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Influenza (flu) is a
viral infection. People often use the term "flu" to
describe any kind of mild illness, such as a cold or a
stomach virus, that has symptoms like the flu. But the
real flu is different. Flu symptoms are usually worse than a cold and last
longer. The flu usually does not cause vomiting or diarrhea in adults.
flu outbreaks happen in late fall and winter.
The flu is caused by
influenza viruses A and B. There are different strains of the flu
virus every year.
The flu causes a fever,
body aches, a headache, a dry cough, and a sore or dry throat. You will
probably feel tired and less hungry than usual. The symptoms usually are the
worst for the first 3 or 4 days. But it can take 1 to 2 weeks to get completely
It usually takes 1 to 4 days to get symptoms of the flu
after you have been around someone who has the virus.
get better without problems. But sometimes the flu can lead to a bacterial
infection, such as an
ear infection, a
sinus infection, or
bronchitis. In rare cases, the flu may cause a more
serious problem, such as
Certain people are at higher
risk of problems from the flu. They include young children, pregnant women,
older adults, and people with long-term illnesses or with
impaired immune systems that make it hard to fight
Your doctor will ask you
about your symptoms and examine you. This usually gives the doctor enough
information to find out if you have the flu, especially if many cases of a
similar illness have occurred in the area and the local health department
reports a flu outbreak.
In some cases, the doctor may do a blood
test or take a sample of fluid from your nose or throat to find out what type
of flu virus you have.
Most people can treat flu
symptoms at home. Home treatment includes resting, drinking plenty of fluids,
and taking medicine to lower your fever.
If you think you have the
flu, your doctor may be able to give you medicine that can make the symptoms
milder. But you need to start taking it within 2 days of your first
You can help prevent the
flu by getting the flu vaccine every year. It's best to get the vaccine as soon as it's available. It comes as a shot or in a spray that you breathe in through your nose.
The U.S. Centers for Disease Control and Prevention recommends that everyone 6 months old and older should get a flu vaccine. The
vaccine is especially important for people who are at higher risk of problems
from the flu, including:
The flu vaccine is also important for health care
workers and anyone who lives or works with a person who is at higher risk of
problems from the flu.
The vaccine usually prevents most cases of
the flu. But even if you do get the flu after you've had the vaccine, your
symptoms will be milder and you'll have less chance of problems from the flu.
You cannot get the flu from the flu vaccine.
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The flu is caused by the
influenza virus. Doctors classify the virus as
influenza type A and type B, each of which includes several subtypes or
strains. Type A is usually responsible for the annual outbreaks that typically
occur in the late fall and early winter.
The influenza virus
changes often, so having flu caused by one strain does not give you full
immunity to other strains.
The virus is spread from person to person through:
If you are infected with the flu, you are most likely to pass it to someone else from 1 day before symptoms start and up to 7 days after
symptoms develop. Children may be infectious for longer than 7 days after symptoms start.
Symptoms usually develop 1 to 4 days after you are
infected. Because symptoms may not develop for a couple of days, you may pass
the flu to someone before you know you have it.
The symptoms of
influenza (flu) appear suddenly and often
Influenza usually does not cause symptoms in the stomach or
intestines, such as vomiting and diarrhea.
Other conditions have symptoms similar to the flu, such as the common cold, bacterial
infections, and infectious
Influenza (flu) usually comes on suddenly. In many
cases people can pinpoint the hour when symptoms started. Symptoms develop 1 to
4 days after you are infected, and they include:
Complete recovery may take 1 to 2 weeks or longer. Fatigue
and weakness can last for several weeks.
influenza may develop in anyone, but they are much more likely in older adults
and people who have other health problems, especially heart and lung
Anyone exposed to an
influenza (flu) virus can become infected. These
viruses are contagious and spread easily among people in groups, such as in
nursing homes, hospitals, shelters, schools, and day cares. Working, visiting,
or living in any of these areas increases your risk of getting the flu.
The risk of having severe symptoms and
complications is higher for:
Call 911 or other emergency services if:
Call your doctor if:
In most healthy people, the
flu will go away in 5 to 7 days, although fatigue can
last much longer. Although you may feel very sick, home treatment is usually
all that is needed. If it is flu season, you may just want to treat your
symptoms at home. Watch closely for
symptoms of a bacterial infection, such as nasal
drainage that changes from clear to colored after 5 to 7 days and symptoms that
return or get worse.
