DEFINITIVE GUIDE

The flu (influenza)

Influenza, commonly known as the flu, is a common viral infection that affects your nose, throat and lungs.

The flu virus is highly contagious and passes from person to person through droplets from the nose, throat or lungs. These droplets can be passed directly, such as when you sneeze, or indirectly, such as when you blow your nose and then touch a door handle.

The flu vaccine (flu jab) can help protect against the virus in some groups of people.

Written by Dr Adam Abbs and Dr Zubair Ahmed. Reviewed by Mr Rajan Mistry. Last reviewed on 27/9/2019. Next review date 27/9/2022.

Fast facts

How long does the flu last?

Most symptoms last for 7 days, but some symptoms may last for up to 8 weeks. The most common symptoms are nasal congestion and a sore throat.

How to get rid of the flu?

There is no cure for the flu but you reduce the duration of the illness by resting, reduce the symptoms with fluids and simple medication from the pharmacy, and look out for complications such as breathlessness, rashes, dehydration, confusion or chest pain.

CHAPTER ONE

Flu signs and symptoms

Flu symptoms can come on suddenly after coming into contact with the influenza virus.

Although the flu can make you feel exhausted, most people feel better within a week. We can help with:

How long does it take for flu symptoms to show? And is it normal for flu symptoms to come and go?

What are the symptoms of the flu?

Here are some signs and symptoms of the flu to look out for in adults:

  • a sudden fever - at a temperature above 38C
  • muscle aches and pains
  • chills and sweats
  • a headache
  • a dry persistent cough
  • fatigue and exhaustion
  • nasal congestion, runny nose, sneezing
  • sore throat
  • loss of appetite
  • nausea

What are the stages of the flu?

The flu is a progressive illness and can affect different people in different ways. It often comes on suddenly and progresses quickly.

  • At the first stage of the illness, day 0, you may not notice any symptoms, however, you are most contagious 24 hours prior to symptoms appearing.

  • At stage 2 of the flu, days 1-3, you may experience early symptoms such as fatigue, aches and pains in the muscles, a fever (temperature over 38C) and a dry cough and sore throat. These are the most common flu symptoms.

  • At stage 3 of the flu, days 4-7, your flu symptoms should start to subside. Your fever should come down, you will be less exhausted and feel fewer aches in your muscles, your cough may start to improve and your breathing will become easier.

Although these are the usual stages of the flu illness, you may be slightly fatigued for up to two weeks and your cough may take longer to get rid of. Some people may experience complications from contracting the flu virus and may end up contracting the secondary infection, pneumonia.

How long am I contagious for?

Once you have contracted the flu virus, you are contagious from 1 day (24 hours) before symptoms begin to appear. You are usually contagious for as long as you have any flu symptoms - about a week. Children and those who are at a higher risk of complications from the flu can be contagious for longer. You are contagious until symptoms fade.

Can I get flu symptoms from the flu vaccine?

The flu vaccine is available on the NHS to some adults and children 6 months of age and older to help protect against infection from the flu virus. The flu vaccine stimulates the body’s development of antibodies. The body’s immune system can then recognise the real influenza virus and will work immediately to fight it off. When the flu vaccine is administered you may experience mild flu-like symptoms for one to two days such as a headache, low fever and mild body aches. This doesn’t mean you have the flu - it is your immune system preparing for the virus.

When should I see a doctor?

There are different ways to treat the flu at home so you may have no need to see a doctor. However, you should see a doctor if you are at a high risk of further complications. For example, if you already have a weakened immune system, chronic illnesses or are pregnant. If you experience symptoms over 2 weeks, you should see a doctor.

If you are experiencing any of these symptoms, seek immediate medical care:

  • severe dehydration
  • recurring fever
  • worsening cough lasting over 2 weeks
  • breathing difficulties
  • dizziness or confusion
  • chest pain
CHAPTER TWO

Do I have a cold or the flu?

You may have experienced flu-like symptoms recently and wondered if you were experiencing a cold or the influenza virus, also commonly known as ‘the flu’.

Although both are respiratory illnesses and are known to share some similar symptoms such as a cough or sore throat, they are caused by different viruses. We can help with:

Do I have the flu or a common cold?

What are the similarities between a cold and the flu?

The terms “cold” and “flu” are often used interchangeably. This is because there are some cold and flu symptoms that are similar so it can be difficult to tell them apart. Similarities of the common cold and the flu include:

  • They are both respiratory illnesses that can affect the nose, throat and lungs.
  • They are both caused by viruses.
  • They share some symptoms, including a sore throat, cough, stuffy nose, sneezing and fatigue.

What are the differences between a cold and the flu?

Colds are much milder and tend not to lead to serious health difficulties. Other differences include:

  • The most common cause of a cold is the rhinovirus, whereas the flu is caused by influenza A and B viruses.
  • Cold symptoms are usually milder than flu symptoms and are gone within a week. However, flu symptoms such as a cough and fatigue can extend further than a week.
  • A cold is usually brought on gradually whereas the flu is abrupt in its onset.
  • Although you can experience fatigue and tiredness with both illnesses, the flu has a more severe effect on energy levels and can make you feel more exhausted.
  • A significant difference between a cold and the flu is that the flu is often accompanied by a fever of over 38C. It is rare to have a fever with a cold.
  • You may experience a cough when you have both a cold and the flu however a flu cough is dry and persistent. The cough that accompanies a cold usually comes with green or yellow mucus.
  • Although the flu is followed by chills and sweats, you will less likely experience chills and sweats with a cold.
  • Aches and pains that you may experience with colds are mild compared to the flu.

