-by Jesse Nieuwenhuis, MD, Family Physician at Orange City Area Health System
It’s that time of year again: the Christmas lights, decorations, music, and good moments to be had with family and friends; what’s not to love? Unfortunately, wintertime also signals in the season for influenza, or simply known as “the flu.” We hear about getting the flu shot now every year, and so what’s the big deal with the flu anyway?
Back in 1918, an influenza epidemic of worldwide proportion infected an estimated 500 million people and killed 50-100 million (3-5% of the world’s population at the time), making it one of the deadliest natural disasters in human history. Most disease outbreaks disproportionately kill the very young, old, and already weakened, but the 1918 pandemic predominantly killed previously healthy adults. Pandemics of influenza have also occurred in 1957, 1968, 1977, and most recently in 2009 with the emergence of the current H1N1 influenza virus, or “swine flu.”
These outbreaks often occur when the influenza virus changes just slightly enough to catch our bodies off guard, making our immune systems less ready to fight off the virus. The flu vaccine was available already in 1945, but its wide acceptance didn’t come until about the late 1990s to early 2000s. Current recommendations are that most people 6 months and older should receive the flu vaccine every year. The importance of getting the flu vaccine every year is that the vaccine changes every year to provide coverage for the most current strains of the influenza virus that are around. So, in general, how effective is the flu vaccine? No vaccine is perfect, and the Centers for Disease Control and Prevention (CDC) estimates that the flu vaccine reduces the risk of getting the flu between 40% and 60%. Although this doesn’t seem like a significant reduction in risk, the flu vaccine is also associated with other benefits including a reduced risk of flu-related hospitalization, lower rates of heart events in those with heart disease, protecting both mom and baby during pregnancy, reducing the risk of a child from dying from influenza, reducing the severity of the illness if you do get sick, and protecting those around you through “herd” immunity.
Peak flu season typically runs from late November to March but varies slightly from year to year. So what are the most typical symptoms of influenza? Contrary to common misconception, the “stomach flu” involving vomiting and diarrhea are not typical symptoms of actual influenza but can be seen with influenza more commonly in children versus adults. Typical flu symptoms include fevers or feeling feverish or having chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, and fatigue or tiredness. These symptoms can be similar to the common cold and other upper respiratory viral infections, but there can be some key differences that can help determine if an influenza diagnosis is more likely. Below is a chart from the CDC that can help show some of the common nuances in signs and symptoms between the cold and the flu. The only sure way to make a diagnosis of influenza is to do laboratory testing, most commonly through swabbing the inside of the nose or the back of the throat.
Flu vs Cold
| Signs and Symptoms |
Influenza |
Cold |
| Symptom onset |
Abrupt |
Gradual |
| Fever |
Usual; lasts 3-4 days |
Rare |
| Aches |
Usual; often severe |
Slight |
| Chills |
Fairly common |
Uncommon |
| Fatigue, weakness |
Usual |
Sometimes |
| Sneezing |
Sometimes |
Common |
| Stuffy nose |
Sometimes |
Common |
| Sore throat |
Sometimes |
Common |
| Chest discomfort, cough |
Common; can be severe |
Mild to moderate; hacking cough |
| Headache |
Common |
Rare |
For most people, treatment of influenza consists of treating the symptoms with over-the-counter medication, staying well hydrated, and lots of rest. If caught in the first 48 hours and/or for people at higher risk of complications from the flu, antivirals can also be used to treat the flu. These antivirals can lessen the symptoms and duration of the illness by 1-2 days and also prevent serious flu complications like pneumonia.
As flu season is now upon us, remember to get your yearly flu vaccine to not only protect yourself but also others as you spend time with friends and family this Christmas season. Please visit with your doctor and go to the CDC website on influenza (
https://www.cdc.gov/flu/) for more information and resources about the flu. This website also gives weekly updates on current flu activity in your local area; so stay tuned, get your flu vaccine, and stay healthy this winter!
