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How Long Does a Flu Last and Ways to Manage Them  

By Dr. Vishesh Bharucha +2 more

Introduction

Influenza or flu is one of the most common and unpleasant illnesses encountered by humans. And when you catch it, one of the first questions that is likely to come to your mind is “how long will this last?” Actually, flu symptoms such as the abrupt onset of high fever, dry cough, and headache, along with muscle pain, are so distressing that you just want the illness to end as quickly as possible. But how?  Well, the solutions are specific to your health, and we’ll have a look at these in this blog.  

What is Influenza (The Flu)?

The flu, commonly known as influenza, primarily affects the respiratory tract but is not limited to the nose, throat, and lungs. It also causes systemic symptoms like fever, muscle pain and malaise, which are mainly due to the immune response to infection1. Influenza viruses are the cause of flu. These viruses can be divided into four types: A, B, C, and D. 

how long does a flu last

When seasonal influenza viruses A (subtypes H1N1, H3N2, etc.) or influenza B lineages (Victoria and Yamagata) infect people, the illness is referred to as seasonal influenza2. Globally, annual influenza epidemics of varying intensity usually happen during colder months in temperate regions3. While mostly it resolves soon, in some cases the disease can prolong and cause certain complications. 

Flu Incubation Period: When Do Symptoms Start?

The main ways by which influenza is transferred from person to person are through direct contact with respiratory secretions and large droplets4. The incubation period of influenza, i.e., the time from infection to development of symptoms, is about 1 to 4 days5


It is important to note that viral shedding (i.e., the virus is shed in nasal and oropharyngeal secretions, which can spread through coughing and sneezing) can take place one day prior to the beginning of symptoms, peak in the first 3 – 5 days, and continue up to seven days after6,7,8. Thus, you can spread the infection even before and after the symptoms show. Viral shedding may be prolonged to 10 days or more in young children9,10, immunocompromised individuals11,15, and severely ill individuals.   

Immunity to influenza immunity is a host characteristic and determines an individual’s vulnerability to infection8. Young children may lack immunity, while older adults may have some cross-protection from prior exposures but remain at higher risk of severe disease. 

How Long Does the Flu Last?

Depending on age, comorbidities, vaccination status, and innate immunity to the virus, the clinical presentation of influenza ranges between mild to severe.1 Influenza symptoms include loss of appetite, headache, acute myalgia (muscle pain), fever, chills, and malaise. In severe cases, there may be respiratory distress, hypoxia, complications (e.g., pneumonia, encephalopathy, myocarditis), and hospital requirement.  

Usually, the patient gets a high-grade fever in the first few days, and then the fever progressively goes down on the second and third days. However, it can continue for four to eight days. During the long recovery phase, that is the weeks that follow, the patient may have complaints of dry cough and malaise16


Thus, majority symptoms resolve in three to seven days, though fatigue and cough can linger longer for 2 weeks more. For high-risk individuals (elderly, individuals with impaired immune system), the illness may last longer17,18.  

Individuals at risk of severe disease or complications from influenza include the following groups22

  • Adults over 65       
  • Individuals who have underlying chronic health issues (Chronic heart, lung, renal, liver, neurological, and metabolic illnesses, including diabetes) 
  • Individuals with weakened immune systems (e.g., following chemotherapy long-term steroid therapy, spleen dysfunction, or HIV infection)  
  • Women who are pregnant, up to two weeks after delivery. 
  • Individuals that are morbidly obese (body mass index >40)      

In a major research assessing the clinical presentation of influenza in children, nearly all (95%) had fever, while cough (77%) and rhinitis (78%) were also rather prevalent. However, headache (26%) and myalgia (7%) were substantially less common19. Younger children have not yet developed immunity to a wide variety of circulating seasonal influenza strains because they have not been exposed to influenza frequently. As a result, they are more prone to get frequent disease20. Additionally, they may develop gastro-intestinal symptoms (vomiting, diarrhoea, abdominal pain, and loss of appetite) and have higher fevers (often linked to febrile convulsions)21. Children often get high fevers and complications (e.g., febrile seizures, otitis media), but not necessarily more severe disease overall.  

