How Does the Flu Affect the Immunocompromised?

Medically Reviewed on 1/24/2023

Woman sick with the flu coughing while on a couch
Catching the flu can be more serious for people with compromised immune systems due to the risk of complications, prolonged illness, weakened immune system, and increased risk of death.

Influenza, or the flu, is a respiratory illness caused by the influenza virus. It is generally a mild illness that can be treated at home with over-the-counter medications and rest. However, for people with compromised immune systems, the flu can be much more serious.

Here are some ways in which the flu can affect immunocompromised individuals:

  • Increased risk of complications: People with compromised immune systems are at a higher risk of developing severe complications from the flu, such as pneumonia, bronchitis, and sinus infections. These complications can be life-threatening and may require hospitalization.
  • Prolonged illness: Immunocompromised individuals may experience a longer and more severe course of the flu as their bodies cannot fight off the virus as effectively. This can lead to prolonged periods of illness and missed work or school.
  • Weakened immune system: The flu can weaken the immune system even further, making it harder for the body to fight off other infections or illnesses. This can lead to a cycle of recurring infections or a general decline in health.
  • Increased risk of death: The flu can be especially dangerous for immunocompromised individuals and the risk of death is higher in this population.

Influenza, or the flu, can be a serious and potentially life-threatening illness for people with compromised immune systems. This includes individuals with HIV/AIDS and cancer, organ transplant recipients, and those taking certain medications that suppress the immune system.

For people with compromised immune systems, the flu can lead to more severe symptoms and complications, such as pneumonia, bronchitis, and sinus and ear infections. These individuals may also be at a higher risk of hospitalization and death as a result of the flu.

Which are the high-risk groups for flu-related complications?

Immunocompromised individuals are people who have a compromised immune system, meaning their body is not able to fight off infections and diseases as effectively as a healthy person's immune system.

Here are some examples of immunocompromised individuals who may be more affected by the flu:

  • People with HIV/AIDS: HIV weakens the immune system, making it difficult for the body to fight infections. People with HIV/AIDS are more likely to get severe illness from the flu, including pneumonia.
  • People with cancer: Cancer treatment, such as chemotherapy and radiation, can weaken the immune system. People with cancer may be more vulnerable to getting severe flu-related complications.
  • Transplant recipients: May have compromised immune systems due to the medications they take to prevent the rejection of the transplanted organ. These individuals are more at risk of getting severe flu-related complications.
  • People with autoimmune disorders: Autoimmune disorders, such as lupus and rheumatoid arthritis, cause the immune system to attack healthy cells in the body. This can weaken the immune system and make individuals more vulnerable to severe flu illness.
  • Children and elderly individuals: Children younger than five years (especially those younger than two years) and elderly individuals older than 65 years are at a higher risk of getting severe illness from the flu due to underdeveloped immune system and aging process that may affect elderly immune system

These individuals are more susceptible to severe infections and complications from the flu. Immunocompromised individuals need to take extra precautions to prevent getting the flu, such as getting a flu vaccine and practicing good hygiene (such as washing hands frequently). If an immunocompromised individual does get the flu, it's important to seek medical treatment as soon as possible to prevent complications.

QUESTION

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Why are immunocompromised people susceptible to complications of the flu?

Immunocompromised individuals are more susceptible to complications from the flu (influenza) because their immune systems are not functioning at full capacity. This means that their bodies are not able to effectively fight off infections or diseases, including the flu.

There are several reasons why immunocompromised individuals may be at a higher risk for complications from the flu:

  • Weakened immune system: Immunocompromised individuals may have a weakened immune system due to conditions such as HIV/AIDS, cancer, organ transplantation, or autoimmune disorders. These conditions can affect the body's ability to produce white blood cells, which are essential for fighting infections.
  • Increased severity of symptoms: For immunocompromised individuals, the flu may cause more severe symptoms, such as high fever, body aches, and breathing difficulties. This is because their immune systems cannot effectively fight off the virus, leading to a prolonged illness.
  • Risk of secondary infections: The flu can weaken the immune system, making it easier for other infections, such as pneumonia, to develop. These secondary infections can be especially dangerous for immunocompromised individuals as they may not be able to fight off the infection.
  • Difficulty recovering: Recovery from the flu can also be more difficult for immunocompromised individuals. This is because their immune systems cannot effectively clear the virus from the body, leading to a more extended period of illness.

Other factors contributing to the risk of complications in immunocompromised individuals include other underlying health conditions, such as respiratory or cardiovascular problems, and a higher risk of developing secondary infections.

What complications of the flu are immunocompromised people susceptible to?

Immunocompromised individuals are at an increased risk of developing serious complications from the flu. The following are some of the complications that immunocompromised individuals may be susceptible to:

