It’s flu season once again, which (hopefully!) means you’ve already been vaccinated, thus reducing your chances of getting the flu and vastly reducing your chances of getting severely ill. If you haven’t yet gotten the flu shot, it’s not too late — although the CDC recommends getting one by the end of October, you should still be able to get one as long as the flu is circulating and unexpired vaccines are available.
But let’s say you end up with the flu this year despite your best efforts to prevent it. You felt fine, then, seemingly out of nowhere, you’re feverish, your legs hurt, and you can barely get out of bed. There’s a lot of sometimes-conflicting advice out there about how to treat the flu, so we spoke to Vanessa Raabe, an assistant professor of medicine and pediatrics at NYU Langone’s Vaccine Center, about flu best practices and treatment options for flu season 2019 to 2020.
1. No, don’t “starve a fever.”
I’ve never looked into the old maxim “Feed a cold, starve a fever” before or really even thought about it (except as an excuse to snack heavily when I get a cold), so it comes as no huge surprise when Raabe tells me it doesn’t really carry medical weight. “We encourage people to eat to keep their blood sugar up and make sure they have energy, because we need energy to fight off an infection,” she says. People with the flu may experience a reduced appetite (and, occasionally, nausea), so you don’t have to force-feed yourself, but you definitely shouldn’t refrain from eating if you’re hungry. Food will help!
2. Hydrate, hydrate, hydrate.
Even more important than eating, says Raabe, is making sure to drink lots of fluids. “When you have a fever, when you have an infection, you breathe out more water and you go through water faster, so it’s easier to become dehydrated,” she says. Most of us probably don’t drink enough water as it is, so we should take extra care to hydrate when we’re sick. Water is great and so is Gatorade and so is tea — whatever liquid that is mostly water and that you can consume a lot of, and keep down, is good.
3. Get to the doctor ASAP.
For the flu, it’s really important to get to the doctor within 48 hours of your first symptoms to prevent the infection from spreading, says Raabe. Here it might be helpful to make a distinction between the common cold and the flu, which can have overlapping symptoms. With a cold, your symptoms tend to come on gradually: A two-day sore throat is followed by congestion is followed by a cough or similar. But with the flu, you’ll likely start feeling very sick very suddenly, and that’s when you should act.
“If it comes on very suddenly — if you’re having fever, chills, body aches, along with a stuffy nose and cough or sore throat — that’s when we want people to be thinking about the flu,” says Raabe. “We do have medications that can shorten the duration of symptoms, but those are actually most effective if you take them in the first two days.” If you get to the doctor within 48 hours of the onset of symptoms, you might be given the flu test (which involves a nose swab), or you might just be prescribed one of the approved flu medications right off the bat to be safe.
4. Take Tamiflu or Xofluza as directed.
If you make it to the doctor in time, you’ll likely be given a prescription for Tamiflu, though a new flu medication called Xofluza was approved for use last year. Each medication works a little differently and will be prescribed case by case. Tamiflu prevents the flu virus from spreading. “A virus gets into a cell, then makes lots and lots of copies of itself inside the cell, but it has to get out of the cell to then infect other cells in your body,” explains Raabe. “Tamiflu stops that from happening.” Because there’s more data on Tamiflu and it’s approved for young children as well as pregnant women, it will still be given to most patients. The downside is that you take it for five days, and it can cause nausea.
Xofluza works a little differently, preventing the stage in which the virus is trying to replicate itself to make new copies, says Raabe. Xofluza has the advantage of being a single dose, though that dose also causes nausea. Still, it isn’t approved for kids under 12 or pregnant women, so for now, it’s less commonly prescribed, says Raabe.
5. Use over-the-counter meds with caution, but avoid aspirin.
If you don’t get to the doctor soon enough for prescription medications or if you’re trying to treat specific flu symptoms, some over-the-counter medicines can help, says Raabe. Ibuprofen (like Advil) and acetaminophen (like Tylenol) can help reduce a fever and ease body aches, and other medications can reduce congestion. Unfortunately, most medications that claim to treat a cough don’t work very well, says Raabe. And people with the flu should definitely avoid aspirin. “There’s an association between patients using aspirin for influenza with a condition called Reye’s syndrome, which can be really serious and cause swelling of the liver and the brain and lead to very bad outcomes,” says Raabe. She adds that if you’ve been taking aspirin long-term for another condition, you don’t necessarily need to stop if you get the flu, but make sure your doctor knows you’re taking it.
6. Rest and stay home as much as possible.
Most people with the flu aren’t going to feel like doing very much, and Raabe says it’s best to listen to that instinct. Getting as much sleep and rest as possible will help your body recover, and because those are things one typically does at home, they will also help prevent the flu from spreading. “Most people can spread the virus for up to a week afterward, so you want to reduce the chance of giving coworkers or kids at school the flu,” says Raabe. As far as returning to one’s workout routine after the flu, Raabe again says it’s a matter of listening to your body. Exercise should wait until your fever has been gone for at least 24 hours, and if it you’re still achy and it doesn’t feel good, it’s too soon.
7. And finally: The best treatment is prevention.
The flu is not fun in the best of cases, and in the worst it’s lethal. “The number of flu deaths in the U.S. usually outweighs the number of motor-vehicle deaths every year,” says Raabe. “We do see a lot of people die from the flu.” Raabe likens the flu shot to using a seat belt: It might not prevent 100 percent of accidents (though, again, it reduces the likelihood you’ll go to the doctor with flu symptoms by 40 to 60 percent), but it does an awful lot to protect you in the worst-case scenario.