Health Center: What to do if you think you have Influenza

  Are you sure it’s Influenza?

Influenza is a very specific illness caused by the influenza virus. People often diagnose themselves with “the flu” when they have all kinds of symptoms, and they are as often wrong in their diagnosis as they are right. 

The symptoms of Influenza are fever >100, runny nose and cough, headaches and body aches, and sometimes vomiting and diarrhea. Symptoms usually last 5-7 days, though there can be residual cough and fatigue for several weeks.

Many conditions can be confused with Influenza. The following are a few that are common on college campuses.

• The common cold or viral upper respiratory infection (URI): Colds usually have runny nose and cough like the flu, but generally there is not the high fever and the head and body aches that influenza has.
• Bacterial Pneumonia: This can be tough to distinguish from influenza, and sometimes people can have both conditions at once. Pneumonia is an infection in your lungs that usually causes a productive cough and significant fever. If you have a fever that will not respond to Tylenol or Ibuprofen, chest pain or any difficulty breathing, or a significantly worsening and productive cough, you should be checked out for pneumonia.
• Bronchitis: This is an infection in the airways above the lungs. People with bronchitis usually have a productive cough but not the fever or level of illness of either pneumonia or influenza.
• Sinusitis: This usually follows 7-10 days of thick nasal discharge and presents with facial pressure and sometimes fever.
• Strep throat: This usually presents with sore throat and fever but without runny nose and cough. If you take a flashlight and look at your tonsils in the mirror, you will often see it covered in white spots. There are often swollen lymph nodes that feel like lumps in the neck close to the angle of the jaw.
• Mononucleosis: This can be another tough one to distinguish from influenza. Mono can present many different ways, but often fatigue is the prominent symptom. Other symptoms can include sore throat (with tonsils with white spots like strep), swollen lymph nodes or lumps in the neck and elsewhere, abdominal pain, rash, and fever.
• Gastroenteritis or “stomach flu”: Even though people like to call this the flu, it is not! Symptoms are nausea, vomiting, and/or diarrhea and sometimes fever. Unlike influenza, there are not the respiratory symptoms.
• Kidney infection or pyelonephritis: Symptoms can include fever, vomiting, and sometimes scant and dark, concentrated urine. Unlike influenza, there are not the respiratory symptoms.

If you are not sure whether or not you have influenza or some other condition, you should see a health professional to help determine the cause. When you call for an appointment, do tell them that you may have the flu so that they can advise you of steps to take to prevent spread of infection to others when you come for your appointment.

When should I suspect Influenza and stay away from classes, etc?

If you have a fever > 100 and suspect flu, stay out of classes. If your fever is less than 100 (without Tylenol or ibuprofen on board), you can go to classes but monitor your symptoms, wash your hands, cover your cough, and don’t talk in people’s faces. If you have flu, you should remain out of class until you are fever-free for 24 hours without Tylenol or ibuprofen. This will usually take 5-7 days.

How should you manage the symptoms of Influenza?

Get plenty of rest and fluids. Monitor your temperature with a thermometer and use Acetaminophen (Tylenol) or Ibuprofen (Motrin) to keep your fever down. Cover your cough and sneeze. Consider wearing a mask and telling close contacts that you have the flu. Monitor for complications. Minimize contact with others until you have been without fever for 24 hours. This includes staying out of class and eating your meals in your room. Your roommate or other close contacts may want to discuss using Tamiflu if they have a chronic health condition.

If you have a fever greater than 100 and think you have the flu, notify Residence Life staff, Bon Appetit, your professors. Contact the University Health Center if you have questions or concerns.

Are there medications that can treat influenza?

Tamiflu is a medication specific for influenza; it does not help with other conditions. It must be taken within 48 hours of symptom onset. It can help both with the duration and intensity of the flu. To minimize the development of resistance, you must take the full 5-day course. Relenza is a less commonly used flu medication that comes in an inhaler.

If you have a chronic health condition like asthma or diabetes, Tamiflu can significantly lower the chance of complications from the flu. Remember, it must be started early to be of any benefit. 

What complications can occur?  

Dehydration, pneumonia and respiratory distress are the most common.

What are symptoms of dehydration?  

Fevers and sometimes vomiting can put you at risk for dehydration. Symptoms include thirst, dizziness, palpitations (rapid heartbeat), fainting, decreased concentrated urination and confusion. Mild symptoms can usually be self-managed by drinking fluids with electrolytes; e.g. Gatorade, non-diet clear sodas, apple juice, etc. More severe symptoms may necessitate IV fluids. Call the health center and discuss with triage nurse if symptoms are significant.

What are symptoms of pneumonia or respiratory distress?  

Difficulty breathing, shortness of breath, fevers that cannot be controlled or return after being gone for 24 hours, or pain or pressure in chest. People with these symptoms can discuss by phone with a triage nurse at the health center or go directly to an emergency room.

Final thoughts?  

Most young healthy adults with influenza get better within 5-7 days. If you have an underlying health condition or think you might have a complication, seek medical evaluation early.