This American Family Physician review, published in October 2026, summarises prevention, diagnosis and treatment of influenza for primary care.
Annual vaccination is recommended for everyone from six months of age without a contraindication, including in pregnancy. Point-of-care rapid testing in selected patients increases antiviral prescribing and reduces antibiotic prescribing when positive, but a negative rapid test does not exclude influenza. Antivirals are advised as early as possible for patients who are hospitalised, severely or progressively ill, or at high risk of complications; they can be considered for symptomatic household contacts of high-risk people and for health workers caring for them. Oseltamivir and baloxavir are the usual options.
The honest numbers matter in a short consultation: started within 24 to 36 hours, antivirals shorten symptoms by about 20 hours, and the review finds little or no evidence that they reduce complications. In India, influenza seasonality differs between regions, so the right time to vaccinate and to raise suspicion depends on local patterns.
- Offer annual influenza vaccination to every patient over six months, including pregnant women.
- Start antivirals promptly in high-risk, hospitalised or worsening patients without waiting for a test.
- Do not use a negative rapid test to rule out influenza.
- Tell low-risk patients antivirals shorten illness by about a day, not more.
- Consider antivirals for symptomatic carers of high-risk household members.
Why it matters
Antiviral demand rises every season, and the expected benefit for a healthy adult is smaller than many patients assume.
Don't overread it
A narrative review; the 20-hour figure comes from trial data in mostly low-risk adults.
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