Flu symptoms, prevention and vaccination - your questions answered

Child flu

As winter draws in, it’s crucial we look after ourselves as well as our families. Flu, in particular, can be a threat at this time of year. GP and broadcaster, Dr Rosemary Leonard answered Mumsnetters' queries on topics ranging from the flu vaccination, to potential flu remedies and preventative action parents can take to avoid infection

1. Can you have a flu jab if you are pregnant or breastfeeding?

“All pregnant women should have the flu vaccine. The immune system is weaker during pregnancy and this means that flu during pregnancy can be a very serious illness, which may require treatment in hospital. Not only that, but having flu in pregnancy increases the risk of having a premature birth, and the baby having a low birthweight. Having the flu vaccine can help prevent this, and the flu antibodies the vaccine produces can cross the placenta, and give the baby some protection against flu for the first few months of life. The vaccine can be given safely at any stage of pregnancy, and is available free on the NHS.

It is also safe for the vaccine to be given while breastfeeding, but once the baby is born, it is only given to mothers who have an underlying medical condition, such as asthma, that means they are in an ‘at risk’ group."

2. I’ve heard that if you have flu, you shouldn’t seek medical attention as you will spread it. At what point is someone, particularly a child, ill enough to seek medical attention for flu?

“Flu can make you feel really ill, and when everything hurts so much it’s difficult to get out of bed to just get to the bathroom, it’s tempting to call for medical help, especially when the symptoms continue for 5 days, sometimes more. However, as flu is caused by a virus, and therefore antibiotics don’t help, for most people who are otherwise fit and healthy your doctor can’t help. You should consider visiting your GP if you are pregnant or have an underlying health condition or if you develop chest pain, breathlessness, or are so ill you cannot eat or drink. The best way of managing flu is to take regular paracetamol and ibuprofen, and to drink enough fluids (such as water, tea, coffee) so that you don’t become dehydrated.”

3. I've heard it's possible to have flu very mildly, and a cold very severely – so is there a way to tell which you have?

“In my experience, it’s very rare for flu to be a mild illness – if you think you have ‘mild flu’ then you probably have not got an illness caused by a flu virus! Proper flu tends to come on very quickly, and cause a fever, tiredness and muscle aches, while colds (which are also caused by viruses) tend to come on more gradually, and cause more in the way of a bunged-up streaming nose, blocked sinuses and a sore throat. Colds can be severe, and make you feel pretty rotten, but unlike flu, you are unlikely to be laid up in bed for several days.”

4. How long can the flu virus survive on surfaces in the home?

“Flu viruses can live outside the body, on hard surfaces, such as door knobs, phones or keyboards for several hours. To reduce your risk of catching flu (or spreading it to other people), make sure you wash you hands regularly with soap and water, and clean hard surfaces regularly. It also helps to use tissues to cover your mouth and nose when you cough or sneeze, and throw them in the bin immediately afterwards.”

5. As there are so many strains of the flu how effective is the vaccine overall – how many strains can it cover for?

“There are three types of flu virus – A, B and C, (with A being the most serious) and in addition, there are numerous different types of each. The injectable vaccine and the nasal spray both cover for a selection of A and B types. A group of experts meet for the World Health Organization (WHO) in February to work out the most likely strains to be around in the northern hemisphere the following winter, and the vaccine is then manufactured according to their recommendations. Most of the time, the WHO is right, but occasionally a new strain of virus appears over the summer, or the virus changes slightly making the vaccine less effective. Unfortunately, even if the vaccine covers for the right strains, it isn’t 100% effective. Last year however, the nasal vaccine is thought to have reduced the number of children suffering from flu by 66%, and in adults under 65, the jab reduced flu cases by 40%. In older adults, whose immune systems may not be as efficient, it was much less effective. The flu vaccine is however the best protection that we have against the flu, and it is recommended that all eligible individuals receive it.”

6. Does taking a vitamin C supplement daily help to ward off the flu?

“Unfortunately not. There is no evidence that taking extra vitamin C can help prevent either colds or the flu.”

