What to do if you have the flu

by Chuck Roberts
LRMC Public Affairs

Peak flu season in Europe hasn’t arrived yet (that usually occurs in February through March) but that doesn’t mean people aren’t getting the flu. But how do you know if that sick and achy feeling is just a bad cold or the flu, and once you determine your particular type of illness, what should you do to minimize the discomfort and get better?

Army medical officials offer the following guidance on what to do if you think you or your children have seasonal flu or flu-like illness.

“There are several steps you can take to prevent you and your family from getting ill such as getting your flu shot, washing your hands and covering your cough. If you do get ill it is important to stay at home to decrease the risk of spreading the flu to others,” said Lt. Col. Kathi Hill, Chief of Preventive Medicine at Landstuhl Regional Medical Center, and the Europe Regional Medical Center Command Consultant for Public Health Nursing.

Some common questions may be:
What are the symptoms to look for?

If you wake up not feeling well, the following are common flu symptoms: fever (typically greater than 100 F or 37.8 C). It is important to know that you can still have the flu without a fever, headache, extreme tiredness, dry cough, sore throat, runny or stuffy nose or body aches. Stomach symptoms such as nausea, vomiting and diarrhea may also occur, but are more common in children that adults. Some people infected with the flu may have respiratory symptoms without a fever.

Should I contact my healthcare provider or go the Emergency Room if I think I have the flu?
If you get sick with flu symptoms and are at high risk of flu complications, or you are concerned about your illness, call your healthcare provider for advice. High risk individuals should seek care early if they develop flu symptoms. Their providers will determine whether flu testing or treatment is needed.

The following individuals are at higher risk for severe illness or complications from flu:
• Children younger than 2 years old
• People 65 and older
• Pregnant women

People who have:
• Cancer

• Blood disorders (including sickle cell disease)

• Chronic lung disease [including asthma or chronic obstructive pulmonary disease (COPD)]

• Diabetes, heart disease, kidney disorders, liver disorders

• Neurological disorders (including nervous system, brain or spinal cord)

• Neuromuscular disorders (including muscular dystrophy and multiple sclerosis)

• Weakened immune systems (including people with AIDS)

Should I go to the emergency room?
The emergency room should be used for people who are very sick. You should not go to the emergency room if you are only mildly ill. If you go to the emergency room and you are not sick with the flu, you may catch it from people who do have it. An emergency room visit should be made if you or your child experience chest pain, shortness of breath, wheezing, fever with a rash, unable to take in water, sudden dizziness, or confusion. If you are unsure, you should call your health care provider.

Fortunately, most healthy people with mild flu illness do not need medical care or antiviral drugs. Over-the-counter cold and flu medications can help lessen symptoms such as fever, cough and congestion.

How should I treat myself or my child while sick at home?
• Stay home for at least 24 hours after your fever has gone (temperature is below 100 F or 37.8 C) except to get medical care or for other necessities. Your fever should be gone without the use of fever-reducing medicine, or when all your symptoms have resolved.

• If you must leave your home or barracks for healthcare or food procurement, wear a surgical/face mask. Try to arrange for a family member, friend or neighbor to obtain food and other items for you.

• Keep away from others as much as possible. This is very important to help reduce the spread of the virus! Healthcare workers may return to work after a 24-hour fever free period but cannot care for immune-compromised patients for seven days from symptom onset and until 24 hours without fever, whichever is longer. All home, isolation and exclusion periods apply regardless of whether antiviral medications are taken.

• Drink clear fluids (such as water, broth, sports drinks, electrolyte beverages for infants) to keep from being dehydrated, get plenty of rest and follow good hand, respiratory and cough hygiene measures.

• Do not share dishes and eating utensils. These can be washed in the dishwasher or with hot soapy water.

• Have everyone in the household wash hands often with soap and water, especially after coughing or sneezing. Alcohol-based hand cleaners are also effective. Restrict visitors to the home!

• Cover your cough and wash your hands often, even when taking antiviral medications, to prevent spreading influenza to others. Avoid close contact (within six feet) with others and do not go to school or work while ill.

• Call your clinic if you (or your child) experience any side effects; i.e. nausea, vomiting, rash, or unusual behavior.

• If you or your child is prescribed antiviral medications, please take all of it as directed.

• Take over-the-counter medications for symptom relief as needed for fever, pain and cough. These include medicines such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin, Nuprin), and/or cough and cold medicines. These medicines do not need to be taken regularly if your symptoms improve.

• Do not give aspirin (acetylsalicylic acid) or products that contain aspirin (e.g. bismuth subsalicylate – Pepto Bismol) to children or teenagers 18 years old or younger.

• Children younger than 4 years of age should not be given over-the-counter cold medications without first speaking with a healthcare provider. Call your medical provider or clinic for guidance.

• Throw away tissues and other disposable items used by the sick person in the trash. Wash your hands after touching used tissues and similar waste.

• Keep surfaces (especially bedside tables, surfaces in the bathroom, and toys for children) clean by wiping them down with a household disinfectant according to directions on the product label. If using individual moistened cloths change them frequently and discard.

• Linens, eating utensils and dishes belonging to those who are sick do not need to be cleaned separately, but importantly these items should not be shared without washing thoroughly first.

• Wash linens (such as bed sheets and towels) by using household laundry soap and tumble dry on a hot setting.

• Avoid “hugging” laundry prior to washing it to prevent contaminating yourself.

• Wash your hands well after handling dirty laundry

• Designate one person as the ill person’s caregiver, if possible. Try to identify a person as the primary caretaker who is not at high risk of flu associated complications.

• When holding small children who are sick, place their chin on your shoulder so that they will not cough in your face.

• Monitor yourself and household members for flu symptoms and contact your local health care clinic if you have questions.

• Minimize close face-to-face contact (less than about 6 feet away) with the sick person. If close contact is unavoidable, consider wearing a facemask (surgical mask) if available and tolerable.

• Used facemasks should be taken off and placed immediately in the regular trash; avoid reusing if possible. Wash your hands immediately afterwards.

In Germany, beneficiaries can call the Nurse Advice Line 24 hours a day at 00800-4759-2330 from most countries in Europe.
• Belgium: 0800-17920
• Italy: 800-877660
• Greece: 008-001-1815-3044
• From U.S.: 1-888-475-9233
• Turkey: 00-800-13815-9042

No one in my family has gotten the flu yet. Should I still receive the flu vaccine?
Yes. Seasonal flu vaccinations are available at your local health clinic. The Center for Disease Control recommends that even if you have had the flu you should receive the influenza vaccine. The vaccine covers three strains of flu so being vaccinated protects you from other strains. Health officials advise everyone to get their flu vaccine.