1. Health

It's flu season, and how: Here's what you need to know

Published Jan. 19, 2018

Cristi Fryberger, a fifth-grade teacher, was headed back for the first day of classes at St. Petersburg Christian School after the Christmas break but didn't feel well. She left a couple of hours later and went to an urgent care clinic, where a swab of her nose and an in-office rapid test soon confirmed she had the flu. "I was surprised because I thought I would feel a lot worse," said the 34-year-old Clearwater resident, "but they told me this is just day one and I saw what they meant after that."

The next day and for four days after her diagnosis, Fryberger, the mother of a 9-year-old daughter and 14-year-old stepson, felt so sick that she could hardly get out of bed. "I don't think I've ever had the flu before. I've had colds but not this," she said. "It wipes you out. I didn't have the energy to get out of bed. Thank goodness my kids are older."

That's pretty typical of how flu patients feel, said Dr. Keith Waldrep, director of physician services for BayCare Urgent Care. "The distinguishing factor with the flu is the misery," said Waldrep, who oversees BayCare's 15 urgent care clinics in Pasco, Pinellas, Hillsborough and Polk counties. "With the flu, the body aches, you have the fatigue and people are just confined to bed. It's difficult to function. With a cold, most people can still function. But with the flu they can't. They're miserable."

In addition to body aches and fatigue, other common symptoms of influenza include fever that lasts several days, chills, a sore throat, a headache, coughing and a runny or stuffy nose.

The onset of symptoms is usually sudden. Many patients can tell you what time they started feeling bad. Illness can range from mild to severe; sometimes there can be life-threatening complications.

All four family members in Fryberger's household were sick in succession, although Fryberger was the only one who was tested for influenza. "The whole house got sick," she said, "starting with (my daughter) the day after Christmas with a cough and a low-grade fever. Then my husband, who had the same thing, then Julian, my stepson, he seemed to be worse, then mine started." Fryberger said she and Julian, who has a chronic illness, seemed to suffer the most, while her daughter and husband seemed to have a milder case of the illness.

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Waldrep said that on a recent day in the urgent care clinic he saw 60 patients and 22 were positive for the flu. "That's a lot," he said, adding that the flu patients he and his colleagues are seeing are more sick than usual. That tells him that the circulating flu viruses are very aggressive. "The most alarming trend, though, is the higher percentage of patients over age 65 we're seeing with the flu," Waldrep said. "They are at high risk for complications from the flu, and this H3N2 strain that's circulating right now seems to be targeting them."

H3N2 is the predominant strain of influenza that has sickened millions of Americans across the United States. The flu season typically starts in October and peaks in January or February, but cases may continue for months after the peak. The Centers for Disease Control and Prevention reports widespread flu activity in every state except Hawaii.

Dr. Jason Castro, a family medicine physician at the Tampa General Medical Group in Tampa Palms, said his group is seeing a lot of influenza as well. "We aren't sending many to the hospital, fortunately, but the patients we're seeing are sick, have a lot of symptoms, and they are taking a lot of time to get better."

Castro said it's important to be aware of the symptoms of the flu so, if necessary, you can get medical care to prevent serious complications and to prevent infecting others.

Once you've been infected, it can take from one to five days for symptoms to appear. You're most contagious, most likely to spread the virus, the day before you develop symptoms and for about the next four to five days or until the day after your fever breaks. So during that infectious time, you should take particular precautions to prevent spreading the virus to others. That means wash your hands frequently, stay at home, don't invite visitors over and cover your mouth with a tissue when you cough or sneeze, disposing of the tissue properly. Be sure caregivers wash their hands, too. Castro said that covering your mouth and nose can't be stressed enough. You're more likely to spread the flu by coughing or sneezing directly on people and less likely to pick it up from touching surfaces and objects.

Castro also recommends going to the doctor at the first sign of symptoms so you can be tested and, if positive, be given a prescription for a flu-fighting drug such as Tamiflu, which can shorten the duration of illness. "But, Tamiflu must be given within the first 24 to 30 hours of developing symptoms to get the greatest benefit. Most doctors won't give it to you if you've been sick for 72 hours or longer," he said. Tamiflu can shorten the course of influenza by up to three days if given early enough.

Fryberger, who decided against flu shots for herself and her family, took Tamiflu and was able to resume normal activities in about six days. But up until that point she said she was either in bed or on the couch. How sick you get depends on how much virus you're exposed to and your general health at the time you become ill. People with illnesses such as heart, lung, kidney and other chronic diseases are at high risk for serious complications from the flu. So are those with a compromised immune system, including cancer and HIV patients. Pregnant women and women who have given birth within two weeks are also at high risk for complications. So are adults age 65 and older and the very young.

Otherwise healthy adults who come down with the flu can often take care of themselves at home. Those in high-risk groups and those with chronic medical conditions will likely need to see or at least talk with their doctor. You should go to the emergency room if you have difficulty breathing, have a fever that isn't controlled with over-the-counter medication (after taking two doses), can't keep fluids down or have chest pain, confusion or dizziness. Emergency symptoms in children include difficulty breathing, bluish skin color, not drinking, fewer wet diapers, not waking or interacting, fever with skin rash and uncharacteristic irritability.

While no Tampa Bay area hospitals are reporting an influx of flu patients, some are seeing higher than normal flu-related admissions. As of Jan. 11, Morton Plant Hospital in Clearwater had admitted 34 flu patients; St. Joseph's Hospital in Tampa, 43; and St. Anthony's Hospital in St. Petersburg, 41. As of Jan. 9, Tampa General Hospital had admitted 14 flu patients.

According to the CDC, flu cases may be starting to level off, but the season is by no means over.

If you haven't gotten the flu vaccine and haven't had the flu, then the recommendation is still to get a flu shot.

"If you do come down with the flu, chances are you will have a less severe case if you are vaccinated," Waldrep said.

More importantly, the greater the number of people who are vaccinated, the fewer the number of people who can become infected and transmit the flu to high-risk individuals — people you encounter in the grocery store, at church, school, the gym, your own family.

"You're doing something good for others," Waldrep said. "We have a long season still ahead of us. I think we'll see flu cases all the way up until May. So get the vaccine if you haven't had the flu."

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