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Flu: What to do if You Get Sick

December 29, 2022

WHAT SHOULD I DO IF I GET SICK?

Most people with flu have mild illness and do not need medical care or antiviral drugs. If you get sick with flu symptoms, in most cases, you should stay home and avoid contact with other people except to get medical care.

If, however, you have symptoms of flu and are in a higher-risk group, or are very sick or worried about your illness, contact your health care provider (doctor, physician assistant, etc.).

Certain people are at increased risk of serious flu-related complications (including young children, people 65 and older, pregnant people, and people with certain medical conditions). For a full list of people at increased risk of flu-related complications, see People at Higher Risk of Developing Flu–Related Complications. If you are in a higher-risk group and develop flu symptoms, it’s best for you to contact your doctor early in your illness. Remind them about your higher-risk status for flu. CDC recommends that people at higher risk for complications should get antiviral treatment as early as possible, because benefit is greatest if treatment is started within 2 days after illness onset.

DO I NEED TO GO TO THE EMERGENCY ROOM IF I AM ONLY A LITTLE SICK?

No. The emergency room should be used for people who are very sick. You should not go to the emergency room if you are only mildly ill.

If you have emergency warning signs of flu sickness, you should go to the emergency room. If you get sick with flu symptoms and are at higher risk of flu complications or you are concerned about your illness, call your health care provider for advice.

WHAT ARE EMERGENCY WARNING SIGNS OF FLU?

People experiencing any of these warning signs should obtain medical care right away.

In children

  • Fast breathing or trouble breathing
  • Bluish lips or face
  • Ribs pulling in with each breath
  • Chest pain
  • Severe muscle pain (child refuses to walk)
  • Dehydration (no urine for 8 hours, dry mouth, no tears when crying)
  • Not alert or interacting when awake
  • Seizures
  • Fever above 104°F
  • In children less than 12 weeks, any fever
  • Fever or cough that improve but then return or worsen
  • Worsening of chronic medical conditions

In adults

  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest or abdomen
  • Persistent dizziness, confusion, inability to arouse
  • Seizures
  • Not urinating
  • Severe muscle pain
  • Severe weakness or unsteadiness
  • Fever or cough that improve but then return or worsen
  • Worsening of chronic medical conditions

These lists are not all inclusive. Please consult your medical provider for any other symptom that is severe or concerning.

ARE THERE MEDICINES TO TREAT FLU?

Yes. There are drugs your doctor may prescribe for treating flu called “antivirals.” These drugs can make you better faster and may also prevent serious complications. See Treatment – Antiviral Drugs for more information.

HOW LONG SHOULD I STAY HOME IF I’M SICK?

CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or other necessities. Your fever should be gone without the need to use a fever-reducing medicine, such as Tylenol®. Until then, you should stay home from work, school, travel, shopping, social events, and public gatherings.

CDC also recommends that children and teenagers (anyone aged 18 years and younger) who have flu or are suspected to have flu should not be given Aspirin (acetylsalicylic acid) or any salicylate containing products (e.g. Pepto Bismol); this can cause a rare, very serious complication called Reye’s syndrome. More information about Reye’s syndrome can be found here.

WHAT SHOULD I DO WHILE I’M SICK?

Stay away from others as much as possible to keep from infecting them. If you must leave home, for example to get medical care, wear a facemask if you have one, or cover coughs and sneezes with a tissue. Wash your hands often to keep from spreading flu to others.

To learn more, please visit https://www.cdc.gov/flu/treatment/takingcare.htm.

CDC Director Adopts Preference for Specific Flu Vaccine for Seniors

December 20, 2022

CDC Director Rochelle P. Walensky, M.D., M.P.H., adopted the Advisory Committee on Immunization Practices’ (ACIP) recommendation to preferentially recommend the use of specific flu vaccines for adults 65 years and older, including higher dose and adjuvanted flu vaccines. The preference applies to Fluzone High-Dose Quadrivalent, Flublok Quadrivalent and Fluad Quadrivalent flu vaccines.

While flu seasons vary in severity, during most seasons, people 65 years and older bear the greatest burden of severe flu disease, accounting for the majority of flu-related hospitalizations and deaths. Additionally, changes in the immune system with age mean that older adults often do not have as strong an immune response to vaccination as younger, healthy people. “Given their increased risk of flu-associated severe illness, hospitalization, and death, it’s important to use these potentially more effective vaccines in people 65 years and older,” said José R. Romero, M.D., Director of CDC’s National Center for Immunization and Respiratory Diseases. Additionally, data has shown that racial and ethnic health disparities exist in populations that receive a high-dose flu vaccine compared with standard-dose flu vaccines. “This recommendation could help reduce health disparities by making these vaccines more available to racial and ethnic minority groups,” said Dr. Romero.

