Colds and the Flu

Overview

What is the common cold and the flu?

The common cold and the flu are viral infections of the respiratory tract, which includes the throat, nose, airways and lungs.

Symptoms

How can I tell if I have a cold or the flu?

Although the common cold and the flu share many similar symptoms, they are 2 different conditions.

The symptoms of a cold develop slowly and can include:

  • Fever up to 102°F
  • Runny or stuffy nose (often with green- or yellow-colored discharge)
  • Sore throat
  • Cough
  • Sneezing
  • Fatigue
  • Muscle aches
  • Headache
  • Watery eyes

Cold symptoms generally are milder than flu symptoms.

Flu symptoms usually appear suddenly and can include:

  • Fever over 102°F
  • Stuffy nose
  • Nausea
  • Chills and sweats
  • Fatigue
  • Muscle aches, especially in your back, arms and legs
  • Cough
  • Headache
  • Loss of appetite

Should I call my doctor?

In most cases, you don’t need to see your doctor when you have a cold or the flu. However, if you have any of the symptoms in the box below, call your doctor.

Call your doctor if you have these cold and flu symptoms:

In children:

  • High fever (above 103°F), or a fever that lasts for more than 3 days
  • Symptoms that last for more than 10 days
  • Trouble breathing, fast breathing or wheezing
  • Bluish skin color
  • Earache or drainage from the ear
  • Changes in mental state (such as not waking up, irritability or seizures)
  • Flu-like symptoms that improve, but return with a fever and a worse cough
  • Worsening of a chronic medical condition (such as diabetes or heart disease)
  • Vomiting or abdominal pain

In adults:

  • A high, prolonged fever (above 102°F) with fatigue and body aches
  • Symptoms that last for more than 10 days or get worse instead of better
  • Trouble breathing or shortness of breath
  • Pain or pressure in the chest
  • Fainting or feeling like you are about to faint
  • Confusion or disorientation
  • Severe or persistent vomiting
  • Severe sinus pain in your face or forehead
  • Very swollen glands in the neck or jaw

Causes & Risk Factors

What causes colds and the flu?

Viruses cause colds and the flu. More than 200 different viruses can cause colds. Not as many viruses cause the flu. That’s why there’s a shot available for the flu and not for colds.

Prevention

Can I prevent catching a cold or the flu?

You can reduce your risk of catching a cold or the flu by washing your hands frequently, which stops the spread of germs. Eating healthy, exercising and getting enough sleep also play a part in preventing colds and the flu because they help boost your immune system.

Cough and sneeze into the inside of your elbow (rather than into your hand). Clean common surfaces such as table and counter tops, your child’s toys, door handles and bathroom facilities with anti-bacterial disinfectant. This can help stop the spread of germs.

The best way to avoid getting the flu is to get the influenza vaccine. You should get the vaccine when it becomes available each fall (in October or November), but you can also get it any time throughout the flu season (into December, January and beyond). The vaccine is available by shot or by nasal spray. The vaccines work by exposing your immune system to the flu virus. Your body will build up antibodies to the virus to protect you from getting the flu. The flu shot contains dead viruses. The flu shot is safe for adults and all children 6 months of age and older, and it is strongly recommended that all children 6 months of age to 59 months of age get a yearly flu shot. The nasal-spray vaccine contains live but weakened viruses. It is safe for adults and all children 2 years of age and older who do not have asthma or breathing problems. You cannot get the flu from the flu shot or the nasal-spray vaccine.

Some people who get the vaccine will still get the flu, but they will usually get a milder case than people who aren’t vaccinated. The vaccine is especially recommended for people who are more likely to get really sick from flu-related complications.

Treatment

What can I do to feel better?

There’s no cure for the common cold. All you can do to feel better is treat your symptoms while your body fights off the virus.

For the flu, your doctor will probably recommend that you treat the symptoms until you feel better. In severe cases, your doctor may prescribe an antiviral medicine. Antiviral medicines can shorten the length of time you are sick with the flu. These medicines come as pills, syrup or in an inhaler. The inhaled type may cause problems for some people who have asthma or chronic obstructive pulmonary disease (COPD).

What medicines can I give my child?

There is no cure for the cold or the flu, and antibiotics do not work against the viruses that cause colds and the flu.

Pain relievers such as acetaminophen (one brand: Children’s Tylenol) can help ease the pain of headaches, muscle aches and sore throats as well as treat fevers. Be sure you are giving your child the correct dose according to his or her age and weight.

Nasal sprays and decongestants are not recommended for young children, as they may cause side effects. Cough and cold medicines are not recommended for children, especially those younger than 2 years of age. There is also little evidence that cough and cold medicines and nasal decongestants are effective in treating children.

To treat a cold or the flu, make sure that your child rests and drinks plenty of fluids. You can use a humidifier to help moisten the air in your child’s bedroom. This will help with nasal congestion. You can also use a saline nasal spray to thin nasal mucus, and a bulb syringe to suction mucus out of your baby or child’s nose.

What over-the-counter medicines can I take for a cold or the flu?

