Influenza (flu): common cause and treatment

What is influenza?

Influenza is characterised by a runny nose, sore throat, headache, fever and aching muscles and joints.

Influenza is a viral disease that usually strikes between October and May.

It lasts from three to five days and can be followed by fatigue for two or three weeks. It usually causes aching muscles and joints, headaches, cough and fever with a temperature of between 38^o and 40^oC.

Although it can become a much more severe illness, leading to pneumonia, nerve and brain damage and even death – such complications are rare.

Because it is a viral infection, it cannot be treated with antibiotics. Antiviral agents can reduce the severity and duration of infection, but these are generally prescribed only if there are concerns regarding complications of the infection or transmission of more severe strains of the virus. The best remedy is rest while drinking plenty of fluids.

It's possible to get vaccinated against influenza, which is especially advisable for the elderly and people with heart and lung diseases.

In 2009, a pandemic (global outbreak) of swine flu (H1N1 influenza A) was associated with high complication rates in pregnant women.

H1N1 has been included in the 2010 to 2011 vaccination programme. Vaccination is recommended therefore for pregnant women and is also advised for children under 5 years

In the UK vaccination is offered to:

• anyone with chronic cardiac or respiratory conditions, such as asthma
• anyone with chronic kidney diseases
• anyone with chronic neurological diseases
• anyone with immunodeficiency
• pregnant women
• children under 5 years of age
• anyone who may otherwise be at increased risk.

What are the symptoms?

• Headache.
• Fever (38^o to 40^oC).
• Aching muscles and joints.
• Chest pains.
• Lack of appetite.
• Fatigue and weakness.
• A runny nose and sore throat.
• Dry cough.
• Restless sleep.
• Chills and shivering.
• Indigestion.
• Vomiting or diarrhoea.

What can I do?

• Step up your fluid intake – you lose a lot of liquids during a fever.
• Rest, preferably by staying in bed.
• Try to get plenty of sleep.
• If you have a cough, an over-the-counter cough remedy may ease your symptoms. The pharmacist is the best person to advise on this.
• Avoid smoking and drinking alcohol.
• Paracetamol (eg Panadol, Calpol) or aspirin (eg Aspro clear) will reduce fever and muscle aches. (Note that aspirin should not be given to children under 16 years of age, unless on the advice of a doctor.) Ibuprofen (eg Nurofen) will also relieve these symptoms. These painkillers are also found combined with medicines such as nasal decongestants in various over-the-counter cold and flu remedies. Ask your pharmacist for advice about which are most suitable for relieving your symptoms.
• Consult a doctor if the symptoms do not disappear after a week, or sooner if you feel worse.

How is influenza spread?

Influenza is a viral disease, which is passed from one person to another through the air. The disease infects the nose, throat or lungs. Droplets can contaminate the skin and frequent hand washing is advised.

It often breaks out as an epidemic, which quickly spreads from town to town and country to country. Typically, an area can have epidemic conditions for a period of four to six weeks before it eases off.

Are there different types of influenza?

Yes, there are three types of influenza.

Type A

The most serious type with the most acute symptoms. It is also the most common form, usually breaking out every two or three years. The 2009/2010 pandemic was caused by influenza A H1N1.

Type B

Similar symptoms to type A, but not as serious. The outbreaks happen every four to five years.

Type C

The mildest type, with symptoms similar to a cold.

How long will the influenza last?

Usually, influenza lasts three to five days. If it goes on for more than a week or if the symptoms are very severe, you are advised to consult your doctor.

A bad case of influenza has the potential to develop into a more serious condition like pneumonia or sinus trouble, and in rare cases it can be life-threatening.

Who is at risk?

Influenza can be dangerous to the elderly, especially those who live in residential homes where there is more risk of contracting the virus through contact with others.

People with lung and heart diseases are also more likely to develop complications due to an attack of flu. Those at risk are advised to get a yearly vaccination. Consult your doctor if you have any problems or questions.

Other important facts

• Both colds and flu are caused by a virus but the symptoms of influenza are usually more severe.
• Antibiotics have no effect against influenza.
• Damp or cold cannot cause influenza. However, sudden changes in temperature may cause the symptoms to appear more quickly.
• People are seldom infected by the same type of influenza twice because resistance develops within two or four weeks. However, the influenza virus constantly mutates into slightly different versions of itself, which is one reason why vaccination is sometimes ineffective. The vaccination also needs to be done yearly to keep up the person's level of immunity. The type of vaccination given each year changes slightly, as this is the ‘best guess’ vaccination to cover the likely type of influenza virus that will be most common that year.
• It's possible to pass on the infection the day before you develop the symptoms yourself. You can also pass on the infection until the day after your fever has disappeared.

Current evidence does not support a preventative effect of homeopathy in influenza and influenza-like syndromes. Vaccination should still be the preventive measure for patients at risk, ie those over 65 years and with heart or lung diseases.

