Flu-Related Illnesses and Who's Most at Risk

By Dianne Lange. Medically reviewed by Tom Iarocci, MD. May 7th 2016

Recovering from the flu can be agonizing enough, but add to that any complications, and you may feel as if you’ve been hit with a dozen bulldozers. While developing any complications of the flu, you may first start to feel better, but then, wham: Symptoms make an unwelcome comeback. This time around, you have a headache, your cough brings up greenish-yellow mucous and you may become short of breath.

If you begin recovering from the flu but then experience any of these acute symptoms, see your doctor or go to an urgent care clinic or the emergency room, says internist Susan J. Rehm, MD, vice chair of the department of infectious disease at Cleveland Clinic and medical director of the National Foundation for Infectious Diseases.

Flu-Related Conditions

Flu symptoms that worsen or return after you start feeling better indicate the virus is morphing into another serious health threat, such as:

  • Pneumonia
  • Bronchitis
  • Sinus infection
  • Ear infection
  • Reye’s syndrome

The flu can also aggravate any chronic conditions you may have, including asthma, diabetes and congestive heart failure.

Are You at Risk?

Developing any complications of the flu are more likely in various people, including:  

  • Adults 65 and older;
  • Children younger than 5 years old, especially those younger than 2;
  • Pregnant women; and
  • Native Americans and Alaska Natives.

Furthermore, the Centers for Disease Control and Prevention warns that people with very specific medical conditions are at even greater risk of developing complications of the flu, including those with:  

  • Lung diseases, such as asthma and cystic fibrosis;
  • Disorders of the brain, peripheral nerves and muscles, such as cerebral palsy;
  • Spinal cord disorders or injuries;
  • Seizure disorders, such as epilepsy;
  • A history of stroke;
  • Muscular dystrophy;
  • Developmental disorders, such as mental retardation and developmental delays;
  • Heart disease, congestive heart failure or coronary artery disease;
  • Blood disorders, such as sickle cell disease;
  • Endocrine disorders, such as prediabetes;
  • Kidney and liver disorders;
  • Metabolic disorders, such as inherited metabolic disorders and mitochondrial disorders;
  • Weakened immune systems related to HIV or cancer;
  • Weakened immune systems from certain medications, such as chronic steroid use;
  • Long-term aspirin therapy in people younger than 19 years old (who might be at risk for Reye’s syndrome); and
  • A body mass index of 40 or greater, indicating obesity.

If a pulmonary disease already compromises your lungs, then a secondary infection such as bacterial pneumonia could be life-threatening.

Preventing Complications With the Flu Vaccine

Experts recommend all adults get a flu shot yearly, and the CDC reports that during the moderately severe 2012–2013 flu season, getting the flu shot led to a 17 percent overall reduction in severe health outcomes.

For people with a chronic condition, getting the flu vaccine can be a lifesaver. In fact, a review of studies involving more than 6,000 people with heart disease found that the risk of cardiovascular events, including another heart attack, was significantly lower in people who got the flu vaccine compared with those who skipped it.

The flu vaccine was also associated with 43 percent fewer flu-related hospitalizations, particularly for the elderly with pneumonia and those with diabetes.

For Caregivers

When it comes to flu complications, family caregivers should be on alert. “This flu season, we’re seeing normal healthy people get severe flu and need to be hospitalized in intensive care,” says Rehm.

Whether it’s your child, parent, spouse or friend, make sure your loved one gets a flu vaccine. And perhaps most important, call for emergency care right away if he or she has acute warning signs, such as trouble breathing, persistent vomiting and a blue-gray skin tone.

Next Steps

If you suspect you or a loved one has any flu-related complications, call for help immediately. Don’t wait.

In trying to prevent any complications, time is also of the essence. Here are some good rules of thumb:

  • “Get medical treatment early,” urges Rehm. “Prescription antiviral drugs can shorten the time you’re sick and prevent serious complications, but you have to act fast,” says Rehm.
  • Don’t take any over-the-counter medications without clearing it with your doctor first because some widely available remedies may interact with prescribed drugs.
  • Finally, don’t jump back into life too quickly. Rehm recommends allowing 24 fever-free hours to pass before resuming everyday activities.

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