ACIP voted to preferentially recommend the use of higher dose flu or adjuvanted flu vaccines over standard-dose unadjuvanted flu vaccines for people 65 years and older. This recommendation was based on a review of available studies which suggests that, in this age group, these vaccines are potentially more effective than standard dose unadjuvanted flu vaccines. Dr. Walensky’s adoption of the ACIP recommendation makes this recommendation official CDC policy, which will be further detailed in an upcoming Morbidity and Mortality Weekly Recommendation Report later this summer.

In recent years, CDC has not recommended any one flu vaccine over another for any age group, and there is still no preferential recommendation for people younger than 65. People 65 and older should try to get one of the three preferentially recommended vaccines, however, if one of these vaccines is not available at the time of administration, people in this age group should get a standard-dose flu vaccine instead.

To learn more, please visit https://www.cdc.gov/media/releases/2022/s0630-seniors-flu.html.

Flu Symptoms and Complications

December 12, 2022

Flu Symptoms

Influenza (flu) can cause mild to severe illness, and at times can lead to death. Flu symptoms usually come on suddenly. People who have flu often feel some or all of these symptoms:

  • fever* or feeling feverish/chills
  • cough
  • sore throat
  • runny or stuffy nose
  • muscle or body aches
  • headaches
  • fatigue (tiredness)
  • some people may have vomiting and diarrhea, though this is more common in children than adults.

*It’s important to note that not everyone with flu will have a fever.

More information is available at  Flu and COVID-19 symptoms.

Flu Complications

Most people who get flu will recover in a few days to less than two weeks, but some people will develop complications (such as pneumonia) as a result of flu, some of which can be life-threatening and result in death.

Sinus and ear infections are examples of moderate complications from flu, while pneumonia is a serious flu complication that can result from either flu virus infection alone or from co-infection of flu virus and bacteria. Other possible serious complications triggered by flu can include inflammation of the heart (myocarditis), brain (encephalitis) or muscle tissues (myositis, rhabdomyolysis), and multi-organ failure (for example, respiratory and kidney failure). Flu virus infection of the respiratory tract can trigger an extreme inflammatory response in the body and can lead to sepsis, the body’s life-threatening response to infection. Flu also can make chronic medical problems worse. For example, people with asthma may experience asthma attacks while they have flu, and people with chronic heart disease may experience a worsening of this condition triggered by flu.

People at Higher Risk from Flu

Anyone can get sick with flu, even healthy people, and serious problems related to flu can happen to anyone at any age, but some people are at higher risk of developing serious flu-related complications if they get sick. This includes people 65 years and older, people of any age with certain chronic medical conditions (such as asthma, diabetes, or heart disease), pregnant people and children younger than 5 years, but especially those younger than 2 years old.

Cold Vs. Flu

Signs and SymptomsColdInfluenza (Flu)
Symptom onsetGradualAbrupt
FeverRareCommon; lasts 3-4 days
AchesSlightCommon; often severe
ChillsUncommonFairly common
Fatigue, weaknessSometimesUsual
SneezingCommonSometimes
Chest discomfort, coughMild to moderate; hacking coughCommon; can be severe
Stuffy noseCommonSometimes
Sore throatCommonSometimes
HeadacheRareCommon

Emergency Warning Signs of Flu Complications

People experiencing these warning signs should obtain medical care right away.

In Children

  • Fast breathing or trouble breathing
  • Bluish lips or face
  • Ribs pulling in with each breath
  • Chest pain
  • Severe muscle pain (child refuses to walk)
  • Dehydration (no urine for 8 hours, dry mouth, no tears when crying)
  • Not alert of interacting when awake
  • Seizures
  • Fever above 104 degrees Fahrenheit that is not controlled by fever-reducing medicine
  • Worsening of chronic medical conditions

In Adults

  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest or abdomen
  • Persistent dizziness, confusion, inability to arouse
  • Seizures
  • Not urinating
  • Severe muscle pain
  • Severe weakness or unsteadiness
  • Fever or cough that improve but then return or worsen
  • Worsening of chronic medical conditions

These lists are not all inclusive. Please consult your medical provider for any other symptom that is severe or concerning.

To learn more, please visit https://www.cdc.gov/flu/symptoms/symptoms.htm.

Flu and People 65 Years and Older

December 5, 2022

People 65 years and older are at higher risk of developing serious flu complications compared with young, healthy adults. This increased risk is due in part to changes in immune defenses with increasing age. While flu seasons vary in severity, during most seasons, people 65 years and older bear the greatest burden of severe flu disease. In recent years, for example, it’s estimated that between 70 percent and 85 percent of seasonal flu-related deaths have occurred in people 65 years and older, and between 50 percent and 70 percent of seasonal flu-related hospitalizations have occurred among people in this age group.