Cold vs flu treatment

You can determine what relief is suitable for your cold or flu symptoms using the checker below.

Cold and flu symptom checker

You can check your symptoms against the cold and flu symptom checker below.

CHAPTER THREE

How to treat the flu

There is no cure for the flu yet. This is because the strains of influenza virus can mutate every year. This is also why the flu vaccines need to be taken every year. However, there are steps you can take to get better more quickly.

It is important to treat your flu symptoms as soon as you notice them so they do not get worse. The flu is progressive and can lead to a more serious complication like pneumonia. We can help with:

What symptom relief is available for the flu?

How to treat the flu fast

Although there is no fast cure to get rid of the flu, there are steps you can take to speed up the recovery process to get rid of the flu faster:

  • The best way to treat the flu is to get plenty of rest. Rest is essential for recovery as it allows the body to focus on healing rather than other activities which may be extraneous.
  • You should drink plenty of fluids to prevent dehydration. Sweating is a symptom of the flu that causes you to lose the water in your body. It is also important to keep hydrated if you have a runny nose as water thins out the mucus you produce. The types of fluids you can take include water, honey and lemon in hot water, soups, juices and herbal tea.
  • Over-the-counter medications are effective flu treatments for adults as they can help with the aches and pains that come with the flu. Medicines such as paracetamol and ibuprofen can be found at your local pharmacy.
  • Other over the counter flu remedies include decongestants such as Sudafed, these can be helpful in reducing upper respiratory symptoms. Be cautious with these remedies as they often contain paracetamol or ibuprofen, so you need to be careful not to overdose.
  • To treat flu fever, you should first determine your temperature with a thermometer. If your temperature is over 38C, you will know that you have a fever. You can treat this fever by wearing breathable fabrics, keeping hydrated and taking tepid baths and using cold compresses. If your temperature is above 39C, and doesn’t reduce with paracetamol and ibuprofen, you should seek immediate medical attention.
Important

If you are trying to treat severe flu symptoms such as difficulty breathing, dizziness, confusion and chest pain, you should seek medical attention right away.

What are the best flu medications?

You should speak to your GP about the best flu medications for you, however, here are some medicines that work well for colds and flu:

  • Decongestant nasal spray or drops
  • Sudafed, or similar - unblocks sinuses and dries runny noses
  • Steam inhaler - helps with decongestion
  • Ibuprofen - works for fever, aches and pains
  • Paracetamol - works for fever, aches and pains
  • Vicks VapoRub, or similar - good for nasal catarrh, congestion and sore throat
  • Saline nasal sprays or drops - may help break up congestion

Side effects of the flu treatments

Some flu treatments can have side effects:

  • The flu vaccination can cause you to have mild flu symptoms a day or two after you have been administered with the vaccine. Some side effects can include soreness in your arm from the vaccine, mild fever, nausea, headache and muscle pain. If you experience severe symptoms following the vaccine you should consult with a doctor.
  • Antiviral medications may have side effects such as nausea, vomiting, cough, diarrhoea and a stuffy nose.
  • Medications you purchase at pharmacies can come with side effects. Make sure to read instructions and warnings on the packaging thoroughly to be safe.

How to care for someone with the flu

Here are some steps you can take to care for someone with the flu:

  • Ensure they have any medications they need and over-the-counter pain relievers such as ibuprofen or paracetamol.
  • Make sure they are comfortable and resting with blankets in case they get chills.
  • If the infected person gets the sweats, they should wear breathable fabrics. You can also keep them cool by dipping a flannel in cold water and gently dabbing their forehead and neck.
  • Make sure someone with the flu has enough fluids such as soup, water, juices or herbal tea.
  • If the infected person you are caring for shows severe symptoms, help them see a GP or call NHS 111.

It is important to keep yourself safe from the flu while you are caring for someone who is infected. You can do this is in various ways:

  • Make a separate sick room for them
  • Wash your hands often
  • Keep track of the sick person’s personal items
  • Avoid being face to face
  • Get a flu vaccine
  • Use a face mask when caring for them
  • Make sure all surfaces are disinfected and cleaned properly
  • Make sure the infected individual is disposing of their used tissues properly
CHAPTER FOUR

Home remedies for the flu

Aside from buying medications at your local pharmacy, there are many ways to treat your flu symptoms at home. For example, you may have ingredients in your kitchen that help such as lemon and honey.

There are great natural remedies to treat your flu symptoms that you may not have heard of. We can help with:

What are some home remedies for the flu? How can I treat my flu naturally?

What remedies might be good for sore throats?

Sore throat remedies include:

Apple cider vinegar

Some people believe that a good home remedy for sore throats is apple cider vinegar. Apple cider vinegar might have many health benefits and is identified as an ancient folk remedy. It has an active ingredient called acetic acid, which may help kill bacteria. It might help relieve flu symptoms such as sore throats and coughs. To use this remedy, put 1 tablespoon of apple cider vinegar in a cup of warm water and drink. You can add honey for a sweeter flavour.

Gargle salt water

Another great home remedy for sore throats could be salt water. Salt water might help to reduce swelling in your throat by extracting water from the throat tissue. Try adding one teaspoon of salt to a cup of warm water and gargle this mix. Remember to spit the mix out - do not swallow.

