When to see a healthcare provider for flu-like symptoms

Every year, rates of influenza in the U.S. begin to rise in November, peak between January and February and begin to decline in March. The 2019-2020 flu season resulted in 38 million infections, 18 million health care visits, 400,000 hospitalizations, and 22,000 deaths.

Now that we’re in the midst of the 2020-2021 flu season, rates of influenza are beginning to climb again (although at a lesser rate than in previous years due to COVID-19). It’s important to be aware of flu-like symptoms and the difference between a virus and bacteria. Here are some red flags to look for and prepare for flu season.

1. You are under 2 years old or over 65

Young children and older adults are at a higher risk of flu complications than other age groups. Children under age 2 are at a higher risk of complications because their immune systems are immature, and they are more prone to dehydration and other flu-related conditions. Children under 6 months are at especially high risk because they are too young to receive a flu shot.

Older adults are at a higher risk of flu complications because they often have a weakened immune system and because the flu can worsen the underlying medical conditions many seniors have, including diabetes and heart and lung disease.

2. You have shortness of breath

While a persistent dry cough can be par for the course when it comes to the flu, shortness of breath is a red flag that warrants prompt medical attention.  Shortness of breath can indicate viral pneumonia, respiratory distress, or bacterial pneumonia.

If you have shortness of breath, a detailed evaluation is warranted. This exam includes a measurement of your oxygen saturation and other vital signs, a lung exam, and, in many cases, a chest X-ray. It's also good to be mindful that flu-like symptoms and COVID-19 symptoms such as low-grade fever, nasal congestion, and sore throat can be the same thing.

3. You have persistent vomiting or diarrhea

Vomiting and diarrhea are common symptoms of influenza. While they’re more common in children than adults, patients of any age can experience vomiting and diarrhea. If these symptoms persist, they can lead to dehydration and electrolyte imbalances. Anyone with persistent gastrointestinal symptoms should seek medical attention to see if I.V. fluids, blood work, or prescription-strength medications are indicated.

4. Your symptoms last more than 2 weeks

A viral infection should run its full course within 10-14 days. If your symptoms persist beyond 14 days, it’s important to seek medical attention to see if there’s another underlying cause that requires further evaluation or treatment.

5. You have underlying health conditions

For patients with underlying health conditions, influenza can not only cause flu-like symptoms; it can also worsen pre-existing conditions, including asthma, diabetes, heart disease, kidney disease, and chronic lung disease. The same applies to patients who are pregnant since the flu can cause complications that affect both the mom and baby.

6. Your symptoms suddenly worsen

One of the risks of viral infections is that they can lead to secondary bacterial infections. These infections happen for two primary reasons. First, the body’s immune system is weakened from fighting the virus, so it’s more susceptible to other pathogens. And second, the mucus membranes in the upper and lower respiratory tracts are inflamed, making them easier for bacteria to penetrate.

Common secondary infections in influenza patients include sinusitis, pneumonia, sepsis, and meningitis.  If you seem to be recovering from the flu but suddenly develop a fever or worsening symptoms, it’s wise to seek medical attention to see if antibiotics are warranted.

7. You have COVID-19 symptoms

COVID-19 and influenza are both respiratory viruses, so many flus, and COVID symptoms overlap. These common symptoms include a fever, cough, headache, nasal congestion, body aches, fatigue, and diarrhea.

However, the data we have so far indicates that while the mortality rate from the seasonal flu is 0.1%, the mortality rate from COVID-19 is as high as 3-4%. So, it’s important to seek medical attention if you have symptoms unique to COVID, including a loss of taste or smell, severe shortness of breath, or blue lips.

Symptomatic patients often benefit from rapid flu and rapid COVID-19 tests, which can determine a diagnosis, inform a patient’s treatment plan, and decrease their risk of spreading an infection to the people around them.

Written by Sarah Thebarge, Physician Assistant