"Flu" what a month!

What a crazy winter we have had so far! Finally settling down after the long 2 years of the Covid-19 pandemic, we are now facing another pandemic and again with so many similar symptoms. If you or your family have not been affected by the latest outbreak of Influenza you are doing really well! Each week we are seeing so many of our patients affected by this bug and it is not taking any prisoners. In many ways we need to approach influenza like we approached Covid-19. To save you time, we referred to the NSW Health website to get some information regarding influenza and what we can do. 

What is influenza? 

Influenza, or flu, is a highly contagious respiratory illness caused by influenza viruses. There are two main types of influenza virus that cause infection in humans – types A and B – and many sub-types or strains. Flu can occur throughout the year but flu activity usually peaks in winter. Flu is a vaccine-preventable illness but a new vaccine needs to be given each year because influenza viruses change (mutate) constantly. A new flu vaccine is prepared each year to best match the strains predicted for the coming influenza season. 

What are the symptoms of flu? 

People with influenza typically experience some or all of the following symptoms for at least a week: 

• fever and chills 

• cough, sore throat and runny or stuffy nose 

• muscle aches, joint pains, headaches and fatigue (feeling very tired) 

• nausea, vomiting and diarrhoea (more common in children than adults) 

Some symptoms may last for more than a week. Some people may also experience very mild symptoms, particularly if they have some immunity from a previous infection or vaccination. 

Seek immediate medical advice if the illness quickly becomes worse or if any of the following occurs: 

• shortness of breath or rapid breathing 

• chest pain 

• confusion or sudden dizziness 

• persistent vomiting. 

How is flu spread? 

Influenza viruses are mainly spread by droplets made when an infected person coughs or sneezes. Influenza can also spread after touching surfaces where infected droplets have landed. Influenza can be spread to someone by an infected person even before their symptoms begin. Adults with influenza are infectious from the day before their symptoms start until 5-7 days later. Young children and people with weakened immune systems may be infectious for longer. 

Who is at risk of flu? 

While anyone can get influenza, people at higher risk of complications from influenza infection (and who are eligible for free annual flu vaccine) include:

• children aged 6 months to 5 years 

• people aged 65 years and older 

• Aboriginal and Torres Strait islander people aged aged 6 months and over 

• Pregnant women

Individuals aged 6 months and over with certain medical conditions predisposing to severe influenza are also at increased risk (and who also eligible for free annual influenza vaccine). These conditions include: 

o cardiac disease, including cyanotic congenital heart disease, coronary artery disease and congestive heart failure 

o chronic respiratory conditions, including suppurative lung disease, chronic obstructive pulmonary disease and severe asthma 

o other chronic illnesses requiring regular medical follow up or hospitalisation in the previous year, including diabetes mellitus, chronic metabolic diseases, chronic renal failure, obesity, and haemoglobinopathies 

o chronic neurological conditions that impact on respiratory function, including multiple sclerosis, spinal cord injuries, and seizure disorders 

o impaired immunity, including HIV, malignancy and chronic corticosteroid use

o children aged 6 months to 10 years on long term aspirin therapy. 

How is flu prevented? 

Get a flu shot Influenza vaccination each year before winter arrives is the best way to prevent influenza.

• Seasonal influenza vaccination is available for anyone aged 6 months and over to protect against influenza, provided they do not have a medical reason that precludes them from receiving influenza vaccines. 

• People at higher risk of influenza complications (see “Who is at risk”) are strongly recommended to have an annual influenza vaccination, and are eligible for free influenza vaccine under the National Influenza Vaccination Program 

• In addition to people eligible for free vaccine, influenza vaccination is also recommended for those who frequently come in to close contact with other people at higher risk of influenza complications (such as health care workers and family members), to help protect vulnerable people from infection. 

Sneeze into your elbow Sneeze into your elbow instead of your hands, or cover your face with a tissue when you cough or sneeze and throw used tissues in a rubbish bin.

Clean your hands Wash your hands thoroughly and often. Wash hands for at least 10 seconds, especially after coughing, sneezing or blowing your nose, or use an alcohol-based hand rub. 

Stay at home if sick If you are sick with flu, stay at home and avoid close contact with other people to prevent them from also becoming sick. Keep sick children away from school and other activities. Wait at least 24 hours after fever resolves so you that you are unlikely to infect other people. This is especially important if you visit people who are more likely to get really sick if they get the flu - including pregnant women, infants, older people or people in hospital or residential aged care. Similarly, if you think you may have influenza and you need to see a doctor, call ahead so the clinic can take precautions to reduce the risk to other people. 

How is flu diagnosed?

Doctors usually diagnose influenza based on symptoms. The diagnosis can be confirmed by testing a sample of fluid taken from the back of the nose and throat or a blood sample. These tests are usually only needed if the illness is severe or if there is an increased risk of complications. 

How is flu treated? 

The symptoms of influenza are usually managed by bed rest, drinking plenty of fluids, and taking simple analgesics for muscle aches and pains. Children under 16 years of age must not be given aspirin-containing medications while ill with influenza. This is due to the increased risk of children developing Reye syndrome, a form of encephalitis and liver degeneration. Specific influenza antiviral medicines can reduce the severity and the duration of influenza but need to be taken within 48 hours of the first symptoms. These medicines need to be prescribed by a doctor, and are usually considered for people at higher risk of complications from influenza infection. 

What is the public health response?

Laboratories must notify cases of influenza to their local public health unit. Individual cases are managed by their health care provider. Public health action focuses on outbreaks in high-risk settings such as health care facilities, special schools, residential care facilities, and Aboriginal communities.