You Should Know These Serious Symptoms of Influenza as Cases Rise

Doctors explain what to know about influenza and signs that indicate you have been hit with the flu.

Published on January 6, 2023 | 7:15 AM

It’s been a historically bad flu season that started two months early with “at least 20 million illnesses, 210,000 hospitalizations, and 13,000 deaths from flu,” the Centers for Disease Control and Prevention states. However, cases are starting to peak. “Seasonal influenza activity remains high but is declining in most areas,” the CDC reports. In addition the CDC website states, “The number of flu hospital admissions reported in the HHS Protect system decreased nationally from the week prior for the third week in a row.” That said, it’s not over and with three viruses still circulating, taking precautions is the only way to help prevent sickness.

One way to do this is to stay home if you’re experiencing symptoms. Keep kids home from school until they clear, “Diana Lev, MD Internist and Family Medicine with Dignity Health Medical Group Northridge advises. “School is one of the highest spreaders. Older people and small children run the highest risk of hospitalization. Influenza is responsible for 12,000-50,000 yearly deaths in the last decade. This season is predicted to run later than normal this year, possibly into April, so please continue to get your flu vaccines.”

In addition, the CDC encourages people to get a flu shot. “An annual flu vaccine is the best way to protect against flu. Vaccination helps prevent infection and can also prevent serious outcomes in people who get vaccinated but still get sick with flu. CDC continues to recommend that everyone ages 6 months and older get an annual flu vaccine as long as flu activity continues.” With so many viruses hitting at once and symptoms overlapping, it’s hard to tell which virus you may have, but doctors Eat This, Not That! Health spoke to explain what to know about influenza and signs that indicate you have it. As always, please consult your physician for medical advice.

1. Why Influenza is Common in the Winter

Dr. Lev says, “There is not a single answer for this, but the original Italian name itself alludes to this fact. Influenza di freddo–influence of the cold. Shorter time in the sun, crowding indoors, and dry weather are all responsible.”

Michael D. Wang, Geriatric Medicine, Medical Staff at Beverly Hospital, Vice President, Clinical Affairs at Welcome Health Medical Group tells us, “Influenza is a seasonal virus – it comes when it’s cold, comes out when crowds are indoors. This is likely because of how the virus survives – spreading human to human, benefiting when humans are breathing, coughing and sneezing nearby. The route of spread is similar to that of coronavirus, making masking, distancing and hand hygiene similarly helpful for preventing the contagion.”

Tameem Alhayya MD, Chief of Department of Medicine and Family Practice at Beverly Hospital and Co-Founder and CEO of Sunrise Medical Associates, LLC explains, “Influenza occurs in outbreaks and epidemics worldwide, mainly during the winter season in temperate climates. Annual influenza epidemics typically occur October to March in the United States. It is unclear why Influenza strikes more in cold weather. It has been suggested by epidemiologists that during the winter, people spend more time indoors with the windows sealed, so they are more likely to breathe the same air as someone who has the flu and thus contract the virus. Another possible culprit is that days are shorter during the winter, and lack of sunlight leads to low levels of vitamin D and melatonin, both of which require sunlight for their generation. This compromises our immune systems, which in turn decreases ability to fight the virus. Also influenza virus itself may survive better in colder, drier climates, and therefore be able to infect more people.”

2. Why Influenza is Bad This Season

Dr. Wang explains, “The human immune system is a defense system that learns. As it sees and reacts to foreign attackers, it develops defenses specific to those enemies. The last few years have been dominated by coronavirus and marked by a relative absence of flu. We’ve not seen enough flu to develop our common defenses. Nor have we received enough of the flu vaccine in our population. For these reasons, our defenses are down and flu is an advantage this year. January is too late to benefit from the flu vaccine!”

Dr. Lev tells us, “For the last 2 years, almost nobody caught the flu. We were wearing masks, and stayed out of contact with others. Immune systems do not build antibodies and in essence forget the virus. We also produced an entire 2 years of children who have never been exposed to the flu, making them unprepared for this year, as well as people who thought that they no longer needed the vaccine this year. This made the virus spread like wildfire through schools and our communities. The season began earlier than normal and we expect it to last longer this year. For a virus this is the best habitat.”

Dr. Alhayya says, “With the fast spread of COVID since early 2020, many governments and municipalities implemented shutdown and masking mandates. Those measures, along with the general population’s self-implemented precautionary measures, have helped prevent transmission of respiratory illness in general. When those measures are lifted and people resume intermingling, transmission of respiratory viruses hits again affecting more people than pre pandemic rates and leading to severe cases in young children, elderly and immunocompromised patients.”

3. Why It’s Taking So Long to Get Over the Flu

According to Dr. Lev, “This goes back to our bodies not being sick for so long, and the co-infections. Our antibodies are not ready to fight this, like they were when we were sick yearly. It takes longer for our bodies to react effectively. If someone did not receive the vaccine, their infection tends to last longer with more severe symptoms. This is all because the body forgot this virus and it multiplies more before our immune system starts fighting the influenza virus effectively. We are also seeing Influenza infections together with other viral infections in many people. The more co-infections you have, the longer it will take to resolve.”

