Home Management of Influenza

General Recommendations

• The American Thoracic Society recommends that patients with uncomplicated influenza should stay home, maintain hydration, rest, and practice strict respiratory hygiene including covering coughs/sneezes and performing hand hygiene after contact with respiratory secretions, while monitoring for warning signs that require medical attention 1
• Patients should stay home and avoid contact with others until fever-free for 24 hours without antipyretics to prevent transmission to high-risk individuals 1
• The Centers for Disease Control and Prevention recommends that household members and caregivers of high-risk patients should receive annual influenza vaccination 2

Symptomatic Management

• The British Thoracic Society recommends that patients should monitor their temperature regularly and use antipyretics as needed for comfort 3
• The American College of Physicians recommends that patients with influenza should get plenty of rest and drink plenty of fluids to maintain hydration, although the strength of this evidence is low 3

Warning Signs Requiring Medical Attention

• The American Thoracic Society recommends that patients should seek immediate medical evaluation if they develop difficulty breathing or shortness of breath 4, 5
• The British Thoracic Society recommends that patients should seek immediate medical evaluation if they develop persistent chest pain or pressure 4
• The American College of Emergency Physicians recommends that patients should seek immediate medical evaluation if they develop confusion or altered mental status 4, 5

Special Considerations for Patients with Asthma or COPD

• The American Thoracic Society recommends that oseltamivir (oral neuraminidase inhibitor) is the preferred antiviral for patients with underlying airways disease 3
• The European Respiratory Society recommends that treatment with oseltamivir should be initiated within 48 hours of symptom onset for maximum benefit 3

Prevention Strategies for Household Members

• The Centers for Disease Control and Prevention recommends that household members and caregivers of high-risk patients should practice the same respiratory hygiene and hand hygiene measures 1
• The World Health Organization recommends that household contacts should consider antiviral prophylaxis for unvaccinated household members during outbreaks 2

Hospitalization

• The British Thoracic Society recommends that patients should be evaluated for hospitalization if they have a CURB-65 score of 2 or higher, which includes confusion, urea >7 mmol/L, respiratory rate ≥30/min, blood pressure with systolic <90 mmHg or diastolic ≤60 mmHg, or age ≥65 years 4, 5