(VAERS filed) in OCT 1986, he was in his usual state of excellent health and felt well on the day of vaccine receipt. He does not recall any symptoms of recent respiratory or gastrointestinal infections. To the best of his recollection, the flu vaccine was the only vaccine that he received on that day. He had typically received flu vaccines annually and had experienced mild, flu-like symptoms post-vaccination, but not after every flu vaccine; with previous reactions, his symptoms usually never lasted more than a few days. In 1986, pt does not recall any significant swelling, redness, tenderness, or itching at vaccination site. Pt also denies symptoms consistent with a hypersensitivity reaction following vaccine receipt-no flushing, itching, dyspnea, hives, facial swelling, and itching or swelling of throat and/or tongue within the 1st 48 hours of vaccine receipt. Pt's reaction began approximately 2-5 days after vaccine receipt when he began feeling feverish (his wife checked his temperature, and while he does not recall specifics, he knows it was elevated > 100 degrees) and he was shivering. He also experienced severe headaches, fatigue (describes overall energy level at that time as 30% of his baseline (100%), runny nose, and a dry, hacking cough. The day after symptom onset, when he awoke, he felt even worse and went on Sick Call. He was given a cold pack and placed on qtrs x2-3 days, and then he stayed in bed through the subsequent weekend. In addition to the cold pack, he used a vaporizer at home for 1 week, but did not think it helped. The following Monday (approximately 1 week post-vaccination), his symptoms continued with the same intensity, except his fever, chills, and runny nose had improved, while his coughing episodes had increased. When he went on sick call again, he was placed on qtrs again x1 week. His sxs continued another 10 days, except the fevers, chills, and runny nose resolved during this time frame. His cough was triggered anytime he tried to exert himself and remained unproductive. His headaches continued to be "severe", but over the next 2 weeks, improved. His cough, however, continued approximately 5-6 weeks post vaccination. By this time, pt had been back to work for a couple of weeks. He thought he might gradually regain his energy and stamina if he resumed running; after jogging 1 mile, he felt okay, but at the end of the run, he describes himself as "incapacitated...coughing for twenty minutes straight". A couple of days later, he tried running again and experienced a similar episode. Over the next month, this continued, with improvement of fatigue and coughing only after exertion, especially after running. After another month, he was no longer coughing at the end of his runs and he was feeling like he was almost back to his baseline. Pt's sxs did not recur until around OCT 1987. He was in another state and had not received the flu vaccine, but reports he experienced fatigue and a dry, hacking cough, associated with exertion. He did not experience fevers and chills, and he did not experience severe headaches, but may have experienced intermittent, moderate headaches. He rested for 3 days after onset and felt better, except the cough persisted. Just as with the previous year, patient gradually resumed running and experienced severe coughing episodes upon completion. This gradually improved over a 6-week period before resolving. Around the end of OCT or beginning of NOV 1988, while in another country, pt's cough returned, and was once again associated with exertion, and persisted about 3-4 weeks. He had not received a flu vaccine in 1988 prior to the return of his cough. His coughing episodes have not recurred since 1988. Between OCT 1986 and NOV 1988, patient did not seek additional medical evaluations of his symptoms beyond his initial visits to Sick Call.