Flu & People with Asthma

Flu & People with Asthma

People with Asthma Are at High Risk of Developing Flu-Related Complications

Getting a flu vaccine during 2020-2021 is more important than ever because of the ongoing COVID-19 pandemic. Flu vaccination is especially important for people with certain underlying medical conditions, like asthma, heart disease, and diabetes. People with these types of conditions are at higher risk of developing serious complications from flu. Many of these conditions also increase the risk for serious outcomes from COVID-19.

People with asthma are at high risk of developing serious flu complications, even if their asthma is mild or their symptoms are well-controlled by medication. People with asthma can develop swollen and sensitive airways, and flu can cause further inflammation of the airways and lungs. Flu infections can trigger asthma attacks and a worsening of asthma symptoms. Flu also can lead to pneumonia and other acute respiratory diseases. In fact, adults and children with asthma are more likely to develop pneumonia after getting sick with flu than people who do not have asthma. Asthma is the most common medical condition among children hospitalized with flu and one of the more common medical conditions among hospitalized adults.

A Flu Shot is the Best Protection Against Flu

Flu vaccination is especially important for people with asthma because they are at high risk of developing serious flu complications. Flu vaccines are updated as needed each season to keep up with changing viruses. Also, immunity wanes over a year so annual vaccination is needed to ensure the best possible protection against flu. A flu vaccine protects against the flu viruses that research indicates will be most common during the upcoming season. The 2020-2021 vaccine has been updated from last season’s vaccine to better match circulating viruses. Immunity from vaccination sets in after about two weeks.

Adults and children with asthma are more likely to develop pneumonia after getting sick with flu than people who do not have asthma.

Flu Vaccines for People with Asthma

  • Injectable influenza vaccines (or flu shots) are approved for use in people 6 months and older regardless of whether or not they have asthma or other health conditions. Flu shots have a long-established safety record in people with asthma.
  • The nasal spray vaccine (or LAIV) is an option for use in people 2 through 49 years old who are not pregnant, but people with certain chronic medical conditions (such as asthma) should generally not receive LAIV.
    • People of any age with asthma might be at increased risk for wheezing after getting the nasal spray flu vaccine and should talk to their health care provider before getting the nasal spray vaccine.
    • Children 2 to 4 years old who have asthma or who have had a history of wheezing in the past 12 months should not get the nasal spray vaccine.
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There are several flu vaccine options available this season. Your health care professional can answer any questions you might have about flu vaccine.

Get pneumococcal vaccines.

  • People who have asthma should also be up to date with pneumococcal vaccination to protect against pneumococcal disease, such as pneumonia, meningitis, and bloodstream infections. Talk to your health care provider to find out which pneumococcal vaccines are recommended for you.
  • Pneumococcal pneumonia is an example of a serious flu-related complication that can cause death. You can get either pneumococcal vaccine (but not both) when you get a flu vaccine.

Other Preventive Actions for People with Asthma

In addition to getting a flu vaccine, people with asthma should take the same everyday preventive actions CDC recommends of everyone, including avoiding people who are sick, covering coughs, and washing hands often.

Specific Health Actions for People with Asthma

  • Take asthma medication exactly as your doctor or other medical professional tells you to do. Know how to use your asthma inhaler if your doctor of other medical professional tells you to use one.
  • Plan ahead to maintain sufficient supplies of your regular medications for chronic medical conditions (e.g. at least a 2-week supply).
  • Know and avoid the asthma triggers that can cause you to have an asthma attack.
  • Follow an updated, written Asthma Action Plan developed with your health care provider.
  • Follow this Asthma Action Plan for daily treatment to control asthma long-term and to handle worsening asthma, or attacks.
  • If your child has asthma, make sure that his or her up-to-date written Asthma Action Plan is on file at school or at the daycare center. Be sure that the plan and medication(s) are easy to get to when needed.

Symptoms and Treatment

Because you are at high risk of developing serious flu complications, if you get sick with flu symptoms call your health care provider right away. There are antiviral drugs that can treat flu illness and prevent serious flu complications. CDC recommends prompt treatment for people who have influenza infection or suspected influenza infection and who are at high risk of serious flu complications, such as people with asthma.

Symptoms

Flu symptoms include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people may also have vomiting and diarrhea. People may be infected with flu and have respiratory symptoms without a fever.

More information on when to seek emergency care is available below.

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Treatment

  • Treatment should begin as soon as possible because antiviral drug treatment works best when started early (within 48 hours after symptoms start).
  • For you to get an antiviral drug, a health care provider needs to write a prescription. These medicines fight against flu by keeping flu viruses from making more viruses in your body.
  • Antiviral drugs can make your flu illness milder and make you feel better faster. They may also prevent serious health problems that can result from flu illness.
  • Oseltamivir (available as a generic version or under the trade name Tamiflu®) or peramivir (trade name Rapivab®) are the two antiviral drugs that can be used in people with asthma. People with asthma should not use zanamivir (trade name Relenza®), a different antiviral drug, because there is a risk it may cause wheezing in people with asthma or other lung problems.

When to Seek Emergency Medical Care

Anyone experiencing any of the following emergency warning signs of flu sickness, including people with asthma, should seek medical attention right away.

Emergency Warning Signs of Flu

People experiencing these warning signs should obtain medical care right away.

In children

  • Fast breathing or trouble breathing
  • Bluish lips or face
  • Ribs pulling in with each breath
  • Chest pain
  • Severe muscle pain (child refuses to walk)
  • Dehydration (no urine for 8 hours, dry mouth, no tears when crying)
  • Not alert or interacting when awake
  • Seizures
  • Fever above 104°F
  • In children less than 12 weeks, any fever
  • Fever or cough that improve but then return or worsen
  • Worsening of chronic medical conditions

In adults

  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest or abdomen
  • Persistent dizziness, confusion, inability to arouse
  • Seizures
  • Not urinating
  • Severe muscle pain
  • Severe weakness or unsteadiness
  • Fever or cough that improve but then return or worsen
  • Worsening of chronic medical conditions

These lists are not all inclusive. Please consult your medical provider for any other symptom that is severe or concerning.


Source: U.S. Centers for Disease Control and Prevention, December 2020

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