Flu horrid but often not serious

This week is a free-for-all on flu questions from my patients. May you all feel better soon. To those who are high risk and as yet unimmunised, call your GP and schedule a jab. - Dr Gary
What are the symptoms of flu?

An influenza-like illness is basically fever, sore throat or cough, often accompanied by headache, muscle aches and fatigue. Kids may have more diarrhoea and vomiting than adults. Flu is viral, spread by droplets coughed or smeared on surfaces, and usually runs its course over a week or so without serious problems.
How long am I contagious to others?
From one day before you develop your first symptom to more than a week later. In two recent studies, 10 per cent of 2009 H1N1 patients were still shedding virus 10 days after their symptoms began. Tamiflu, an antiviral, shortened the time of contagiousness by only three days.
How effective is Tamiflu?
It can lessen symptoms, shorten flu duration by one or two days, decrease contagiousness, and possibly lessen more serious complications such as pneumonia. I have been mostly using it for patients ill enough to be put into hospital and pregnant women.
Who is at most risk of complications?
Young children and those over 65, pregnant women, and the chronically ill, especially immunocompromised and those with lung disease.
How dangerous is H1N1 flu really?
I apologise for using US data but it was easily accessible, well-referenced, and the numbers were large enough for extrapolation. The 2009 H1N1 flu in the US caused an estimated 20 per cent of the population to become ill, put one in 1000 Americans in hospital and killed one in 25,000. About 12,000 Americans were killed by 2009 H1N1. However, regular "seasonal" flu kills about 30,000 a year. The big difference is that with regular flu, 90 per cent of those who die are older than age 65. With epidemic flu, such as swine flu, 90 per cent have been younger than age 65. In New Zealand in 2009, H1N1 was blamed for about 35-50 deaths and a thousand hospitalisations.
Most patients I've been seeing in the ED have felt horrible, with high fevers and muscle aches, but have not been seriously ill. In most cases, analgesia and fever control via paracetamol and ibuprofen, combined with oral fluids, has had patients feeling better.

Gary Payinda MD is an emergency medicine consultant in Whangarei.
Have a science, health topic or question you'd like addressed? Email: drpayinda@gmail.com
(This column provides general information and is not a substitute for the medical advice of your personal doctor.)