Thus, it can be summarized that symptoms typically last till a week, but fatigue and malaise may linger longer for a week or more. However, this duration is prolonged in the above-mentioned high-risk groups, who can have more severe disease and children who are prone to frequent infections. 


How Long Is the Flu Contagious?

The flu is contagious means it can spread to others due to ongoing viral shedding in the infected individual. Presymptomatic shedding usually occurs about 24  hours before the disease manifests, and patients are typically contagious for 5 to 7 days after onset, while some studies suggest that it may continue till 10 days later23. It should be noted that children, elderly, individuals with weakened immune system, and patients with chronic illnesses may have prolonged periods of shedding and infectiousness17,24.  

Flu Symptoms Timeline: What to Expect Day by Day

Flu symptoms might appear suddenly and persist for a few weeks. Following is the normal pattern of a flu episode16

  • Days 1–3: A sudden onset of fever, headache, sore throat, dry cough, muscle weakness, and occasionally a stuffy nose. 
  • Day 4: Muscle aches and fever usually improve in 3 – 4 days in uncomplicated cases. But coughing, hoarseness, dryness, or sore throat become more apparent. Fatigue is common. 
  • Day 8: Most acute symptoms resolve. Fatigue and coughing may often persist beyond Day 8, sometimes upto 2 weeks. 

Thus, improvement in uncomplicated influenza should be noticed in 3 – 7 days. However, fatigue and coughing may last longer for 1 – 2 weeks.  If a typical course of flu is accompanied with shortness of breath, then it is not normal. The most common complication in children is otitis media; in adults, bronchitis and secondary bacterial infections are frequent25. Pneumonia is a serious complication, especially in high-risk individuals. Primary viral pneumonia, which is caused by the influenza virus, can occur as a continuum of the acute influenza illness. It is severe, rapidly progressive, but less common. Secondary pneumonia, which occurs after a few days, is a mixed viral and bacterial infection16. Secondary bacterial pneumonia occurs after initial improvement, often due to S. pneumoniae, S. aureus or H. influenzae26. If symptoms persist or newer ones like shortness of breath occur, consult your doctor immediately.      

Treatment & Home Remedies

  • Antivirals:  Antivirals are indicated for anyone at high risk of complications, hospitalized patients, or those with severe/progressive disease. There are two types of anti-influenza medications: M2 inhibitors (like amantadine and rimantadine) and neuraminidase inhibitors (like oseltamivir,zanamivir,peramivir). M2 inhibitors (amantadine, rimantadine) are usually not recommended due to widespread resistance in circulating influenza A strains. Peramivir (IV neuraminidase inhibitor)27 and Baloxavir marboxil (cap-dependent endonuclease inhibitor) are now widely used in some regions. These antiviral drugs (e.g., oseltamivir, baloxavir), if started early (within 48 hours of symptom onset), can modestly reduce symptom duration and complications. 
  • Home Remedies: In a study28, some herbal remedies were found to be effective against respiratory viruses. These include natural products like licorice roots, elderberry, Echinacea, pomegranate, guava tea, and Bai Shao. Probiotics, zinc, selenium, vitamin C, seaweed extract, yeast-based products, and garlic extract were among the supplements that showed beneficial effects against respiratory viruses. However, evidence for herbal remedies is limited, inconsistent, and often not influenza-specific. Further studies are needed to confirm their use in influenza.  

Note: These home remedies should be used after consulting a doctor, especially if you have any pre-existing medical conditions. 


When to See a Doctor?

If you are in a high-risk group for a serious infection or have any concerns, see a doctor. Get medical help right away if you suffer from any of the following symptoms1:  

  • Chest pain  
  • Shortness of breath 
  • Sudden dizziness 
  • Disorientation 
  • Severe vomiting 
  • Fever with a rash 
  • Continuous cough and wheezing  

Prevention & Flu Season Tips

Influenza Vaccine: Annual immunization against seasonal influenza is the most effective way to avoid influenza and its serious consequences. New vaccinations are created every year to match circulating viruses29 since the influenza virus undergoes antigenic drift, which outpaces the immune system’s ability to defend against novel versions30. The main issue is antigenic drift (minor mutations) and occasional antigenic shift (major changes in Influenza A)21.  

