We have all been there early in the term: cough, headache, and general grogginess. Now some may rightly attribute this to the debauchery of the prior night, but there is another, more pervasive cause, the infamous freshers' flu, but what really is it that drives us to deplete the Sainsbury’s pharmaceutical aisle?

Freshers flu is the blanket term given to practically any illness contracted during the start of Michaelmas. These infections are typically upper respiratory tract infections, meaning they irritate the process of breathing, causing the coughs that echo through lecture halls. 

Something to note is that the name freshers flu is itself misleading. Flu is an abbreviation for disease caused by influenza viruses, a family of viruses, meaning they often cause similar symptoms: fever, runny nose, sore throat, muscle pain, headache, coughing and fatigue. However, as we are aware, there is a great disparity in what freshers flu does to people. Some are bedridden and feverish for days, while others get away with a light cough and sore throat, which implies that a variety of different diseases are at play. 

One could be forgiven for assuming that freshers’ flu is most prevalent during freshers’ week

Influenza may well be one of the culprits. Other contenders include respiratory syncytial virus (RSV) and metapneumovirus. All of these have national peaks during autumn and winter, coinciding with Michaelmas. These are often more serious, so if you can’t drag yourself to your supo, you might be suffering from one of these.  

If you are suffering from more mild symptoms, you may be infected by one of a range of other viruses, including rhinoviruses (such as the common cold), adenoviruses, and the microscopic elephant in the room, coronaviruses. It must be noted that these are groups of infections and not specific types of viruses. However, their symptoms are generally similar and without a test, it is very difficult to tell them apart. Their mild symptoms mean that they are not tested for in routine surveillance (with the obvious exception of COVID-19), and tests are not readily available, allowing them to run unidentified through the academic population.

One could be forgiven for assuming that freshers’ flu is most prevalent during freshers’ week. However, this is unlikely due to the exponential nature of disease spread (think back to those case number graphs in the early COVID pandemic). Cases of general unwellness tend to peak at two to four weeks after the start of term, just in time for week five blues. 

However, there may be some redemption for use of the term ‘freshers’, given it is used in reference to those who are most likely to be infected. The spread of disease requires contact with people, and increased contact in more intimate environments increases the risk of transmission. Freshers are likely to attend more social gatherings than their elders, and these tend to be open-invite based, often bringing diverse groups of people into contact. In contrast, older years may mostly socialise within defined groups of people. This means that diseases can circulate to and from freshers through their much broader networks than typically exist for second and third years.

In regards to what facilitates the spike in illness during the start of the academic year, the most likely cause is the convergence of swathes of people from across the globe, allowing for people to contribute their home’s diseases into Cambridge’s microbial mixing pot. Poor diet, stress, low sleep and heavy alcohol consumption (when compared to the prior summer holiday lifestyle) increase susceptibility to disease. This, combined with the colder weather that encourages indoor congregation (perfect for spreading respiratory illnesses) means that infection rates are high. 

Although unpleasant, freshers’ flu is generally benign. However, it must not be confused with meningitis, a far more serious condition that can cause a rapid deterioration in health and subsequent death. Meningitis is an infection that causes the linings of the brain and spinal cord to swell, and it has symptoms similar to freshers’ flu:  a runny nose, headaches and high temperature. Unlike freshers’ flu, it can also involve light sensitivity and a stiff neck. If meningitis is suspected, immediately call the emergency services.