Over-the-counter medicines cannot cure a cold or the flu. Medicine can, however, help relieve some of your cold or flu symptoms. Check with your doctor before giving any medicine to children.

Many cold and flu products are available without a prescription.

Respiratory Infections During Pregnancy

What is a viral respiratory infection?

A viral respiratory infection is a contagious illness that can affect your respiratory tract (breathing) and cause other symptoms. The flu and the common cold are examples of viral respiratory infections. Other examples of respiratory viruses are:

  • Chickenpox (varicella)
  • Fifth disease
  • Cytomegalovirus (say: “si-to-meg-ah-low-vi-russ”)
  • Rubella (also called German measles)

What if I’m exposed to a viral respiratory infection when I’m pregnant?

Pregnant women can be exposed to people with viral infections at work and at home. Most of the time, the woman doesn’t get infected. Even if she does, most viruses won’t hurt her baby. However, some viruses can cause miscarriage or birth defects in the baby.

If you’re exposed to a person who has chickenpox, fifth disease, cytomegalovirus or rubella while you’re pregnant, you should tell your doctor right away. Your doctor will want to know how much contact you’ve had with the infected person.

Here are some questions your doctor may ask you:

  • Did you touch or kiss the infected person
  • How long were you in contact with the infected person?
  • When did the infected person get sick?
  • Did a doctor diagnose the infected person’s illness? Were any tests done?

What should I do if I’m exposed to chickenpox?

Chickenpox is caused by the varicella virus and is highly contagious. It can be serious during pregnancy. Sometimes, chickenpox can cause birth defects. If you’ve had chickenpox in the past, it is unlikely you will catch it again and your baby will be fine. If you have not had chickenpox or if you’re not sure, you should see your doctor right away. Your doctor will test your blood to see if you are immune.

Many people who don’t remember having chickenpox are immune anyway. If your blood test shows that you’re not immune, you can take medicines to make your illness less severe and possibly help protect your baby from chickenpox.

What should I do if I’m exposed to fifth disease?

Fifth disease is a common virus in children. Half of all adults are susceptible to fifth disease and can catch it from children.

Children who have fifth disease usually develop a rash on their body and have cold-like symptoms. They may have red cheeks that look like they’ve been slapped or pinched. Adults who get fifth disease don’t usually have the “slapped cheek” rash. Adults who contract fifth disease usually have very sore joints.

If you get fifth disease early in your pregnancy, you could have a miscarriage. Fifth disease can also cause birth defects in your baby (such as severe anemia). If you’re exposed to fifth disease, call your doctor. Your doctor may have you take a blood test to see if you’re immune. You may also need an ultrasound exam to see if the baby has been infected.

What if I’m exposed to cytomegalovirus?

Cytomegalovirus usually doesn’t cause any symptoms, so you probably won’t know if you have it. It’s the most common infection that can be passed from mother to baby. Cytomegalovirus affects 1 of every 100 pregnant women. It can cause birth defects (such as hearing loss, development disabilities or even death of the fetus).

It’s important to prevent cytomegalovirus because there’s no way to treat it. Women who work in day care centers and in a health care setting have the highest risk of getting infected. Pregnant women with these jobs should wash their hands after handling diapers and avoid nuzzling or kissing the babies. If you think you’ve been exposed to a person who has cytomegalovirus, you should see your doctor right away.

What if I’m exposed to rubella (German measles)?

Since 1969, almost all children have had the rubella vaccine, so it is a rare disease today. At the first prenatal visit, all pregnant women should be tested to see if they’re immune to rubella. Women who are not immune to rubella should get the vaccine after the baby is born. It’s even better to be tested before you get pregnant, so that you can get the vaccine if you need it.

If you’re exposed to rubella when you’re pregnant and are not immune, severe birth defects or death of the fetus can occur. Symptoms of rubella in adults are typically joint pain and occasionally an ear infection. Talk to your doctor if you are experiencing these symptoms.

What if I’m exposed to influenza?

Influenza hardly ever causes birth defects. It can be more serious for the mother if she gets the flu while pregnant. You might get very sick. If you’ll be pregnant during the flu season (from October through March), you should get a flu shot in the fall.

A note about vaccines

Sometimes the amount of a certain vaccine cannot keep up with the number of people who need it. Read here about vaccine shortages.

What about other viral infections?

Most other respiratory viruses (such as regular measles, mumps, roseola, mononucleosis [“mono”] and bronchiolitis) don’t seem to increase the normal risk for birth defects. In normal pregnancies, the risk of serious birth defects is only 2% to 3%. To protect yourself from all infectious viruses, wash your hands frequently (especially after using the restroom or before a meal).

H1N1 Influenza

What is H1N1 influenza?

H1N1 influenza (also known as swine flu) is an infection caused by a virus. H1N1 flu began to occur in the United States in spring 2009. At first, the infection was called swine flu because early tests showed that the virus was like flu viruses that occur in swine (pigs). H1N1 affects humans.

How is H1N1 flu different from seasonal flu?

H1N1 flu is like the seasonal flu in that both infections are caused by viruses.