Early treatment (within 48 hours of your
first symptoms) with antiviral medicines may reduce the severity of influenza
and may prevent serious flu-related complications.1
Babies, older adults, and people who have chronic health problems are more
likely to have complications from the flu, and they may need to see a doctor
for care beyond home treatment. But not all antiviral medicines work against
all strains of the flu. Talk to your doctor if you think you may need an
Call your doctor if you think your symptoms
are caused by something other than the flu.
These health professionals can diagnose and treat the
A doctor who specializes in treating infectious diseases
may be needed if the diagnosis is not clear or if severe complications
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Doctors can diagnose
influenza (flu) using your symptoms alone if many
cases of a similar illness have occurred in the community and if the local
health department has confirmed a flu outbreak.
Tests to confirm
you have the flu and to find out the type of virus may be important if:
Testing may involve blood tests (rarely used) or a
culture to identify the virus. Some cultures take 24
to 48 hours for results, so they will not help your doctor decide whether to
prescribe an antiviral medicine. A rapid flu test is now available that gives
results in 30 minutes. Although this test is not 100% accurate, it can be
useful when deciding whether to use an antiviral medicine.
In most healthy people,
influenza (flu) will go away in 5 to 7 days. The worst
symptoms usually last 3 to 4 days. Home treatment to ease symptoms and prevent
complications is usually all that is needed.
People at high risk of complications are encouraged to
contact a doctor within 48 hours of their first symptoms to find out whether
they need medicine to shorten the illness. They also should call a doctor to
receive medicine if they have been exposed to the flu.
If medicines are not used, contact your doctor if symptoms
of a complication develop.
You can help prevent
influenza by getting immunized with an influenza
vaccine each year as soon as it's available.
Yearly immunization with
inactivated influenza vaccineinactivated influenza vaccine(What is a PDF document?) (flu shot) or the
nasal spray flu vaccinenasal spray flu vaccine(What is a PDF document?) prevents flu infection and its complications in
healthy people ages 2 through 49 years can choose to get the
nasal spray form of the vaccine (such as FluMist) instead of the flu shot. The nasal
spray vaccine contains components of live viruses, so it should not be given to
people who have certain long-term (chronic) health conditions, such as heart or
lung problems. Close contacts of these people in high-risk categories can be
given either type of vaccine, with one rare exception. Immunization with the
inactivated virus (flu shot) is preferred over the nasal spray vaccine for
close contacts of people with severely
impaired immune systems during times when a protected
environment is needed. This avoids the risk of transmitting an active flu virus
from the nasal spray vaccine. If the nasal spray vaccine is used, contact with
anyone in this high-risk group should be avoided for 7 days. For close contacts
of people in all other high-risk categories, vaccination with either the flu
shot or the nasal spray is considered safe.
You should not
get the nasal spray if you:
Even if a flu vaccine does not prevent the
flu, it can reduce the severity of flu symptoms and decrease the risk
of complications. Studies have found that the flu shot
results in fewer days missed from work and fewer visits to a doctor for
respiratory infections, and it reduces the number of people who develop
complications from the flu, such as
pneumonia.2 And the flu vaccine can help protect the babies of women who got the vaccine while they were pregnant.3, 4
spite of these results, many people choose not to get a flu vaccine. Some do not
get the vaccine because of
myths they believe about the flu or the vaccines. These include beliefs that the flu is a minor illness or that the vaccine causes the flu. The
shot may cause
side effects, such as soreness or fever, but they are usually
minor and do not last long. And a type of flu shot (Fluzone Intradermal) is available that uses a much smaller needle than a regular flu shot. It is injected into the skin instead of into a muscle. This usually causes less discomfort at the time of the shot. People 18 to 64 years old can get this shot. Most, but not all, types of flu vaccine contain a small amount of egg.
Although antiviral medicines sometimes prevent the flu,
they do not work in the same way as a yearly immunization and should not
replace a flu shot or dose of the nasal spray vaccine.
The person who gives the vaccine may tell your child or you not to get it if your child or you:
Because the nasal spray vaccine is more expensive than a
flu shot, it may not be covered by your health insurance plan. Check with your
Almost every community has a program that offers flu vaccines at low cost
during the flu season. You also can get a flu vaccine during a
routine visit to a doctor or pharmacy. Many health clinics have set
hours at the start of the flu season for people to get flu vaccines without needing
to make an appointment.
Increase your chance of staying healthy by:
antiviral medicines (oseltamivir and zanamivir) can help prevent the flu caused by
influenza A and B viruses. These medicines may also reduce the length of the
illness if they are given no more than 48 hours after the first symptoms.
