What groups are at high-risk for flu complications?

Symptoms | Complications | Risk factors | How to avoid flu complications

Currently, the U.S. is experiencing what many have dubbed a “tripledemic”—that is, an uptick in COVID-19, RSV, and flu cases occurring at the same time. Typically, the influenza virus peaks between December and February every year, but occasionally the peak lasts until May, according to the United States Centers for Disease Control and Prevention (CDC). This year the flu spiked much earlier than usual. What’s more, the 2022-2023 flu season is worse than it’s been in 13 years, reports the Washington Post. 

“The flu can really hit you hard, causing symptoms like fever and chills, sore throat, and body aches,” says Karen Berger, Pharm.D., a member of the SingleCare Medical Review Board. Flu symptoms can be more severe if you have chronic medical conditions. 

“Serious and life-threatening complications may occur from the flu,” Dr. Berger explains. “Older adults, pregnant women, and patients with other medical conditions are at an even higher risk for these complications.”

Common flu symptoms

When should you suspect you have the flu? Common symptoms include:

• Fever and chills
• Cough
• Sore throat
• Muscle or body aches
• Headaches
• Fatigue
• Vomiting and diarrhea (though this is more common in children)
• High fever or feeling feverish in some people
• Runny or stuffy nose

When you’re feeling miserable, it’s natural to be worried that you’ve caught COVID-19 or RSV. It can be hard to know if your symptoms can be treated at home or if you should visit a healthcare provider. If you think you may have been exposed to coronavirus, call your physician for advice, but many times the treatment for the symptoms above is to stay home until they pass.

RELATED: Coronavirus vs. the flu vs. a common cold

If you find you’re suffering from the symptoms below, you seek medical attention immediately in an emergency room or call 911:

• Difficulty breathing
• Chest pain
• Confusion
• Severe or persistent vomiting
• Sudden dizziness
• Severe neck stiffness
• Loss of consciousness 

These could be signs of a life-threatening complication from the flu or another illness.

Possible flu complications

Though most people who get the flu recover in about two weeks, others will experience complications, some of which can be deadly. They include:

• Sinusitis and ear infections
• Pneumonia or other lung disease
• Inflammation of the heart (myocarditis), brain (encephalitis), or muscle (myositis, rhabdomyolysis)
• Respiratory and kidney failure
• Sepsis

The most common flu-related complications are bacterial pneumonia and ear and sinus infections in young children. Symptoms of pneumonia include serious chest congestion or pain, trouble breathing, a 102-degree fever or higher, and a cough that produces mucus and/or pus.

What’s more, if you have a chronic medical condition, the flu can exacerbate your baseline medical issues. Those with asthma may have increased respiratory difficulty while sick with the flu, and those with chronic heart disease may find their breathing or extremity swelling gets worse from the flu.

RELATED: Sinus infection treatments

High-risk groups for flu complications

There are several risk factors that make one more susceptible for flu complications. They include:

• Age: All children less than 5 years of age are considered at high risk of complications, and the risk is higher in those younger than 2 years of age and highest if younger than 6 months of age. On the other end of the spectrum, adults 65 years old or older are also considered at increased risk of complications. 
• Where you live or work: Those in dense living or working conditions, such as nursing homes or military barracks, are at increased risk of complications of the flu.
• Having a weakened immune system: Everything from cancer treatments, immunomodulating medications, anti-rejection drugs, long-term use of steroids, being the recipient of an organ transplant, and having blood cancer or HIV/AIDS can weaken your immune system and make it easier for you to fall ill with the flu and develop complications.
• Certain ethnicities: American Indians or Alaskan natives are at higher risk of developing complications from the flu.
• Having a chronic condition: If you have asthma, chronic obstructive pulmonary disease, diabetes, heart disease, neurological or neurodevelopmental disease, an airway abnormality, and kidney, liver or blood disease, and contract the flu you are at higher risk of complications.
• Using aspirin under age 19: People who are younger than 19 years of age and receiving long-term aspirin therapy are at risk of developing Reye’s syndrome if infected with seasonal influenza.
• Pregnancy: Expectant mothers are more likely to have complications of the flu because pregnancy is an immunocompromised condition. This risk increases in the second and third trimesters. New mothers are also more likely to develop complications if infected in the two weeks after giving birth.
• Obesity: Those with a body mass index (BMI) of 40 or more are at a higher risk of flu complications.

How to avoid flu complications

The good news is there are ways to minimize your risk of getting the flu, which decreases the potential for serious complications. 

1. Get a flu vaccine.

“The best thing you can do is get your flu shot every year,” says Charles Parks Richardson, MD, a cofounder of Cleveland Heart. “Even if the flu shot doesn’t protect you 100%, if you are exposed to the flu virus, there’s a good chance that the symptoms will be less severe. Getting the flu shot is the absolute best way to prevent [the] flu and its complications, including hospitalizations and death.” A new subtyped flu vaccine is offered every year in the fall. So, your flu vaccine from the fall/winter before is not sufficient. 

And with RSV, COVID-19, and the flu spreading widely, the best way to protect yourself is to get the flu vaccine and the COVID-19 vaccine series including the bivalent booster. Experts say that you can receive the flu and COVID-19 vaccine at the same time with good effectiveness and no increased post-vaccination discomfort. 

RELATED: Flu vaccination 101

2. Stop the spread of germs. 

You can stop the spread of germs by handwashing, cover ingyour nose and mouth when you cough or sneeze, and avoiding touching your eyes, nose, and mouth. Regularly clean and disinfect surfaces like your computer keyboard, phone, faucets, handles, and knobs. And wear a mask in public. 

3. Treat your symptoms and boost your immune system.

If you get the flu, consider taking antiviral medications, such as Tamiflu. These antivirals are physician-prescribed medications that are ideally initiated within 48 hours of symptom onset (but can be started later if the patient is severely ill or hospitalized). These medications may decrease your amount of time ill and decrease or eliminate your risk of flu-related complications.

RELATED: Does Tamiflu work?

There are ways to treat your symptoms to make your recovery more comfortable: Get plenty of rest and fluids. Take over-the-counter medicine like ibuprofen or acetaminophen to reduce fever or body aches. Cough suppressants and salt-water gargles treat sore throats and cough.

Dr. Richardson suggests “supplementing vitamins year-round, but especially during flu season. Vitamin C, vitamin D, and zinc as well as keeping hydrated are very beneficial.”