What is influenza (also called flu)?
The flu is a contagious respiratory illness caused by influenza viruses that infect the nose, throat, and lungs. It can cause mild to severe illness, and at times can lead to death. The best way to prevent the flu is by getting a flu vaccine each year.
Signs and symptoms of flu
People who have the flu often feel some or all of these signs and symptoms:
- Fever* or feeling feverish/chills
- Sore throat
- Runny or stuffy nose
- Muscle or body aches
- Fatigue (very tired)
- Some people may have vomiting and diarrhea, though this is more common in children than adults.
*It’s important to note that not everyone with flu will have a fever.
How flu spreads
Most experts believe that flu viruses spread mainly by droplets made when people with flu cough, sneeze or talk. These droplets can land in the mouths or noses of people who are nearby. Less often, a person might also get flu by touching a surface or object that has flu virus on it and then touching their own mouth, eyes or possibly their nose.
Period of contagiousness
You may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick. Most healthy adults may be able to infect others beginning 1 day before symptoms develop and up to 5 to 7 days after becoming sick. Some people, especially young children and people with weakened immune systems, might be able to infect others for an even longer time.
How serious is the flu?
Flu is unpredictable and how severe it is can vary widely from one season to the next depending on many things, including:
- what flu viruses are spreading,
- how much flu vaccine is available
- when vaccine is available
- how many people get vaccinated, and
- how well the flu vaccine is matched to flu viruses that are causing illness.
Certain people are at greater risk for serious complications if they get the flu. This includes older people, young children, pregnant women and people with certain health conditions (such as asthma, diabetes, or heart disease), and persons who live in facilities like nursing homes.
Flu seasons are unpredictable and can be severe. Over a period of 30 years, between 1976 and 2006, estimates of flu-associated deaths in the United States range from a low of about 3,000 to a high of about 49,000 people.
Complications of flu
Complications of flu can include bacterial pneumonia, ear infections, sinus infections, dehydration, and worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes.
Who is at high risk for developing flu-related complications?
- Children younger than 5, but especially children younger than 2 years old
- Adults 65 years of age and older
- Pregnant women
- American Indians and Alaskan Natives seem to be at higher risk of flu complications
- People who have medical conditions including:
- Asthma (even if it’s controlled or mild)
- Neurological and neurodevelopmental conditions [including disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy, epilepsy (seizure disorders), stroke, intellectual disability (mental retardation), moderate to severe developmental delay, muscular dystrophy, or spinal cord injury]
- Chronic lung disease (such as chronic obstructive pulmonary disease [COPD] and cystic fibrosis)
- Heart disease (such as congenital heart disease, congestive heart failure and coronary artery disease)
- Blood disorders (such as sickle cell disease)
- Endocrine disorders (such as diabetes mellitus)
- Kidney disorders
- Liver disorders
- Metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders)
- Weakened immune system due to disease or medication (such as people with HIV or AIDS, or cancer, or those on chronic steroids)
- People younger than 19 years of age who are receiving long-term aspirin therapy
- People who are morbidly obese (Body Mass Index [BMI] of 40 or greater)
Use of the nasal spray seasonal flu vaccine
Vaccination with the nasal-spray flu vaccine is an option for healthy* people 2 to 49 years of age who are not pregnant. Even people who live with or care for those in a high risk group (including health care workers) can get the nasal-spray flu vaccine as long as they are healthy themselves and are not pregnant. The one exception is health care workers who care for people with severely weakened immune systems who require a protected hospital environment; these people should get the inactivated flu vaccine (flu shot).
Who should not be vaccinated against seasonal flu?
Some people should not be vaccinated without first consulting a physician. They include:
- People who have a severe allergy to chicken eggs.
- People who have had a severe reaction to an influenza vaccination in the past.
- Children younger than 6 months of age (influenza vaccine is not approved for use in this age group).
- People who have a moderate or severe illness with a fever should wait to get vaccinated until their symptoms lessen.
- People with a history of Guillain-Barré Syndrome (a severe paralytic illness, also called GBS) that occurred after receiving influenza vaccine and who are not at risk for severe illness from influenza should generally not receive vaccine. Tell your doctor if you ever had Guillain-Barré Syndrome. Your doctor will help you decide whether the vaccine is recommended for you.
If you have questions about whether you should get a flu vaccine, consult your health care provider.