Just in time for the peak of cold and flu season, a Roper St. Francis Healthcare affiliated family medicine doctor shares how to decipher the chilly months’ most common maladies
By Stratton Lawrence
The “common cold” may be a misnomer—more than 200 distinct viruses can cause what we call a cold, bringing with them mucus buildup, sore throat, stuffy nose and fatigue. Flu, however, is always caused by one of three viruses and their sub-types. The congestion that accompanies each can sometimes lead to a third common condition: sinus infection, which can be either viral or bacterial
If you’ve already battled feeling crummy this season—or want to be ready to fight whatever may come your way—read on for how to identify the differences between these similar yet distinct illnesses, and how to best treat each.
According to research from Duke University, American adults experience an average of two to four cases of the common cold each year, contributing to 150 million lost workdays. A cold typically begins with a scratchy throat before settling into full-on cough and congestion by day four or five. Most colds run their course within 10 days.
Children are more susceptible to colds than adults, catching an annual average of six to eight. “Other than potentially running a mild fever—which isn’t common among adults with a cold—symptoms are pretty much the same for children,” explains Dr. Sarah Crickman, a Roper St. Francis Healthcare affiliated family medicine doctor. “Expect a runny nose, cough and an increase in irritability in young children.”
Because colds are viruses, antibiotics aren’t an effective treatment, stresses Dr. Crickman, who adds that a cold can typically be remedied at home. “We recommend drinking lots of fluids, getting rest and taking over-the-counter cold medications to ease your discomfort until symptoms pass.”
If you have a particularly intense cold, you may wonder if it’s the flu. But usually, “if you’ve got the flu, you know it,” says Dr. Crickman. “Flu has an abrupt onset—it hits you like a ton of bricks. All of a sudden you’re running a fever of 100 degrees or higher, your body aches and you have all the classic cold symptoms like a sore throat, runny nose and cough.”
In some cases, influenza can lead to complications like dehydration or even pneumonia, a potentially life-threatening infection in the lungs. Because of this, Dr. Crickman says it’s always wise to see a doctor if you suspect the flu.
For the average patient, treatment will be similar to that for a cold: rest, lots of fluid and over-the-counter medications to mitigate symptoms, which can last up to two weeks. Although flu does have an antiviral treatment, called Tamiflu, it’s rarely prescribed to healthy adults because it only shortens the course of the illness by about a day. However, it’s often used to treat those who are at higher risk for complications from the flu—including people 65 and older, pregnant women, young children (particularly babies under 2), diabetics and those with chronic respiratory, heart and immune system disorders.
If symptoms of pneumonia develop—a severe cough with greenish, yellow or even bloody mucus; shortness of breath; sharp or stabbing chest pain that worsens when you inhale deeply or cough; fever; and loss of appetite—seek care immediately.
If you’ve ever gotten sick, felt better then gotten sick again, there’s a good chance you’ve had a sinus infection. When sinuses get clogged with mucus and are unable to drain properly—as can be the case when you have a cold or the flu—both viral and bacterial infections can fester, causing prolonged symptoms as well as headaches and pain and pressure in the face. (Sinus infections are also common in the spring and fall, when allergies can lead to mucus buildup).
“Most sinus infections are viral. Doctors need more information about duration and fluctuation of symptoms to determine if a sinus infection is bacterial in nature,” explains Dr. Crickman. “If a patient has already been ill for more than a week and experiences a worsening of symptoms or facial pressure, they may have developed a bacterial sinus infection, which would require antibiotics.” If left untreated, certain infections could lead to rare but more serious conditions such as meningitis, so see your doctor if symptoms worsen or don’t resolve within seven to 10 days.
Dr. Crickman is quick to dispel one myth: Green snot automatically calls for antibiotics. “I hear all the time, ‘My snot is green, so I know that I need antibiotics.’ While that’s the case when we’re dealing with a bacterial sinus infection, it’s not a rule. Viral infections can cause yellow or green snot, as well.”
Past being plain unpleasant, the viruses that cause colds and flu are highly contagious through air and touch. So wash your hands frequently, cover your mouth when you cough and, if you are feeling sick, stay home. The extra work day one person misses can save dozens of other people from missing time too.
Is your sick baby tugging at his ear? Because of their undeveloped immune system and anatomy, babies between 6 months and 2 years are prone to ear infections, which occur when fluid caused by a cold, sinus infection or allergies builds up in the ear canal and harbors a bacterial infection. Symptoms include ear pain (your baby may tug on their earlobe), difficulty sleeping, unusual fussiness and fever. Make an appointment with the pediatrician if symptoms arise.
Sore throat … or strep throat? Strep throat, an infection caused by streptococcus bacteria, is most common among children ages 5 to 15. Telltale symptoms include pain swallowing; tonsils that are red, swollen or have white patches on them; and a severe sore throat that lasts more than 48 hours. Symptoms warrant a trip to the doctor; there, he or she will test for the bacteria and may prescribe antibiotics (though not all cases of strep require them).
Protect & Prevent
Dr. Crickman shares how to stave off these common illnesses
Common cold & flu:
1. Avoid people who are coughing and sneezing as much as possible because many viruses are airborne. And if you’re the one hacking, stay home until your symptoms pass.
2. Wash your hands often with soap and warm water, scrubbing for at least 20 seconds (or about the time it takes to sing “Happy Birthday” twice).
3. Use antibacterial wipes to clean tables, counters and other surfaces (like the grocery cart) when out and about.
Flu: Get the flu vaccine. Despite press about the 2018 flu shot being ineffective against the H3N2 strain of influenza, the vaccine still saved lives and prevented countless cases of flu across the country. “There’s some thought that even if the flu shot doesn’t prevent all flu, it makes symptoms less severe,” says Dr. Crickman. “That can be very important for people with chronic medical problems, who are pregnant and others who are at higher risk for complications.”
Sinus Infection: Using decongestants and manual flushes like saline solution in a neti pot during a cold can’t always prevent a bacterial sinus infection, but it can help. “Anything that loosens up mucus and keeps your sinuses flowing will help relieve the stagnant backup that can foster an infection,” says Dr. Crickman.
Need to see a doctor right away? Roper St. Francis Express Care has locations around the Lowcountry and Roper St. Francis Virtual Care is available 24/7 at rsfh.com/virtualcare.