Hi Dr. Nick | Issue 07
The Fresher Flu is that wonderful bug which, much like freshers themselves, runs rampant through the halls of Dunedin and spills out onto the street, making everybody’s life worse as a result. Like New Zealand’s Got Talent, it’s a complete misnomer; Fresher Flu is not related to freshers or the flu.
Throughout the world people talk about the “flu” as if it’s a cold that levelled up and evolved after a bit of a battle with our immune systems. In Dunedin we slap the word “Fresher” in front of it because fuck first years, amirite? Really, “the flu” only refers to Orthomyxoviridae: a very specific family of RNA viruses that leave you in a worse state than a quick game of Scrumpy hands before your floor BYO.
The Flu is a pig of a bug that sees most people bed-bound and miserable for 4-5 days. Along the way you’ll experience fevers, chills, rigors (uncontrollable shaking like a polaroid picture and jerking like a pubescent boy with uncapped broadband), muscle weakness and extreme fatigue. You’ll also have the classic cold-like blocked nose, runny nose, sore throat and whinging little bitch syndrome.
Typically people with the flu who show up to their doc don’t believe the diagnosis. They come in expecting “meningitis” or something equally as dramatic and generally spout something like “I’ve had the flu before and this is nothing like that.” In reality, what they’ve had before, and what we call the Fresher Flu, is a different viral infection of the upper airways.
There are a whole heap of viruses that cause those sorts of colds – most commonly, rhinovirus. Most of the symptoms of a cold aren’t really because of the virus itself, but because of the immune and inflammatory reaction the body mounts against it. The fevers, pain, difficulty breathing and buckets full of mucous all come from the body trying to kill off the bug on board, which is why so many roads lead to Rome when it comes to airway infections.
As the symptoms are caused by your immune system, and your immune system is reacting to a virus, antibiotics won’t help at all. Antibiotics only work on bacteria, and not all antibiotics work on all types of bacteria. There are strict guidelines on when to give antibiotics for respiratory infections but, like the “David Clark for Dunedin North” Facebook page, not many people follow them.
It’s actually pretty hard to pick a bacterial infection from a viral infection in the clinic. The parts of the historic chest exam we used to rely on have been shown to be pretty poor at determining which is which. Largely, it’s a numbers game – viral infections are ridiculously more common. And most of those occasional bacterial infections don’t require antibiotics to be cleared in a young, otherwise healthy, group.
But it’s hard to say “no” all the time when people relentlessly ask for things. It’s why Mum always bought you candy at the supermarket, it’s why you subsequently developed Diabetes, and it’s why a lot of people end up on antibiotics for no reason. Next week we’ll talk about why that’s so dangerous – spoiler: it involves shitting yourself to death.