The flu is more than an annoyance for people with asthma. Since asthma irritates the airways, flu may make symptoms worse or cause a flare-up as airways narrow with mucus buildup.

It is critical for people with asthma to get the annual flu shot. Doctors recommend the flu vaccine every year because the viruses that cause influenza mutate rapidly and immunity decreases after one year.

Flu vaccines are available as an injection or a nasal spray (LAIV). However, nasal spray vaccines have limitations: they are not available for people with asthma or pregnant women and they are only given to those ages 2-49.

If you have asthma and get the flu, check in with your doctor even if your symptoms don’t seem severe. The risk of severe complications such as pneumonia may make you a candidate for antiviral drugs. These can make your symptoms milder and prevent complications. They are most effective when taken at the start of an infection.

Pay attention to these flu warning signs that signal immediate medical attention is needed:

• Fever above 104°
• Trouble breathing
• Wheezing or whistling breath
• Chest pain
• Dizziness or confusion
• Not urinating, dehydration
• Seizures
• Bluish lips or face
• Severe muscle aches that cause trouble/refusal to walk
• Fever or cough that improves but then worsens
• Weakness or unsteadiness
• Symptoms of a chronic medical condition worsen

If you have asthma, be especially vigilant against the flu. Along with getting the flu vaccine, make sure to follow good hygiene such as washing hands frequently and avoiding others who are sick with flu. It’s also important to avoid spreading the flu if you have it. Stay home if you’re sick and cough or sneeze into your elbow rather than your hand.