After an incubation period of 1 to 3 days, an Influenza illness is generally characterized by the abrupt, sudden onset of high fever, frequently with chills or rigors, headache, feelings of tiredness, muscle aches, and a dry cough. High fevers up to 103 to 105 F degrees are common with influenza. Then, the respiratory signs of sore throat, nasal congestion, and cough become more prominent. Less commonly, eye redness and watery discharge, abdominal pain, nausea, vomiting and diarrhea can also be present with the “flu”.  In some children, influenza can have the appearance of a simple “cold virus” or it can appear as a fever illness with few respiratory signs. In newborn babies and very young infants, influenza can produce a variety of symptoms which can be more serious. The infection can look like sepsis in a young infant (a severe, generalized bacterial infection) requiring several tests to investigate this possibility.  Besides the above routine symptoms of the flu, it can occasionally cause croup, apnea, or pneumonia in these infants.

Some older children with the flu can have a tendency to develop tenderness of the calf portion of the leg and refuse to walk.  This symptom of the flu may develop several days into the influenza illness. This is especially prone to happen with Influenza type B infections. Reye syndrome, a severe disease producing inflammation of the brain and liver with the development of coma, has been associated primarily with influenza B, but also with influenza A infection. The development of Reye syndrome in people infected with the flu has been associated with the consumption of aspirin.  Obviously you should not take aspirin if you have the flu to avoid this potential complication.

Generally, Influenza is spread from person to person by direct contact, large droplet infection (as from a sneeze), or from articles recently contaminated by nasal secretions. You can catch the flu through the air when a person who has the virus sneezes, coughs, or speaks. People also can catch the virus after touching a contaminated object that someone with the virus sneezed or coughed on. Influenza organisms can live on surfaces for several hours (4 to 8 hours).  Therefore, cleaning of surfaces and discarding used tissues are very important during flu outbreaks, especially in schools. During an outbreak of influenza, the highest attack rates occur in school-age children. Secondary spread to adults and other children within the family is very common.

Influenza is highly contagious, especially among institutionalized populations. People with the flu are most infectious in the 24 hours before the onset of symptoms and during the period of peak symptoms. They usually remain contagious until 5 to 7 days from the onset of illness have past. However, the contagiousness of the flu can last longer in young children and immunodeficient patients.

After five days, fever and other symptoms have usually disappeared. But a cough and weakness may persist for several more days. All symptoms are usually gone within seven to 14 days. Pneumonia, sinusitis, and ear infections are occasional complications of the flu.

Because the flu is a viral illness, antibiotics don’t help. There are flu medications which can shorten the duration and diminish the severity of the illness if begun within 24 to 48 hours of the onset of the illness.  Should you become ill with the flu, and desire to be treated by a flu medication, you should contact us early in the illness to obtain appropriate treatment.

Any of the following symptoms during a flu illness are concerning and should prompt an office visit: fast breathing, trouble breathing or wheezing, bluish skin color, not drinking enough fluids (the signs of dehydration are a dry mouth and poor urine output, less than three times per day), child being very sleepy or lethargic, or fever with the development of a rash. In babies, severe irritability should prompt a visit. Lastly, after the flu symptoms have improved, any worsening that returns with fever and a worse cough is a sign of pneumonia and should prompt and office visit.

Here are some tips for avoiding the flu:  avoid touching your eyes, nose, and mouth; teach your child to wash their hands often; get plenty of sleep and rest to keep your immune system healthy; cover your nose and mouth with a tissue when you sneeze or cough and put used tissues in the trash; if you don’t have a tissue, cough or sneeze into your upper sleeve, not your hands; clean your hands after coughing or sneezing – wash with soap and water or use alcohol-based hand cleaner.

Treatment of the flu:

  • drink lots of fluids to prevent dehydration.
  • get plenty of sleep and rest.
  • take acetaminophen or ibuprofen to relieve fever and aches if you must, but remember that fever helps the flu go away faster if it is not treated.
  • do not give aspirin if you have the flu.  This is to prevent Reye’s syndrome.
  • wear layers, since the flu often makes a person cold one minute and hot the next (wearing layers – like a T-shirt, sweatshirt, and robe – makes it easy to add or subtract clothes as needed)
  • call a doctor if your child seems to get better but then feels worse, develops a high fever, has any trouble breathing, or seems confused.  These can be a signal complications of the flu.
  • keep sick kids home from childcare or school and limit their contact with others; kids should stay home 7 to 10 days after the onset of illness.
  • if your child becomes ill with a flu like illness consult us early in the illness so that Tamiflu can be prescribed.
Reviewed 3/17/17 by Dr. Byrum