Every year, more than half a million students arrive at university across the UK. The transition can be thrilling – but for many, it also brings aching muscles, exhaustion and a pounding head. Not a hangover. “Freshers’ flu.”
As a long-time student and teaching assistant, I know freshers’ flu well. But as a former public health employee, and someone nearing the end of a PhD on student health, I have also noticed how consistently it gets dismissed – by students and staff alike. Despite growing awareness of circulating illness since the Covid-19 pandemic, freshers’ flu remains largely unaccounted for in higher education policy and practice.
That is a problem, because it risks further disadvantaging marginalised students, not least through the exacerbation of chronic illness symptoms. What it means for students marginalised in other ways is even less understood – because the research simply is not there yet.
A pocket full of posies
Freshers’ flu is not one illness, but a catch-all term for the cold-like bugs that hit many students soon after term begins, likely spread by the sudden mixing of germs between people from different places. Despite the name, it is not just a first-year problem: later-year students and unlucky staff catch it too, and it can crop up throughout the year, though autumn and winter, when illness circulates more freely, tend to hit hardest. There is no cure. The Department for Education’s 2021 guidance recommends rest, hydration, staying away from others while ill and good hygiene to avoid catching it in the first place.
A 2023 publication of historical data from Cambridge students suggests growing interest in circulating illness on campus. But despite calls for more attention – a 2015 piece in The Conversation among them – freshers’ flu remains under-researched and under-appreciated. My view is that this stems from how freshers’ flu is treated as inevitable, a rite of passage, tangled up with popular ideas about “unhealthy” student habits, combined with a broader tendency to conceal infection under social and academic pressure, as research in 2014 found.
The equity issue
This piece does not offer new biological explanations of freshers’ flu. Instead, it looks at what happens when freshers’ flu is treated as a foregone conclusion. My argument is that widely accepting freshers’ flu as normal amounts to a form of institutional invisibilisation of marginalised students, particularly those with long-term health conditions.
My research found that freshers’ flu occupied real headspace for students with long-term conditions, wary of a new “germ ecosystem of colds”, as one participant put it. Several described needing to avoid getting “too rundown, too vulnerable”, especially where their condition involved immune system dysregulation.
Their fears were often realised. Catching freshers’ flu was understood to trigger a worsening of condition-related symptoms, including increased fainting, and hospitalisation in extreme cases. Having a long-term condition also seemed to make freshers’ flu harder to shake off – one student described being ill for “probably eight weeks”, a length of time that was hard to recover from, both socially and academically. Recovery was complicated by practical barriers too: difficulty swallowing pills linked to chronic pain, or a sore throat interfering with inhaler use.
Some students felt what they were going through was “the same as everybody”. Rather than a reason to dismiss freshers’ flu, I would argue that this attitude – held even by students at greater risk – reflects a troubling level of acceptance, with real consequences. The idea of freshers’ flu as inevitable led some students to wrongly attribute flare-ups to infection, delaying help-seeking.
While not the focus of my research, participants’ experiences hint at challenges facing other marginalised groups. Neurodivergent and D/deaf students, who may process sensory input differently, could struggle in lecture halls filled with coughing – one student described being brought to tears by the noise.
Beyond sensory and health differences, what happens when a student who needs paid work to afford university misses a shift while bedridden – will their employer be sympathetic, or assume a hangover? What about students with caring responsibilities, whose illness reaches beyond campus? Do international students, whose families cannot easily make an emergency visit or send a care package, suffer disproportionately when they fall ill so far from home? Do estranged students, without parental support to fall back on, feel more isolated when sick? Do students facing financial hardship face extra pressure when the cost of over-the-counter medication, or a trip home to recover, is prohibitive?
My as-yet unpublished findings point to some hard truths here, and I would urge others to pick up these questions in their own research and practice.
A tissue! A tissue! We all fall down
Because freshers’ flu affects students directly, it inevitably affects universities too. High levels of illness restrict academic engagement and drive poorer outcomes. Sickness among students and staff piles extra pressure onto already-stretched professional services. And universities are increasingly alert to the impact of poor mental health, which is likely worsened when students are also physically unwell. Freshers’ flu, then, is not just a problem for students and student-facing staff, some of whom are themselves vulnerable to infection – it is a problem for the whole sector.
Higher education researchers and practitioners should revisit freshers’ flu as a genuine equality, diversity and inclusion issue, addressing it explicitly in sickness and absence policies, and committing to better support for students who fall ill. Streamlining self-certification, through example wording or pre-filled forms for freshers’ flu scenarios, would ease the administrative burden on marginalised students during an already difficult transition. Ventilating physical spaces gained traction during the pandemic, but controlling infection through building design remains a real challenge, particularly in older estates, and needs addressing.
Raising awareness of freshers’ flu, and how to talk about it, through sector and university-level campaigns championed by students’ unions, could make a genuine difference – including being clear about what freshers’ flu is not. Meningitis, for example, can resemble freshers’ flu but, as recent outbreaks have shown, carries deadly risk. Any information shared should account for cultural differences in how people understand health and illness.
Ultimately, teaching structures are not built to accommodate illness. Fixed timetables make it easy to fall behind, and the lack of any mitigation for freshers’ flu disproportionately affects students for whom “temporary” infection has long-lasting consequences. Universities should consider reduced timetables and online attendance options early in the term – cutting the spread of infection while limiting what unwell students miss. Beyond freshers’ flu, a more flexible start to the academic year would smooth the sharp transition from home to university, with benefits well beyond illness alone.
Any of these measures would help build what is really needed: a sector-wide shift in attitude towards freshers’ flu. Students and staff should not have to accept the status quo. What could you do to make a change?
