Respiratory infection information for rheumatic disease patients (Influenza, COVID-19 and common respiratory viruses)

Respiratory infections can be spread via respiratory droplets when people cough or sneeze. They can also be spread by touching a surface or an object that droplets have landed on from an infected person. It can be spread before, after or whilst a person is unwell.

• Avoid others who are sick. Take extra care to remain separate from any members of your household who are at higher risk of more severe infection.
• Stay at home if you feel unwell so you don't pass your virus to other people.
• If you are sick, avoid touching your eyes, nose and mouth.
• Avoid sharing cups, glasses and cutlery with people who are sick.
• Wear a mask in shared areas or when caring for other members of your household.
• Wash your hands regularly with soap and water (or use an alcohol-based hand sanitiser), and as soon as possible after sneezing or coughing. 
• Cover your nose and mouth with a tissue when coughing and sneezing or use the inside of your elbow. Don't use your hands.
• Discuss with your GP or rheumatologist if you should withhold your rheumatic disease medications whilst unwell.

• Rest.
• Keeping hydrated with regular sips of water, or an electrolyte replacement drink if you have vomiting or diarrhoea.
• Over-the-counter medication like paracetamol and ibuprofen may be used for short-term relief of symptoms. Pregnant women or those on certain medications should avoid ibuprofen, speak to your doctor if you are not sure. Remember all medicines should be used following the manufacturer's instructions.
• Antibiotics should not be used as they are ineffective against viruses and may cause harm if taken incorrectly.
• Discuss with your GP or rheumatologist if you should withhold your rheumatic disease medications whilst unwell.
   

Influenza (flu) is highly infectious. 2 main viruses cause flu, Influenza A and B. Flu can be more serious than a cold and severe cases can result in breathing difficulties and pneumonia. People can die from flu. Flu can occur throughout the year, but it is most common in Autumn and Winter.

Symptoms include:

• Fever and chills
• Cough, sore throat and runny or stuffy nose
• Muscle aches, joint pains, headaches and fatigue (feeling very tired)
• Nausea, vomiting and diarrhoea (more common in children than adults).

Symptoms may last for more than a week. Some people may have a very mild illness (those who have some immunity from a previous infection or those who have been vaccinated), whilst others may become very unwell. Those particularly at high risk of flu, include the elderly, the very young, pregnant women, people over 65 years of age, Aboriginal and Torres Strait Islanders and those who are immunocompromised (those with a weaker immune system).

Diagnosis and treatment
Flu is diagnosed with a PCR (nose and throat) swab. If you become unwell, and you suspect you may have flu, it is important to speak with your GP to see if you should be tested. 
Antivirals may be offered to patients with severe disease and to people at higher risk of severe disease from influenza. Antiviral treatment should be started as soon as possible after the onset of symptoms, ideally within 48 hours of symptom onset.

Get vaccinated
You should talk to your GP and rheumatologist about receiving a flu vaccine. A flu vaccine will not give you the flu, nor will it prevent you from catching flu, but it will prevent severe disease or complications from developing, particularly if you are at high risk. Anyone over the age of 6 months can be vaccinated against flu.
 

Most people with COVID-19 have mild symptoms that can be managed at home and will recover in a few days. Some people have no symptoms at all. 
If you test positive on a RAT/ PCR test you may be eligible for antiviral treatments for COVID-19 and you should contact your doctor.

Those eligible for treatment include:

• People 70 years of age or older
• People 50 to 69 years of age with 2 additional risk factors for severe illness 
• An Aboriginal, Torres Strait Islander and Pacific Islander person, 30 to 69 years of age with 1 additional risk factor for severe illness
• People 18 years of age or older and are moderately to severely immunocompromised or have previously been hospitalised from COVID-19.

Risk factors include:

• Living in residential aged care
• Living with disability with multiple conditions and/or frailty (but not limited to living in supported accommodation)
• Neurological conditions like stroke or dementia and demyelinating conditions e.g. multiple sclerosis, Guillain-Barre Syndrome
• Chronic respiratory conditions including COPD, moderate or severe asthma
• Obesity or diabetes (type I or II requiring medication)
• Heart failure, coronary artery disease, cardiomyopathies
• Kidney failure or chronic liver disease
• Living remotely with reduced access to higher level healthcare.

ARA COVID information resources
•    COVID Vaccination information leaflet for patients

Further resources
•    If you think you have symptoms of COVID-19, call the Healthdirect Australia helpline on 1800 022 222.

Respiratory viruses (respiratory syncytial virus (RSV), human parainfluenza virus (HPIV), rhinovirus etc.) cause illnesses that affect the nose, throat and breathing passages including the lungs. These viruses commonly result in mild cold or flu-like symptoms in most people, except in those with risk factors, the elderly and the very young. 

Most symptoms, including runny nose, cough, headache, fevers are mild and short lived. Rarely these viruses can cause more serious infections including; bronchitis, pneumonia or acute middle ear infections.

The RSV vaccine is available in Australia but is not currently funded under the National Immunisation Program.  Contact your GP or rheumatologist if you have any further questions.

Those at increased risk of more severe disease include:

• People aged 60 years and older
• Pregnant women
• Aboriginal, Torres Strait Islander and Pacific Islander people (from age 35 years and over)
• People with obesity, diabetes, serious cardiovascular disease, chronic lung disease (including severe asthma requiring hospitalisation in last 12 months), severe chronic liver or kidney disease, active cancer or who are immunocompromised
• Some people with a disability including those with a disability that affects their lungs, heart or immune system
• Residents of aged care and disability care facilities
• People aged 18 years and older who are unvaccinated.

• COVID vaccinations
• Advice for GPs and resources for GPs
• NSW Health Infectious diseases fact sheets