Disease Fact Sheets: Influenza a.k.a The Flu


Influenza, commonly known as “The Flu”, is an infection of the nose, throat and lungs caused by the influenza A or B (or rarely C) viruses. It is highly infectious.

In Indonesia, there is no particular season for Influenza, thus may occur all year long. This fact sheet covers seasonal influenza – information on avian influenza in humans, swine influenza (H1N1 and H3N2) and pandemic influenza are provided in separate factsheets.

How influenza is spread

influenza spreadInfluenza virus is spread when an infected person talks, coughs or sneezes small droplets containing infectious agents into the air. The droplets in the air may be breathed in by those nearby.

Infection may also be spread by contact with hands, tissues and other articles soiled by infected nose and throat discharges. Public items and/or surfaces may also be sources for Influenza virus transmission, e.g. mobile phones, elevator buttons, keyboards, door knobs, etc.

 

Signs and symptoms

Symptoms include:

  • rapid onset of fever
  • headache
  • muscle aches
  • fatigue
  • sneezing
  • running nose
  • sore throat
  • a cough.

Most people recover within a week, although the cough and fatigue may last longer. Influenza is much more serious than the common cold. It can lead to pneumonia (lung infection or inflammation) and other complications, and even death, particularly in:

  • people aged 65 years and over
  • pregnant women
  • young children
  • people with chronic conditions like heart disease, diabetes and lung disease.

Influenza v Common Cold

influenza vs cold

Influenza and pregnancy

Pregnant women are more likely to have severe complications from Influenza infection, especially in the second and third trimesters. While the flu virus does not cross the placenta and infect the baby while in the uterus, the high fever and any chest complications caused by flu can be potentially harmful to the baby. Because of these risks, a doctor may recommend antiviral medication for pregnant women with the flu.

The prescription of antivirals to treat Influenza is not common practice in Indonesia. However, there is no evidence that the antiviral medications to treat flu are associated with adverse effects in pregnancy. Similarly, women may continue to breastfeed while taking antiviral medication. The best protection for the mother and baby is for the pregnant mother to have the flu vaccine, which is safe and funded at any stage of pregnancy.

influenza swabDiagnosis

Flu swabs can be used to determine whether or not the upper respiratory infection is caused by Influenza virus. However, this again, is not common practice in Indonesia.

Not all people presenting with the symptoms require flu testing. Clinical symptoms and physical examination may provide suspicion of the disease. However, it is best confirmed by laboratory testing of mucus from the back of the nose or throat.

Incubation period

(time between becoming infected and developing symptoms)

Average of 2 days for seasonal influenza (range 1 to 4 days).

Infectious period

(time during which an infected person can infect others)

Usually from 1 day before onset of symptoms until 7 days after the onset of symptoms. After 5 days the level of infectiousness is probably very low, however some people, especially children and people with weakened immune systems, might be able to infect others for a longer time.

Treatment

Most people recover with rest, drinking plenty of fluids and use of paracetamol for the relief of pain and fever. Unless with a specific doctor’s recommendation, children under 12 years of age should not consume aspirin.

People with moderate or severe illness, pregnant women, those with chronic medical conditions, and those who are immunocompromised may benefit from specific antiviral medication. This can reduce symptoms by about 1 day and prevent some of the more serious complications of flu, but is only effective if commenced within 48 hours of illness onset.

Antiviral therapy may sometimes be used to prevent infection in close contacts of people with influenza, such as vulnerable household contacts and residents of institutions such as aged care facilities. A contact is any person who has been close enough to an infected person to be at risk of having acquired the infection from that person.

When to seek medical advice

Seek medical advice if:

  • cough, stuffy/runny nose, with sudden onset, high fever
  • you are concerned about the symptoms
  • symptoms are getting worse
  • shortness of breath
  • difficulty breathing
  • confusion
  • inability to keep liquids down because of vomiting
  • symptoms of dehydration (such as being dizzy when standing or passing much less urine than normal).

Prevention

  • influenza preventionExclude people with flu from childcare, preschool, school and work until there has been no fever for 24 hours (without using a fever reducing medicine such as paracetamol).
  • Wash hands as soon as possible after sneezing or coughing and after contact with nose and throat discharges or articles soiled by these. Use soap and water or an alcohol based hand rub.
  • Wipe down all frequently touched surfaces regularly with a cleaning cloth dampened with detergent, or a large alcohol wipe.
  • Cover a cough or sneeze with a tissue or your arm, not with your hand. Drop used tissues immediately into a rubbish bin, then wash your hands.
  • Flu vaccines reduce the risk of getting severe influenza. Influenza vaccination is required every year as the flu virus is constantly changing and each year the flu vaccines are altered to provide protection against the strains that are circulating.
  • The recommendation for annual influenza vaccination is for anyone 6 months of age or older who wishes to reduce the likelihood of becoming ill with influenza.
  • Annual influenza vaccination is strongly recommended and should be actively promoted for people at increased risk of complications from influenza infection or who may transmit influenza infection to others who are at increased risk of complications.
  • There are two types of inactivated flu vaccines available; the trivalent and quadrivalent vaccines. However, since the quadrivalent vaccine is relatively new, availability may at times be scarce. The CDC recommends not to delay getting the trivalent vaccine, in cases where quadrivalent vaccine is unavailable.

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