A few weeks ago at church, I witnessed a cultural shift within the congregation. During our morning meet-and-greet portion of the service, the pastor encouraged parishioners to do fist bumps instead of our traditional hand shake, hug or kiss. He cautioned us about spreading germs during this cold and flu season. We even had hand sanitizer strategically placed throughout the building. And I must admit that it was pretty adorable to see the elders of the church bumping fists!
So far this year my office schedule is full of adults and children with this horrible virus that is going around. Patients are coming in with high fevers, coughs, chills and sore muscles. Not all of these are influenza infections. However, some are indeed the dreaded “flu.”
I wanted to spend a little time clarifying the difference between “a cold” versus “the flu.” I hear a lot of people claiming they had “the flu” but in actuality they probably had any number of other viruses. In a study of preschool aged children in Australia, picornovirus made up 50 percent of the viruses seen with the next highest prevalence seen by adenovirus. The most common virus in adults is rhinovirus.
Rhinovirus is transmitted via small and large particle aerosol and hand contamination. Your colleague coughs but forgets to cover his mouth. The infected droplets from his respiratory tract get on the phone that you share as well as travel through the air. You then touch the phone and later self-inoculate yourself by touching your mouth. It is also important to know that viruses can last two hours to seven days on inanimate objects. In a 2002 study of 1,100 airplane passengers, 20 percent reported a cold five to seven days after their flight.
The common cold or upper respiratory infection causes symptoms such as runny nose, cough, nasal congestion, and sometimes mild fever. Symptoms typically peak at day three or four and begin to resolve around day seven. However, symptoms can last 10 days to rarely three weeks.
Now in my experience, it is usually at day four when patients start demanding antibiotics. It is very difficult for patients to accept that there are no medicines that I can prescribe that will eradicate the virus. Antibiotics treat bacterial infections, not viruses. Nevertheless, there are medications such as nasal sprays and decongestants to treat some of the symptoms. In addition, rest, fluids, and fever-reducing medications such as acetaminophen and ibuprofen are also beneficial.
In contrast, influenza has a much more dramatic constellation of symptoms and presentations. Influenza is contracted in similar ways as the other less virulent viruses. However, patients are far sicker: higher fevers, greater fatigue, and severe muscle pain. Patients often report feeling like “they have been hit by a Mack truck.” I can usually just walk in the exam room and make this diagnosis by just looking at the patient. These patients look ill. These patients are sprawled out over the table and barely have enough strength to sit upright.
Each year there are approximately 30,000 deaths related to influenza. Young children and the elderly are the most vulnerable. It is not uncommon for persons infected with influenza to also have a superimposed pneumonia as well. The pneumonia is a result of fluid secretions accumulating in the lungs and that fluid becoming infected with bacteria. This viral/bacterial duo increases morbidity and mortality and often many of these patients need hospitalization which may include an intensive care unit admission.
Treatment for influenza and other viruses is essentially the same. However, if influenza is confirmed within the first 48 hours of symptoms, a medication called Tamiflu can be prescribed. Tamiflu does not “cure” the flu. Tamiflu simply lessons the duration of the illness and symptoms may or may not be as severe. It is also important for the household contacts of the person infected with influenza to also receive a prophylactic dose of Tamiflu to prevent acquiring the virus. But this must also be given within 72 hours.
So during this cold and flu season, please adhere to these guidelines to stay healthy:
- Cover your mouth when you sneeze/cough; use the crook of your arm
- Wash hands often; use hand sanitizer liberally
- After washing hands, use a clean paper towel to turn off faucet and to open doors
- Keep your immune system healthy by eating 5 to 9 servings of fruits/veggies daily
- If you have a fever or flu-like symptoms, please stay home from work or school
- Get your flu vaccine; It does not give you “the flu”
Take home point this week: Not every runny nose and body ache is “the flu.”
Yours in Service,
Denise Hooks-Anderson, M.D.
Assistant Professor
SLUCare Family Medicine
yourhealthmatters@stlamerican.com
