Infections and fever
Epidemic infections
For infections such as flu and COVID-19
with a medical interpreter
24 hours a day, 365 days a year
OK to consult together
payment information
About
About Epidemic infections
We treat epidemic infections such as flu and COVID-19. Depending on your symptoms and wishes, you can also ask about testing and prescription medication.
Why it happens
These illnesses occur when viruses such as influenza or the COVID-19 virus pass from person to person through droplets from coughs and sneezes or through hands that carry the virus. As the virus multiplies in the body, the immune system tries to get rid of it, which is thought to cause whole-body symptoms such as fever, fatigue and muscle aches. The incubation period is generally about 1–5 days depending on the virus, and people become contagious from around the time symptoms appear.
What's happening in the body
Viruses enter the body through droplets from coughs and sneezes, or when you touch your mouth, nose or eyes with hands carrying the virus. Once inside cells in the lining of the nose and throat, the virus uses those cells to make large numbers of copies of itself and spreads to nearby cells. The body's immune system then releases substances that cause inflammation to get rid of the virus. Whole-body symptoms such as fever, joint pain and severe fatigue are thought to be caused by this immune response rather than by the virus itself. A fever is also a sign that your body is fighting the virus, so the height of the fever alone doesn't determine how serious the illness is. The incubation period is generally about 1–5 days, and people become contagious shortly before symptoms appear. This is why people can spread it without realizing.
Main symptoms
- Sudden fever or chills
- Severe fatigue, feeling heavy and tired
- Joint and muscle aches
- Sore throat
- Cough, runny nose, blocked nose
- Headache
- Loss of taste or smell (can occur with COVID-19)
- In children, diarrhea or vomiting may also occur
When you can wait and see
What you can do yourself
- Drink fluids often (oral rehydration solutions can be convenient)
- Get plenty of rest and eat what you can manage
- Keep the room at a comfortable temperature and humidity, and don't let your body get too cold
- At home, don't share towels or dishes, and ventilate often
- Your strength may take a few days to return after the fever goes, so don't jump back into full activity
Please consult us
If any of the following apply
- You have a sudden high fever or severe fatigue
- An infection is going around your family or workplace
- You're at higher risk of severe illness and want advice early
Seek care right away
If any of the following apply
- Difficulty breathing, rapid breathing, or getting out of breath with slight activity
- Chest pain or a strong feeling of pressure
- Drowsiness or confusion, or slow to respond when spoken to
- Bluish-purple lips or face
- Unable to drink, and no urine for half a day or more
Don't wait for a Cotovia consultation; call the emergency number in your country.
See the emergency guide for each countryIf you're not sure, ask us on LINE
Differential
Telling it apart from similar conditions
Symptoms that look the same may need different care depending on the cause. Use this as a guide to find what's closest to your situation.
Flu
Sudden fever, severe joint and muscle aches and whole-body fatigue come first
Within 48 hours of onset, you can ask about antiviral treatment options
COVID-19
Along with fever, taste or smell may be affected
Can be identified by testing
Dengue
Possible mosquito bites, pain behind the eyes, rash, severe joint and muscle pain
A blood test is needed. Seek care urgently if there is stomach pain, repeated vomiting or a tendency to bleed
Common cold
Mild to moderate fever. Mainly nose and throat symptoms, with mild whole-body symptoms
Mainly monitoring at home
Malaria
Travel to an area where malaria occurs, recurring fever and chills
An urgent blood test is needed
* This is not a complete list. If you're not sure, please consult us.
When it might be something else
Course
Typical course
This is the general course. Actual progress varies from person to person.
- Onset to 48 hours
Sudden fever, joint pain and fatigue build toward their peak
If considering antiviral medication, seeing a doctor within this window is recommended
- Days 2–4
Fever continues, and cough and throat symptoms become more noticeable
Drink fluids and rest. Watch for signs of getting worse
- Days 5–7
The fever starts to go down and whole-body symptoms ease
Even after the fever goes, you may still be shedding the virus for a while
- 1–2 weeks
A cough or tiredness may linger
If a cough lasts 2 weeks or more, please consult us, as there may be another cause
Local Insight
For people living in Southeast Asia
The climate, healthcare and access to medication differ from Japan. Here are points specific to this region.
In Singapore and Malaysia, close to the equator, flu is reported to have no clear season and to circulate throughout the year. The Japanese idea that flu is a winter illness may not apply.
In Thailand, the Philippines, Vietnam and elsewhere, outbreaks tend to peak during the rainy season (roughly months 6–10, June to October). It's worth discussing vaccination timing based on local patterns.
Whether the Northern or Southern Hemisphere vaccine strain is used may differ by country. Please consult a doctor, including about your vaccination history in Japan.
Mosquito-borne infections such as dengue and chikungunya also start with a high fever, so don't assume a fever means flu. Please also tell us about recent travel and any mosquito bites.
Care
What Cotovia can do
- Consultation and rapid testing as needed (testing is at the doctor's discretion)
- Prescriptions for antiviral drugs, fever reducers and painkillers (prescribing is at the doctor's discretion)
- Advice on preventing spread to your family and on recovering at home
Tests you may have
Not knowing what will happen can make people hesitate to seek care, so here's what actually takes place.
