Guidelines for Recognizing Influenza (Flu)

From the Hawaii State Department of Health:

Guidelines for Recognizing Influenza (Flu)
Symptoms and Management

Signs and Symptoms of Influenza (Flu)

Infection with the influenza virus typically causes:
• fever (temperature >100º F)
• cough
• sore throat
• tiredness
• headache
• muscle aches.

Other Facts about Influenza Infection

The influenza virus is spread by the tiny droplets expelled when an infected person coughs or sneezes. These respiratory droplets do not usually remain airborne as they are heavy enough to quickly fall out of the air; however, they can spread approximately 3-6 feet from the infected individual. Infection can result from breathing in these droplets before they fall or by touching a surface on which the droplets landed (such as a doorknob or computer keyboard) and then touching the mucous membranes of the mouth, nose, or eyes. Depending on conditions, the virus may live for 1-2 days on hard surfaces.

A person infected with influenza can spread the virus in their respiratory droplets for about 24 hours before they begin to feel ill and will continue to expel the virus in respiratory secretions for about 7 days after they develop symptoms (children may spread the virus for up to 10 days after the start of illness).


How to Limit the Spread of Infection

• Stay healthy – eat, rest, drink plenty of fluids, exercise, and get vaccinated yearly against seasonal flu
• Wash your hands frequently or use alcohol-based hand sanitizing gel
• Clean hard surfaces such as doorknobs and telephones with disinfecting wipes
• Cover your nose and mouth with the inside of your elbow or a tissue when you cough or sneeze and encourage others to do the same
• Put used tissues in the trash
• Stay home from work if you are ill, and keep your children home from school if they are ill
• Practice social distancing (for example, work from home, bank on the internet, or avoid unnecessary travel)
• Be prepared if you are asked to voluntarily remain at home – have an emergency supply kit for your home including water, food, and medications (both basic non-prescription medications like ibuprofen and at least a 2 week supply of prescription medications.)


What to Do if You Are Ill

A fever may indicate infection with influenza. Have a thermometer at home and know how to use it properly.

• Place the thermometer bulb under the tongue for at least two minutes
• Wait more than 10 minutes after eating or drinking before taking your temperature
• A temperature 100º F or higher indicates a fever

If you have a fever and have recently traveled to a country or state where avian or swine influenza is present, or if you have been in contact with someone who has, you should contact your doctor immediately and avoid contact with other persons to whom you could spread infection. Before you arrive, call your doctor’s office to let them know that you are concerned about influenza infection. Putting on a surgical-type mask may be helpful to decrease the chance of spreading infectious respiratory droplets.

If you have not recently traveled or been in contact with anyone who has, you may still wish to see your doctor for seasonal influenza treatment or to exclude other illnesses (including leptospirosis or dengue fever). In general, healthy persons with seasonal flu may remain at home and care for themselves as described in the next section.

If the pandemic phase increases, meaning there is human-to-human transmission of a pandemic influenza virus, persons with fever should follow the directions issued by HDOH to obtain treatment from the appropriate hospital, clinic, or alternate health care facility.


Caring for a Person Infected with Influenza at Home

The ill person should:

• Avoid contact with healthy family members
• If possible, stay in a separate room with the door closed
• If possible, use a separate bathroom that is cleaned daily with household disinfectant
• Cover coughs and sneezes with a tissue and dispose of the tissue in the trash
• Wear a surgical-type mask, if available
• Not go out to go to work, school, the store, or anywhere else
• Drink plenty of fluids and eat a healthy diet as possible
• Get plenty of rest
• Take over the counter medications (e.g. to treat fever, congestion, cough) as needed to support you through the illness
• Children (18 years and under) should NOT take aspirin or aspirin-containing products (e.g. bismuth subsalicylate – Pepto Bismol) if influenza is suspected because of the risk of Reye syndrome, a rare but serious complication. For children, other medications such as acetaminophen (e.g. Tylenol) or ibuprofen (e.g. Advil or Motrin) may be used for relief of fever.

Other people in the house should:

• Discourage visitors
• If possible, have only one adult in the home care for sick persons. Because this adult may be at higher risk of becoming infected and may spread the virus to others even before feeling ill, he or she should wear a surgical mask when leaving the house.
• Avoid having pregnant women care for the sick person
• Try to stay away from the ill person, or stay 6 or more feet away
• Wash their hands with soap and water or use an alcohol-based hand gel frequently, including after every contact with a sick person or the person’s room or bathroom.
• Encourage the ill person to drink plenty of fluids and a nourishing diet and get plenty of rest.
• Not use the ill person’s plates, silverware, towel, or toothbrush
• Wash the ill person’s sheets and clothing with detergent and tumble dry on high heat
• Wash any other items touched by the ill person with soap and water or clean with disinfectant wipes
• Monitor the ill person for signs of potential need for specialized health care at an appropriate facility. Such signs may include:
- Shortness of breath or increasing difficulty breathing
- Persistently high fever (temperature greater than 102º F) despite taking
appropriate medications (e.g. acetaminophen [e.g. Tylenol] or ibuprofen [e.g.
Advil or Motrin])
- Mental confusion
- Lethargy (i.e., not alert or responding to normal stimuli)
• If the ill person shows signs of worsening or if uncertain, contact your primary care physician and/or public health authorities (contact information will be made available during a pandemic)

Stay at home when they have a fever and during the time that are most likely to spread the infection to others (7 days after the start of illness for adults, and 10 days after the start of illness for children).


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