Clinical Features

Classic flu symptoms include fever of 38.6° to 39.8°C (101° to 103°F), with chills or rigor, headache, myalgia, and generalized malaise. Respiratory symptoms include dry cough, rhinorrhea, and sore throat, frequently with bilateral tender, enlarged cervical lymph nodes. The onset of symptoms is typically rapid and dramatic; many patients recall the exact time of onset. Ocular symptoms include eye pain, light sensitivity, tearing, and pain with lateral gaze. Myalgias and arthralgias, but not arthritis, are extremely common. The myalgias often affect back muscles in adults and calf muscles in children. Almost half of affected children have gastrointestinal symptoms, but these are unusual in adults. The elderly do not usually have classic symptoms and may have with only fever, malaise, confusion, and nasal congestion.

The fever generally lasts 2 to 4 days, followed by rapid recovery from most of the systemic symptoms. Cough, fatigue, and occasionally depression may last for several weeks following recovery.

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