Since antibiotics kill bacteria and not viruses, they are not routinely prescribed for the flu. They may be used if complications such as a chest infection caused by a bacteria or pneumonia develops. A small number of patients may require admission to hospital if complications develop.
What complications of flu can develop?
If you are normally well then it is very unlikely that you will develop complications and you should make a full recovery. You need to see a doctor if your symptoms change or get worse. Complications are more likely if you are in certain at risk groups (who should get the flu vaccination ) such as:
- Patients aged 65 or over.
- Patients with chronic lung, heart, kidney disease
- Patients with Diabetes
- Patients whose immune system is compromised – eg on chemotherapy /longterm steroids.
- Patients with MS, other chronic neurological conditions, previous stroke or live in a nursing home.
- Mums to be.
This is why we recommend flu vaccination in these patients.
The most common complication is a chest infection caused by a bacteria. This may develop secondary to the viral infection and pointers towards this include worsening cough, recurrence of temperatures, chest pain, shortness of breath and an increased respiratory rate (fast breathing). Antibiotics may be required in this scenario.
One thing that has changed over the years with our understanding of the flu is the significance of the colour of our sputum (phlegm). Green or yellow sputum does NOT necessarily mean that you have a secondary bacterial infection.
Other complications that can occur include sinusitis (a sinus infection) and an ear infection. Other serious complications are rare, such as brain inflammation (encephalitis).
The above information is intended as advice only and should you have any concerns contact your own Doctor.
Dr Ciaran Roarty MB BCh BAO MICGP DRCOG is a full-time GP at Scally McDaid Medical Practice , Scally Place, Letterkenny, Tel 0749164111