Dr. Wang says, “I’m not sure the duration of flu this season is different from prior seasons, except that compared to the last two years, we are seeing higher rates of flu. It has always been that for some influenza can improve in days, but in others, symptoms can persist for several weeks. There also may be other factors: fewer defenses against the flu, more exposure this year (less masking, more crowding), and more probability we may get more than one viral infection.”

Dr. Alhayya tells us, “Adults with uncomplicated influenza typically have fever and respiratory symptoms for about three days, after which time most show signs of improvement; complete recovery may take 10 to 14 days (longer in adults ≥65 years); however, some patients have persistent symptoms of weakness or fatigue for several weeks.”

4. Influenza Signs and Symptoms that Sending People to the ER

Dr. Lev states, “This varies. Most people come in for cough or fever that last more than a few days. Some come because they are living with immunocompromised or elderly people, and they want to know exactly what they have, to be able to protect them better. Children and the elderly come in for shortness of breath, and are more likely to be admitted for this. As a society, we have forgotten over the last few years that we used to stay home, keep our kids home, and let the flu run its course.”

Dr. Wang adds, “Symptoms have always driven people to be seen in urgent settings. ER’s typically get crowded in winter months. This year, perhaps our collective experiences with COVID’s potentially bad outcomes, our higher expectation for diagnostic certainty, and expanded treatment options for viruses have fueled utilization for emergent urgent services. And while COVID rates are not surging as bad as before due to higher widespread immunity, flu and RSV have rebounded this year, creating a triple threat to care facilities. In general, healthy populations, particularly those who are immunized, don’t need to occupy ER and urgent care centers. They don’t get as sick. Medications for COVID19 and flu don’t help much. They can ride out the virus at home. This is where getting the latest fall vaccines for COVID and flu can be super helpful both to recipients, and our health care facilities.”

The CDC says, “Flu signs and symptoms usually come on suddenly. People who are sick with flu often feel some or all of these symptoms:

Fever*/feeling feverish or chills
Cough
Sore throat
Runny or stuffy nose
Muscle or body aches
Headaches
Fatigue (tiredness)
Some people may have vomiting and diarrhea, though this is more common in children than adults.

*It’s important to note that not everyone with flu will have a fever.”

5. How to Tell Influenza From Other Viruses

According to Dr. Wang, “Sometimes the flu can have a distinctive sudden onset of symptoms of muscle pain, headaches and fevers. However, the symptoms from different viruses more often overlap – runny nose, congestion, sore throat, cough, and gut symptoms. Moreover, receiving vaccine updates may lessen severity and duration of symptoms. People with different chronic illnesses or age can show signs differently. We often cannot tell the difference on clinical grounds. What public health agencies tell us about what is going around can be telling. Testing can tell the difference.”

De. Lev says, “This is the hard part. Covid, Flu, Rhinovirus, Metapneumovirus…. all mimic each other. It is hard to tell. Flu tends to have a bad cough with muscle aches, fever, headache, without a significant sore throat. Covid as an example can have loss of taste, and rhinovirus does not usually have a cough. But all of these are not always necessary for any of these viruses, making it very difficult this season to differentiate them.”

6. Hospitals and Healthcare Worked are Stressed

Dr. Wang emphasizes, “Hospitals and healthcare workers have had their hands full. More caution during COVID times have created busier processes, making routine work more resource-intensive. Just as in other industries, healthcare can also struggle to keep our workforce strong and supported. The ones you encounter working are at times picking up part of the load for someone else. Be kind to healthcare workers; a little appreciation goes a long way.”

Dr. Lev says, “We are seeing many patients daily, but the Covid pandemic prepared us to deal with large numbers of patients with viral illnesses. It is busy, but manageable. Most people do not need to be admitted to the hospital, so we have the capacity to sustain these numbers.”

Dr. Alhayya shares, “Hospitals and healthcare workers have suffered major stress and burn out during COVID pandemic. Now, with the rise of flu and other respiratory illnesses such as RSV, stress is mounting again upon the health care system, filling hospital beds and leaving patients stranded in ER many hours/days.”

7. How to Treat the Flu at Home

Dr. Lev emphasizes, “Most importantly stay home and stay warm. Remember that the flu likes the cold.

–Cough — dextromethorphan OTC. Cough drops, menthol. Tea with honey for anyone >1 years of age. Honey has natural antimicrobial properties. Any warm broth will make the throat feel better.

–Muscle cramps — any NSAID like Ibuprofen and plenty of fluid. Not using your muscles by resting and sleeping will help your body heal faster.

–Congestion — humidifier since Influenza likes dry air, various nose sprays, and pseudoephedrine (check with your doctor first). The hot liquids used for coughing will frequently open up the nose as well.”

Dr. Wang states, “Most do recover from the flu by themselves. Enable our bodies to recover by resting up and staying hydrated. Watch for sudden worsening in the pattern of symptoms – this may represent a superimposed bacterial infection, like pneumonia. People who are at high risk for complications may consider drug treatment for the flu. Seeking and receiving treatment early (within 48 hours) is part of their key to recovering well at home.”

Dr. Alhayya says, “Uncomplicated flu infection in healthy individuals is better to be treated at home with antipyretic medications such as acetaminophen or ibuprofen to reduce fever and muscle aches. Drinking plenty of water and other non sugary drinks. Rest as needed and staying at home to lessen the spread of the disease.”