Lemon and Honey

Another great home remedy for sore throats could be honey and lemon in hot water. Lemon has vitamin C and antioxidants and honey might help to fight infection and relieve throat pain. Mix both in a cup of warm water and drink.

Chicken Soup

Drinking chicken soup with garlic might also be a great home remedy for sore throats. Garlic contains bioactive compounds that might help fight the flu.

Peppermint Tea

Peppermint tea is a great option for soothing a sore throat. Peppermint tea has potentially anti-inflammatory compounds and the mint can give a slight numbing sensation for your sore throat

Lemon and Ginger Tea

Ginger has anti-inflammatory and anti-bacterial properties that might help relieve your sore throat as well as congestion, nausea and fevers. Place some ginger in a cup of lemon tea and drink it to relieve your symptoms.

What remedy is good for fever?

To treat your fever at home, first take your temperature with a thermometer. If your temperature is above 38C, you will know you have a fever. Once you identify that you have a fever, good home remedies could include:

  • A cool flannel. Dip a flannel in cool water and dab this over your head and neck to keep cool and reduce your temperature.
  • Paracetamol and ibuprofen. Both can reduce your temperature and help you to feel better. A high temperature can make you feel very unwell. Be careful to make a note of the ibuprofen and paracetamol in your over the counter remedies to ensure you don’t overdose on these.
  • A tepid bath. To use this home remedy for fever, you should give yourself a sponge bath but do not immerse your body. Instead, wipe down with a lukewarm wet cloth. It is important not to use ice or freezing water as this can reduce your temperature too quickly.

What remedy is good for aches?

The best home remedy for treating aches and pains is rest. This will allow your joints and muscles to relax as you won’t be over-exerting your body with physical activity.

Another great at home natural remedy for aches and body pains is a warm bath. Warm baths can soothe your muscles and reduce the aches you feel. Warm baths can also promote sweating which can help you release the toxins in your body. You can also add Epsom salt and baking soda to your bath water as these reduce body aches. Stir 1/4 to 2 cups of baking soda into your bath water and let it dissolve. Alternatively, you can mix ⅓ cup of Epsom salt into your bath water. Don’t take a warm bath if you have a temperature.

What remedy is good for a cough?

A great at-home remedy for coughs is the use of steam. Steam helps to loosen up phlegm and can work for both a productive and dry cough. You can run a hot shower or bath and stay in the room while it fills up with steam. Alternatively, fill a large bowl with hot water and lean over the bowl with a towel over your head. A few drops of essential oils such as eucalyptus and rosemary can be added to the water to help you feel better.

Other home remedies for a cough include:

  • Using a humidifier. Add essential oils to your humidifier for a greater effect.
  • Homemade peppermint and ginger cough syrup. Mix 4 cups of warm water with a cup of honey, 3 tablespoons of ginger and 1 tablespoon of chopped peppermint together. Drinking this about twice a day as you would with an over-the-counter cough syrup will help relieve your flu cough.
  • Marshmallow root contains anti-inflammatory and pain relieving properties that might help coughs. Marshmallow root may also protect your mucous membrane tissue. Steep marshmallow root in boiling water, strain the mixture and you can drink this up to three times a day until your flu cough is gone.
  • Turmeric. Is believed to contain antiviral, antibacterial and anti-inflammatory properties. You can add turmeric with honey and black pepper to milk twice a day to help your cough.

What remedy is good for headaches?

Your flu symptoms can cause your body to lose water which can lead to a headache. You should be keeping hydrated in order to avoid this. Home remedies for a headache include:

  • Apply a cold compress to your forehead to ease your headache symptoms. This works by constricting the blood vessels in the affected area, which reduces pain.
  • Over-the-counter pain relief is also a great home remedy for a headache. You can buy medicines such as paracetamol and ibuprofen to help ease your pain.
  • A headache might cause you to be sensitive towards the light. Try dimming the lights to prevent worsening your headache. If you are unable to look at a TV or telephone due to a headache, we recommend you see a doctor as soon as possible.
  • Use an eye mask while you sleep to make sure no light worsens your headache.
CHAPTER FIVE

The flu vaccine

How do you can stop yourself from getting ill during the flu season? The best way to avoid contracting the influenza virus is to get the flu vaccine.

The flu vaccine is available to some groups of people on the NHS. If you are in this group, you can schedule an appointment with your GP or pharmacist before flu season starts. We can help with:

What is the flu shot? And where is my nearest pharmacy?

What is the flu vaccine?

The flu vaccine or ‘flu shot’ is an injection you can take to protect against the flu. It is helpful to take the flu vaccine before the flu season begins because the flu virus spreads easily during the winter months. You should get the flu vaccine typically around two weeks before the flu season starts. You can speak to your GP about the type of flu vaccine that is right for you. Children over 2 years are also able to get the flu vaccine in the form of a nasal spray.

How does the flu vaccine work?

The flu vaccine works by prompting the body’s immune system to make antibodies. The flu vaccine contains inactive strains of the influenza virus. When this is injected into the body, the immune system responds by creating antibodies which identifies the virus as a threat and fights it off.

When you are then exposed to the real flu virus, the immune system is able to recognise the virus quickly and produce the right antibodies. To fully build up immunity to the flu virus, this can take anywhere from 10 to 14 days. This is why it is advised to take the vaccine two weeks prior to flu season to be protected.

