Use common sense with winter flu symptoms

By Rita Rubin
USA Today

If you get a flu shot and still go on to develop flu-like symptoms, don't panic and jump to the conclusion that you have anthrax.

Every year, tens of millions of Americans — if not more — come down with flu-like symptoms, and fewer than half of them actually have the flu, says medical epidemiologist Keiji Fukuda, an influenza expert at the federal Centers for Disease Control and Prevention.

But that doesn't mean they have anthrax, Fukuda said.

In previous years, Americans tended to call any flu-like symptoms "the flu." Though they were wrong more than half the time, it didn't matter much.

This flu season, though, inhalation anthrax is the default diagnosis in the minds of many Americans, especially in light of the death last week of a New York City woman who had the disease.

Unlike previous victims, she was neither a postal worker nor an employee of a news organization.

"I think that we all recognize that there is a high level of concern about anthrax throughout the country," says Fukuda. He says he has heard from many doctors and state health departments wrestling with the anthrax-vs.-flu question.

"This can be a very difficult issue," Fukuda says. "In some instances, it can be difficult to tell the difference between early inhalation anthrax cases and flu-like illness cases from other causes."

At a meeting last week in San Francisco of the Infectious Disease Society of America, Maj. Jon Woods, a physician at the Army Medical Research Institute of Infectious Diseases, noted that differentiating run-of-the-mill flu-like symptoms from bioterrorism-related flu-like symptoms would be difficult.

"I don't believe there's any great way of distinguishing early whether it be pneumonia, plague, Bacillus anthracis, Q fever, tularemia or even smallpox very early on," Woods said. Most of these diseases will cause symptoms of malaise, fever and headache, he said.

Doctors and patients need to use common sense in determining what the symptoms mean, Fukuda says. "Anthrax really has not been diagnosed in most parts of the country, whereas we expect to see millions and millions of flu cases," he says.