Is It the Flu? Ultimate Flu Guide with Symptoms, Treatment, and Prevention for Older Adults
This article was reviewed by Mighty Health physician, Eric Tam, MD. Dr. Eric Tam is a board certified family physician. Having received his training at UCSF’s Family and Community medicine program, he recognizes the importance of understanding the world his patients come from. As a result, he approaches every patient with humility and deep empathy.
Influenza (flu) season is tough for everyone, but especially for older adults. Fortunately, you can take steps to reduce your chances of catching the flu, and to reduce its symptoms.
The flu develops as the result of infection from an influenza virus. Influenza A and B are the types that cause flu epidemics each year. These viruses change each year, so the flu virus that caused illness last year may not be around to cause illness this year.
The influenza virus attacks cells in your respiratory tract, which includes your nose, throat, and lungs. The symptoms of the flu usually last 4 to 7 days.
Thousands of People Get the Flu Each Year
The influenza (flu) virus causes as many as 41 million cases of the flu in the United States each year, according to the Centers for Disease Control and Prevention (CDC). The flu sends 140,000 to 710,000 to the hospital annually, and it claims thousands of lives each year.
The flu can also cause pneumonia, which can also lead to death, so many health officials combine the number of deaths from flu and pneumonia together.
The exact timing of the flu season varies from year to year, but usually begins in October and ends as late as May. Flu activity season usually peaks between December and February.
Understanding the Flu in Older Adults
The Immune Response to the Flu Virus
As we age, our immune systems weaken. Our immune system “learns” to recognize specific viruses, such as the influenza viruses, and “remembers” how to fight them.
The immune system contains several specialized cells, known as lymphocytes, and each has a different job. The two main cells of the immune system are T cells and B cells.
When the human body encounters a virus or other pathogen for the first time, cells of the immune system transport the virus to the lymph nodes. Some T cells fight the harmful cells directly and die off after the danger is over.
Other immune cells, known as memory T cells, learn what the pathogen looks like. If the specific pathogen should ever enter the body again, the T cells would recognize it and launch an attack against it. Memory T cells live for a very long time.
B cells produce antibodies, which are special proteins that bind to and neutralize the flu virus.
The main difference between T cells and B cells is that T cells fight the flu directly, while B cells fight the flu virus indirectly by producing antibodies.
Immature T cells and B cells are produced in bone marrow then move to the thymus gland in your neck, where they mature before entering your bloodstream. As we get older, our bone marrow and thymus gland produces fewer lymphocytes, which makes it harder for your immune system to identify and attack flu viruses. To make matters worse, the T and B cells do not function as well as we age. As the result of fewer lymphocytes that don’t work as well, older adults cannot fight off flu viruses as well as younger people.
How the Flu Spreads
Most medical professionals believe that the influenza virus spreads when someone with the flu coughs, talks, or sneezes, spraying tiny droplets into the air. These droplets can land in the nose or mouth of someone nearby, which allows the virus to easily enter their bodies. It is also possible for someone to get the flu by touching an object or surface that has a flu virus on it, and then touching their own nose, mouth, or eyes.
How Serious is the Flu for Seniors?
The flu is more dangerous for older adults than for younger people for several reasons. An older adult’s immune system is weaker, so they may be less able to fight off two infections at the same time. In other words, a senior with the flu may be more vulnerable to a secondary infection, such as pneumonia. In fact, flu and pneumonia were the eighth leading cause of death in the United States in 2016, according to the American Lung Association.
The flu poses a special problem for seniors in other ways. For example, flu increases the risk of heart attacks in older adults by as much as 3 to 5 times and increases the risk of stroke by 2 to 3 times within the first two weeks of infection, according to the National Foundation for Infectious Diseases. The risk for these serious complications remains high for several months. All this means people ages 65 and up are about 6 times more likely to die from the flu or its complications.
Flu Symptoms in Older Adults
Older adults with the flu tend to have the same symptoms as do younger people, with some exceptions. In people of all ages, flu symptoms may include:
Fever - a temperature of 100.4 and above.
Cough
Sore throat
Runny or stuffy nose
Headache
Body aches
Fatigue
Chills
Some older adults with the flu may experience nausea vomiting, and/or diarrhea, although gastrointestinal (GI) symptoms associated with the flu are more common in children.
Other older adults with the flu may have the respiratory symptoms, such as cough, but not have a fever.
Is it a Cold, the Flu, or COVID?
Colds, flu and COVID are all caused by respiratory viruses, so they produce similar symptoms – without medical testing, it can be hard to tell which virus made you ill. To make it even more confusing, not everyone with the same type of infection will develop the same symptoms, and the severity of the symptoms can vary greatly from person to person.
Differentiating between cold, flu, COVID is challenging, but important for older adults, as the complications and treatment approaches are quite different for colds than for COVID or the flu.
The Common Cold Presents the Fewest Symptoms:
Sore throat
Runny or stuffy nose
Cough
Sneezing
Both COVID and the Flu Cause:
Fever and/or chills
Muscle pains
Headache
Body aches
Feeling weak or tired
Runny or stuffy nose
Sore throat
Cough
Shortness of breath or trouble breathing
Vomiting and diarrhea
Main Takeaway:
If you’re presenting with any of the symptoms above, get tested right away for flu and COVID. The sooner you know what you have, the sooner you can start treatment.
Treatment for Flu in Seniors
Because the flu and COVID share many of the same symptoms and respond to different medications, treatment for the flu should start with an accurate diagnosis. Contact your doctor if you think you have the flu or COVID.
If your symptoms are not severe, you may be able to treat the flu at home with over-the-counter medications. Acetaminophen and ibuprofen can reduce fever and ease body aches, for example. Get a lot of rest and drink plenty of fluids, such as water and juice. Avoid alcohol and do not smoke, as both can worsen your symptoms.
Prescription drugs, known as antivirals, can help you feel better when taken within 48 hours after symptoms begin.
Antibiotics don’t kill viruses, so they won’t help you get over the flu. However, your doctor may prescribe antibiotics to treat secondary infections caused by bacteria, such as some types of pneumonia.
When to Seek Additional Care
Contact your doctor if your symptoms worsen. You may need to visit the emergency department if you:
Feel short of breath or have trouble breathing
Feel weak, dizzy, or confused
Develop pain or pressure in your chest or abdomen that does not go away
Have a fever or cough that goes away and comes back, as these may be signs of a secondary infection, such as pneumonia
Experience a worsening of other chronic health problems, such as heart disease or asthma
Develop any symptoms that worry you
Preventing the Flu
The Flu Vaccine
Vaccinations provide the best protection against the flu. A vaccine contains a weakened or deactivated version of the flu virus that teaches your immune system to recognize the most active strains of the flu virus.
More Flu Prevention Tactics
In addition to getting a flu vaccine, you can take other steps to avoid getting the flu or giving it to others. These steps include:
Avoiding close contact with people who are sick; staying away from others when you are sick
Covering your nose and mouth when you cough and sneeze to prevent spreading the flu virus to others
Washing your hands with soap and warm water when available, or with an alcohol-based hand rub when you don’t have access to soap and water
Avoid touching your eyes, nose or mouth
Clean and disinfect any surfaces that may have been contaminated with the flu virus
Stay home for at least 24 hours after your fever is gone; go out only to get necessities or to seek medical care
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