How long does the flu vaccine last?

When you take the flu vaccine, you will be protected from the virus when your immune system comes into contact with it. However, the flu vaccine does not last forever unlike some other vaccines. The flu vaccine provides protection from the influenza virus for around 6 months. The reason it does not last for longer is because the antibodies that are produced when the vaccine is administered start to wane. The strains of influenza viruses also change year to year and mutate frequently so new antibodies need to be produced. This means 2017, 2018, 2019, and 2020 flu vaccines are all different to target each new strain.

Researchers from the World Health Organisation (WHO) try to determine which strains of influenza virus are likely to appear each year in the northern hemisphere. Based on the WHO recommendations, vaccine manufacturers develop vaccines to target the most likely strains for the upcoming flu season.

What are the benefits of the flu vaccine?

There are many benefits of taking the flu vaccine:

  • It prevents you from contracting the flu during flu season.
  • It prevents you from passing on the flu to others.
  • It lasts up to 6 months.
  • Pregnant women are able to pass on antibodies from their vaccination to their unborn child.
  • Women who are breastfeeding are able to pass on antibodies to their children through breast milk.
  • The flu vaccine can prevent you from getting complications of the flu.

What are the side effects of the flu vaccine?

The flu vaccination can cause you to have mild flu symptoms a day or two after you have been administered with the vaccine. Some side effects can include:

  • Soreness in your arm from the vaccine
  • Mild fever
  • Nausea
  • Headache
  • Muscle pain
Important

If you experience severe symptoms following the vaccine you should consult with a doctor.

Should I get the flu vaccine?

Not everyone needs the flu vaccine! You should have the flu vaccine if you:

  • are 65 years old or over
  • are pregnant
  • have certain medical conditions
  • are living in a long-stay residential care home or other long-stay care facility
  • receive a carer's allowance, or you are the main carer for an elderly or disabled person whose welfare may be at risk if you fall ill
  • are a healthcare worker

Where can I get the flu vaccine?

You can get the flu vaccine at a local pharmacy offering the service or your GP surgery. It is helpful to call the pharmacy first to check that they offer this service. Always check to see if you are eligible for the flu vaccination on the NHS - if you’re not eligible you can pay for this privately.

Tip

Some midwifery services also offer the flu vaccine for pregnant women.

CHAPTER SIX

Know what causes the flu

A common misconception is that cold weather causes the flu. However, this is not the case. You can get the flu anytime. The flu is more prominent in winter because it’s transmitted faster from person to person in these months.

You can catch the flu from an infected person through a simple handshake. We can help with:

What is a flu epidemic? How is the influenza virus spread?

What are the flu causes?

Every year, very often during winter, many people contract the flu virus. This creates a high risk of flu spreading rapidly.

The flu can be caused by different types of influenza viruses:

  • Influenza A virus - can affect both humans and animals. It constantly mutates and can be the cause of flu epidemics. Type A can have different strains.
  • Influenza B virus - can affect humans only. The effects of type B are not as severe as type A. Occasionally, however, it can cause severe complications. Type B flu is caused by one strain.
  • Influenza C virus - can affect humans only. The effects are much milder than type A or B.

How does the flu spread?

It is possible to transmit the flu virus to others one day before symptoms start to appear. This allows the flu to spread easily as you can spread the flu to others before you realise you are ill.

The influenza virus can be found in respiratory droplets and is passed from person to person when one comes into contact with these droplets. There are different ways in which the flu virus is spread:

  • Direct bodily contact with the respiratory droplets of an infected person (through actions like kissing).
  • When the flu virus becomes airborne. This happens when an infected person talks, sneezes or coughs. If you are up to 6 feet away, you can become sick too. Hugs and handshakes can also pass on the virus.
  • When you come in contact with an item that has infected respiratory droplets on it such as used tissues, cups and utensils.
  • Being in the same room with someone who is ill with the flu.
  • When you touch contaminated surfaces or beads of moisture that contain the virus and then touch your mouth, nose or eyes.

What causes a flu epidemic?

You may have heard of a flu epidemic or breakout during past winter seasons. An epidemic can be described as an outbreak of disease in a defined region. A flu epidemic may occur when a mutated strain of the influenza virus is not accounted for in the flu vaccine. If a flu epidemic is declared in a region, that indicates that there is an outbreak of flu and the number of people with the flu has risen significantly higher than the typical levels within that region or community. A pandemic, on the other hand, indicates a global outbreak of the disease.

Why does the flu spread in winter?

The flu is likely to spread during winter for various reasons:

  • When it is cold outside, people are more likely to stay packed together indoors. When people are together, the virus has a chance to pass on quickly from one person to another.
  • Our immune systems may be weakened by the lack of vitamin D and melatonin in the winter months as we are more likely to stay indoors.
  • The influenza virus is spread more easily in cold, dry and low humidity weather.
CHAPTER SEVEN

How to prevent the flu

Prevention is the best medicine for the flu. There are daily habits you can adopt to reduce your risk of contracting the influenza virus.

Not only will taking these steps prevent you from catching the flu, it will also protect the people around you.

We can help with how to prevent getting the flu after being exposed and how to prevent spreading the flu in your home.

What are the risk factors for contracting the flu?

