Cold and Flu (Influenza)

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All fevers should be measured and investigated for the cause. 

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Influenza is caused by a virus that replicates in the human body. 

Colds and flu are extremely contagious. They are spread by airborne droplets of mucus, expelled when an infected person coughs sneezes or breathes into the air. The viruses can also be passed on by physical contact if the recipient picks up the virus on their hand and rubs their eyes or nose-which provides entry points for the virus. One infected person can pass on the virus to many others, and you are probably most infectious a day before symptoms develops.

Signs and symptoms:

Many symptoms of cold and flu are similar, however flu symptoms tend to worsen dramatically.

 Runny nose in with the mucus becomes think and green-yellow.

 Sneezing

 Sore throat and cough

 Wild fever and headache

 Flu symptoms tend to also include the following

 High fever, sweating and chills

 Aching muscles

 Headaches

 Severe exhaustion and weakness

 Loss of appetite

WARNING

If you have a cold or flu and you experience difficulty in breathing at any time, or if a fever lasts more than a few days, see a doctor urgently! You can develop a chest infection, such as pneumonia or other infection, such as sinusitis or ear infection.

The following may help to soothe the symptoms of a cold or flu.

 Drink lots of cold fluids will help to reduce a fever.

 Take painkillers to help reduce any fever and relieve he pain of a sore throat.

 Keep warm and have plenty of rest.

 Take decongestants to clear a stuffy nose.

 Avoid alcohol and smoking.

Make sure room is well ventilated and avoid spending time in stuffy, smoky or polluted atmospheres.

Who is most at risk?

 Newborn babies and infants that were premature or had low birth weight.

 The elderly

 Smokers

 Asthmatics

 People with weakened immune systems (diabetes or AIDS)

 People with poor nutrition and poor general health.

TREATMENT 

Dr.Paul recommends antiviral therapy for individuals with severe disease. Antiviral therapy should be initiated as soon as possible since antiviral therapy is most likely to provide benefit when initiated within the first 48 hours of illness. Treatment should not be delayed while awaiting the results of diagnostic testing, nor should it be withheld in patients with indications for therapy who present >48 hours after the onset of symptoms, particularly among patients requiring hospitalization. Furthermore, patients who have a negative rapid antigen test for influenza but in whom the clinical suspicion for influenza infection is high should be treated with antivirals since the sensitivity of these tests may be low.

We recommend antiviral therapy with oseltamivir for all individuals with confirmed or suspected influenza virus infection who are severely ill, such as those with lower respiratory tract infection (eg, dyspnea, tachypnea, unexplained oxygen desaturation), and those who are showing signs of rapid clinical deterioration; we recommend treatment for such patients whether they present early in the course of infection (<48 hours after symptom onset)  or later.

We recommend antiviral therapy with oseltamivir or zanamivir for outpatients who present within 48 hours of symptom onset with confirmed or suspected influenza infection and who are at increased risk for complications. We also recommend antiviral therapy for outpatients who present >48 hours after symptom onset with confirmed or suspected influenza infection and who are at increased risk for complications provided that they are not yet improving.

We suggest antiviral therapy for patients who present within 48 hours of symptom onset with mild illness and who are not at increased risk for complications. There is high quality evidence for benefit to the individual patient; however, there is only low quality evidence regarding the magnitude of the risk of promoting resistance, which remains a major concern. Additionally, when supplies are limited, antivirals should be reserved for high-risk patients.

We recommend that patients with uncomplicated influenza who have had more than 48 hours of influenza signs and symptoms not be treated with antivirals.

We suggest treating all pregnant women with suspected or confirmed influenza, even those who present >48 hours after onset of symptom onset provided that they are not yet improving.

Choice of antiviral agent

A neuraminidase inhibitor Oseltamivir or Zanamivir  is the recommended antiviral agent for the treatment of patients with influenza infection.

The recommended dose of zanamivir is 10 mg (two inhalations) twice daily; the recommended dose of oseltamivir is 75 mg orally twice daily; the recommended dose of peramivir is 600 mg IV as a single dose.

When to see a doctor:

Arrange an appointment or just walk into Dr. Paul’s Clinic if you have an infection that seems to be lasting longer than usual or if the symptoms seem to be worse than you would usually expect. Flu can lead to some life threatening complications and it is important to see a doctor if you suspect that you have a serious infection and if your symptoms are not showing any sign of improvement after two or three days.

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