Allercy and Asthma Health
The Official Publication of AAN - MA

Cover Story:
Steering Clear of the Flu This Season

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By Roger D. Seheult, MD

The flu (or influenza) season is upon us, and it's time to protect ourselves from the virus and its complications as best as we can. According to the CDC, there is about a 5-20% chance of getting the flu this year and about a 1/1000 chance of being hospitalized. Of course, people who are older and have asthma or other lung diseases are at an increased risk of the flu and its complications.

First of all how do I know if I have the flu?

Symptoms of the flu can vary but usually include fever, headache, tiredness, cough, sore throat, nasal congestion or runny nose, body aches and, in children especially, diarrhea or vomiting.

Am I at risk for complications from the flu?

You are if you are over 50 years old, live in a nursing home, have heart or lung disease, are pregnant or have a compromised immune system such as HIV/AIDS.

What are the more common complications of getting the flu?

Common complications include pneumonia, muscle aches, and heart attacks. Other complications include ear and sinus infections, flare ups of bronchitis, asthma, emphysema, and congestive heart failure.

What can I do to prevent getting the flu?

First of all, you can get the vaccine. There are two general forms including a shot in the arm and a nasal swab. You should get them each year. Last year's shot doesn't work for this year. You should avoid contact with sick people, wash your hands with soap and water or use alcohol-based hand rub if water and soap are not available.

Ok, what do I do if I think I've already contracted the flu?

There actually are antiviral drugs that can speed up the course of the flu and help prevent complications. If you get the flu, antiviral drugs are a treatment option. Check with your doctor promptly if you get flu symptoms and if you have a high risk condition such as asthma, diabetes, or chronic heart disease as it is best to start therapy early (less than two days) in the course of the flu. Children and pregnant women can take these drugs.

Is there anything in particular that I can do to manage my asthma during the flu?

Again, be aware the a flu vaccine is the best way to prevent getting the flu. But if you have asthma and you get the flu, make sure that you check with your doctor to see if antiviral drugs are right for you. You may need to increase the amount of albuterol or rescue inhalant you are using. If this is significant you should let your doctor know early on as additional medications or even oral or parenteral steroids may be necessary. Early signs of sinusitis such as sinus pressure could also herald the onset of an asthma exacerbation and should be noted. You should not share asthma medication or equipment. Carry a rescue inhaler with you at all times.

Are there any "myths" about the flu that I should know?

There is a lot of mis-information out there on this subject. Here are a few myths:

  1. The flu shot can give you the flu. It simply can't since the dead virus in the injectable is just that: dead, and the live virus in the nasal swab is sufficiently deactivated so that it doesn't cause any symptoms.

  2. All you can do is wait it out. As we've discussed, there are antivirals that can shorten the course of the flu and prevent some of the feared complications of the flu.

  3. You only get the flu once a year. There are many strains of the flu virus. The flu vaccine tries to cover you for the most common strains, however, there are many strains and you may get more than one in any particular season. It's best to avoid the most common by getting the flu vaccine.
The flu doesn't look like it's going away anytime soon. Each year we must be prepared to protect ourselves from infection and from its complications. Fortunately, we are not helpless. For those of us with chronic lung diseases such as asthma and bronchitis, we must be vigilant and make sure that we are protected by getting the flu vaccine, wash our hands, avoid sick contacts, and be prepared to seek medical attention for antiviral medication in the case of flu-like symptoms to avoid a lengthy and complicated course.

Roger Seheult, MD, is assistant professor of medicine at Loma Linda University School of Medicine, and a critical care intensivist, pulonologist, internist, and sleep specialist at Beaver Medical Group and San Gorgonio Memorial Hospital in Banning, CA.

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