Winter Maladies: Influenza  and Pneumonia in Older Adults

By Richard O’Boyle, Publisher
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Most of us have gotten used to coming down with at least one bad cold each winter. Suffering through the sniffles, coughs, and fatigue for anywhere from a few days to a few weeks. But for the elderly, winter maladies such as a bad cold, the flu, or pneumonia can be deadly.

According to the National Institutes of Health, 35 to 50 million Americans come down with the flu during each flu season, which typically lasts from November to March. The fever, exhaustion, and aches and pains of the flu can be debilitating for a week or two, but for the elderly and those with compromised immune systems, the flu can be much more serious. An estimated 115,000 hospitalizations and about 20,000 deaths occur each year from the flu or its complications.

Influenza, commonly call “the flu,” is a contagious disease that is caused by a virus that attacks the nose, throat, and lungs. The flu is spread when an infected person coughs, sneezes, or speaks and sends flu virus into the air, and other people inhale the virus. Flu may, less often, be spread when a person touches a surface that has flu viruses on it – a door handle, for instance – and then touches his or her nose or mouth. It’s a good idea to steer clear of people who have the flu or recently got over an infection. It also makes sense to keep your hands clean.

The flu is different from a cold or pneumonia. The flu usually comes on suddenly and may include these symptoms:

  • Fever
  • Headache
  • Tiredness (can be extreme)
  • Dry cough
  • Sore throat
  • Nasal congestion
  • Body aches

A cold, while a common wintertime infection, rarely causes fever or the extreme exhaustion that the flu does.

Treating and Preventing the Flu

The flu is caused by a virus, so antibiotics (like penicillin) don’t work to cure it.  If you begin to develop these symptoms you should be prepared for one to two weeks of illness:

  • Rest
  • Drink plenty of liquids
  • Avoid using alcohol and tobacco
  • Take medication to relieve the symptoms of flu

If given within two days of the onset of flu-like symptoms, some antiviral drugs may be used to shorten the duration of the infection. The impact of these drugs is not dramatic: they have been shown in medical studies to shorten symptoms by only about one day. Notably, these antivirals have not been shown to reduce the chance of getting complications such as pneumonia; and they have only been tested in people with “uncomplicated” conditions. Doctors should use caution in administering these antivirals if the patient is taking antihistamines or anticholinergic drugs to prevent side effects.

The best way to prevent the flu is to get an influenza vaccine (“flu shot”) in October before the virus begins to spread through communities, according to the Advisory Committee on Immunization Practices. Individuals who work with or care for the elderly and those with chronic medical conditions should also get vaccinated. Certain individuals who have extreme allergies to eggs or other components of the vaccine should not be vaccinated. A flu shot should be given each and every year since the strains of the disease change and the potency wears off.

Your doctor, nursing home medical director, or community organization such as pharmacy or senior center, will be able to arrange for you to get a flu shot. Medicare pays for flu shots for people aged 65 and older.

When the Flu Goes from Bad to Worse

For adults aged 65 and older, the flu can trigger complications or worsen existing health conditions, such as asthma or congestive heart failure. Bacterial infections such as pneumonia, bronchitis, and sinus and ear infections may develop just when you feel like you are getting better. These infections, particularly pneumonia, take advantage of your weakened lungs. In some cases, pneumonia may be caused by the flu virus itself. Pneumonia is an infection of the air sacs of the lung that causes the sacs to become clogged with pus and mucus.

Watch out for the following symptoms after a brief period of improvement after having the flu:

  • High fever
  • Shaking chills
  • Chest pain with each breath
  • Coughing that produces thick, yellow-greenish-colored mucus

Pneumonia can be a very serious and sometimes life-threatening condition, especially in the elderly. If you have any of these symptoms, you should contact your doctor immediately so that you can get the appropriate treatment. The doctor may require chest x-rays, blood tests, or a bronchoscopy where a thin viewing tube is inserted into the lungs.

Individuals aged 65 and older, as well as those with chronic disorders of the lungs or heart, and cirrhosis are most at risk for developing pneumonia. You can receive a pneumococcal vaccination on the same day that you get the flu shot, and for those covered under Medicare Part B, it is also free when ordered by a physician. The pneumococcal vaccine can be given at any time of year and is a once-in-a-lifetime vaccination for most people.


 - “Focus on the Flu” National Institute of Allergy and Infectious Diseases
 - “Flu in the United States” Centers for Disease Control and Prevention
 - “Prevention and Control of Influenza” Recommendations of the Advisory Committee on Immunization Practices
 - “Health Information: Flu and Pneumonia” Centers for Medicare and Medicaid Services


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