Flu and wheezing: what should you know?

Wheezing is a whistling sound caused by narrowed or inflamed airways. Influenza may inflame the breathing tubes and make an existing asthma or COPD pattern flare. Acute bronchitis can also cause cough and noisy breathing after a viral infection. In babies and young children, bronchiolitis is another possibility. Allergic rhinitis does not usually narrow the lower airways, but allergy exposure can coexist with asthma. Sudden wheezing with facial swelling, hives or throat tightness may signal anaphylaxis and is an emergency.

Sit upright, rest and take small sips of fluid. Follow your personal asthma or COPD action plan, including prescribed reliever medicine, exactly as directed. Do not borrow another person's inhaler. Avoid smoke, fragrances and strenuous activity while breathing is irritated. A clinician may assess oxygen levels, listen to your chest and decide whether inhaled treatment or a nebuliser treatment is appropriate. Antivirals or other treatment may be considered for some people with flu, depending on timing and risk factors.

Call emergency services for severe breathlessness, inability to speak normally, blue or grey lips, chest pain, collapse, confusion, or rapidly worsening wheeze. Treat wheezing with throat tightness, facial swelling or widespread hives as an emergency. Seek same-day medical advice if your reliever is not helping, you are breathing faster than usual, fever is worsening, or you have asthma, COPD, heart disease, pregnancy or a weakened immune system.

Could flu have triggered asthma, COPD or another airway problem? How should I adjust my written action plan? Do I need an examination, oxygen check, inhaler review or nebuliser treatment?