Can influenza (flu) cause wheezing?

From the Guidelines

Yes, influenza can cause wheezing, particularly in individuals with pre-existing chronic lung disease, as noted in approximately 10% of cases 1. Wheezing is a high-pitched whistling sound that occurs when breathing, typically during exhalation, and is caused by narrowed or inflamed airways. The influenza virus can irritate and inflame the respiratory tract, including the bronchial tubes, leading to increased mucus production and swelling that narrows the airways.

Some key points to consider:

• Wheezing is more common in patients with underlying chronic lung disease, such as asthma or chronic obstructive airways disease (COPD) 1.
• Clinical findings may include a toxic appearance, hot and moist skin, a flushed face, injected eyes, and hyperaemic mucous membranes around the nose and pharynx, with tender cervical lymphadenopathy found in a minority of cases 1.
• If you experience wheezing with the flu, it's essential to:
  1. Stay hydrated to help thin mucus secretions
  2. Use a humidifier to moisten the air
  3. Try over-the-counter expectorants like guaifenesin to help loosen mucus
• For more severe cases, a doctor may prescribe:
  • Inhaled bronchodilators (e.g., albuterol) to open airways
  • Corticosteroids to reduce inflammation
• Seek immediate medical attention if wheezing is severe, persistent, or accompanied by difficulty breathing, chest pain, or bluish skin color, as these could indicate a more serious complication like pneumonia or exacerbation of underlying conditions like asthma 1.

From the Research

Influenza and Wheezing

• Influenza, commonly known as the flu, can cause respiratory symptoms, including wheezing, especially in individuals with pre-existing respiratory conditions such as asthma or chronic obstructive pulmonary disease (COPD) 2, 3.
• Wheezing is a common symptom associated with various disease processes, including asthma and COPD, and can be triggered by viral respiratory infections like influenza 4.
• The relationship between influenza and wheezing is complex, and while influenza can exacerbate underlying respiratory conditions, it is not the sole cause of wheezing 2, 5.

Respiratory Conditions and Wheezing

• Asthma and COPD are two common respiratory conditions that can cause wheezing, and individuals with these conditions are more susceptible to exacerbations triggered by viral infections like influenza 2, 6, 5.
• The severity of wheezing can vary depending on the underlying condition and the presence of other comorbidities, such as heart disease or diabetes 6, 3.
• Influenza vaccination has been shown to reduce the incidence of influenza-related acute respiratory illness, including wheezing, in individuals with COPD 3.

Diagnosis and Management

• The evaluation of wheezing typically includes a chest x-ray, pulmonary function testing, and a trial of short-acting beta agonists 4.
• Advanced imaging may be necessary to rule out malignancy, especially in older adults with a history of tobacco use and new-onset wheezing 4.
• Effective management of wheezing requires a standardized approach, including expeditious symptom management and consideration of underlying respiratory conditions 4.