  • Pneumonia: An infection of the lungs that can be caused by the flu virus. It can cause cough, fever, breathing difficulties, and chest pain. Pneumonia can be especially dangerous for immunocompromised individuals, leading to severe respiratory distress and potentially life-threatening complications.
  • Bronchitis: An inflammation of the bronchial tubes, which can be caused by the flu virus. It can cause coughing, chest pain, and shortness of breath. Bronchitis can be especially dangerous for immunocompromised individuals as it can lead to respiratory failure.
  • Sinusitis: An inflammation of the sinuses that can be caused by the flu virus. It can cause nasal congestion, sinus pressure and facial pain. Sinusitis can be especially dangerous for immunocompromised individuals as it can lead to respiratory failure.
  • Ear infections: Can be caused by the flu virus. These can cause symptoms such as ear pain, dizziness, and hearing difficulty. Ear infections can be especially dangerous for immunocompromised individuals as they can lead to hearing loss and other serious complications.
  • Myositis: An inflammation of the muscles that can be caused by the flu virus. It can cause symptoms such as muscle weakness and pain. It can be especially dangerous for immunocompromised individuals as it can lead to severe muscle damage and potentially life-threatening complications.
  • Sepsis: A serious and potentially life-threatening condition that can occur when the body's response to an infection damages its own tissues and organs. Sepsis can be caused by the flu virus and can be especially dangerous for immunocompromised individuals as it can lead to organ failure and death.
  • Acute respiratory distress syndrome (ARDS): A severe respiratory illness that can occur as a result of the flu or other infections. It is characterized by inflammation and fluid accumulation in the lungs, which can lead to breathing difficulties and low oxygen levels in the blood. ARDS can be life-threatening, especially in immunocompromised individuals.
  • Reactivation of latent infections: The flu can weaken the immune system, which can lead to the reactivation of latent infections, such as herpes simplex virus or varicella-zoster virus (the virus that causes chickenpox and shingles).
  • Respiratory failure: The flu can cause inflammation in the airways and lungs, leading to difficulty breathing. In severe cases, this can progress to respiratory failure, a life-threatening condition in which the body is unable to get enough oxygen.
  • Cardiac complications: The flu can also cause inflammation in the heart muscle, leading to problems such as myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the lining around the heart). These complications can be serious, especially in immunocompromised individuals who may have a harder time fighting off the infection.
  • Neurological complications: The flu can also lead to encephalitis (inflammation of the brain) and meningitis (inflammation of the membranes surrounding the brain and spinal cord). These complications can be serious and may require hospitalization.
  • Multiple organ failure: In severe cases of the flu, an individual may develop multiple organ failure, which means that two or more organs are not functioning properly. This can be life-threatening and requires immediate medical attention.

Immunocompromised individuals should seek medical attention if they develop flu symptoms as early treatment can help prevent complications.

What are flu treatment options for immunocompromised people?

Treatment of flu in immunocompromised people can involve a combination of antiviral medications, supportive care, and preventive measures to reduce the risk of complications

  • Antiviral medications: These drugs work by inhibiting the replication of the influenza virus and can effectively reduce the severity and duration of flu symptoms. They are most effective when started within the first 48 hours of symptom onset. Common antiviral medications for flu include Tamiflu (oseltamivir), Relenza (zanamivir), and Rapivab (peramivir). These medications work by inhibiting the replication of the influenza virus and can be most effective when taken within the first 48 hours of symptom onset.
  • Supportive care: Supportive care measures can be used to help manage the symptoms of flu in immunocompromised people. This may include rest, hydration and over-the-counter pain medications to help alleviate symptoms such as fever, body aches and fatigue.
  • Immunoglobulin therapy: Involves administering immunoglobulins, which are proteins that help the body fight infection. Immunoglobulin therapy may be used in immunocompromised people, who are at a high risk of severe illness or complications from the flu.
  • Corticosteroids: These medications may be used to reduce inflammation and improve symptoms in severe cases of flu. They can be administered orally or intravenously.

The most appropriate treatment for flu in immunocompromised people will depend on the specific circumstances and should be determined in consultation with your physician.

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How can we prevent complications of the flu in immunocompromised people?

There are several ways to prevent complications of the flu in immunocompromised people:

  • Get vaccinated: The flu vaccine is the best way to prevent the flu and its complications. The vaccine can be given as a shot or nasal spray, and it is safe and effective for most people, including those who are immunocompromised.
  • Practice good hygiene: Washing your hands frequently with soap and water and covering your mouth and nose when you sneeze or cough can help prevent the spread of the flu.
  • Stay away from sick people: If you are immunocompromised, it is important to avoid close contact with people who are sick as they may be more likely to transmit the flu to you.
  • Keep your home clean: Regularly cleaning and disinfecting common surfaces, such as doorknobs, countertops, and toys, can help prevent the spread of the flu.
  • Take antiviral medications: If you are at a high risk of developing serious complications from the flu, your healthcare provider may prescribe antiviral medications to help prevent or treat the flu. These medications can be taken as a pill or inhaled through a nebulizer, and they work by attacking the flu virus and stopping it from replicating.
  • Get plenty of rest and eat a healthy diet: Getting enough rest and eating a healthy diet can help boost your immune system and help you recover more quickly if you get the flu.

If you are immunocompromised and experience flu-like symptoms, it is important to seek medical attention as soon as possible. Early treatment can help prevent serious complications and may shorten the duration of the illness.

Medically Reviewed on 1/24/2023
References
Influenza in Immunosuppressed Populations https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2775097/

The Natural History of Influenza Infection in the Severely Immunocompromised vs Nonimmunocompromised Hosts https://academic.oup.com/cid/article/58/2/214/336884

You, Immunosuppression and the flu https://www.health.ny.gov/publications/2446.pdf

INFLUENZA AND IMMUNOSUPPRESSION https://www.santemonteregie.qc.ca/sites/default/files/2018/10/fiche_personnesimmunosupprimees_en.pdf

Infections in Immunocompromised Patients https://www.stjude.org/treatment/patient-resources/caregiver-resources/infection-tips/infections-immunocompromised-patients.html