Although the flu virus can be easily spread, there may be certain things you are doing which can put you more at risk of contracting the flu:

Worrying

Worrying about getting sick can actually make you ill. When we worry too much, we can affect our immune system as stress causes our fight-or-flight response to kick in and our cortisol levels to increase. When there is a threat this could be a helpful response, however, when you are stressed for an extended period of time, these raised cortisol levels can have an adverse effect on your immune system, causing you to be susceptible to illnesses and viruses like the flu.

Drinking alcohol

Drinking alcohol can also put you at risk of getting the flu. If you consume a large amount of alcohol in a short time period, you may not only have a hangover but this can also cause you to end up with a weakened immune system. This affects your ability to fight off viral infections like the flu. Alcohol can also dehydrate you and this can affect the ability of your nose and throat to trap germs and bacteria and get rid of them with the formation of mucus.

Antiviral medications

If you take antiviral medications as a precaution in order not to catch the flu, you may actually be doing more harm than good. Taking antiviral medications before you are ill causes you to be at risk of the flu as the virus can become resistant to these medications.

Smoking

Smokers are more susceptible to viral infections as cigarettes weaken the tiny hair-like structures in the lungs and nasal passages that trap and get rid of bacteria and germs. Damaged lungs lead you to be more at risk of suffering complications following exposure to the flu virus.

Not cleaning

You can be at risk of catching the influenza virus if you are coming in contact with contaminated surfaces or infected individuals. It is important to wash your hands when you touch surfaces that many people are likely to have touched such as a handrail.

Getting too close

Close contact with people who have the virus through handshakes, hugs or kisses can lead to you being ill. During flu season, you can be more at risk if you are in close physical contact with many people.

How to prevent the flu after being exposed

You may have been exposed to the flu virus unknowingly through contact with an infected person or through touching contaminated surfaces. In order to prevent the flu after being exposed, you should avoid touching your nose or mouth with your hands. The flu virus is airborne when an infected individual sneezes or coughs but it can enter your body when your hands have been affected and you touch your face.

Wash your hands regularly as you may touch your face without realising. The flu virus lives on hard surfaces for about 24 hours so it is important to adopt the habit of washing your hands regularly, especially during flu season. Lather your hands with soap and warm water, rinse and wipe them dry with a clean towel.

If you feel the need to sneeze or cough, you may automatically reach up to your mouth. If your hand is infected, this can lead to you becoming ill. In order to avoid this, sneeze or cough into a clean tissue and throw the tissue away immediately.

Flu season and how to prevent becoming infected

The best way to prevent getting infected during flu season is to get vaccinated if you are in an at risk group. The flu vaccination gives you immunity against strains of the influenza virus for about 6 months. You can also:

  • Avoid coming into close contact with people who you think may be infected.
  • Try to use only your own equipment at work and avoid using other people’s phones, desks and computers if you think they may be infected.
  • Clean work equipment and tools with disinfectant wipes regularly.
  • Stay home if you feel some symptoms of the flu.
  • Avoid touching your face and try to cough and sneeze into clean tissues rather than your hands.

How to prevent the flu naturally

To help prevent the flu naturally, you can:

  • Avoid crowds. Crowds allow for the spread of germs and viruses easily.
  • Wash your hands regularly. Lather your hands with soap and warm water, rinse and wipe them dry with a clean towel.
  • Avoid touching. Wash your hands before and after touching your nose, mouth and eyes. If you have infected respiratory droplets on your hands, you can infect yourself by touching your face.
  • Be healthy. Maintaining a healthy immune system is a natural way to prevent the flu.
  • You can do this with regular exercise and a balanced diet. Make sure you consume fruits and vegetables high in vitamins and minerals, reduce stress and sleep for 7-9 hours each night.
  • Quit smoking. Smokers are more susceptible to viral infections and appear to have more exaggerated responses.

How to prevent the flu from spreading

It is important that you not only protect yourself from the flu but protect others by taking measures to stop the flu from spreading. One way to stop the flu from spreading is to stay home if you are ill. Working through an illness puts a strain on your immune system and allows the flu virus to spread to others.

You can also prevent the flu from spreading by:

  • Washing your hands regularly. This will stop the virus being transferred from your hands to surfaces that others may touch.
  • Cleaning and disinfecting potentially exposed surfaces in your home. This includes doorknobs, countertops, tables, telephones and light switches.
  • Staying and sleeping in a separate room.
  • Sneezing or coughing into a clean tissue and immediately disposing of it.
CHAPTER EIGHT

For parents - the flu in children

It can be very worrying when symptoms of the flu appear in children. It’s important to remember that there are many ways to help minimise the effects of the flu.

We have some useful advice and support to help your child recover quickly. We can help with:

When to take your child to the hospital for the flu? How can the flu affect toddlers?

Signs of the flu in children

In children, like adults, the flu can have an abrupt onset and symptoms can appear around 2 days following exposure to the influenza virus. The symptoms of flu in children include:

  • a fever (at a temperature above 38C)
  • dizziness and weakness
  • pains and aches in the body
  • a persistent dry cough
  • congestion in the chest and nose
  • chills and shivering
  • a headache
  • a sore throat
  • a runny nose
  • ear pain
  • diarrhoea and vomiting
  • a reduction in appetite

How long does the flu last in children?

Flu symptoms in toddlers and older children can last up to 14 days, but typically symptoms should subside within a week. Symptoms such as a cough can last up to 3 weeks.