7. Apart from 'catch it, bin it, kill it', are there any other useful prevention measures that can be followed?

“The best way to help prevent catching the flu is to be really careful about basic hygiene, which means washing your hands regularly, and also try and keep them away from your face. You should also clean surfaces such as keyboards, telephones, and remotes regularly – I know it’s a real faff, but honestly, it’s worth it, especially if someone around you is unwell. And use tissues to cover your mouth and nose when you cough and sneeze. You can’t catch flu by going out for a walk with wet hair, but you can easily catch the flu from going to a crowded supermarket – apart from all the people coughing and spluttering, just think what could be on the trolley handle – so doing your shopping online from home could be seen as another way of keeping your self well!”

8. To help with hydration when children have the flu is it better to give them something to boost their energy too like Lucozade or is plain water better?

“Generally, the best way of keeping hydrated is with plain water. However, if a child is really ill then I’m a great believer in ‘a little of what you fancy does you good’, and if the only way of getting some fluids into them is via sweetened drink, then that’s what I would give. And the sugar they contain could give energy if a child doesn’t want to eat anything. However, anything containing sugar (and that includes fruit juice), is really bad for young teeth, and sugary fizzy drinks are even worse (the fizz comes dilute acid) so they really are best avoided if possible.”

9. Is there any scientific research confirming that a male adult with flu is more unwell than a female with flu?

“Sadly not – despite all the stories, there is no scientific evidence that there is any difference between flu in men and women!”

10. As a healthy adult do I need to buy a flu jab every year or will I still have reasonable immunity from previous years' jabs?

“The flu virus is very variable, and changes over time. Every year there are different strains around, and this is the reason a new vaccine is produced, with the aim of protecting against the virus that is likely to be most common for the coming winter. Vaccination from previous years is not likely to protect against this year’s strain. Unless you have an underlying health condition, such as diabetes, severe asthma or are very overweight, or are the main carer of an older or disabled person you won’t be eligible to have the vaccine free on the NHS. However, if you’d like to have the vaccine you can pay for it to be given to you at most chemists.”

11. How can my daughter have a flu vaccination if she is 10-years-old? Our GP won't do it as she has no pre-existing condition. Her school won't as she is too old, and private pharmacies won't as she is too young. Everyone else in my family has had it now.

“A flu vaccination cannot be given on the NHS to children older than eight, unless they have a medical condition that means they are in an ‘at risk’ group. I have been told that a few pharmacies are willing to vaccinate children, but being honest, I haven’t found any in my local area. The only other option is to go to a private vaccination clinic, but this is costly, and the chances are if you choose this route, then your child will be given the vaccine by injection. I haven’t been able to find any clinics in London that have supplies of the nasal vaccine – in practice this only seems to be available on the NHS.

The good news for your daughter is that as everybody else in the family has received the flu vaccine, the chances of her catching the flu at home will be significantly lowered. The reduction of spread like this is also one of the reasons that the NHS vaccinates young children as they do. Young children are the worst spreaders of flu, and by vaccinating all children aged two to eight (as well as other eligible groups such as older people) the prevalence of flu should be lowered in the overall population, reducing your daughter’s chances of catching it."

12. Why can't adults over 18 have the nasal spray?

“Weirdly, the nasal spray doesn’t seem to work very well in adults – it only works well in children and young adults under 18. This is why adults should have the vaccine via a jab.”

13. Quite a few people I know say they will never have the flu jab again as it made them really ill – can the vaccine do that?

“No – the flu vaccine cannot give you flu. If you get flu soon after having the vaccine, then it really is just coincidence – you’d have got it whether you had the vaccine or not. That being said though, the vaccine can give you a sore arm, and aching muscles for a day or so afterwards, and the nasal vaccine can cause a blocked or runny nose, headache and tiredness, plus loss of appetite. But none of those side effects are anything like as bad as an attack of real flu!”

14. If a child isn't able to have the flu spray in future (because of possible allergic reaction this year), what are the alternatives? Can they have the same injection as I get in future?

“First of all, you need to clarify with your GP whether your child had a genuine allergic reaction to the flu spray, or whether something else could have been to blame. Generally, children with milder egg allergies can be given the nasal spray. Children who are known to be severely allergic to eggs (had previous anaphylaxsis requiring admission to intensive care) should seek specialist advice. If your child cannot have the nasal spray because it is not suitable for them, they will be offered an injected vaccine instead. However, this will only be offered to them if they are in an ‘at risk’ group, that is, they have an underlying health condition that puts them at risk of flu.”