Dr Ian Bogle on the NHS emergency crisis

Dr Ian Bogle, chairman of the British Medical Association, says people who have uncomplicated viral infections should stay at home rather than ring the over-stretched emergency services.

"You may feel miserable and wretched with the flu, but it is best to go to bed and take aspirin or paracetamol," he said.

He also advised people with routine matters not to visit their GP while the crisis continues.

He said the workload on doctors over the Christmas period has been the worst he has seen in 30 years of working as a doctor.

"It is the consequence of long-term underfunding of emergency services and years of efficiency savings," he said.

He added that the government's "obsession" with waiting lists was diverting attention from the long-term emergency service crisis.

No cure

The Royal College of General Practitioners' (RCGP) flu monitoring unit says the winter flu crisis is not unusual.

It has not yet reached epidemic proportions and is not on a par with the last serious flu outbreak, in 1995, which saw 230 cases per 100,000 a week.

Flu is a virus spread by breathing and cannot be cured, but its symptoms can be treated. The most difficult to treat are aches and pains, high fever and a lingering cough.

Those most at risk are the elderly, the very young and those with damaged immune systems.

The vulnerable can obtain vaccines against the flu, but once a person has the flu, Dr Doug Fleming, the RCGP's flu expert, says they should :

• take paracetamol to treat the high fever and aches and pains
• take a linctus to treat the cough or drink lots of hot, sweet fruit drinks, such as hot lemon with honey
• because the fever causes sweating and dries out the body, patients should increase the amount of juices, water and hot drinks they take
• smoking aggravates the flu so patients should steer clear of smoky atmospheres
• people with a high fever and muscle pain should rest in bed. This should relieve the aches and pains and will ensure the virus is not spread.

Antibiotics are not effective against flu viruses, but aspirins can be taken, although not by children with the flu.

This is because they could be at risk of developing Reye's syndrome, a neurological disorder which is linked to aspirin use by the young.

The drug rimantadine can be used to treat influenza type A virus infections in adults - the strain now affecting the UK, but it has no effect on influenza type B infections.

However, although used to treat mainly the elderly in the USA, iit is not commonly prescribed in the UK and can lead to side effects.

It is not a cure, but can reduce symptoms and the length of time a person suffers fever if taken within 48 hours of the onset of flu.

Rimantadine is a derivative of the drug amantadine, which has been used to treat Parkinson's disease and causes side effects such as insomnia and dizziness.

Secondary infections

Secondary infections that develop as a complication of flu claim hundreds of lives each year.

Dr Ian Bogle: underfunding is a long-term problem

They include pneumococcal pneumonia which can lead to bacteramia or blood poisoning.

The campaign group, Action Against Pneumococcal Infection (AAPI), says around 50,000 cases of pneumonia in the UK are caused by the flu virus every year.

Most people have pneumococci bacteria in the respiratory system, but usually they are resistant to it.

However, a bout of flu can lower that resistance, leading to pneumococcal pneumonia. Sufferers can need hospital treatment and antibiotics and some die.

The AAPI says around 20% of those who do receive treatment die and the figure rises to 40% for the elderly, very young or those whose immune system has been damaged.

There are vaccinations which can give protection against pneumococcal infection for life.

Some influenza viruses are more dangerous than others.

The worst episode in history was the 1918 Spanish Flu pandemic in which between 20 and 40 million people died.

Epidemics

Scientists do not know why some viruses become mass killers, but recent research suggests a molecular mechanism may allow a virus to cause sweeping and potentially fatal damage to the body.

Normally influenza is confined to cells within the respiratory system, but some viruses have a unique key which unlocks the door to cells throughout the body.

The new discovery could allow doctors monitoring flu viruses to spot changes which might give a virus pandemic potential.

Influenza virus surface proteins alter frequently, requiring new vaccines to be developed to protect against them.

The viruses are never the same each year, but normally the surface proteins undergo slight changes.