Antiviral agents such as oseltamivir (Tamiflu) and zanamivir (Relenza) can shorten the duration of infection.

There are concerns that widespread use of such agents can encourage the emergence of resistant strains of virus. These agents are generally used therefore when there are particular risks of complications or to limit transmission of the more severe strains of the virus.

Despite the bewildering number of over-the-counter remedies for 'flu', all are symptom relievers only, and the number of active ingredients is quite small.

People taking other medicines should check with the pharmacist before taking a flu remedy in case of interaction between medicines.

Lower abdominal pain in women

What causes lower abdominal or 

pelvic pain?

All women feel discomfort or pain in the lower abdomen below the navel from time to time, for instance, before or during menstruation.

Taking note of certain symptoms will help you and your doctor accurately diagnose the problem, although this can be difficult.

In many cases it can be difficult to identify the cause of the pain, but noting certain features will help you and your doctor come to a likely diagnosis.

The most common causes are a urinary disorder such as a bladder or kidney problem, a bowel problem or a condition involving the reproductive system – the uterus, Fallopian tubes and ovaries.

Type of pain arising from the 

urinary system

Pain from the urinary system can indicate such conditions as cystitis (inflammation of the bladder), inflammation of the collecting system of one or both kidneys (pyelonephritis), kidney stones or uncommonly tumours.

Typical symptoms of infections are a burning sensation when passing urine and a need to empty the bladder more frequently. In addition, pain travelling from the back and around to the front might suggest a kidney infection or kidney stone.

The pain associated with kidney stones may be particularly severe. The presence of blood in the urine raises the possibilities of infection, kidney or bladder stones or even a bladder or kidney tumour. Both benign and malignant tumours can first make themselves noticed in this way. The presence of blood in the urine always requires further investigation and should be reported to your doctor.

The duration of the pain will further help you and your doctor to make the correct diagnosis.

Type of pain arising from conditions of the 

intestines

The bowel can give rise to a wide variety of symptoms including pain.

Constipation and diarrhoea can be painful in themselves, and the change in bowel habit usually identifies the pain as coming from the bowel. Pain from the bowel is often described as colicky in nature. This means that the pain or discomfort comes in waves with little or no discomfort in between the pain.

Bloating or swelling of the lower abdomen may be present in many intestinal (bowel) conditions including irritable bowel syndrome.

The passing of fresh blood or altered blood (black motions) from the back passage should be reported to your doctor as investigation is usually necessary.

Type of pain arising from conditions of the 

reproductive organs

Pain might originate from the uterus (womb), Fallopian tubes or ovaries. It is usually felt in the middle of the lower abdomen, above the line of pubic hair as far up as the navel. Occasionally, the pain is more to one side, which is more typical of a pain coming from an ovary.

There might be discomfort or even pain during intercourse (called dyspareunia) felt deep within the pelvis.

Pain originating from the uterus is usually worse at the time of a woman's period (dysmenorrhoea).

Examples of conditions of the reproductive organs giving rise to pain includeendometriosis, pelvic inflammatory disease, ovarian cysts, fibroids and problems related to the early stages of pregnancy such as miscarriage and ectopic pregnancy.

In any case of sudden, severe, unexplained abdominal pain your doctor should be contacted.

What will the doctor do?

Acute and sudden pains are always worrying but chronic pain can also have serious implications and a doctor should be consulted.

The doctor will ask about periods, passing of urine and bowel movements. They might also ask if there have been episodes of nausea, vomiting, or fever. If appropriate, they may ask questions concerning the person's emotional life - family, friends, work - and their sex life.

The doctor will want to examine you. This will involve feeling your abdomen and, in addition, an internal examination (vaginal,rectal or sometimes both) may be necessary.

Further investigations or treatment will be based upon the description of the pain and the findings of the doctor's examination.

Typically, a urine sample will be requested and tested for any signs of infection.

If a kidney problem is suspected than an ultrasound scan of the kidneys and bladder will be arranged.

If a problem with the womb or ovaries is suspected, swabs from the vagina looking for any infection might be performed and an ultrasound scan of the womb and ovaries is commonly performed.

If a bowel problem is suspected, a sample of the motion is often investigated for signs of infection and you may be recommended to have a telescopic examination of the bowel called an endoscopy.

Painful menstruation (dysmenorrhoea)

What are menstrual pains?

Many women experience pain or discomfort at the time of their periods. For most, the pain or unease is not so severe that it interferes with their daily lives or requires any special attention.

However, for some women their monthly period is problematic and almost disabling because of the pain and inconvenience caused. They may have to take time off from school or work and stay at home for one or two days.

Although painful, periods are only sometimes a sign of an actual disease.

If period pains are more than an inconvenience then it is wise to consult your doctor or gynaecologist.

