Got flu? Avoid ER, experts say

Published 9:31 am Wednesday, January 30, 2019

The Centers for Disease Control reports that influenza activity in Alabama is now widespread and likely to increase. Alabama’s Department of Public Health also reports that almost every Alabama county is experiencing significant flu activity.

As Alabama and the rest of the country enter the height of flu season, University of Alabama at Birmingham medical caregivers want to remind the public that, if you are normally a healthy person who is experiencing flu-like symptoms — high fever, muscle or body aches throughout the body, exhaustion, and loss of appetite — do not go to the emergency department.

“If you have all of those classic flu-like symptoms, it’s really best to either see or call your primary care provider or visit an urgent care clinic,” said Stephen Russell, M.D., associate professor of internal medicine and pediatrics at the UAB Medicine-Leeds clinic. “Most healthy adolescents and adults without chronic illnesses can be treated quickly and most effectively this way, and it won’t put a strain on city and community emergency departments, which typically care for acute and severely injured patients.”

When patients who are otherwise healthy are experiencing flu-like symptoms and come to local emergency departments, it creates severe overcrowding situations and delays for all patients during flu season, says Janyce Sanford, M.D., professor and chair of UAB’s Department of Emergency Medicine. It also puts other immuno-compromised patients — and even healthy hospital visitors and staff — at greater risk of contracting the flu.

“Emergency departments often see the most critical of patients, many of whom don’t have an intact immune system, and they are at risk of severe — possibly life-threatening — complications from the flu,” Sanford said. “And while nursing staffs like ours have all had their flu shots, they are at risk for catching other viral diseases, making them sick and unable to work, which further exacerbates delays in care.

“The other side of that is that, if you come to the emergency department and you don’t have the flu, you have heightened your risk of catching it or other communicable diseases by being in the hospital. It’s better to stay home until you are fever-free, treat your symptoms and call your primary care provider to discuss the possibility of antiviral medication, such as oseltamivir.”

Russell says patients should never hesitate to call their primary care physicians if they are sick. “That’s why primary care and urgent care physicians practice, to help those in need,” Russell said. “Call if you are sick or experiencing the onset of symptoms.”

Another option for many Alabamians is UAB eMedicine, which features a team of clinicians who can treat more than 20 common medical conditions virtually for a flat $25 fee.

What are the exceptions for patients with flu-like symptoms visiting an emergency department?

Sanford says infants, toddlers, and those over the age of 65 with severe chronic illnesses — cancer, COPD, heart disease, diabetes, etc. — and suppressed immune systems should consider an emergency department visit.

Those who contract the flu and consequently experience chest pain, shortness of breath, persistent vomiting, altered mental status or fever with rash also should go to the emergency department. Children who are persistently irritable, vomiting, not taking fluids, have difficulty breathing, experience fever  with rash or seem confused also should be treated at the emergency department, Sandford says.


“Call your primary care or urgent care doctor, and wash your hands, wash your hands, wash your hands,” Sanford said.