Clinical Features of Influenza

There is a tendency for patients, and regrettably even some doctors, to label all respiratory ailments as "flu," being reluctant to confess to taking a few days off work for anything less! In reality, of course, influenza is a distinct clinical entity characterized by abrupt onset of fever, sore throat, nonproductive cough, myalgia, headache, and malaise. The uncomplicated syndrome is over in 3-7 days, but the cough and weakness may sometimes persist for another week or more.

Complications depend on the age of the patient. Young children may develop croup, pneumonia, or middle ear infection. However, most deaths occur in the elderly and are most frequently attributable to secondary bacterial pneumonia (usually due to Staphylococcus aureus, Streptococcus pneumoniae, or Haemophilus influenzae) and/or to exacerbation of a preexisting chronic condition such as obstructive pulmonary disease or congestive cardiac failure. Some of the elderly seem just to fade away.

Whereas 80-90% of influenza-related deaths occur in people over the age of 65 (especially over 75), the risk is at least as great for invalids of any age who suffer from chronic conditions affecting the pulmonary, cardiac, renal, hepatic, or endocrine systems. Further, the success of modern medicine in keeping alive so many children with congenital diseases such as cystic fibrosis and immunodeficiencies, and patients of any age with organ transplants or AIDS, has increased the number of younger people at risk of death during an influenza epidemic.

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