Flu symptoms: when flu medicine helps and when to get care in person

Flu symptoms usually come on all at once. You may have some or all of these:

• Fever or chills (not everyone with flu has a fever)
• Cough
• Sore throat
• Runny or stuffy nose
• Body aches
• Headache
• Feeling very tired
• Throwing up or diarrhea (this is more common in children)

A cold most often starts slowly and is milder. Flu tends to hit hard and fast, with fever, aches and deep tiredness.

Flu and COVID-19 can look the same. A test is the way to tell them apart. That matters, because the medicines for them are not the same.

Flu medicines are called antivirals. They fight the flu virus. You need a prescription to get them.

They work best when you start them within 2 days of your first symptoms. They can cut about a day off the time you are sick. Starting early may also help prevent problems like pneumonia.

Starting later can still help some people, most of all people at higher risk or people who are very sick. So do not skip calling a doctor just because 2 days have passed.

Most healthy people with flu get better without flu medicine. A doctor can help you decide if it makes sense for you.

Antibiotics do not treat flu. They only work on germs called bacteria, and flu is a virus.

The most common side effects of oseltamivir, a flu medicine, are an upset stomach, throwing up and headache.

Anyone can get very sick from flu. Some people have a higher chance of serious problems:

• Adults 65 and older
• People who are pregnant
• Children younger than 5, and most of all those younger than 2
• People of any age with a long-term health problem, such as asthma, diabetes or heart disease

If you are at higher risk and you think you have flu, contact a doctor right away. The CDC says people at higher risk should start flu medicine as soon as they can.

In adults:

• Trouble breathing or feeling short of breath
• Pain or pressure in the chest or belly that does not go away
• Dizziness or confusion that does not go away, or being hard to wake up
• Seizures
• Not peeing
• Very bad muscle pain
• Feeling very weak or unsteady
• Fever or cough that gets better, then comes back or gets worse
• A long-term health problem that is getting worse
• Coughing up blood

In children, also watch for:

• Fast breathing, or ribs that pull in with each breath
• Lips or face that look blue
• Not alert or not playing or talking when awake
• Signs of dehydration: no pee for 8 hours, a dry mouth, or no tears when crying
• A fever over 104°F that does not come down with fever medicine
• Any fever in a baby younger than 12 weeks
• Very bad muscle pain (the child will not walk)

Call 911 or go to the emergency room for trouble breathing, chest pain or blue lips.

• Stay home and away from other people, except to get medical care.
• Go back to normal activities only when, for at least 24 hours, you feel better overall and you have had no fever without using fever medicine.
• Cover your coughs and sneezes, and wash your hands often.

A flu shot each year is the most important step to lower your chance of getting flu. The CDC says everyone 6 months and older should get one each flu season.

If you are in Virginia or West Virginia, you can start a flu visit online at any time. It is for otherwise healthy adults and children 4 and older (with a parent or legal guardian) whose flu symptoms started in the last 2 days and who have no warning signs. If your symptoms started more than 2 days ago and you are at higher risk or feel very sick, contact a doctor in person.

You answer a few questions on your phone or computer. There is no video call. A board-certified physician reviews your answers. If flu medicine is right for you, the doctor can send a prescription to your pharmacy. If you need to be seen in person, the doctor will tell you.

Visits start at $59. You see the price before you pay, and you do not need insurance. A basic work or school note can be included if the doctor thinks it is right.