Rapid antigen test
Distinguishing flu from COVID-19
Blood test
Assessing the possibility of other infections such as dengue, and the degree of dehydration or inflammation
Chest imaging
When pneumonia is suspected as a complication
Treatment options
Antiviral medication
Slows the spread of the virus
Whether it's suitable depends on the time since symptoms started. Prescribing is at the doctor's discretion
Fever reducers and painkillers
Eases fever and pain
Until dengue has been ruled out, some fever reducers and painkillers that may increase bleeding should be avoided. Please ask us before taking anything on your own
Fluids and electrolytes
Prevents dehydration
Dehydration sets in more easily in hot, humid conditions
Symptom relief (such as cough medicine)
Eases uncomfortable symptoms
Considered according to your symptoms
* Tests, procedures and prescriptions are decided by the doctor after a consultation. Services may vary by country and location.
Preparation
Before your visit
When seeing a doctor abroad, simply organizing what you need to say makes a big difference.
What to bring
- Passport or residence card
- Insurance card and your insurer's contact details
- Your medication record and the medication you currently take (the actual items or photos)
- A record of your temperature (when and how high)
What to tell us
- When symptoms started, what they were and in what order they appeared
- How your temperature has changed (the highest it reached)
- Any mosquito bites, and where you've traveled in the past 2 weeks
- Whether anyone around you has the same symptoms
- Chronic conditions, allergies and possible pregnancy
Self Care
What you can do yourself
Along with seeing a doctor, here are things to keep in mind in daily life.
Prevention
- Consider vaccinations such as 1 flu shot each year (ask a doctor about timing based on local outbreaks)
- Make a habit of washing hands with soap and using hand sanitizer
- Wear a mask in crowds during outbreaks
- Stay home from outings and work when you feel unwell
How to Consult
How to be seen
Choose from 3 ways to be seen, depending on your symptoms and schedule. If you're not sure, we'll guide you on LINE.
Online consultations
See a doctor by video call from home or the office. Medication delivered or from a pharmacy.
Available for this symptom
In-person care
In-person consultations at our clinics and partner hospitals, including tests and procedures.
Available for this symptom
Cotovia Counter
Support with an interpreter for visits to general hospitals.
Available for this symptom
If an online consultation finds that tests or procedures are needed, we'll guide you to in-person care or Cotovia Counter.
From consultation to receiving medication
Add us on LINE and consult
Tell us your symptoms, and we'll recommend the right way to be seen.
Book and be seen
See a doctor online or at the nearest location, with an interpreter present.
Receive your medication
Have it delivered or pick it up at a pharmacy or the clinic (varies by country).
Follow-up
You can also consult us on LINE about how you're doing afterward.
Special Care
People who need extra care
Children
Seek care urgently if your child can't drink, hasn't passed urine for half a day or more, or is limp and slow to respond. Diarrhea or vomiting may also occur
Older adults and people with chronic conditions
Complications such as pneumonia are more likely. Please consult us early, even if symptoms are mild
Pregnant women
Some medications can't be used. Be sure to tell us if you could be pregnant
People with asthma or heart or kidney conditions
Symptoms may get worse more easily
FAQ
FAQ
Common questions before a visit, and common assumptions that lead people to judge for themselves.
QI heard I can buy antibiotics at a local pharmacy. Is it OK to take them?
In some Southeast Asian countries, antibiotics can be bought without a prescription. However, flu and COVID-19 are caused by viruses, and antibiotics are not expected to work against them. Taking them unnecessarily can also lead to resistant bacteria, so please don't decide on your own and consult a doctor.
QCan you really get the flu in the tropics?
Yes. Near the equator, flu circulates throughout the year, so you need to be careful in every season.
QCan I get a medical certificate to submit to my company?
After the consultation, you can discuss documents with the doctor to the extent they judge necessary. Formats and availability may vary by country and location.
QWhat can I do to avoid infecting my family?
The basics are resting in a separate room, ventilating shared spaces, not sharing towels and dishes, and washing hands thoroughly. You can also ask us for specific advice for your household.
Common misconceptions
Myth The higher the fever, the more serious it is
Fact How high a fever is doesn't necessarily match how serious the illness is. Difficulty breathing and changes in consciousness are more important signs
Myth Once the fever is gone, you're no longer contagious
Fact You may still be shedding the virus for a while after the fever goes
Myth You can't get the flu in Southeast Asia because it's hot
Fact According to WHO reports, flu circulates all year round in the region
Myth A fever means flu
Fact There are feverish illnesses common in this region, such as dengue and malaria. Deciding on your own is dangerous
Myth Antibiotics will work
Fact Antibiotics don't work on viruses. They are only used when a bacterial infection develops as well
Feel free to ask us on LINE first
It's fine to contact us even if you're not sure you need to see a doctor. We're available in Japanese 24 hours a day, 365 days a year.
- Symptoms
- When it started
- Your country of residence
- How you'd like to be seen
Sending these 4 things helps us respond faster. It's fine if you don't have them all.
Ask us on LINE