Lupus is a chronic autoimmune condition where the immune system mistakenly attacks healthy tissues and organs, causing widespread inflammation in joints, skin, kidneys, blood cells, brain, heart, and lungs. Influenza, or the flu, is a common respiratory illness caused by viruses that infect the nose, throat, and sometimes the lungs. While the flu can cause mild to severe illness in the general population, it presents unique and often more serious challenges for individuals living with lupus.
Increased Vulnerability for Lupus Patients
Individuals with lupus face increased vulnerability to severe flu outcomes. Lupus involves an overactive and misdirected immune system, making it less effective at fighting infections like the flu. Many common lupus treatments further contribute to this susceptibility. Immunosuppressant medications (e.g., corticosteroids, methotrexate, azathioprine, mycophenolate mofetil, biologic drugs like belimumab or rituximab) dampen the immune system to control lupus activity. While essential for managing the disease, these medications reduce the body’s ability to fight foreign invaders, increasing susceptibility to infections and weakening the flu response. Additionally, the chronic inflammation characteristic of lupus can predispose the body to more severe inflammatory responses when an infection like the flu occurs.
Specific Risks and Symptoms
Contracting the flu with lupus carries several specific risks and can lead to more severe complications. Severe respiratory complications, including pneumonia (viral or secondary bacterial) and acute respiratory distress syndrome (ARDS), are primary concerns. Viral infections like the flu can trigger lupus flare-ups, manifesting as increased fatigue, joint pain, skin rashes, kidney involvement, or other organ-specific symptoms. A weakened immune system also makes lupus patients more prone to secondary bacterial infections (e.g., ear or sinus infections) and can further strain already compromised organs like the kidneys, heart, or lungs, potentially leading to damage or dysfunction. Flu symptoms in lupus patients generally resemble those in the broader population (fever, cough, body aches, fatigue), but may be more severe, prolonged, or challenging to differentiate from a lupus flare.
Managing Flu Symptoms
Prompt medical attention is crucial for lupus patients suspecting flu; contacting a rheumatologist or primary care physician immediately allows for timely intervention. Early diagnosis can lead to antiviral medications (e.g., oseltamivir, zanamivir, peramivir, baloxavir marboxil), often recommended for lupus patients and most effective when started within 48 hours of symptom onset to reduce illness severity and duration. Beyond antivirals, supportive care includes rest and hydration. Fever reducers may be used, though caution is advised regarding NSAIDs for some lupus patients; a doctor should always be consulted. In some cases, doctors might temporarily adjust lupus medications, potentially reducing immunosuppressants, during acute infection, but any changes must only be done under strict medical guidance. Immediate emergency care is warranted for symptoms like difficulty breathing, chest pain, sudden dizziness, severe persistent vomiting, confusion, or worsening chronic medical conditions.
Preventing Flu Infection
Proactive measures are recommended for lupus patients to prevent flu infection, with the annual inactivated seasonal flu vaccine being the most effective preventive measure. This vaccine is safe for lupus patients and does not typically trigger disease flares, though some studies note a slightly reduced immune response compared to healthy individuals; however, the live attenuated nasal spray flu vaccine is not recommended for those with compromised immune systems. Beyond vaccination, diligent hygiene practices reduce infection risk; frequent handwashing, especially after coughing, sneezing, or touching surfaces, is effective. Avoiding touching the face (eyes, nose, mouth) helps prevent viral entry, as does minimizing contact with sick individuals, avoiding large crowds during flu season, and considering mask-wearing in high-risk settings. While secondary to vaccination and hygiene, a healthy lifestyle (adequate sleep, balanced diet, stress management) can support overall immune function.