During a flu outbreak, these medicines may be given at the same time as a flu
vaccine and for 2 weeks after while your body produces
antibodies to protect you from the virus. The influenza medicines are usually given to people who are very sick with the flu or to those who are likely to have complications from the flu. But they may also be used for a person who has been sick with the flu for less than 48 hours. These
medicines are taken by mouth (pill) or inhaled into the lungs (inhaler).
The antiviral medicines
amantadine and rimantadine have been used to prevent flu caused by influenza A.
But for the past few years the U.S. Centers for Disease Control and Prevention
(CDC) has advised doctors not to use these medicines to treat or prevent the
flu.6 These medicines have not worked against most
types of the flu virus. Amantadine and rimantadine do not protect against
influenza B. Be sure to talk with your doctor about the medicine that
is best for you.
If you have
influenza, you can expect the illness to go away on
its own in about 7 to 10 days. In the meantime, you can take steps to feel
Some antiviral medicines reduce the
severity and shorten the duration of
influenza (flu) symptoms by 1 to 1½ days if given
within 48 hours of the first symptoms.1 These
medicines are not intended to substitute for getting a flu vaccine each
year. Rather, antiviral medicines may help control outbreaks and
prevent the spread of infection, especially in people at
high risk for flu complications.
The antiviral medicines
oseltamivir and zanamivir are used to prevent and treat influenza A and B
infections. They can reduce the severity and shorten the duration of flu
symptoms.7 Amantadine and rimantadine have been used
to help prevent and treat the flu caused by influenza A (but not influenza B)
infection. But for the past few years the U.S. Centers for Disease Control and
Prevention (CDC) has advised doctors not to use amantadine or rimantadine to
treat or prevent the flu.6 These medicines have not
worked against most types of the flu virus. It is important to talk with your
doctor about the medicine that is best for you.
Two types of antiviral medicines can treat influenza
The effectiveness of antiviral
medicines can vary from year to year. Some years a medicine may not work
against the types of influenza virus causing symptoms. Your doctor can help you
decide whether antiviral medicines are likely to help you.
people do not need antiviral medicines. They recover from influenza without
But since most people who have the flu feel quite sick, some people may choose to take medicine even
if they are at low risk for complications.
You cannot prevent the
flu or make yourself feel better faster by taking:
The Centers for Disease Control and Prevention (CDC) is
an agency of the U.S. Department of Health and Human Services. The CDC works
with state and local health officials and the public to achieve better health
for all people. The CDC creates the expertise, information, and tools that
people and communities need to protect their health—by promoting health,
preventing disease, injury, and disability, and being prepared for new health
Fiore AE, et al. (2011). Antiviral agents for the treatment and chemoprophylaxis of influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR, 60(1): 1–25.
Nichol KL, et al. (2007). Effectiveness of influenza
vaccine in the community-dwelling elderly. New England Journal of Medicine, 357(14): 1373–1381.
Zaman K, et al. (2008). Effectiveness of maternal influenza
immunization in mothers and infants. New England Journal of Medicine, 359(15): 1555–1564.
Eick AA, et al. (2011). Maternal influenza vaccination and effect on influenza virus infection in young infants.
Archives of Pediatrics and Adolescent Medicine, 165(2): 104–111.
Leyer GJ, et al. (2009). Probiotic effects on cold and influenza-like symptom incidence and duration in children. Pediatrics, 124(2): e172–e179.
Centers for Disease Control and Prevention (2006). CDC Health Alert: CDC Recommends Against the Use of Amantadine and Rimantadine for the Treatment or Prophylaxis of Influenza in the United States During the 2005–06 Influenza Season. Available online:
Cooper NJ, et al. (2003). Effectiveness of
neuraminidase inhibitors in treatment and prevention of influenza A and B:
Systematic review and meta-analyses of randomised controlled trials.
BMJ, 326(7401): 1235.
Other Works Consulted
American Academy of Pediatrics (2011). Recommendations for prevention and control of influenza in children, 2011–2012. Pediatrics, 128(4): 813–825.
Centers for Disease Control and Prevention (2013). Prevention and control of seasonal influenza with vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2013–2014
. MMWR, 62(RR07): 1–43. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6207a1.htm?s_cid=rr6207a1_w.
U.S. Centers for Disease Control and Prevention (2011). Maternal and infant outcomes among severely ill pregnant and postpartum women with 2009 pandemic influenza A (H1N1)—United States, April 2009–August 2010. Morbidity and Mortality Weekly Report, 60(35): 1193–1196.
November 7, 2013
E. Gregory Thompson, MD - Internal Medicine & Christine Hahn, MD - Epidemiology
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