How to treat the flu in children

There are many ways to help treat flu symptoms in your child:

  • For aches and pains, you can give your child a paracetamol syrup such as Calpol
  • Your child should get plenty of rest and stay home from school. This can also prevent the spread of the flu to other children.
  • They should drink regular fluids in the form of soups, herbal teas, lemon and honey tea, juices and water.
  • To treat a fever, make sure your child is wearing light fabrics. You can also cool them down with a tepid bath or cool flannel. Make sure not to use ice or cold water as this can make their temperature drop too quickly.
  • To help your child’s sore throat or congestion, you can take them into a steamed bathroom for a few minutes or use a humidifier in their room.
  • You can use a saltwater (saline) drops to treat your child’s stuffy nose.
  • When you are treating your child, make sure to wash and disinfect your hands regularly after you come into contact with them.
  • Tissues should be disposed of immediately and sheets and clothing should be washed regularly.
  • Trying to keep them at a distance from their siblings, especially babies, will help protect the rest of the family.

When to take your child to see a GP

You can treat your child at home for the flu unless they become unwell, as below, or you are worried.

Signs you should watch out for that may indicate further complications include:

  • Breathing difficulty. If you notice a wheezing sound or irregular breathing patterns when your child breathes this could signal the need for immediate medical attention.
  • If you see a dip in their skin at the base of their neck or under their ribs when they breath in
  • A persistent fever or a spike in the fever above 39C
  • A stiff neck
  • A rash that doesn’t disappear when you push on it or roll a glass over it
  • If your child refuses to be held or touched, or they show extreme fussiness or irritability
  • A severe headache
  • If you are struggling to wake your child up
  • Symptoms of severe dehydration with a refusal to eat or drink
  • If their lips, tongue or nail beds have a slight blue colour
  • If they haven’t passed urine for 8 hours
  • Or simply if you are worried, and you feel something isn’t right
Important

If your child’s condition does not improve or if you feel they may be getting worse rather than better, you should take your child to see a GP.

How to prevent flu in children

If your child has the flu, you can get it too. You can prevent the flu in children and the spread of the virus by taking certain precautions:

  • Children aged 2 and above are able to take the nasal spray flu vaccine. This nasal spray vaccine can be administered by a nurse to children aged 2 and 3. Children in reception as well as in higher school years (1-5) can get this vaccination at their school. Children who are already ill should not take the flu vaccine. A side effect of the nasal flu vaccine for children is a runny nose.
  • You can prevent the flu in toddlers and children by making sure the surroundings they are likely to be in and the surfaces they are likely to touch are clean and disinfected. This can include cars, countertops, tables and floors.
  • You can teach your child to wash their hands regularly so as not to catch or pass on the virus. Other family members should also pick up the habit of washing their hands regularly and thoroughly.
  • You can teach your child to cough or sneeze into their elbow rather than their hands so as not to touch their face or pass on the virus.
CHAPTER NINE

For parents - the flu in babies

Babies are more susceptible to illnesses because their immune system is still developing. When a newborn catches the flu, this can be very worrying as they are unable to communicate how they feel.

There are signs you can look out for to spot if your baby has contracted the influenza virus. We have some helpful advice for parents on how to prevent and manage the flu in babies. We can help with:

What to do when my newborn is exposed to the flu?

What are the signs of flu in babies?

If your baby is younger than 3 months, the flu can quickly progress into pneumonia. There are certain symptoms to look out for in babies and newborns to identify if they have contracted the flu virus:

  • tiredness or excessive sleeping
  • a frequent cough
  • fussiness
  • a fever above 38C
  • chills or body shakes
  • a runny nose or a stuffy nose
  • a sore throat
  • persistent vomiting or diarrhoea
  • ear pain
  • eye redness
  • reduced amount of wet diapers
  • no tears when they cry

How long does the flu last in babies?

The flu can last in babies for 7 to 14 days. Flu symptoms usually last a week but at times these symptoms can linger up to 2 weeks. You can tell your baby is better when they no longer show any of the symptoms of the flu. It is important to take your child to a GP if you notice more severe symptoms or if you notice your child is not getting better after 2 weeks.

How does the flu start in babies?

Newborn babies and babies under the age of 2 are susceptible to getting sick with the flu as they do not have a fully developed immune system so they are highly susceptible to viruses and infections. The flu can start in babies by coming into contact with respiratory droplets that contain the influenza virus.

The flu can progress quickly. If you notice these symptoms in your baby, you should seek medical help:

  • cough
  • congested nose
  • high fever
  • fussiness

If you notice further symptoms you should seek help from a healthcare professional immediately. These further symptoms can include:

  • lack of water in the eyes when they cry
  • lack of wet nappies within 8 hours - this is a sign of severe dehydration
  • persistent vomiting
  • persistent diarrhoea
  • very high fever (greater than 39C)
  • difficulty breathing (their abdomen moving more than their chest, dips under and around the rib cage and neck)
  • refusing to eat or drink

Premature babies are at very high risk of complications following a flu infection. Babies that suffer from chronic health conditions such as asthma, heart disease and blood disorders such as sickle cell disease are also at a high risk of complications. These babies need immediate medical assessment if they become unwell.

Important

If your child is under 12 months old, you should see a doctor to assess their symptoms thoroughly.

