Waterloo | Influenza Update

If you are unwell

A. Is It The Flu?

The most prominent characteristics of the flu are the sudden appearance of a fever (38°C or 100.4°F or more), a dry cough and aching in the body, especially in the head and lower back and legs. Usually the person feels extremely weak and tired and doesn’t want to get out of bed. Other symptoms can be chills, aching behind the eyes, and loss of appetite, a sore throat and a runny, stuffy nose. After your symptoms first appear you can spread the virus to others for 4-6 days or more.

B. What Can You Do For Yourself?

• Rest - Probably, you will feel very weak and tired until your temperature returns to normal (about three days), and resting will provide comfort and allow your body to use its energy to fight the infection. You should avoid contact with others while the infection is contagious (at least six days after the first symptom appears).
• Drink plenty of fluids - Extra fluids are needed to replace those lost because of the fever (sweating). If your urine is dark, you need more to drink. Liquids, especially warm ones like chicken soup, help loosen mucus. Try to drink a glass of juice/water or an equal amount of some other fluid every hour while you are awake.
• Take acetaminophen or ibuprophen as recommended on the package to bring down your fever and ease your muscle pain (unless your doctor says otherwise).
  • CHILDREN UNDER 18 YEARS OF AGE SHOULD NOT TAKE ACETYLSALICYLIC ACID (ASA) OR ANY PRODUCTS CONTAINING ASA. The combination of influenza and ASA in this age group has been known to cause Reye’s syndrome, a very serious condition affecting the nervous system and liver.
  • ANTIBIOTICS ARE NOT EFFECTIVE AGAINST INFLUENZA because it is a virus, and antibiotics fight bacteria. A hot water bottle or heating pad may also relieve muscle pain. A cup of Epsom salts in a warm bath may be soothing.
• Gargle - with a glass of warm water to ease a sore throat. Sugarless hard candy also helps, as do lozenges.
• Use saline nose drops or spray (ones that contain salt water but no medicine) to help soothe or clear a stuffed nose. Try not to blow your nose as this could send infected secretions into your sinuses. Wipe your nose with disposable tissues and put them in the garbage can immediately. Cover your nose and mouth with tissues when you cough or sneeze and throw them in the garbage as well. Wash your hands often.
• Do not smoke — it is very irritating to the damaged airways.
• If you are a single parent, or you are responsible for the care of someone who is frail or disabled, you may need to call someone to help you until you are feeling better.
• If you buy medicine at the drug store to treat your symptoms (“over-the-counter” medications), check with the pharmacist to see if it is the best one for you. Mention if you have a chronic illness or are taking any other medicine. Take into consideration that:
• It is better to buy a remedy that treats only one symptom. This way you are not taking in substances that are doing nothing, or that may trigger an adverse reaction.
• Read the label to be sure that the ingredient treats the symptom you have.
• Extra strength remedies contain a higher dose of the ingredient. Try the standard dose first. It may work fine and not have the same risk of side effects.
• Long acting medications tend to have more side effects than short acting medications.
• Read the label and note any possible side effects or interactions with other drugs or health conditions.
• If you have a chronic condition and are taking prescription medications, it is a good idea to ask the pharmacist to suggest a medication that would be safe for you to take, if you have not already discussed this with your doctor.

Muscle pain and fever — Acetaminophen is a good choice because it causes less stomach irritation than other drugs. Acetylsalicylic acid should not be given to children under the age of eighteen.

A cough can be helpful if it gets rid of mucus. If a dry cough is keeping you awake, a cough suppressant, Dextromethorphan is safe and effective. If you need help loosening mucus, an expectorant such as Guaifenesin is good. It is not helpful to take a suppressant and an expectorant together.

A stuffy nose — Decongestants help shrink swollen blood vessels in the nose. There are two kinds’ pills and nose drops/sprays. Nose drops/sprays act in minutes. They work better and have fewer side effects than the pills. However, they only work for 2 or 3 days, and then they make matters worse. Oxymetazoline, Phenylephrine and Xylometazoline are nose drops/sprays. If your nose is still stuffy after three days, you may want to switch to the pills. The pills take 1/2 hour to work. They may cause dry mouth, sleep disturbances and other side effects. Pseudoephrine is a decongestant in pill form.

Sore throat - Some medications work by numbing the throat, Dyclonine works the best.

Others are Benzocaine, Hexylreorcinol, Menthol and Phenol. These are lozenges or throat sprays. Other lozenges act by coating the throat. They may contain honey, herbs or pectin.

Ingredients to avoid:

_ Phenylpropanolamine (PPA) has been linked with strokes.

Note: Older people may become much more sensitive to medications in general and may experience more side effects, especially to the nervous system (e.g., confusion). It is best to take no more than three or four medications at a time. This includes both prescription and over the counter drugs.

If you have any questions at all about medications, don’t hesitate to talk to your pharmacist.

Generally, people begin to feel better after their temperature returns to normal, in about three days, and are ready to return to their normal activities/work in about a week. It is common for tiredness and a cough to linger on for several more weeks.

When to seek medical attention

If you are a normally healthy person and have been suffering with the flu, it is time to call the doctor or health help line if:

• You become short of breath while resting or doing very little;
• Breathing is difficult or painful;
• You are coughing up bloody sputum;
• You are wheezing
• You have had a fever for three or four days and you are not getting better - or you may be getting worse;
• You have started to feel better, and suddenly you get a high fever and start to feel sick again;
• It is noted by yourself or others that you are extremely drowsy and difficult to wake up or that you are disoriented or confused;
• You have extreme pain in your ear.

Seek medical care as soon as possible, in order to prevent your condition from worsening. Bacteria may have invaded your damaged tissues. At this point your doctor may consider giving you an antibiotic.

If you have heart or lung disease or any other chronic condition that requires regular medical attention, if you are frail, or if you have an illness or are on treatments or medications that affect your immune system and you get the flu, call your doctor.

If you are living with a long-term illness, your doctor may suggest changes to your usual management routine and/or provide you with extra help in treating the flu and preventing complications e.g., antiviral drugs. These medications must be taken within 48 hour of the first symptoms to be effective so call your doctor right away.

What your doctor may prescribe

Recently, drugs called antivirals have been developed which can fight viruses. To treat influenza, they must be started within 48 hours of the first symptoms of the flu – the sooner, the better.

At the time of a pandemic, antivirals will likely be in short supply. Health Canada will provide advice as to who should get antivirals as a priority. For example, persons with underlying chronic diseases may be one of the first groups to receive treatment with antivirals. If you are in a priority group and you have symptoms of the flu, you should call your doctor straight away. If you are a healthy person and have not been identified as being in a priority group for antivirals, you do not need to call your doctor unless you have the more severe symptoms listed above.