Flu and People with Asthma

What is Asthma?

Asthma is a lung disease that is caused by chronic inflammation of the airways. It is one of the most common long-term diseases of children, but adults can have asthma, too. Asthma attacks occur when the lung airways become swollen and tighten due to airway inflammation. Asthma attacks can be caused by “triggers” such as airway infections, allergy particles, chemical irritants, and air pollution. During an attack, people with asthma experience symptoms such as wheezing, breathlessness, chest tightness, and nighttime or early morning coughing. Often, asthma attacks can be prevented by limiting one’s exposure to triggers and by properly using asthma medications.

People with Asthma Are at High Risk of Severe Disease and Complications from Flu

Though people with asthma are not more likely to get the flu, influenza (flu) can be more serious for people with asthma, even if their asthma is mild or their symptoms are well-controlled by medication. This is because people with asthma have swollen and sensitive airways, and influenza can cause further inflammation of the airways and lungs. Influenza infection in the lungs can trigger asthma attacks and a worsening of asthma symptoms. It also can lead to pneumonia and other acute respiratory diseases. In fact, adults and children with asthma are more likely to develop pneumonia after getting sick with the flu than people who do not have asthma. Asthma is the most common medical condition among children hospitalized with the flu and one of the more common medical conditions among hospitalized adults. For information about underlying health conditions in reported flu hospitalizations, see the FluView Interactive application.

If You Have Asthma, You Need to Take Steps to Fight the Flu

• Everyone with asthma who is six months and older should get a flu vaccine to protect against getting the flu.
  • Vaccination is the first and most important step in protecting against influenza. Even if you don’t have a regular doctor or nurse, you can get a flu vaccine.
  • Flu vaccines are offered in many locations including doctors’ offices, clinics, health departments, pharmacies, college health centers and increasingly by a number of employers and public schools.
  • Which flu vaccine should people with asthma get?
    • Flu shots (made with inactivated (killed) flu virus) are approved for use in people 6 months and older regardless of whether or not they have asthma or other health conditions.
      • The flu shot has a long established safety record in people with asthma.
    • Nasal spray vaccine: The nasal spray vaccine is approved for use in people 2 through 49 years of age.
      • Children 2 years through 4 years who have asthma or who have had a history of wheezing in the past 12 months should not get the nasal spray vaccine.
      • People of any age with asthma might be at increased risk for wheezing after getting the nasal spray flu vaccine.
      • Also, the safety of the nasal spray flu vaccine in people with lung disease and some other high risk conditions has not been established.
  • Pneumococcal infections are a serious complication of influenza infections and can cause death. Pneumococcal vaccines may be given at the same time as influenza vaccine.
• Take everyday preventive actions to stop the spread of flu:
  • Stay home when you are sick, except to get medical care. Stay away from other people who are sick.
  • Cover your nose and mouth with a tissue when coughing or sneezing and throw the tissue away. If you do not have a tissue, cough or sneeze into your elbow or shoulder not your bare hands;
  • Wash your hands often with soap and water, especially after coughing or sneezing;
  • Avoid touching your eyes, nose, or mouth (germs are spread that way); and
  • Clean and disinfect frequently touched surfaces at home, work or school, especially when someone is ill.
• Follow an updated, written Asthma Action Plan developed with your doctor.
  • Follow this plan for daily treatment to control asthma long-term and to handle worsening asthma, or attacks.
  • If your child has asthma, make sure that his or her updated, written Asthma Action Plan is on file at school or at the daycare center. Be sure that the plan and medication(s) are easy to get to when needed.
• If you do get sick with flu symptoms, call your doctor and take flu antiviral drugs if your doctor recommends them.
  • Treatment should begin as soon as possible because antiviral drug treatment works best when started early (within 48 hours after symptoms start).
  • Antiviral drugs can make your flu illness milder and make you feel better faster. They may also prevent serious health problems that can result from flu illness.
  • Oseltamivir (Tamiflu®) is an antiviral drug that can be used to treat flu. To get oseltamivir (Tamiflu®), a doctor needs to write a prescription. This medicine fights against the flu by keeping flu viruses from making more viruses in your body.
  • People with asthma should not use zanamivir (Relenza®), a different antiviral drug, because there is a risk it may cause wheezing in people that already have asthma or other lung problems.

Questions & Answers

If I am younger than 50 and have asthma can I get the nasal spray vaccine?

While the nasal spray flu vaccine is approved for use in people 2 years through 49 years of age, children 2 years through 4 years of age who have asthma or who have had a history of wheezing in the past 12 months should not get the nasal spray vaccine. Also, it’s important to note that people of any age with asthma might be at increased risk for wheezing after getting the nasal spray flu vaccine. In addition, the safety of the nasal spray flu vaccine in people with lung disease (like asthma) and some other high risk conditions has not been established. There is a precaution noting this in the prescribing information for the nasal spray vaccine. On the other hand, the flu shot has a long, established safety record in people with asthma. Your doctor or other health care professional can further advise you on which flu vaccine is best for you.