Flu-like Symptoms Following a Dive

I have been a certified diver since 1976. Over the past three years I have developed a condition related to diving: within two to four hours of my last dive on the first day of diving, I usually develop flu-like symptoms, including malaise, chills and fever.

Although I don't experience other symptoms such as headache, trouble breathing or neurological symptoms, I do get a vague sense of irritation in my lungs and sometimes a dry cough. By the next day I am usually better. I have had a normal chest X-ray, EKG and blood chemistries, but no diagnosis has been made. Can you help?

This malady has several possible explanations. Compressed gas breathing may result in pulmonary barotrauma; saltwater aspiration, directly or through a poorly functioning regulator, may also cause these symptoms. Mild decompression illness (DCI) can cause fatigue, but usually not chills and fever. This could be a condition that existed prior to the dive and coincidentally manifested itself afterwards (flu, perhaps). It is possible that breathing air under pressure may spread microorganisms from the breathing apparatus into the lungs. This was described in "Proceedings of the Eighth Symposium on Underwater Physiology," A.J. Bachrach and M.M. Matzen, editors, Undersea Medical Society, Bethesda, 1984, pp. 113-180.

This condition could possibly be prevented by routine regulator maintenance and cleaning. DAN's records show similarities in calls concerning these otherwise unexplainable symptoms; and although this information is anecdotal, it deserves investigation. Unfortunately, most callers did not seek a medical evaluation while they were symptomatic, and reported symptoms after they had resolved. In each case the diver experienced flu-like symptoms within hours of the dive. This was always immediately after the first dive day or first dives in a series. Symptoms all resolved within 48 hours, many times within 24 hours.The limited calls to DAN do not indicate that this is a widespread problem, but DAN needs more information on this malady and its relationship to diving. Post-dive symptoms must be carefully considered; continuing to dive with symptoms could cause additional problems. DAN always recommends that you be examined by a physician or other healthcare professional. The possibility of decompression sickness must always be included in a differential diagnosis when a medical complaint is raised following a dive.