Symptoms and When to call for help

Symptoms of the flu include:

  • Fever (101° – 104°), lasting 3 – 5 days
  • Headache, severe muscle and joint aches
  • Sore throat
  • Tiredness, can be extreme and last 2 weeks or more
  • Dry cough
  • Runny or stuffy nose

What to do if you have flu symptoms:

  • Rest in bed
  • Drink lots of fluids (water or juice)
  • Take non-aspirin pain relievers to reduce fever and pain (Never give aspirin to children or teens with fever - they can get a serious disease called Reye syndrome.)
  • Stay home and avoid public activities for at least 5 days (7 days for children), so that you don’t pass the flu to other people

If you are at risk for complications from the flu, call a health care provider as soon as you have flu-like symptoms.

People at risk for complications from the flu include:

  • Infants and young children
  • People 65 years of age and older
  • Pregnant women
  • People with chronic medical conditions such heart or lung disease, diabetes and people whose immune system is weakened because of disease or medicine.

Call for help immediately if:

  • Breathing is fast, difficult or painful
  • The skin is dusky or bluish in color
  • The person has chest pain
  • The person is disoriented
  • The person is unable to walk or sit up, or function normally (others might be the first to notice this, especially in elderly people)

Call a health care provider if:

  • The fever lasts more than 3 - 5 days
  • The fever or cough goes away for 24 hours or more, and then returns
  • There is colored mucous with the cough
  • The person is not able to drink enough fluids (urine is dark or has not urinated for 12 or more hours)

Call a health care provider if your child or the person you are caring for has any of the symptoms above, or if he or she:

  • Still “acts sick” once the fever is gone
  • Looks very sick or is unusually drowsy or fussy
  • Has a stiff neck, severe headache, severe sore throat, severe earache or unexplained rash, or has repeated vomiting or diarrhea
  • Has a fever and has had a seizure
  • Gets the flu and has a weakened immune system because of disease of medicine

Protecting Yourself Against Seasonal and H1N1 Flu

Influenza, known as flu, is a very contagious disease of the respiratory (breathing) system. The flu is caused by a virus that is easily passed from one person to another by coughing and sneezing. For most people, the flu makes them feel very sick, but they generally get better in about a week. However, young children, people older than 65 years of age, pregnant women and people with chronic medical conditions can have serious complications from the flu. These complications can include pneumonia and worsening of medical conditions like heart disease, diabetes, or asthma.

The following tips can help protect you and your loved ones during the regular flu season, as well as from the threat of H1N1 flu or any other cough illness.

  • Get flu vaccine every year.
  • The best way to prevent the flu is to get flu vaccine every year.
  • The "flu shot" is an inactivated vaccine (containing killed virus) that is given with a needle. The flu shot is for everyone 6 months of age and older, including pregnant women and people with chronic medical conditions.
  • The flu vaccine that you get every year does not protect you against H1N1 flu.
  • Ask your health care provider if you should get pneumococcal vaccine.
  • Pneumococcal vaccine (pneumonia shot) may be recommended for you if you have a medical condition like diabetes, heart or lung disease, or a weak immune system, or if you are 65 years of age or older.
  • Wash your hands.
  • Wash your hands often with soap and water, or use an alcohol-based hand sanitizer.
  • Cover your mouth when you cough or sneeze.
  • Cough or sneeze into a tissue or the inside of your elbow. Throw tissues away and wash your hands.
  • Don’t touch your eyes, nose or mouth.
  • This decreases the chance that you will get the flu virus or other germs into your body, or that you will pass the flu to others.
  • Clean things that are touched often, such as door or refrigerator handles, computer key boards/mouse, phones and water faucets.
  • Avoid contact with people who are sick.
  • Avoid unnecessary holding, kissing or sharing food, dishes and glasses with anyone who has a cold or the flu. People with young children, weak immune system or a chronic illness should avoid large crowds, if possible.

Flu: What You Can Do

Keep the following supplies available. They are useful when caring for yourself or someone with the flu. Many of these supplies can be found at the supermarket, convenience store, or drugstore.

