Influenza is a viral infection of the respiratory tract caused by seasonal influenza viruses, and it is recognised by its abrupt onset: fever and chills, headache, widespread muscle aches, marked fatigue, a dry cough and a sore throat. For most patients treatment is supportive, aimed at easing symptoms, preventing dehydration and watching for complications, with antiviral treatment prescribed by a doctor for selected groups when it can be started early in the illness. It helps to separate influenza from a common cold. A cold begins gradually with sneezing, a runny or blocked nose, and little or no fever, and usually allows the person to carry on with the day. Influenza develops within hours and puts the patient in bed with fever and body aches. In practice the diagnosis is clinical during the season when the virus is circulating, and a rapid nasal swab test may be used when a treatment decision depends on it, for example in a high risk or hospitalised patient. The limits of treatment need to be stated plainly. **Antibiotics do not treat influenza**, because they have no effect on viruses; taking them unnecessarily drives bacterial resistance and causes side effects with no benefit, and a doctor prescribes them only if a secondary bacterial infection appears. Intravenous fluids are not a routine influenza treatment and do not shorten the illness; they are used when there is genuine dehydration or the patient cannot drink. An antiviral, when appropriate, shortens the illness and reduces the risk of complications in those most exposed, but it does not stop the disease at once. Finally, do not give any medicine containing aspirin to a child or teenager during a viral illness, and ask your doctor or pharmacist about a suitable alternative. Those most exposed to complications include pregnant women, young children, adults over sixty five, and people with chronic lung, heart, kidney or diabetic disease, reduced immunity or severe obesity. They should be assessed early rather than waiting. Suitability for any treatment, antivirals included, is decided by clinical examination and by assessing risk factors, not by reading.
Procedure steps
- 1
Assessment and risk stratification
The doctor asks when symptoms began, how they progressed, how long they have lasted and whether you were exposed to a sick contact, then measures temperature, pulse, breathing rate and oxygen saturation, examines throat, ears and chest, and identifies whether you belong to a high risk group.
- 2
Testing when it changes management
Not every patient needs a test. A rapid nasal swab or a broader respiratory panel is requested when it will change the decision: a high risk patient, an atypical presentation, or a need to distinguish influenza from another infection.
- 3
Supportive treatment
The core is rest, regular fluid intake and a suitable antipyretic chosen by the doctor, together with salt water gargles and saline nasal rinses. Watch urine output and activity level, as these are the best indicators of adequate hydration.
- 4
Considering an antiviral
If you are in a high risk group, or symptoms are severe and started recently, the doctor discusses an antiviral, whose benefit is greatest in the first days. This is a medical decision and not something to obtain on personal initiative.
- 5
Follow up and prevention
Warning signs that require urgent review are agreed, and staying home until the fever has settled without antipyretics is advised to limit spread. The seasonal vaccine for the coming year is discussed for you and for exposed people around you.
Before the procedure
Before the visit, write down exactly when your symptoms started, because that date decides whether an antiviral is still useful. Prepare a list of everything you are taking, including over the counter combination cold remedies, since many already contain an antipyretic and the dose can be doubled unintentionally. Tell the doctor if you are pregnant or breastfeeding, or if you have asthma or another chronic lung condition, heart, kidney or diabetic disease, reduced immunity or take immunosuppressive treatment, and mention any known drug allergy. Drink water before you come, wear a mask in the clinic to protect other patients, and if you are bringing a young child bring the vaccination record. If your fever is unusually high or breathing feels difficult, do not wait for an appointment and go to the emergency department.
After the procedure
Expect fever to last around three days and fatigue with a dry cough to persist for two weeks or more after the fever settles; this does not mean treatment has failed. Keep up fluids and rest, and return to work or school gradually. Seek care immediately for **shortness of breath, rapid breathing or chest tightness**, **blue lips or fingertips**, **chest pain**, **confusion, marked drowsiness or difficulty waking**, **a stiff neck with severe headache**, **clear dehydration with reduced urine output and inability to drink**, **improvement followed by relapse with higher fever and productive cough, which may indicate secondary pneumonia**, or **a seizure**. For an infant, seek care immediately for **refusal to feed, unusual lethargy, visible chest muscle retraction while breathing, or any fever under three months of age**.
Expected duration
The assessment visit usually takes 15 to 30 minutes, while acute symptoms typically last 3 to 7 days with fatigue lingering about two weeks.
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