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The Lowdown on the Flu
Some things to know about the upcoming flu season.

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Every year in the winter season my office is inundated by swarms of people clutching Kleenex boxes looking miserable.  Influenza has reared its ugly head again.


In order to gear up for the upcoming flu season I thought it would be a good idea to provide some quick facts about influenza.


How does one catch the flu?

When someone who has the flu sneezes, speaks, or coughs small droplets filled with flu particles are released.  Some of these droplets are then inhaled into the lungs and attaches to the respiratory lining. The virus then multiplies and causes the common symptoms of influenza infection


What are the symptoms of the flu?

Flu symptoms are more severe than those of colds and come on abruptly. If you have a mild case, the flu may seem a lot like an ordinary cold. But more often, symptoms appear suddenly, and may include:

  • temperature of 101°F or above
  • cough
  • muscle ache
  • headache
  • sore throat
  • chills
  • tiredness
  • feeling lousy all over

Most people recover from the flu within one or two weeks, but others, especially the elderly, may feel weak for a long time even after other symptoms go away.

What can be done if you get the flu?

Symptom Relief

Over-the-counter medications can minimize discomfort associated with flu symptoms, but these medications do not treat the viral infection.

Congestion, cough and nasal discharge are best treated with a decongestant, antihistamine, or in combination. There are many over-the-counter flu remedies that contain both of these ingredients.  Adequate liquids and nutrition are necessary for rapid recovery and to prevent dehydration. Bed rest is also a good idea. Until symptoms are gone, it is not advisable to go back to full activity.

What are the treatments for the flu?

There are effective treatments that can reduce the duration of the suffering caused by the flu and improve your quality of life. See your doctor within 2 days of when flu symptoms appear to find out if these and other treatments are right for you.

The following four antiviral medications are available to treat the influenza virus:

  1. Oseltamivir (brand name: Tamiflu®)
  2. Zanamivir (brand name: Relenza®)
  3. Amantadine (brand name: Symmetrel®)
  4. Rimantadine (brand name: Flumadine®)


The first two medications, Oseltamivir (Tamiflu®) and Zanamivir (Relenza®) are members of a new class of drugs that act against both influenza types A and B, while Amantadine (Symmetrel ®) and Rimantadine (Flumadine®) are older medications that may be used to treat influenza type A only.

Starting treatment with these medications within 2 days after flu symptoms appear will reduce the length of the illness and the severity of symptoms by at least 1 day. Early treatment can lead to faster results, enabling you to resume daily activities in a shorter amount of time.

Remember: Antibiotics are of absolutely no use for influenzaand are used only for bacterial complications after the acute phase is over.

What can be done to prevent getting the flu in the first place?

There are currently two vaccine options, the flu shot and the nasal spray vaccine. The shot gives more reliable protection and the spray is recommended only for non-high risk groups.

The best tool for preventing the flu is the flu vaccine, and the best time to get a flu vaccine is from early October to mid-November. The vaccine can also be given at any point during the flu season, even if the virus has already begun to spread in your community. You need a flu vaccine every year because the virus is constantly changing and new vaccines are developed annually to protect against new strains.


Despite easy availability and access to the flu shot, only 55% of persons over age 65 receive it yearly. In those under age 65 but at high risk for complications, hospitalizations and possible death, the vaccination rate is less than 50%. Most people under age 65 and not at risk don't receive the vaccine, despite its positive benefits.

Some people fear its side effects, but the influenza vaccine causes no side effects in most people. The rare exception is a severe allergic reaction in people with an allergy to eggs. Since viruses used in the vaccine are grown in hens' eggs, those who are seriously allergic to eggs should not receive the influenza vaccine.

Who Should Get a Flu Shot?

  • Adults 50 years or older
  • All children aged 6-23 months.
  • Adults and children ages 2-64 with chronic medical conditions, especially asthma, other lung diseases, and heart disease.
  • All women who will be pregnant during the influenza season.
  • Residents of nursing homes and other chronic care facilities.
  • Health-care workers involved in direct patient care.
  • Out-of-home caregivers and household contacts of children less than 6 months old.
  • Any person who wishes to avoid the flu.


Side Effects and Adverse Reactions to Flu Shots

  • The flu vaccine is made from a virus that is no longer active. Therefore, no one can catch the flu from a flu shot.
  • Less than one out of three people will develop soreness around the injection site for one or two days.
  • Fever, aches and pains are not common and more severe reactions are rare.
    A recent American Lung Association study has proven that the flu shot does not increase asthma attacks.


Nasal Spray Vaccine

In June 2003, the FDA approved FluMist, an influenza vaccine that is the first nasally administered vaccine in the US. It is being billed as the painless alternative to the traditional flu shot. Unfortunately the FDA has approved FluMist only for healthy people between the ages of 5 and 49. The safety of FluMist has not been established in the elderly and people with chronic underlying medical conditions, such as asthma. These high risk groups should avoid the nasal spray vaccine and stick with the flu shot. A study found that children under 5 should also avoid FluMist since those children had an increased rate of asthma and wheezing within 42 days of vaccination.

It is important to note that no vaccine is 100% protective and the flu vaccine is no exception. Sometimes a person who has been vaccinated will still come down with the flu. Because the viruses change often, they may not always be covered by the vaccine. But people who do get influenza after getting the vaccine often have a milder case than those who did not get vaccinated. Also, other viruses cause diseases that seem like influenza, and the flu vaccine does not protect against these other viral infections.

Remember, no vaccine works 100% of the time and prevention is key.

Unfortunately no vaccine is 100% protective and the flu vaccine is no exception. Sometimes a person who has been vaccinated will still come down with the flu. Because the viruses change often, they may not always be covered by the vaccine. But people who do get influenza after getting the vaccine often have a milder case than those who did not get vaccinated.


Since we are on the topic of prevention, I wanted you to know my office has received our first order of influenza vaccinations in the last week.  Please call for an appointment for a flu shot so you can greatly increase your odds of staying well this winter season.


I will be standing by with a box of Kleenex if you need me.

Stay well,


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Andrea Ruman, M.D. - Doctor of Internal Medicine
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Dr. Andrea Ruman: Female medical doctor, physician, internist for Marina Del Rey, Santa Monica, West Los Angeles (LA), and Culver City in California. Specialties include women's health (including physical examinations, pelvic exams and pap smears), weight loss support and preventive medicine.