Flu: When is it serious?

Posted on 6 June 2017

Influenza viruses, or flu for short, spread like wildfire in winter. Although generally harmless, complications can arise, especially in the very young, elderly or immune-compromised. 

Here’s a list of flu symptoms and when to start worrying about them.

Fever

A defining symptom of flu is the presence of a fever. A raised body temperature helps fight infection and is not dangerous, unless consistently high. If your fever is higher than 39.4 degrees you should see a doctor. For newborn babies, 38 degrees and higher will need medical attention. Young children should be treated with fever medications as prescribed by their healthcare providers.

Headache

This is a common flu symptom, however, if it is severe or associated with vomiting and/or neck pain it could be a sign of something more serious like meningitis. A headache that leads to a change in mental state, confusion or severe drowsiness is cause for concern and should be attended to by a doctor.

Coughing

A nagging cough is part and parcel of the flu. It can be a a dry cough or a productive cough, but when it’s accompanied by shortness of breath and/or a rapid heartbeat, it could be a sign of a serious complication developing, such as pneumonia. Similarly, noisy breathing, such as rasping or wheezing needs medical attention.

Pain

Flu makes your joints and muscles ache. Doctors call this myalgia and it’s caused by your immune system releasing inflammatory chemicals to fight the virus. Pain medications and anti-inflammatories can help.

Flu normally lasts 3-7 days. If your muscles are sore and tender for longer than that, get it checked out by your doctor. There may be another underlying cause.

Vomiting

This can accompany the flu or a fever, especially in children under five-years-old. Profuse vomiting could become serious if it leads to dehydration. It could also be serious if there is an inability to tolerate oral fluids persistently or there is blood in the vomit. When dehydration is severe admission to hospital for a drip may be necessary. Young children, people over 65 and pregnant women are particularly vulnerable to dehydration.

Diarrhoea

Gastro-intestinal symptoms such as nausea and bloating are regular flu symptoms. Diarrhoea is less common, but can occur with greater frequency in children. As with vomiting, the thing to watch for is dehydration and blood in the stools, which could indicate something more sinister.

Sore throat

A scratchy throat is often the first sign of flu developing. Soothe it with cold and warm drinks, lozenges and painkillers. If a sore throat is accompanied by a barking cough, difficulty breathing or lasts longer than a week, you need medical attention.

Stuffy nose

A runny or blocked nose is a very common flu symptom. It should abate as you start to feel better and can be treated at home with saline sprays. Ongoing nasal congestion, especially if accompanied by ear pain, headache or pain behind the eyes could indicate a secondary infection that needs attention, such as sinusitis or otitis media (middle ear infection).

Dr Ingrid Human, a general practitioner at Mediclinic Kimberley, says that flu or influenza viruses kill between 6 000 and 11 000 South Africans every year*. She recommends that pregnant women, people older than 65, children between 6 months and four years of age, anyone with a chronic disease, patients on long-term aspirin therapy and healthcare workers are immunised against the dominant flu strains annually.

References:

http://www.bmj.com/content/355/bmj.i6258

https://www.cdc.gov/flu/consumer/symptoms.htm

*https://www.wits.ac.za/news/latest-news/in-their-own-words/2016/2016-06/why-its-still-worth-getting-the-flu-vaccine-this-year.html