Every year, adults and children ≥3 years should receive a single injection of the influenza vaccine (0.5 mL), ideally by October in the northern hemisphere and May in the southern hemisphere16

For children (6 – 35 months), 0.25 mL (for some vaccines) or 0.5 mL depending on formulation is recommended31.  

In addition, to prevent the spread of virus, the following hygiene measures should be taken: 

  • Avoid close contact with people suffering from influenza. 
  • During a flu outbreak, inhabitants of closed settings should be isolated for the duration of the infectious period, which is five days from the onset of symptoms.  
  • Follow proper coughing etiquette and hand hygiene. Cover your mouth and nose when coughing and sneezing. Avoid touching your eyes, nose or mouth. Wash your hands frequently. Wear a mask during the flu season. Properly dispose of the face mask.  
  • In hospitals and assisted living facilities, take into account post-exposure prophylaxis for additional at-risk patients and residents. 
  • If you have the flu, get as much rest, stay at home and drink plenty of fluids.  

Recovery Tips for Bouncing Back After the Flu

  • Consuming a nutrient-dense, well-balanced diet during and after the flue helps support overall recovery.  
  • After the flu, exercise can help increase circulation and elevate your mood but return to exercise should be gradual. Overexertion can worsen post-viral fatigue or trigger myocarditis.  Discuss with your doctor to know the ideal limits. 
  • For fatigue, continue to rest and gradually resume routine activities1. Try to get 8 hours of good sleep.  
  • Try to soothe cough with the help of honey, lozenges and use of a humidifier. However, cough may still persist even after you are not contagious.  
  • Steam inhalation and hydration will help with congestion1
  • Warm baths and over the counter pain relievers will help with myalgia.  
  • Practice good hygiene1
  • Get the flu vaccine to protect yourself from getting flu in the future during the flu season.  

Conclusion

Usually in uncomplicated flu, it takes 3 – 5 days to recover from the symptoms of fever and muscle pain, however, cough and malaise may persist beyond 7 days. People with chronic conditions, elderly individuals, pregnant women and infants <2 years are far more susceptible to flu-related complications. In order to treat the flu, people should rest and avoid exposure during the contagious period. Don’t rush back into your regular activities too soon; instead, be patient and pay attention to your body. To stay healthy during flu season, think about getting vaccinated. The flu vaccine is your best defence against future flu viruses.  

Frequently Asked Questions (FAQs)

What is the difference between influenza and common cold?  

Common cold is caused by viral infections (e.g., rhinovirus, coronavirus, adenovirus).  While some symptoms of a cold may resemble those of influenza, influenza typically lasts longer than a cold and is more severe. Fever and myalgia are more typical of influenza, but in some cases, severe colds (especially in children) can also cause mild fever.  

What are the complications of influenza?  

Pneumonia, myocarditis, myositis and acute respiratory distress syndrome are possible outcomes for just a small portion of influenza patients. Hospitalization and even death may result from these issues. Although those with pre-existing medical illnesses are at a higher risk of complications from influenza, healthy individuals can also experience complications1

What is an ‘enhanced’ influenza vaccine, and how is it different from other influenza vaccines?  

An “enhanced” influenza vaccination is made especially to boost the immune system’s reaction to the vaccine. 
It may include:  
-a greater quantity of antigen without adjuvant (this refers to high-dose inactivated influenza vaccine (HD-IIV)). 
-a regular amount of antigen with an adjuvant (a substance that boosts an immunological response to a vaccine).  
Older adults typically receive less protection from influenza vaccinations than younger adults, and they do not react as well to standard-dose influenza vaccinations as younger adults do.Enhanced vaccines do not guarantee complete protection but improve immune response and effectiveness in the ≥65 age group compared to standard vaccines32