What causes menstrual pains?

The natural pains are caused by contractions in the musculature of the uterus. The contractions are caused by the release of the body's prostaglandins, which are hormones produced by the lining of the womb.

How can you avoid menstrual pains?

The best thing to do yourself, besides convincing yourself that you are not sick, is to stay in good physical health. This can be achieved by a healthy lifestyle with daily exercise, plenty of sleep and rest and, if possible, try to avoid stress. Over-the-counter painkillers, in particular ibuprofen (eg Advil, Nurofen), are often helpful and your pharmacist can often give advise you further on which ones are right for you.

What can the doctor do?

If your period pains are not relieved by simple painkillers then your doctor may wish to perform a pelvic examination to rule out any underlying conditions that can cause dysmenorrhoea.

Depending on this, a pelvic ultrasound scan or laparoscopy may be suggested. Medical treatment includes NSAIDs (non-steroidal anti-inflammatory drugs) and also the contraceptive pill.

By preventing ovulation the contraceptive pill reduces the production of prostaglandins and pain. If the pain is found to be caused by a condition such as pelvic inflammatory disease, endometriosis or fibroids, then the treatment will be tailored towards that condition.

Vitamin A: Food list and Benefits

Vitamin A is one of the most essential vitamins. It is vital for good vision, healthy skin, normal growth and the renewal of body tissue, and it helps protect the body from infections.

Vitamin A is a fat-soluble vitamin that comes in 2 different forms. They are Retinol and Carotene. Retinol is the most purest form of vitamin A, and the Carotene form is converted into Retinol and stored in the liver.

Vitamin A plays an essential role in aiding vision, in maintaining healthy skin and in preserving healthy bones and teeth. It also helps to maintain the mucous membranes, the internal skin surface of our respiratory system and of our digestive organs, and as these are in the first line of attack by an infection, the vitamin became known as the "anti-infective" vitamin for its protective role.

The RNI* for vitamin A for an average adult (not including pregnant or lactating women) is 600-700mcg per day. Normal, healthy adults should NOT exceed 3000 mcg per day!

Consult your doctor before increasing intake of any nutrient or changing your diet in any way!

A List of Rich Sources of Vitamin A

Vitamin A Rich Foods List	Micrograms (mcg)	Portion
Liver (pigs stewed)	23000	100g (3.5oz)
Cod liver oil	18000	100g
Liver Pate	7000	100g
Liver Sausage	2600	100g
Butter (fortified with A)	800	100g
Margarine (fortified with A)	750	100g
Ghee	700	100g
Faggots	450	100g
Cheese (hard)	330	100g
Fresh creams (pasteurised)	> 200	100g
Eggs	200	100g
VEGETABLE SOURCES AS CAROTENE **	mcg
Carrots (raw)	8000	100g
Sweet potato	4000	100g
Capsicum pepper (red)	3800	100g
Spinach	3500	100g
Curly Kale (boiled)	3200	100g
Watercress (too little portion size!)	2500	100g
Mangoes	1400	100g
Apricots	1200	100g
Herbs & Spices High Vitamin A Sources but very low portion size!	mcg	per gram
Paprika	360	1g
Chilli powder	210	1g

** Carotene - not as rich as Retinol as a source of vitamin A.

"Large doses of vitamin A can be dangerous and will cause nausea, vomiting, dizziness, itching skin and even hair loss. Never exceed the limit. If you eat lots of foods rich in vitamin A in the form of carotene the body will absorb it, but take care not to go overboard with supplements or foods high in vitamin A"

  

What if you're not getting vitamin A from foods?

The most notable sign of vitamin A deficiency is poor vision. A condition where the eyes are unable to adjust adequately to darkness is known as night blindness.

Vitamin A deficiency can also lead to skin complaints - on the scalp in the form of dandruff, on the face as acne and other blemishes, and on the body as boils or skin infections like eczema and impetigo. Babies skin rashes and infections MAY be due to this deficiency, as babies cannot store Vitamin A as well as adults.

You may become deficient in vitamin A if you are ill - for instance with a respiratory disease such as pneumonia - and reserves of the vitamin drop, or when certain drugs interfere with it.

Who Needs Vitamin A?

While everyone needs vitamin A, pregnant and breast feeding women should ensure that they are getting more than adequate supplies. Some doctors recommend that babies should be given vitamin A drops but, we recommend you consult your doctor about this issue first, and in any case never exceed the stated dosage!

Children who wont be tempted by foods rich in vitamin A may benefit from cod liver oil or halibut oil tablets. Anyone with a skin complaint (especially adults suffering from acne), may be advised to add extra vitamin A to the diet as this may improve the skin.

Elderly people who have poor diets, people with respiratory illnesses, and smokers should also consider vitamin A supplementation or foods high in vitamin A.

Source: WL