How to treat the flu in babies

You can treat the flu in babies by:

  • Ensuring they get plenty of rest and fluids. Provide fluids to the baby through breast milk or formula.
  • Watching out for signs of dehydration such as a crying without tears and a lack of wet nappies.
  • Using a humidifier to treat coughs and congestion in babies.

How to prevent the flu in babies

If your baby is younger than 6 months old, they should not be getting the flu vaccine, however, there are other ways to prevent the flu:

  • You should get the flu vaccine before your baby is born if you’re pregnant in flu season. This immunity can pass on to your child in the womb and can protect the child when they are born.
  • Breastfeeding your child is another good way to prevent your child from catching the flu virus. There are antibodies within breast milk that can be passed on to your infant. This helps to strengthen your baby’s immune system so their bodies are able to fight off viral infections such as the flu.
  • Keep your baby away from people who are infected with the flu. During flu season, be careful about who your child comes into contact with whether it be through holding the child or giving them hugs and kisses.
  • Wash your hands regularly to prevent spreading germs and viral infections to your baby.
  • Make sure to clean and disinfect surfaces your baby might touch and be aware of their surroundings at all times.
  • Ensure that the people your baby is in contact with the most are vaccinated so that they can remain healthy and not pass on the flu virus to your child.
CHAPTER TEN

What to do - The flu when pregnant

A woman’s body goes through a lot of changes when pregnant. One of the changes is a weakening of the immune system. This makes you more susceptible to viral infections such as the flu.

There are steps you can take to protect yourself and your baby from the flu. We have some helpful advice on treatment and prevention during pregnancy. We can help with:

Is the flu vaccine safe when pregnant?

What are the symptoms of the flu during pregnancy?

Flu symptoms during pregnancy are similar to the flu symptoms in adults who are not pregnant. These symptoms can include:

  • a fever (above 38C)
  • aches and pains
  • a headache
  • chills or sweats
  • a loss of appetite
  • extreme tiredness or fatigue
  • sore throat
  • stomach pain

How to treat the flu when pregnant

You can treat the flu while pregnant by:

  • Getting plenty of rest
  • Drinking plenty of fluids
  • Gargling with salt water
  • Spending a few minutes in a steamed bathroom
  • Using a humidifier, facial steamer or hot-mist vaporizer
  • Drinking a hot lemon and honey drink
  • Using cold flannels if you experience the sweats
  • Using warm flannels if you experience chills
Important

You should see a GP if you feel your symptoms are getting worse or have lasted over 2 weeks.

Safe medications for the flu during pregnancy

After 12 weeks of being pregnant, safe medications to use during pregnancy include:

  • Cough drops and lozenges - soothes your cough
  • Nasal strips - releases congestion
  • Menthol rubs - unblocks sinuses and congested airways
  • Paracetamol - reduces pain and fever
  • Saline nasal drops - dilutes mucus and reduces sinus swelling

What to avoid during pregnancy

You should avoid these medications while pregnant:

  • Aspirin
  • Codeine
  • Bactrim
  • Ibuprofen
  • Naproxen
  • Sudafed
  • Antihistamines

How to treat the flu when breastfeeding

If you contract the flu whilst breastfeeding, you should stay away from over-the-counter medicines such as cough syrups. Paracetamol may be safe to take if not in conjunction with other cold and flu medicines. You should speak to your doctor about what is the best option for you. Other flu remedies when breastfeeding includes:

  • Plenty of rest
  • Lots of fluids
  • Keeping warm
  • Gargling salt water
  • A hot lemon and honey drink
  • A humidifier and face steamer
  • Natural home remedies for the flu

Can I get the flu vaccine during pregnancy?

The flu vaccine is safe during pregnancy. It not only immunises you from strains of the influenza virus but antibodies can also be passed on to your child in the womb through the placenta.

A flu vaccine decreases your risk of getting ill from the flu. Pregnant women are at high risk of complications when ill due to a weakened immune system and should take this precaution to avoid the flu. Talk to your GP or pharmacist about getting the flu vaccination. There are mild side effects of the flu vaccine during pregnancy.

What are the risks and complications of the flu during pregnancy?

Pregnant women are at a high risk of developing complications during pregnancy. This is due to the fact that a pregnant woman’s body is going through a lot of changes. When this happens, the body’s immune system tries to adapt to these changes resulting in a weaker immune system. The body’s weak immune system works to stop the body from rejecting the unborn child in the womb. This makes it harder for the body to fight off infections and makes them more susceptible to complications.

Complications of the flu include:

  • Pneumonia
  • Bronchitis
  • Sinus infections

You should see your doctor if you experience symptoms such as:

  • Dizziness and confusion
  • Chest pain
  • Wheezing or irregular breathing pattern
  • Vaginal bleeding
  • Severe vomiting beyond morning sickness
  • A spike in fever
  • A reduction in fetal movement
  • Not drinking or passing urine for 12 hours
CHAPTER ELEVEN

What are the complications associated with the flu?

If the flu is left untreated or if you already have a chronic health condition, you may be at risk of contracting a more serious illness like pneumonia.

If your flu symptoms have lasted over 2 weeks and seem to be getting worse, it is a good idea to see your GP. We can help with:

What are the complications you can get from the flu? Am I at risk of flu complications?

