Share the Joy, Not the Sneeze
Lights are sparkling, trees are aglow, and friends and family are gathering for holiday parties. During this season of holiday cheer and celebration we see a lot of viral illnesses which lead dampened spirits and hampered plans. The spread of illnesses during the winter is driven primarily by the amount of time spent indoors near each other with less fresh air. Changes in our immune system during the colder season and being exposed to individuals we don’t normally spend time with can also contribute to sickness or new viral illnesses. It’s important to have a keen understanding of viral illnesses so we can all do our part to prevent their spread and facilitate treatment.
THE COMMON COLD
The common cold is a viral infection that includes symptoms such as stuffy-runny nose, scratchy-tickly throat, wet-hacking cough, and often a low-grade fever. Headache, fatigue, and sore muscles may also accompany the respiratory symptoms. The common cold causes inflammation of the membranes in the nose and mouth, which increases secretions that lead to runny nose and cough. The cold virus is spread through airborne droplets which are directly inhaled into the airway or introduced to the mucous membranes of the eyes, nose, or mouth or by touching contaminated surfaces. Symptoms usually start 2-3 days after the virus enters the body and may last several days. Symptomatic treatment includes rest, increased fluids, cool mist humidifier and warm steamy showers, as well as over-the-counter decongestants and antihistamines. Tylenol or Motrin may also be used as needed for headaches or fever. The cold virus does not respond to antibiotics or antiviral medications and they should not be prescribed for symptomatic treatment.
CROUP
Croup is a viral infection affecting the upper airways, usually of infants and children. The infection causes an obstruction of airflow and results in a barking cough associated with the illness. If the obstruction progresses enough, there may even be a harsh sound as air is drawn into the lungs through the narrowing of the airway – this sound is called stridor. If more obstruction occurs, labored breathing may develop resulting in retractions – a sucking in of the breastbone or skin between the ribs as the child struggles to take a breath. Croup is spread through respiratory droplets directly inhaled into the airway or introduced to the mucous membranes of the eyes, nose, or mouth by touching contaminated surfaces. While patients of any age may be infected, croup occurs most often in pediatric patients six months to three years of age. The smallness of their airways results in obstruction symptoms. In adults and older children, this virus may also lead to laryngitis (loss of voice or hoarseness with a sore throat). Treatment of croup is mainly symptomatic, however, if severe stridor or increased difficulty breathing develops, your child should see a physician immediately. Treatment with a corticosteroid may be recommended to decrease the inflammation and aid the obstruction of the airway.
THE FLU
Influenza, also known as the flu, is a viral infection that may affect the entire respiratory system including the nose, throat, airway, and lungs. Symptoms of the flu begin much like a cold with runny nose, sore throat, and cough. Flu symptoms often start suddenly with a high fever, while a cold develops more slowly and usually has a lower grade fever. The flu is also associated with severe fatigue, body aches, headache, and often vomiting and diarrhea (especially in children). There are multiple strains of the flu that circulate during flu season, and this often changes every year. The flu is generally transmitted from direct airway inhalation and less commonly from touching contaminated surfaces. A person exposed and infected with the flu will usually develop symptoms within two days. Those infected are most contagious during the first three to four days of the illness, even before symptoms have developed. The primary distinguishing factor between the common cold and the flu is the secondary complications that often follow infection with the flu. Bacterial pneumonia, ear infections, and sinus infections are common complications of the flu. In patients with underlying respiratory issues, progression to acute respiratory failure may occur. Annual flu vaccination is recommended by the CDC. The vaccination cannot cause the flu and while it is not 100% effective at preventing the illness, it does reduce severity and complications by bolstering the immune response. Antiviral therapies may also be used for treatment of the flu. Most commonly, Tamiflu is used to treat Influenza A; however, its benefits and side effects should be discussed with your physician.
RSV
Respiratory Syncytial Virus (RSV) is a respiratory virus that usually causes cold-like symptoms which last approximately 1-2 weeks. Individuals of any age may contract RSV and while most infections are mild, RSV can be a serious infection for infants and older adults. In fact, RSV is the most common cause of bronchiolitis (inflammation of the small airways of the lungs) and pneumonia in children younger than 1 year of age. RSV is a respiratory droplet-borne illness that transmits primarily through direct airway inhalation or contact with mucus membranes; however, the virus may also be transmitted by touching infected surfaces. Symptoms of RSV normally begin around five days from exposure and infection. A person infected with RSV is contagious for approximately five to seven days, however, symptoms of cough and congestion may extend up to two weeks. Prevention of RSV is mainly accomplished through limiting exposure of at-risk individuals (infants/elderly) to patients with respiratory symptoms. For premature infants with chronic lung disease, monthly antibody injections against RSV may help prevent or reduce the severity of the illness. Antibiotics are not useful in treating RSV infections. Occasionally, a physician may recommend an oral corticosteroid or albuterol inhaler for certain at-risk patients to aid in reducing inflammation of the airways and increase air movement in the lungs.
PREVENTION
For most patients the viral illnesses discussed are usually mild and self-limiting. However, it’s important to note there are thousands of individuals every year that die from the flu and RSV; and occasionally from the common cold and croup. The number-one factor in preventing illness and potentially death is acting responsibly when illness develops. If you or your child is sick and exhibiting symptoms, stay home and do not go to work or school. It’s vitally important to avoid exposure to young infants and elderly who are at a high risk of morbidity from these viruses. Finally, outside of secondary infection, antibiotics are not useful in treating viral respiratory illnesses and in fact, can be harmful by inducing resistant bacterial organisms from antibiotic overuse. If you are prescribed an antibiotic for a likely viral infection, ask the healthcare professional providing your care if that antibiotic is truly necessary.
Kendall Wagner, M.D. is a regular healthcare contributor to Do South® Magazine.
Chaffee Crossing Clinic
11300 Roberts Boulevard, Fort Smith, Arkansas
479.242.5910
chaffeecrossingclinic.com