  • Soap for washing hands
  • Alcohol-based hand sanitizer such as Purell® or a store brand for cleaning hands
  • Medicines:
  • Acetaminophen (such as Tylenol® or a store brand) or ibuprofen (such as Advil®, Motrin®, or a store brand)
  • Cough and cold medicine
  • Throat lozenges
  • Thermometer(s) for checking body temperature
  • Fluids like water, fruit and vegetable juices, soups and broths, and beverages such as Gatorade® or a store brand
  • Foods that are easy to digest (such as oatmeal, applesauce, and rice)
  • Household disinfectant to clean surfaces
  • Paper towels for cleaning and handwashing
  • Trash bags to line waste baskets
  • An extra supply of special foods, medicine, or equipment that are needed by you or family members due to any chronic illnesses
Getting Enough to Drink: Dehydration and the Flu
When people lose more water than they take in, they become dehydrated. Fever, vomiting and diarrhea may make dehydration worse.
  • Signs of Mild or Moderate Dehydration
  • Feeling more thirsty
  • Very dry mouth
  • Less urination or darker urine
  • Slight dizziness or lightheadedness
  • Headache
How to Prevent and Treat Dehydration
  • Drink plenty of water, fruit and vegetable juices, soups and broths, and beverages such as Gatorade® or a store brand.  Avoid caffeine and alcohol.
  • Drink small amounts of fluid often, dehydration can occur very quickly.

When to Call a Doctor

Severe dehydration (not having enough fluid in the body) is a medical emergency. A person with severe dehydration may need fluids intravenously (through a needle in the arm) in a clinic or hospital. While you are waiting for medical help, continue to drink fluids in small amounts often. Get emergency medical care if you have any of these symptoms.

  • Difficulty breathing
  • Extreme irritability, decreased alertness, speech changes, confusion, or unconsciousness
  • Muscle weakness and fast heart rate
Call your doctor immediately if you have:
  • Extreme thirst
  • Very dry mouth or inside of nose, or skin does not bounce back to normal if it is gently pinched
  • Little or no urination
  • Weight loss
  • Fast heart rate
  • Very low activity level

Watch carefully for signs that dehydration is getting worse. Call your doctor if there are any unusual symptoms that concern you.

Fever and the Flu

Fever is a higher than normal body temperature. It is the most common symptom of the flu. Although fever may cause worry, it helps the body fight infection and is usually not harmful.

  • If you have flu, you may experience a fever that:
  • Increases quickly, rising to a peak of 101°–104° F within 12–24 hours.
  • Comes and goes, especially if medicines are used to treat it.
  • Typically lasts 3–5 days.
Treatment
Anyone older than age 6 months who has a temperature below 101°F probably does not need to be treated for fever, unless you are uncomfortable.

Things you can do to keep comfortable with fever:
  • Keep the room comfortably cool.
  • Wear light-weight clothing.
  • Drink fluids, such as water or diluted fruit juices
  • Take a lukewarm shower, especially if:
    • Temperature is above 104°F
    • Unable to take medicine because of vomiting
    • Have had a seizure caused by fever in the past

Do not use cold water, which can cause shivering and make the fever worse.

Do not use rubbing alcohol to try to bring down someone’s temperature. Alcohol can be absorbed through the skin and cause health problems.

Medication
Fever-reducing medicines can be used if the person is uncomfortable. Use medicine that is right for the person’s age and follow label directions carefully. These medicines are safe and effective if given correctly:

  •   Acetaminophen, such as Tylenol® or a store brand
  •   Ibuprofen, such as Advil®, Motrin®, or a store brand
Never give aspirin to someone younger than 19 years old unless recommended by a doctor.

How to take a temperature
Whenever you take your temperature, it is important to remember the following:
  • Always clean a thermometer with soap and water before and after each use.
  • Every time you take a temperature, write down the time, temperature reading, and the type and amount of medicine taken (if any).
  • If you’ve been using medicine to bring down the fever, take your temperature before the next dose is due.
  • The length of time to measure a temperature depends on the type of thermometer you use. Read the manufacturer’s instructions for details.
  • Do not drink any liquid for at least 15 minutes before taking the temperature.
  • Place the thermometer under the tongue towards the back of the mouth. Close your mouth and do  not bite down on the thermometer.
  • Hold the thermometer for the amount of time written in the manufacturer’s directions.
  • Normal temperature ranges: Mouth: 95.9° – 99.5°F

Information Summary for the Doctor

  1. Main reason you are calling
  2. Age
  3. Temperature
  4. Main symptoms
  5. How long has the person been feeling sick?
  6. Any breathing problems? Fast breathing or Shortness of breath?
  7. Do you have a headache?
  8. Vomiting?  If yes, how long?
  9. Drinking fluids?  If not, for how long?
  10. Eating normally?
  11. Sleeping normally?
  12. What have you done to treat the illness?
  13. Has the person traveled in the last week to ten days? Where? When? With whom?
  14. List chronic illnesses or medical conditions:
  15. Pregnant?
  16. List medicines for other illnesses or conditions:
  17. Anyone else in the family sick? Dorm room? Who? How long? What symptoms?

Other References

Mass Department of Public Health   
www.mass.gov/dph/swineflu

Centers for Disease Control   
www.cdc.gov/swineflu/

Boston Public Health Commission    
www.bphc.org