A Flu Vaccine is the Best Protection Against Flu

Flu vaccination has many benefits. It has been shown to reduce the risk of getting sick with flu and also to reduce the risk of more serious flu outcomes that can result in hospitalization or even death. Although immune responses to vaccination may lower in older people, studies have consistently found that flu vaccination has been effective in reducing the risk of medical visits and hospitalizations in older people. Higher dose and adjuvanted flu vaccines are potentially more effective than standard dose of unadjuvanted flu vaccines for people in this age group and are therefore recommended preferentially over a regular dose flu vaccine.

The best way to protect against flu and its potentially serious complications is with a flu vaccine.  Flu vaccines are updated each season because flu viruses are constantly changing. Also, immunity wanes over time. Annual vaccination helps to ensure the best possible protection against flu. A flu vaccine protects against the flu viruses that research indicates will be most common during the upcoming season. (More information about this season’s exact vaccine composition is available at Vaccine Virus Selection.) Flu vaccines for the 2022-2023 flu season have been updated from last season’s vaccine to better match circulating viruses. Immunity from vaccination fully sets in after about two weeks.

Flu vaccination is especially important for people 65 years and older because they are at higher risk of developing serious flu complications. Three specific flu vaccines are preferentially recommended for people 65 years and older over other flu vaccines. People 65 and older should get a higher dose or adjuvanted flu vaccine, including: Fluzone High-Dose QuadrivalentFlublok Quadrivalent, or Fluad Quadrivalent vaccine. These vaccines are preferred for people 65 years and older because a review of existing studies suggested that, in this age group, these vaccines are potentially more effective than standard dose unadjuvanted flu vaccines.

When should I get vaccinated?

For most people who need only one dose of flu vaccine for the season, September and October are generally good times to be vaccinated against flu. Ideally, everyone should be vaccinated by the end of October. Additional considerations concerning the timing of vaccination for certain groups of people include:

  • Most adults, especially those 65 years and older, and pregnant people in the first or second trimester should generally not get vaccinated early (in July or August) because protection may decrease over time. However, early vaccination can be considered for any person who is unable to return at a later time to be vaccinated.
  • Some children need two doses of flu vaccine. For those children it is recommended to get the first dose as soon as vaccine is available, because the second dose needs to be given at least four weeks after the first. Vaccination during July and August also can be considered for children who need only one dose.
  • Vaccination during July and August also can be considered for people who are in the third trimester of pregnancy during those months, because this can help protect their infants for the first few months after birth (when they are too young to be vaccinated).

Specific Flu Shots for People 65 and Older

For the 2022-2023 season, CDC and ACIP preferentially recommend the use of higher-dose flu vaccines (Fluzone High-Dose Quadrivalent inactivated influenza vaccine and Flublok Quadrivalent flu vaccine) or adjuvanted flu vaccine (Fluad Quadrivalent vaccine) over standard-dose unadjuvanted flu vaccines for people 65 years and older. This recommendation is based on a review of available studies which suggests that, in this age group, these vaccines are potentially more effective than standard dose unadjuvanted flu vaccines. More information is available at Flu Vaccines Worked Better than Initially Estimated this Past Season & CDC’s Advisory Council Recommends Specific Flu Vaccines for Seniors. If one of these vaccines is not available at the time of administration, people in this age group should get a standard-dose unadjuvanted inactivated flu vaccine instead. There are other flu vaccines approved for use in people 65 years and older. People 65 years and older should not get a nasal spray vaccine. More information about preferentially recommended flu vaccines is below:

Symptoms and Treatment

Because you are at higher risk of developing serious flu complications, if you get flu symptoms, call your health care provider right away. There are antiviral drugs that can treat flu illness and prevent serious flu complications. CDC recommends prompt treatment with a flu antiviral medication for people who have flu or suspected flu infection and who are at higher risk of serious flu complications.

Symptoms:
Flu symptoms include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, and fatigue. Some people may also have vomiting and diarrhea, though this is more common in children than in adults. People may be infected with flu and have respiratory symptoms without a fever.


Treatment:

  • Influenza antiviral drugs are medicines that fight against flu by keeping flu viruses from making more viruses in your body.
  • Antiviral drugs can make your flu illness milder and make you feel better faster. They may also prevent serious health problems that can result from flu illness.
  • Treatment with an influenza antiviral drug should begin as soon as possible because these medications work best when started early (within 48 hours after symptoms start).
  • You need a prescription from a health care provider for an influenza antiviral medication.
  • There are four FDA-approved flu antiviral drugs recommended by CDC this season that can be used to treat the flu.

Other Preventive Actions

In addition to getting a flu shot, people 65 years and older should take the same everyday preventive actions CDC recommends for everyone, including avoiding people who are sick, covering coughs, and washing hands often.

To learn more, please visit https://www.cdc.gov/flu/highrisk/65over.htm.