Flu

Definition

The flu (influenza) is a viral respiratory illness that causes fever, chills, runny nose, body aches, and cough. It spreads easily from person to person. The flu can cause moderate to severe symptoms. Most people recover fully. Children, older adults, and people with certain health conditions are at risk for severe illness and even death.

Alternative Names

Influenza A; Influenza B; Oseltamivir (Tamiflu) - flu; Zanamivir (Relenza) - flu; Vaccine - flu

Causes

The flu is caused by an influenza virus.

Most people get the flu when they breathe in tiny airborne droplets from the coughs or sneezes of someone who has the flu. You can also catch the flu if you touch something with the virus on it, and then touch your mouth, nose, or eyes.

People often confuse colds, flu, and COVID-19. They are different, but they do have some of the same symptoms. Most people get a cold several times a year. In contrast, people generally get the flu only once every few years. Cold symptoms tend to be more mild compared to the flu and COVID-19. The flu and COVID-19 share many symptoms, so it can be hard to tell them apart. The best way to know is to get tested. COVID-19 self-tests are available over-the-counter at most pharmacies. If needed, your health care provider can test you for the flu.

The flu spreads easily. It can affect a large group of people in a very short amount of time. For example, students and co-workers often get sick within 2 or 3 weeks of the flu's arrival in a school or workplace.

Sometimes, you can get a virus that makes you throw up or have diarrhea. Some people call this the "stomach flu." This is a misleading name because this virus is usually not the actual flu. The flu mostly affects your nose, throat, and lungs.

While certain people are at a higher risk, anyone at any age can develop serious complications from the flu. Those at highest risk include:

Symptoms

Flu symptoms often start quickly. You can start to feel sick about 1 to 7 days after you come in contact with the virus. Most of the time, symptoms appear within 2 to 3 days.

The first symptom is often a fever between 100°F (37.8°C) and 104°F (40°C). An adult often has a lower fever than a child. But not everyone with the flu has a fever.

Other common symptoms include:

Fever usually goes away in 3 to 4 days but may last up to 8 days. Other symptoms get better in 7 to 14 days. The cough and tired feeling may last for weeks. Sometimes, the fever comes back.

Some people may not feel like eating.

The flu can make asthma, breathing problems, and other long-term (chronic) illnesses and conditions worse.

Exams and Tests

Most people do not need to see a health care provider when they have flu symptoms. This is because most people are not at risk for a severe case of the flu.

If you are very sick with the flu, or you are at high risk for severe illness, you should contact your provider.

There is a test to detect the flu. It is done by swabbing the nose or throat. Most of the time, test results are available very fast. The test can help your provider determine the best treatment.

Treatment

HOME CARE

Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) help lower fever and relieve aches. Providers sometimes suggest that you use both types of medicine. Aspirin can also reduce fever and aches, but it may have potential serious side effects, such as stomach bleeding. So it’s best to avoid using aspirin and it should never be given to treat flu in someone age 18 or less.

A fever does not need to come all the way down to a normal temperature to make a difference in how a person feels. Most people feel better when the temperature drops by 1 degree Fahrenheit.

Here are other ways to relieve symptoms:

Certain medicines should not be given to children, or only after a certain age.

ANTIVIRAL DRUGS

Most people with milder symptoms do not need to see a provider or take antiviral medicines. Your provider may recommend antiviral treatment if you are very sick with the flu. You also may be given antivirals if you are at risk for serious illness. Children at risk for a severe case of the flu may also need these medicines.

The health problems below may increase the risk of getting sicker with the flu:

These medicines may shorten the time you have symptoms by about 1 day. They work better if you start taking them within 2 days of your first symptoms.

Antibiotics are NOT used to treat the flu. Antibiotics kill bacteria. They won't work on the viruses that cause the flu.

Outlook (Prognosis)

Millions of people in the United States get the flu each year. Most people get better within a week or two, but thousands of people with the flu develop pneumonia or a brain infection. They may need to stay in the hospital. About 21,000 people in the United States die each year of problems from the flu.

Possible Complications

Complications may include:

When to Contact a Medical Professional

Contact your provider if you or your child get the flu and are at risk for having complications.

Also contact your provider if flu symptoms are very bad and not getting better.

Contact your provider right away if you or your child have:

Any breathing problems are an emergency. Seek medical help right away. 

Prevention

You can take steps to avoid catching or spreading the flu. The best step is for everyone age 6 months and older to get a flu vaccine. There are two types:

Influenza (flu) vaccine (live, intranasal): This vaccine is a nasal spray. People ages 2 through 49 years who are not pregnant may receive LAIV.

Influenza (flu) vaccine (inactivated or recombinant): This vaccine is delivered by injection. Everyone 6 months and older can get the vaccine.

To help prevent spreading the flu when you are sick, stay home and away from others both inside and outside your household

You can go back to your normal activities if both of the following things are true:

Even though you feel better, you may still be able to spread the virus to others for several days. For this reason, once you go back to your normal activities, continue to protect others from illness by taking these steps for 5 days:

If your fever returns after resuming normal activities, you should go back to staying home and away from others. Once your fever and symptoms improve for more than 24 hours, you can resume activities while taking steps to protect others for 5 more days.

References

Aoki FY. Antiviral drugs for influenza and other respiratory virus infections. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 45.

Centers for Disease Control and Prevention website. Flu burden. About estimated flu burden. www.cdc.gov/flu-burden/php/about/index.html. Updated August 2, 2024. Accessed September 6, 2024.

Centers for Disease Control and Prevention website. Influenza (Flu): about influenza. www.cdc.gov/flu/about/. Updated August 13, 2024. Accessed November 26, 2024.

Centers for Disease Control and Prevention website. Influenza (Flu): signs and symptoms of flu. www.cdc.gov/flu/signs-symptoms/. Updated August 26, 2024. Accessed November 26, 2024.

Centers for Disease Control and Prevention website. Influenza (Flu): seasonal flu vaccine basics. www.cdc.gov/flu/vaccines/. Updated September 17, 2024. Accessed November 26, 2024.

Centers for Disease Control and Prevention website. Influenza (Flu): treating flu with antiviral drugs. www.cdc.gov/flu/treatment/antiviral-drugs.html. Updated September 11, 2024. Accessed November 26, 2024.

Centers for Disease Control and Prevention website. Respiratory illnesses: preventing spread of respiratory viruses when you're sick. www.cdc.gov/respiratory-viruses/prevention/precautions-when-sick.html. Updated March 1, 2024. Accessed March 11, 2024.

Havers FP, Campbell AJP. Influenza viruses. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 285.

Ison MG, Lee N. Influenza. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 332.

Treanor JJ. Influenza viruses, including avian influenza and swine influenza. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 165.


Review Date: 7/23/2024
Reviewed By: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 09/06/2024.
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