References

  1. Boktor SW, Hafner JW. Influenza. [Updated 2023 Jan 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459363/
  2. Uyeki TM, Hui DS, Zambon M, Wentworth DE, Monto AS. Influenza. Lancet. 2022 Aug 27;400(10353):693-706. Available from: https://pubmed.ncbi.nlm.nih.gov/36030813/ 
  3. Azziz Baumgartner E, Dao CN, Nasreen S, et al. Seasonality, timing, and climate drivers of influenza activity worldwide. J Infect Dis. 2012;206:838–846. Available from: https://pubmed.ncbi.nlm.nih.gov/22829641/
  4. Brankston G, Gitterman L, Hirji Z, Lemieux C, Gardam M. Transmission of influenza A in human beings. Lancet Infect Dis. 2007;7(4):257–65. Available from: https://pubmed.ncbi.nlm.nih.gov/17376383/
  5. Lessler J, Reich NG, Brookmeyer R, Perl TM, Nelson KE, Cummings DA. Incubation periods of acute respiratory viral infections: a systematic review. Lancet Infect Dis 2009;9:291-300. Available from: https://pubmed.ncbi.nlm.nih.gov/19393959/ 
  6. Department of Health. Routes of transmission of the influenza virus: scientific evidence base review. DoH, 2011. Available from: https://assets.publishing.service.gov.uk/media/5a7c12b2ed915d210ade168a/dh_125332.pdf
  7. Killingley B, Greatorex J, Digard P, et al. The environmental deposition of influenza virus from patients infected with influenza A(H1N1)pdm09: Implications for infection prevention and control. J Infect Public Health 2016;9:278-88. Available from: https://www.sciencedirect.com/science/article/pii/S1876034115001926 
  8. Fiore A, Bridges C, Katz JM, Cox N. Inactivated influenza vaccines. In: Plotkin S, Orenstein W, Offit P, editors. Vaccines. Beijing: Elsevier; 2013. p. 257–93.  Available from: https://www.researchgate.net/publication/322170105_Inactivated_Influenza_Vaccines
  9. R.J. Whitley, F.G. Hayden, K.S. Reisinger, et al. Oral oseltamivir treatment of influenza in children. Pediatr Infect Dis J. 2001; 20(2):127-133. Available from: https://pubmed.ncbi.nlm.nih.gov/11224828/
  10. M. Sato, M. Hosoya, K. Kato, et al.Viral shedding in children with influenza virus infections treated with neuraminidase inhibitors. Pediatr Infect Dis J. 2005;24(10):931-932. Available from: https://pubmed.ncbi.nlm.nih.gov/16220098/
  11.  A. Klimov, E. Rocha, F.G. Hayden, et al.Prolonged shedding of amantadine-resistant influenzae A viruses by immunodeficient patients: detection by polymerase chain reaction-restriction analysis. J Infect Dis. 1995;172(5):1352-1355. Available from: https://pubmed.ncbi.nlm.nih.gov/7594676/
  12.  J.A. Englund, R.E. Champlin, P.R. Wyde, et al. Common emergence of amantadine- and rimantadine-resistant influenza A viruses in symptomatic immunocompromised adults.Clin Infect Dis. 1998;26(6):1418-1424. Available from: https://pubmed.ncbi.nlm.nih.gov/9636873/
  13.  Boivin, N. Goyette, H. Bernatchez. Prolonged excretion of amantadine-resistant influenza A virus quasi species after cessation of antiviral therapy in an immunocompromised patient.Clin Infect Dis. 2002;34(5):e23-e25. Available from: https://pubmed.ncbi.nlm.nih.gov/11807683/ 
  14. W.G. Nichols, K.A. Guthrie, L. Corey, et al. Influenza infections after hematopoietic stem cell transplantation: risk factors, mortality, and the effect of antiviral therapy. Clin Infect Dis. 2004;39(9):1300-1306. Available from: https://pubmed.ncbi.nlm.nih.gov/15494906/
  15. D.M. Weinstock, L.V. Gubareva, G. Zuccotti. Prolonged shedding of multidrug-resistant influenza A virus in an immunocompromised patient.N Engl J Med. 2003;348(9):867-868. Available from: https://pubmed.ncbi.nlm.nih.gov/12606750/ 
  16. Moghadami M. A Narrative Review of Influenza: A Seasonal and Pandemic Disease. Iran J Med Sci. 2017 Jan;42(1):2-13. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5337761/ 