Who is most at risk

The people who are most at risk of developing complications or serious illness from the flu include:

  • Children under 2 years of age
  • Pregnant women
  • Adults over 65 years of age
  • Residents of long-term care facilities
  • People who are obese
  • People taking immunosuppressants like methotrexate or chemotherapy

You are also more at risk if you have:

  • asthma
  • diabetes
  • chronic lung disease
  • heart disease
  • blood disorders such as sickle cell disease
  • endocrine disorders such as diabetes
  • kidney disorders
  • liver disorders
  • metabolic disorders
  • a weakened immune system (people suffering from cancer or HIV/ AIDS)

Ear infections

Ear infections are common in children and can develop after they have been exposed to the flu virus. An ear infection can occur when the viral infection affects the middle ear and causes inflammation. Some symptoms of ear infections include pain or discomfort in the ear, fussiness in children, pressure in the ear, hearing loss and pus-like drainage.

Sinusitis

Sinusitis is another complication which can follow a flu infection. This occurs when the sinus linings become inflamed. This causes a build up of mucus and pressure around the sinuses and can cause a headache. It affects the way mucus is drained into your nose and expelled. Sinusitis can last about two to three weeks. You can treat a sinus infection with warm packs over your face, ibuprofen for the pain and nasal decongestants.

Worsening asthma

The flu is a respiratory infection and can ultimately make the symptoms of your asthma worse. This is because the influenza virus affects your airways and throat. The flu can also lead to asthma attacks. Some symptoms include coughing, wheezing and tightness of the chest. If you feel your asthma symptoms getting worse, you should speak to your doctor about your asthma action plan so they can let you know how to adjust your medication accordingly.

Pneumonia

Pneumonia is one of the most common complications of the flu. It is defined as swelling or inflammation of tissue in the lungs and is often caused by a viral infection. Viral pneumonia is sometimes caused by the flu and is common in young children. Some symptoms of pneumonia include chest pain, difficulty breathing, nausea, rapid heartbeat, loss of appetite, fatigue and confusion. Due to your weakened immune system, you can also develop a secondary bacterial pneumonia. If you think you have either type of pneumonia when you have the flu, you should see your doctor immediately.

Premature labour and delivery

It is possible for women who contract the flu when they are pregnant to have premature labour and delivery. Premature birth and preterm labour is when the baby is born before 37 weeks of pregnancy. The flu may also be linked to potential problems in the child such as low birth weight. It is important to get the flu vaccine when pregnant in order to protect yourself and your child from the flu.

Bronchitis

Bronchitis can sometimes follow the flu. It typically last anywhere from a few days to a few weeks. Bronchitis is described as the inflammation or swelling of the lining of the bronchi. The bronchi are the air passages between the mouth, nose and lungs. You will be able to tell if you have acute bronchitis brought on by the flu if you have a persistent cough which may produce mucus, wheezing, chest tightening, breathlessness, headaches, blocked nose and sinuses. However, symptoms of bronchitis are similar to those of other respiratory illnesses such as asthma and pneumonia so be sure to go to your GP for an accurate diagnosis, especially if you have any tightness or wheezing.

Heart problems

A viral infection like the flu can also cause complications to your heart such as myocarditis. Myocarditis can cause abnormal heart rhythms as it is an inflammation of the heart muscle. There can be damage to the heart if the inflammation is severe but a lot of people recover from this. People who already have cardiovascular issues may also be at risk of a heart attack due to the flu.

Important

If you have any palpitations or chest pain you must call 999.

CHAPTER TWELVE

Get same day treatment with Medicspot

Our vision is to change lives with convenient, accessible healthcare. With over 200 private doctor clinics across the UK, you can find your nearest surgery and see a GP in minutes.

Your private GP can help diagnose your symptoms and let you know if you are suffering from the flu or just a common cold. They will also be able to prescribe antiviral medication if needed and advise you on the best methods to relieve your flu symptoms. We can help with:

Where is your nearest doctor surgery? And how can Medicspot help?

How it works

The Medicspot clinical station allows your GP to measure your blood pressure, offer personalised advice, and prescribe medication as needed.

Find your nearest walk in clinic today.

CHAPTER THIRTEEN

About the authors

Dr Adam Abbs

Dr Adam Abbs qualified as a doctor from Hull York Medical School in 2010. He started training in hospital medicine but then retrained as a general practitioner. Following leading the development of urgent care services in North Manchester, he joined Medicspot in April 2019. He has a special interest in urgent care and also volunteers for numerous children’s cancer charities.

Dr Zubair Ahmed

Dr Zubair Ahmed is a GP and the Co-founder and CEO of Medicspot. He has been a doctor for 12 years after obtaining his medical degree from the University of Aberdeen, Scotland. He worked across a wide array of specialities including cardiology, accident and emergency, and geriatrics before focusing his energies on becoming a General Practitioner.

Mr Rajan Mistry

Mr Rajan Mistry qualified as a pharmacist from The University of Hertfordshire in 2014. He completed his pre-registration with Boots and managed the store in Stanmore, London. Rajan has worked in both community and hospital pharmacies, giving him exposure to clinical governance and dispensing. He is particularly interested in minor ailments and infectious diseases. Rajan joined Medicspot to help make pharmacies the first port of call in primary care and broaden their clinical services.

Disclaimer

This article is for general information only and should not be used for the diagnosis or treatment of medical conditions. Medic Spot Limited has used all reasonable care in compiling the information but makes no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. In the event of an emergency, please call 999 for immediate assistance.