The post Covid era: flu, how long do symptoms last?
Flu is a viral respiratory disease and affects about one billion people worldwide every year
Although it is very common, its impact should not be underestimated: the flu can present itself in various forms of severity, sometimes requiring hospitalisation and in some cases can even have fatal consequences.
How do you get the flu?
Influenza is a viral respiratory disease; the virus is passed from person to person
- through droplets (droplets) that spread when coughing, sneezing or talking (especially in crowded, closed environments);
- through direct contact with infected persons (e.g. through contaminated hands on the eyes, nose or mouth);
- through the use of utensils and objects, since the influenza virus can resist for a long time and reach the body through the mucous membranes.
Flu: how long are you contagious?
Seasonal influenza usually has an incubation period of two days, but can vary from one to four.
Adults can spread the flu from the day before the onset of symptoms to about five days after the onset of flu symptoms, while children and people with a weakened immune system may be more contagious.
What are the symptoms of influenza?
Sudden high fever, cough (usually dry) and muscle aches are the characteristic symptoms of influenza.
Other common symptoms are:
- headaches;
- chills;
- loss of appetite;
- fatigue;
- sore throat.
In children, the flu may also be accompanied by nausea, vomiting and diarrhoea.
Influenza usually lasts from one week to ten days
Influenza can present itself in different forms of severity, and certain population groups, such as younger children and the elderly, run a higher risk of developing serious flu complications such as viral pneumonia, secondary bacterial pneumonia and worsening of underlying medical conditions.
How to prevent influenza?
To prevent influenza, as well as to prevent colds, the same indications apply as to contain the COVID-19 pandemic:
- Wash your hands often and well with soap and water, for at least 40-60 seconds, especially after coughing or sneezing. Alcohol-based sanitisers reduce the amount of influenza virus from contaminated hands and are a good alternative;
- Cover nose and mouth when sneezing or coughing, with disposable tissues that should be thrown away immediately;
- Wearing surgical masks in the presence of symptoms such as coughs and colds can reduce infections among close contacts;
- Staying home in the presence of symptoms, especially in the early stages;
- Avoid close contact with sick people, e.g. by maintaining a distance of at least one metre from someone with flu symptoms and wearing a mask;
- Avoid touching your eyes, nose or mouth. Viruses can spread when a person touches any surface contaminated by the virus and then touches their eyes, nose or mouth.
The flu vaccine
Vaccination is the most effective way to prevent influenza, and every year a vaccine is available for the current flu season.
Flu vaccines contain only inactivated viruses or parts of them, so they cannot cause influenza virus infections.
Getting the flu vaccine significantly increases the likelihood of not getting the flu, and even if you do get sick, the flu form will be less severe and generally free of complications.
Vaccination also protects others, thus reducing the burden on the healthcare system.
Given that the COVID-19 pandemic is still ongoing, extensive vaccination coverage is very important because it helps not to weaken one’s own immune defences, to reduce complications in people at risk, and to avoid overloading hospitals with patients.
Especially in the cold season, many bacterial and viral agents circulate, which can cause respiratory infections and flu-like syndromes: since they are not influenza viruses, the flu vaccine is not effective for these agents.
What are the influenza viruses?
In humans, the main viruses responsible for influenza are types A and B.
Influenza A viruses (circulating in humans and other animal species) are classified into subtypes according to two surface proteins: haemagglutinin (HA) and neuraminidase (NA). Two subtypes of HA (H1 and H3) and two subtypes of NA (N1 and N2) have been recognised among influenza A viruses as causing human disease in recent decades.
Immunity to HA and NA proteins reduces the probability of infection and, together with immunity to internal viral proteins, decreases the severity of illness in the event of infection.
To date, 16 subtypes of HA and 9 of NA have been identified.
Influenza B viruses (present only in humans) do not have distinct subtypes within their surface proteins HA and NA.
Influenza viruses undergo mutations at the level of their surface proteins: these physiological changes allow the viruses to evade the immunity barrier present in people who have had influenza or who have been vaccinated against influenza in the previous year, thus favouring a wide and rapid spread of the infection.
Every year, the composition of influenza vaccines has to be updated.
In order to do this, the surveillance activity is fundamental, which makes it possible to select which strains to include in the vaccine, depending on the degree of epidemiological and serological differences compared to what has circulated in previous influenza seasons.
In Italy, the use of vaccines is approved by the Agenzia Italiana del Farmaco (AIFA), the national regulatory authority for medicines.
Vaccines are approved after a proven efficacy of 60%.
Who should get vaccinated?
The flu vaccine is indicated in all persons from 6 months of age, provided they have no contraindications to vaccination.
Influenza is in fact a serious public health problem and a major cost for case management, disease complications, and the implementation of control measures (in Italy, the InfluNet surveillance network deals with it).
Vaccination is strongly recommended for the following categories
- people aged 60 years and over
- people in close contact with the elderly;
- people at risk of complications who have chronic diseases (diabetes, hypertension, HIV/AIDS, asthma and other chronic heart or lung diseases);
- pregnant women;
- children aged 6 months to 6 years, given the ongoing COVID-19 pandemic, in order to reduce the circulation of the influenza virus among adults and the elderly;
- healthcare personnel.
When to vaccinate against flu?
The vaccination is administered from the beginning of October to the end of December and the vaccine starts to be effective two weeks after the injection; immunity thus obtained declines within 6-8 months.
Being vaccinated the previous year does not protect one in the following year’s flu season, precisely because of the mutation of flu viruses.
The vaccine is administered in a single dose by intramuscular injection into the deltoid of the chosen arm, while in young children the injection is preferably made into the anterolateral thigh muscle, or the vaccine is administered endonasally.
Symptoms may occur after the vaccine, such as:
- pain, erythema, swelling at the injection site;
- general malaise;
- fever;
- muscle pain (myalgia).
Can the flu vaccine and the anti-COVID-19 vaccine be given together?
Yes, there is no contraindication.
The flu vaccine does not interfere with the immune response to other inactivated or live attenuated vaccines, and there are no side effects beyond those already known.
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