  17. Carrat F, Vergu E, Ferguson NM, Lemaitre M, Cauchemez S, Leach S, et al. Time lines of infection and disease in human influenza: a review of volunteer challenge studies. Am J Epidemiol. 2008;167:775–85. Available from: https://pubmed.ncbi.nlm.nih.gov/18230677/ 
  18. Boivin G, Goyette N, Bernatchez H. Prolonged excretion of amantadine-resistant influenza a virus quasi species after cessation of antiviral therapy in an immunocompromised patient. Clin Infect Dis. 2002;34:E23–5. Available from: https://pubmed.ncbi.nlm.nih.gov/11807683/
  19. Selvennoinen H, Peltola V, Lehtinen P, Heikkinen T. Clinical presentation of influenza in unselected children treated as outpatients. Pediatr Infect Dis J. 2009;28:372–5. Available from: https://pubmed.ncbi.nlm.nih.gov/19295464/
  20. Kumar S, Havens PL, Chusid MJ, Willoughby Jr RE, Simpson P, Henrickson KJ. Clinical and epidemiologic characteristics of children hospitalized with 2009 pandemic H1N1 influenza A infection. Pediatr Infect Dis J. 2010;29(7):591–4. Available from: https://pubmed.ncbi.nlm.nih.gov/20589976/
  21. Cohen, C., Reubenson, G. (2017). Influenza. In: Green, R. (eds) Viral Infections in Children, Volume I. Springer, Cham. Avaiable from: https://link.springer.com/chapter/10.1007/978-3-319-54033-7_2
  22. Ghebrehewet S, MacPherson P, Ho A. Influenza. BMJ. 2016 Dec 7;355:i6258. Available from: https://pubmed.ncbi.nlm.nih.gov/27927672/
  23. Wong BC, Lee N, Li Y, Chan PK, Qiu H, Luo Z, et al. Possible role of aerosol transmission in a hospital outbreak of influenza. Clin Infect Dis. 2010;51:1176–83. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC7107804/
  24. Boivin G, Goyette N, Bernatchez H. Prolonged excretion of amantadine-resistant influenza a virus quasi species after cessation of antiviral therapy in an immunocompromised patient. Clin Infect Dis. 2002;34:E23–5. Available from: https://pubmed.ncbi.nlm.nih.gov/11807683/
  25. D. Low. Reducing antibiotic use in influenza: challenges and rewards. Clinical Microbiology and Infection. 2008;14(4):298-306. Available from: https://pubmed.ncbi.nlm.nih.gov/18093237/
  26. Wiselka M. Influenza: diagnosis, management, and prophylaxis. BMJ. 1994;308:1341-1345. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC2540274/ 
  27. Alame MM, Massaad E, Zaraket H. Peramivir: A Novel Intravenous Neuraminidase Inhibitor for Treatment of Acute Influenza Infections. Front Microbiol. 2016 Mar 31;7:450. Available from: https://pubmed.ncbi.nlm.nih.gov/27065996/
  28. Mousa HA. Prevention and Treatment of Influenza, Influenza-Like Illness, and Common Cold by Herbal, Complementary, and Natural Therapies. J Evid Based Complementary Altern Med. 2017 Jan;22(1):166-174. Available from: https://pubmed.ncbi.nlm.nih.gov/27055821/
  29. Glezen WP. Clinical practice. Prevention and treatment of seasonal influenza. N Engl J Med. 2008;359:2579–85. Available from: https://pubmed.ncbi.nlm.nih.gov/19073977/ 
  30. Kilbourne ED. Influenza immunity: new insights from old studies. J Infect Dis. 2006;193:7–8. Available from: https://academic.oup.com/jid/article-abstract/193/1/7/870349?redirectedFrom=PDF 
  31. American Academy of Pediatrics, Committee onInfectious Diseases. Recommendations for Prevention and Control of Influenza in Children, 2024–2025: Policy Statement.Pediatrics. 2024;154(4):e2024068507. Available from: https://publications.aap.org/pediatrics/article/154/4/e2024068507/199041/Recommendations-for-Prevention-and-Control-of?autologincheck=redirected
  32. Wendy Boivin, Mark Loeb, Peter Openshaw, Mansoor Ashraf, Graham Pawelec. Seasonal influenza vaccination: Overcoming immunosenescence with enhanced vaccines.Vaccine: X.Volume 24. 2025;100662:2590-1362. Available from: https://experts.mcmaster.ca/display/publication3609766

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