What to do if you get the flu

Medicine & Science

December 29, 2003|By Jonathan Bor | Jonathan Bor,SUN STAFF

With many experts predicting the worst flu season in years, physicians are hard-pressed to say the bug shouldn't be taken seriously.

But drowned out in the frenzy over fevers, vaccine shortages and missed school days are two pieces of advice, doctors say: Don't panic and don't overmedicate.

Typical signs of the flu are headache, muscle ache, fatigue, exhaustion and cough, sometimes accompanied by a runny nose and sore throat.

The vast majority of people will get better without lots of drugs.

"This year, there's a huge amount of hysteria about flu," said Dr. Michael Cotter, an Owings Mills pediatrician. "For one thing, parents don't understand that when a child gets fever, it's a normal response [to infection] and is not very harmful."

Fever, he said, is part of the body's effort to overcome a virus, In most cases, it will subside after four or five days, however it's treated. In children, this is true of fevers reaching 105 degrees. Pediatricians become concerned about extremely high fevers - say, reaching 107 - and those that last more than four days, he said. But fears that fevers will spark seizures and brain damage are usually unfounded.

Cotter recommends acetaminophen or ibuprofen (sold under brand names such as Tylenol and Advil, respectively) for children who are clearly uncomfortable, but many youngsters cope without medication.

Dr. Daniel Levy, an Owings Mills pediatrician and spokesman for the American Academy of Pediatrics, said fever-reducing drugs may prolong the illness. "You need a certain amount of fever to knock out these bugs," he said.

Decongestants can also backfire, he said, drying up secretions that carry virus out of the body. The drugs can also make a child jittery, while flu preparations with antihistamines can cause drowsiness or excitability.

Parents should focus less on thermometer-reading than on the symptoms that accompany fever, said Cotter. A child with typical flu symptoms and a fever of 104 is probably not at risk. One with a 101 fever and a stiff neck and confusion may have potentially fatal bacterial meningitis - and should be seen immediately.

Parents should also have a doctor check a child whose nails turn blue, who stops urinating, or who gasps and pulls in the skin around the rib cage with every inhalation. These could signal dehydration or respiratory distress.

Adults rarely spike high fevers and when they do, the temperature could be a sign of pneumonia or other serious bacterial illness. "When they go over 103, it's a real red flag," said Dr. J. Glenn Morris Jr., a professor of medicine at the University of Maryland School of Medicine. He suggests fever-reducing drugs for such patients and asks them to come in for evaluation.

Dr. Dana Frank, a Johns Hopkins-affiliated internist, said it's particularly important for elderly patients with flulike symptoms to see a doctor. That's because it's hard for them to distinguish flu from other serious problems such as pneumonia and urinary infections.

Younger patients with chronic illnesses such as cancer and AIDS are at risk for secondary infections and should see a doctor at the first sign of flu.

But Frank encourages younger and generally healthy adults to stay home when they have ordinary flu symptoms - or just call the doctor's office. "I'm afraid they are going to spread it - not just to my staff, but to other patients," he said.

Antiviral drugs such as amantadine and tamiflucan shave about a day off the flu and moderate the discomfort if taken within 48 hours of the first symptoms. But Frank said doctors can prescribe those drugs over the phone. "For adults, aspirin, Tylenol, fluids and rest are really as good as anything else," he said.

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