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    COLD or FLU Why the Difference Matters

    COLD or FLU Why the Difference Matters

    Cough, congestion, body aches, fever. These are some of the most common symptoms seen in primary and urgent care offices, especially in the so-called “cold and flu season” of the winter months. Patients young and old feel miserable, but wonder if they should even make the expensive, time consuming and often less than productive visit to the doctor. Here are some key markers to distinguish between a regular cold or the influenza virus, and tips to prepare for the season ahead. 

    The Common Cold 

    Viruses are microscopic infectious organisms that are generally very contagious. There isn’t just one virus that causes the common cold, but rather an entire group such as rhinovirus, coronavirus, adenovirus, and metapneumovirus. Such viruses are associated with a variety of symptoms like runny nose, congestion, cough, sneezing, fever and body aches. To date, medical science has produced very limited treatment options for colds. Most over-the-counter medications have, at best, modest effects on symptoms. Antibiotics don’t treat colds and vaccines to prevent the cold don’t exist. Luckily, for us, our immune system is our greatest defense against the common cold. 

    A typical cold will last on average three to 10 days. The majority of the symptoms are actually not caused by the infection itself, but rather our body’s immune system trying get rid of it. Most cold viruses will go away if we are patient and give our bodies time to fight them. Secondary bacterial infections are possible, such as ear infections, sinus infections and pneumonia. These are usually the culprits when someone with a cold abruptly gets worse or remains sick beyond the typical 10 days of a regular cold. At this point, an antibiotic can be helpful and it may be time to see your physician. 

    Influenza 

    In contrast, there are some viruses like influenza that are much more aggressive and even fatal. Influenza, or flu, is generally characterized by a sudden onset of high fever (102 to 103 F), body aches and cough. Flu can cause all of the same symptoms as cold viruses, but typically to a much greater degree. Flu is a truly miserable experience for anyone who contracts this illness. Similar to cold viruses, there isn’t a cure. Different from cold viruses, there are options for treatment and prevention. Flu is an often misunderstood illness. Here are five ways to understand the flu a little better. 

    1. FLU DOES NOT CAUSE VOMITING & DIARRHEA 

    Influenza is a respiratory illness. Although people can have vomiting and diarrhea, this is neither typical nor common. This common misconception can lead people to misunderstand what flu is really like, when to seek care, and what flu vaccination prevents. Acute vomiting and diarrhea is frequently caused by a virus, but it’s not the flu virus. 

    2. FLU CAN BE FATAL 

    Estimates of annual flu-associated deaths in the United States since 1976 range from a low of about 3,000 people in 1986-87 to a high of about 49,000 people in 2003-04, according to the Centers for Disease Control and Prevention (CDC). Certain people are at higher risk for complications from flu including older people, infants, children, pregnant women and people with chronic medical problems (heart disease, asthma, diabetes, etc.). However, it is possible for people in great health to get flu and end up very sick, hospitalized, and possibly pass away within a matter of days. This is tragic. Flu is a serious illness that deserves the attention we give it each year. 

    3. Flu Is Preventable 

    Vaccination is the best way to way to prevent flu. Each year, vaccines are produced to protect against three to four flu virus strains, based on previous years, previous epidemics and what the CDC predicts will be active. Annual vaccination is necessary because flu virus is remarkable for its high rates of mutation, making it difficult for our immune systems to protect against new variants. 

    Vaccines are available in different forms, including shots and nasal sprays. Selecting the vaccine that is best for you is something to discuss with your physician. Vaccination is recommended for anyone age 6 months and older. Vaccines typically become available in October, and early vaccination is recommended to allow your body time to produce immunity prior to flu outbreaks. Vaccination is effective. It is estimated to reduce mortality by 41 percent (as high as 75 percent reduction for those previously vaccinated, but as low as 9 percent for those being vaccinated for the first time). 

    The most common reasons patients decline to be vaccinated are 1) “I never get the flu,” and 2) “The flu vaccine makes me sick.” To the first point, flu can affect anyone, even if a patient has been lucky so far. To the second, post-vaccine symptoms are actually an immune response, showing that they are producing immunity to the virus, and thus will be protected. This response is generally much less than they would experience if they actually got sick. 

    4. TREATMENT IS AVAILABLE 

    As mentioned above, doctors don’t have any good treatments for cold viruses. We do, however, have a few anti-virals that are useful for influenza. Tamiflu (oseltamivir) and Relenza (zanamivir) are recommended for severe infections (hospitalization, pneumonia), individuals at high-risk of complications, and others deemed appropriate by physicians. Treatment must be initiated within 48 hours of symptom onset to be effective. Although these are not curative drugs, their use has been shown to reduce duration, severity and complications of influenza. If you think you have the flu, seek care early. 

    5. FLU IS HIGHLY CONTAGIOUS 

    We don’t really know why flu comes back each winter, year after year. It typically starts abruptly, peaking within 2-3 weeks, but then lingers for a few months. We do know that the virus is carried in respiratory secretions, and spread by things like coughing and sneezing. Close contact, less than 6 feet, is usually required, but viruses can live on skin and other surfaces and spread through contact with these. People are thought to be contagious one day before and up to five days after symptoms start. Flu is very contagious. If you get sick, seek care, but otherwise, stay home. Frequent hand washing and covering your mouth while coughing or sneezing is necessary to reduce spread of this pesky virus. 

    Please remember, cold and flu season is coming. The time to get ready is now. Colds are generally mild, require little to no treatment, and go away with the help of our miraculous immune system. Flu is a more serious respiratory viral infection for which there are preventative and treatment options available. Get vaccinated, but if you get the flu, see your doctor to discuss testing and treatment.