SMG 2003-4 Flu Guidelines
We generally see two patterns of viral (flu) syndromes
- respiratory predominant
and GI predominant.
The following is a brief summary of recommendations for self-care. Please contact your
physician if you have further questions or problems.
Respiratory Predominant
Key Symptoms Experienced
- Fever
- Cough (non-productive, occasionally yellow-green)
- Congestion (nose, throat, chest)
- Muscle Aches
- Sore Throat
Description of the Cause
While influenza vaccination in the fall will confer protection from up to 3 different influenza
viruses in winter, respiratory flu syndromes can be caused by a large number of viruses.
Testing to determine whether the infection is caused by a specific
virus is not currently available. Antibiotics play no role in the treatment of the adult with a
viral respiratory syndrome and while commonly requested by patients (and commonly prescribed by
doctors), this inappropriate use of powerful medications is resulting in widespread resistance to
antibiotics (resulting in death or severe illness when antibiotics are not working), a large dollar
cost to our beleaguered health care system, and a large variety of side effects from these antibiotics.
Recommended Self-Treatments and Recommendations
- Fever
- The height of the fever does not strictly correlate with infection severity and so temperature checking
is usually not needed in the normal adult. If you feel hot and sweaty or have cold chills, you are probably
having a fever.
- Ibuprofen (Motrin, Advil) is very effective when taken in doses of 200-400 mg (1-2 tablets) every
four hours. Acetaminophen (tylenol) is an alternative when you cannot take ibuprofen.
- Fluid consumption is important to avoid dehydration from the fever - dilute fruit juices, carbonated
beverages, water, and electrolyte solutions (Gatorade etc) are effective. Intake require several
liters per day-following your urine concentration is helpful, if it is clear, you are drinking enough.
- Cough (non-productive, occasionally yellow-green)
- Cough syrups containing a suppresant (dextromethorphan) and expectorant (guanfescin). Examples Robitussin DM
or Walgreen Brand Waltus)
- Tea with lemon and honey (additional liquor is optional!)
- Maintain adequate hydration
- Congestion (nose, throat, chest)
- Decongestants such as pseudoephedrine or chlorpheniramine.
- Maintain adequate hydration
- Muscle Aches
- Ibuprofen (Motrin, Advil) is very effective when taken in doses of 200-400 mg (1-2 tablets) every
four hours. Acetaminophen (tylenol) is an alternative when you cannot take ibuprofen.
- Sore Throat
- Ibuprofen (Motrin, Advil) is very effective when taken in doses of 200-400 mg (1-2 tablets) every
four hours. Acetaminophen (tylenol) is an alternative when you cannot take ibuprofen.
- Lozenges, hard candy, cool liquids.
- Get an influenza vaccine next year!
- Wash your hands frequently, cover your mouth when couging
When to call your doctor
- If you have other medical problems (such as asthma, emphysema, diabetes, heart disease)
- If symptoms persist more than 7-10 days
- If you develop difficulty with breathing, pain with breathing, or uncontrollable cough
- If you have any other questions or problems of concern
GI Predominant
Key Symptoms Experienced
- Fever
- Nausea and/or vomiting
- Diarrhea (loose, watery, yellow to brown, no blood or mucous)
- Muscle Aches
- Stomache ache, cramping, hiccups, increased heartburn
- Absence of lower abdominal pain
- Absence of stiff neck, severe headache, rash
Description of the Cause
Viral GI syndromes in adults are caused by a large number of viruses. Antibiotics play no role in the
treatment of viral GI syndromes.
Recommended Self-Treatments and Recommendations
- Fever
- The height of the fever does not strictly correlate with infection severity and so temperature checking
is usually not needed in the normal adult. If you feel hot and sweaty or have cold chills, you are probably
having a fever.
- Ibuprofen (Motrin, Advil) is very effective when taken in doses of 200-400 mg (1-2 tablets) every
four hours. Acetaminophen (tylenol) is an alternative when you cannot take ibuprofen.
- Fluid consumption is important to avoid dehydration from the fever - dilute fruit juices, carbonated
beverages, water, and electrolyte solutions (Gatorade etc) are effective. Intake require several
liters per day-following your urine concentration is helpful, if it is clear, you are drinking enough.
- Nausea and/or vomiting
- Small sips of water, carbonated beverage, electrolyte solutions. Increase as tolerated.
- Crackers, toast, broth, rice.
- Wait 1-2 hour after vomiting before attempting intake of fluid, if fluid tolerated over 2-4 hours, try
small amounts of food (crackers etc)
- For nausea accompanied by heartburn, consider antacids (tablet or liquid) or over the counter remedies
for acid (Pepcid-AC, Tagamet-HB etc).
- Diarrhea (loose, watery, yellow to brown, no blood or mucous)
- Start with fluids - electrolyte solutions (gatorade etc), dilute fruit juices, carbonated beverages.
- Dilute drinks containing sugar (glucose) with or without electrolytes are absorbed in greater quantities then
pure water when diarrhea is present.
- Introduce Bananas, Rice, Applesauce, Toast if tolerating liquids and both.
- Muscle Aches
- Ibuprofen (Motrin, Advil) is very effective when taken in doses of 200-400 mg (1-2 tablets) every
four hours. Acetaminophen (tylenol) is an alternative when you cannot take ibuprofen.
- Stomache ache, cramping, hiccups, increased heartburn
- Same as nausea/vomiting treatment (see above)
- Wash your hands frequently
When to call your doctor
- If you have other medical problems (such as diabetes, heart disease, intestinal disorders of any kind)
- If symptoms persist more than 7-10 days and/or are refractory to above treatments.
- If there is significant abdominal pain or uncontrollable vomiting
- If stool or vomit material has blood or large amounts of mucous.
Links for Further Information
Last Update 12.7.203 PM Ford, M.D.