Beware – It’s Cold & Flu Season

Written by: Dr. David Bloom

Yes we’re in the middle of the notorious time when we are surrounded by so many ill people.  And now it is pretty common knowledge that hand washing with soap and water or at least a fair scrub with anti-bacterial gel can reduce your chance of getting infected.  (And don’t forget about keeping hydrated, exercising, avoiding the ill when possible, and getting a flu vaccine).

But what should you do when symptoms begin?  Fortunately our patients know they can easily contact one of our personal concierge physicians for the most specific advice.  Still, it is good to know that the most common infections, although annoying, are relatively benign.  These consist of the hundreds of cold viruses that are very contagious, and amazingly can produce a wide variety of symptoms.  In fact, this is often a big clue that a virus has taken hold – you develop symptoms in more than one area (lungs, sinus, nose, stomach, intestine, throat, ears, skin, and/or eyes).  And within the first few days, the virus is usually more annoying as the symptoms seem to move from one site to the next.   Plus, you will likely guess correctly when you have a virus since these make up nearly 90% of seasonal bronchitis, sinusitis, ear infections, etc.  On average, a virus tends to run its course in about 7 days and you guessed it – antibiotics won’t help that. 

On the other hand, bacteria tend to stick with predominantly one area (such as only the throat with a Strep infection).   Bacteria also tend to worsen with time, especially after the 4th or 5th day of an infection (while the viral colds tend to begin to improve by then).  These conditions may be treated with an appropriate antibiotic – but remember that only about 1 in 10 colds is truly caused by a bacteria.

Finally, it is important to note that the “king” of viruses is the flu.  Although influenza is caused by hundreds of different flu viruses, the flu tends to hit much harder and almost all of the body areas at once.  In fact, body/muscle aches are much more common with a flu infection than with the non-flu viruses mentioned above.  Also, the flu is almost always accompanied by a fever with chills, a dry cough, and a very noticeable headache.  Patients should consider calling their doctor for an anti-flu medication such as Tamilflu if their symptoms fit for the flu and they are at risk for complications (the CDC recommends avoiding anti-viral meds in healthy people if not at risk).  The tricky part is that for this medication to work, it needs to be started within the first 48 hours.

Now back to the most common troublemaker, the viral infection.  Although antibiotics (even the famous Z-pak) are not helpful, there are many ways to treat the symptoms.  One may choose salt water gargles, over-the-counter medications, vitamin C, proper hydration with good fluid intake, rest, and so on depending upon which symptoms he or she has.  There are even very helpful prescription products such as nasal steroids, antihistamines/decongestants, and narcotic cough syrups. 

Recently, studies are now discrediting any help from the previously recommended Echinacea.  Although no longer proven to be beneficial, it has not been found to be harmful and still may help some patients.

Finally, when you or a loved one gets infected, watch for the development of any serious signs, even if you have already been examined recently.  These include shortness of breath, chest pain, dehydration, fainting, mental status changes, etc.  Also, one must be even more cautious when the sick person is a child, elderly, or has a serious underlying health condition.  Then the phone call and doctor visit is mandatory – and you would have wished you had just washed your hands more often.