What is it?

Influenza/parainfluenza, or “flu,” is a contagious viral infection caused by several types of orthomyxovirus. The virus is passed to others by respiratory droplets produced when people infected with the virus talk, cough, or sneeze.

Symptoms

Symptoms can include any combination of:

• Sudden onset of fever and/or chills

• Headache

• Nonproductive cough

• Generalized discomfort and muscle pain

• Runny nose and nasal congestion

• Abdominal pain

• Nausea/vomiting

• Diarrhea

Evaluation & Treatment

If an athlete starts to develop the symptoms listed above, a physician should evaluate the illness. The sports medicine physician will listen to the history of the illness and perform a physical exam. It is possible that a test commonly referred to as a “rapid influenza diagnostic test” will be performed.

These tests usually provide results in less than 30 minutes. The test involves a health care provider swiping the inside of the nose with a swab and then processing the test. These “rapid” tests vary in accuracy; therefore one can still have the flu even with negative results. In this situation, a sports medicine physician may still diagnose one with flu based on the overall condition and developing symptoms. Symptoms usually last 3-7 days. Treatment for the flu includes rest and medication for symptomatic relief of fever and pain.

Further prescription antiviral medication may be prescribed to decrease the duration and severity of the infection, depending on how long the symptoms have been present and the overall health of the patient. Antibiotics may be given for secondary bacterial infections (infections that develop later on top of the flu infection) if they develop, but that is very rare and antibiotics are not necessary for viral infections such as the flu or a “cold.”

Injury Prevention

The best identified way to prevent the flu is to get a flu vaccination each year. Other preventative measures include avoiding contact with people who are sick, frequent hand washing, and not sharing food or drinks to avoid coming in contact with oral secretions of a patient who is infected. As influenza is highly contagious, the athlete must be occasionally isolated briefly from the team to prevent the spread of the virus.

Return to Play

If the athlete has a fever, he or she should not be allowed to practice or compete until the fever has resolved for 24 hours. If the athlete needs ibuprofen or acetaminophen to keep his/her temperature in the normal range, he/she still should not compete. The fever and associated vomiting and diarrhea often seen with flu can lead to significant levels of dehydration. Therefore, it is important for the athlete to be adequately rehydrated before resuming activities.

AMSSM Member Authors
Richard E. Eccles, MD and Joseph N. Chorley, MD

References
Seasonal Influenza: Flu Basics. Centers for Disease Control and Prevention Website. http://www.cdc.gov/flu/about/disease/index.htm Updated September 6, 2016 Accessed September 14, 2016
Kimberlin D, Brady M, Jackson MA, Long S. Red Book, 30th Edition (2015), 2015 Report of the Committee on Infectious Diseases, 30th Edition. Illinois: American Academy of Pediatrics; 2015.