oa SA Pharmaceutical Journal - Prodromal symptoms of flu : malaise, rigors, fever and myalgia : evidence-based pharmacy practice



Influenza is a common and important source of morbidity and mortality. It is a viral infection that occurs worldwide, and has no borders. The influenza virus is spread by inhaling droplets that have been coughed or sneezed by an infected person, or by having direct contact with an infected person's nasal secretions. Although definitions of influenza-like illness have been proposed, it is still not clear whether recognition of a constellation of symptoms or a syndrome is reliable enough for the clinical diagnosis of an influenza infection. Typical symptoms include malaise, rigors, fever, myalgia, a sore throat, and a runny or stuffy nose. Different non-pharmacological and pharmacological treatment options exist. Antibiotics have no place in the treatment of uncomplicated influenza. In South Africa, most cold and flu preparations contain a combination of active ingredients. Usually, they include a non-steroidal anti-inflammatory drug (NSAID). This article describes the epidemiology of influenza and the typical prodromal symptoms, from a patient and practitioner perspective. It discusses a threshold model for the diagnosis of influenza, and treatment options for uncomplicated influenza, including the use of NSAIDs.


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