Who Is Most at Risk of Flu Complications?

While the flu can feel pretty awful, it usually goes away in about a week with rest and fluids. But some people are at serious risk of needing hospital care — or even dying — from the flu.

Before the COVID pandemic, the flu and flu-related pneumonia caused more than 55,000 deaths per year. An estimated 140,000 to 710,000 Americans will end up in the hospital with the flu every year.

Fortunately, there are many ways to protect yourself and vulnerable people in your life from the flu.

Flu Complications

Flu complications are health problems that result from the flu. They are much more likely to occur in people who are more medically vulnerable.

They can include:

  • Pneumonia (or lung infection).
  • Ear infection.
  • Organ failure.
  • Worsening of an existing heart problem.
  • Bronchitis.
  • Sinus infection.
  • Asthma attack.

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Who Is at Risk of Flu Complications?

The following groups are at a higher risk of flu complications, compared to the general population.

Young children

Kids under five are more at risk of the flu than the general population. Those younger than two are especially at risk of flu complications, such as sinus, ear, and lung infections.

This is because their immune systems aren’t fully mature. Plus, they usually don’t have immunity from a previous flu infection.

Infants under the age of six months are even more at risk because they are too young to receive the flu vaccine.

Adults 65+

Older adults are at a greater risk of flu complications, like pneumonia (a lung infection) or perhaps an asthma attack. This is because their immune systems are generally not as robust as younger adults. Plus, they are more likely to have health conditions that put them at a higher risk of flu complications.

Pregnant women

Those who are pregnant are at greater risk of needing hospital care from the flu. This is because the immune system becomes somewhat suppressed in pregnancy to prevent the body from rejecting the fetus. Plus, changes that happen during pregnancy puts stress on the organs, and the flu can add to this stress.

People with chronic health conditions

The body’s response to the flu can cause an underlying condition to worsen.

For example, people with heart disease are six times higher to have a heart attack in the week after a flu infection. This is due to increased swelling that occurs as the immune system floods the blood with virus-fighting proteins. Increased swelling in the airways, meanwhile, can trigger asthma attacks.

In other cases, a health condition can impair the immune response to the flu. For example, HIV can weaken the immune system. People with health conditions that require medications that impair the immune system are also more at risk.

Conditions that can make flu complications more likely include:

  • Asthma.
  • Blood conditions, like sickle cell disease.
  • Chronic Obstructive Pulmonary Disease (COPD).
  • Heart disease.
  • Diabetes.
  • Kidney and liver disorders.
  • Metabolic disorders.
  • Neurodevelopmental disorders, like cerebral palsy.
  • A weak immune system, due to HIV/AIDS, or certain medications, for example.
  • Obesity.

Flu Treatments

People who are immunocompromised with the flu have treatment options. People who have a condition that puts them at risk of flu complications should also seek advice from their doctor if they get the flu.

Those at a higher risk of flu complications may benefit from an antiviral medication. There are different types of antiviral medications. They reduce the virus’s ability to reproduce in the body.

Your doctor can suggest the best one for you, based on your age and health conditions. Antiviral drugs work best if people take them in the first 48 hours of getting flu symptoms.

Antiviral drugs can reduce the severity of flu symptoms. On average, they reduce the time a person is sick by about one day. Some studies show they reduce flu complications in children, pregnant women, and older adults.

However, antiviral drugs are not guaranteed to prevent hospitalization or death. The best way to prevent flu complications is to get vaccinated.

When Should You Seek Medical Care for the Flu?

You should go to the hospital, or take a loved one to the hospital, for any of the following symptoms:

  • Fast breathing.
  • Trouble breathing.
  • Chest pain.
  • Bluish lips or face.
  • Severe weakness or muscle pain.
  • Dehydration (no urination over 8 hours, dry mouth)
  • Seizures
  • High fever (above 104°F)
  • Confusion.
  • Low alertness.
  • Fever or cough that returns or worsens after improving.
  • Worsening of an existing health problem, like diabetes or heart disease.

Caregivers should always take a child to the hospital if they have a fever and are younger than three months. This is because their airways are very small, and any fever-causing infection can be more dangerous for them.

The Role of Vaccination

The best way to protect yourself from the flu is to get vaccinated. The good news is that vaccination also decreases your chance of passing the flu to someone who is at risk of flu complications.

Children are not eligible for flu vaccination before six months. Women who get the flu vaccine in pregnancy will pass on immunity to the baby. Breastfeeding after getting the flu vaccine is another way to strengthen an infant’s immune system.

Flu season typically peaks between December and February. “Make sure to get your flu vaccine before the end of October to protect yourself from the flu and its complications,” says Hande Atalay, MD, of White Oak Primary Care-UPMC.

That gives your body time to make antibodies before flu season begins. It also ensures that your antibodies don’t wear off before flu season ends.

Studies show that flu vaccination reduces the risk that an adult will need to go to the intensive care unit (ICU) by 82%. Vaccination reduces this risk among children by around 74%.

In addition, flu vaccination lowers the risk of flu complications in people who have heart disease, lung disease, and diabetes.

How Else Can You Protect Yourself from the Flu?

You can reduce your risk of getting the flu, or passing the flu to others, by:

  • Washing your hands often.
  • Covering your mouth when you cough.
  • Avoiding people who are sick.
  • Staying home when you are sick.
  • Frequently cleaning high-touch surfaces, like faucets, counters, etc.
  • Wearing a mask in crowded indoor settings.
  • Wearing a mask if you are sick and need to go out in public.
Sources

Centers for Disease Control and Prevention. Vaccine effectiveness: How well do flu vaccines work? Link

Centers for Disease Control and Prevention. Disease Burden of the Flu. Link

National Foundation for Infectious Diseases. Are you at risk for serious flu-related complications? Link

National Institute on Aging. Flu and Older Adults. Link

Nemours Kids Health. Fevers. Link

Dr. Timothy Uyeki. High-risk groups for influenza complications. Journal of the American Medical Assoication. Link

About UPMC

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