H1N1 flu is more common in people younger than age 25. Seasonal flu tends to infect people 65 years of age and older.

H1N1 flu also is active earlier in the year. It began to appear in the spring of 2009. Seasonal flu occurs later in the winter, with December, January and February being peak months.

Can I catch H1N1 by eating pork?

No, the H1N1 virus is not spread by eating pork or pork products.

What are the symptoms of H1N1 flu?

Symptoms start 3 to 5 days after you have been exposed to the virus and last about 8 days. Symptoms may include:

  • Fever
  • Sore throat
  • Cough
  • Muscle aches
  • Headache
  • Chills
  • Fatigue
  • Runny or stuffy nose
  • Vomiting
  • Diarrhea

Who should get the H1N1 vaccine?

There are 2 types of flu vaccine. The trivalent flu vaccine protects against the 3 strains of flu that are expected to be the most common this flu season. The quadrivalent vaccine protects against 4 strains. The flu vaccine has protected against H1N1 since 2010, and the 2014-2015 flu shot will also protect against H1N1.

The Centers for Disease Control and Prevention recommends that anyone 6 months of age or older receive the flu vaccine, especially groups at higher risk of complications from flu. These include:

  • Pregnant women
  • People who live with or take care of children younger than 6 months of age
  • People who work in health care or emergency services
  • Children and young adults between 6 months and 24 years of age
  • People between 25 and 64 years of age who are at risk of having complications from the H1N1 virus, such as people who have weak immune systems or chronic health problems like asthma or heart disease

Is the vaccine safe?

Yes, the seasonal flu vaccine that also protects against H1N1 is considered very safe. Rarely, some people may have an allergic reaction to the vaccine. Tell your doctor if you have ever have had a reaction after receiving a flu vaccine, have had an allergic reaction to chickens or egg protein, or have a fever or illness that is more than “just a cold.”

When should I see my doctor?

If you’re not in one of the at-risk groups listed above, your body will probably fight off the virus on its own. If you think you might have H1N1 flu, call your doctor to see whether or not you need to come for an office visit. Signs that the H1N1 flu requires your doctor’s attention include:

In children, concerns include:

  • Trouble breathing
  • Shortness of breath
  • Confusion
  • Not drinking enough fluids
  • Trouble waking up
  • Flu-like symptoms that go away and then return with a fever and cough
  • Fever combined with a rash
  • Extreme irritability that makes the child push away from being held

How will my doctor know I have H1N1?

Your symptoms alone may alert your doctor that you have H1N1 flu. Most rapid tests can show if you have the flu, but these look for many viruses, not just the H1N1 virus. A test can be done that will show if you have the H1N1 virus specifically, but getting the results takes a few days. Your doctor may want to start treating you right away. That is why many doctors do not bother testing if your symptoms point to H1N1 flu. This is especially true if your community is in the middle of an H1N1 outbreak with lots of people infected.

If I have H1N1, will I need a prescription to get better?

Most people with the H1N1 flu will get better without needing a prescription. Your doctor may decide that you need a prescription if you are at risk of flu complications, or if:

If you have any of these risk factors, your doctor may prescribe an anti-viral drug, such as oseltamivir or zanamivir. Anti-viral drugs decrease the flu virus’ ability to reproduce. These drugs can shorten the time you are sick, reduce the severity of the symptoms and prevent problems that the flu can cause. These drugs work best if they are started right at the beginning of flu symptoms.

  • You have severe illness or are in the hospital from the flu
  • You have the flu and are at risk of having problems from the flu, such as children younger than 2 years old, adults 65 years and older, pregnant women and people who have chronic health problems or weak immune systems
  • You have the flu and are having signs of a more serious infection, such as shortness of breath
  • You are younger than 19 and are on long-term aspirin therapy

What else can I do to feel better?

If you have a fever, you can treat it with medicines that reduce fever. These include medicines such as acetaminophen (one brand name: Tylenol), ibuprofen (some brand names: Advil, Motrin) or naproxen (one brand name: Aleve). These drugs also relieve aches and pains. Never give children or teenagers 18 years or younger aspirin because of the risk of Reye’s syndrome. Reye’s syndrome is a serious illness that can lead to death.

You should also drink plenty of fluids to stay hydrated and get plenty of rest. Rest helps your body fight infection.

What else can I do to avoid getting H1N1 flu?

Stop the spread:

  • Cover your nose and mouth with a tissue when you cough or sneeze.
  • If you don’t have a tissue, cough or sneeze into your upper elbow, not your hands.
  • Put used tissues in the trash.
  • Wash your hands often with soap and water or an alcohol-based hand sanitizer.
  • Avoid touching your eyes, nose or mouth.
  • Avoid people who are sick.
  • Don’t share personal items, such as makeup, eating and drinking utensils, or sports or office equipment.
  • If you get sick, stay home from work or school, and avoid being around people. Stay home at least 24 hours after your fever breaks.

Enterovirus D68

What is H1N1 flu?

The H1N1 influenza (also called swine influenza or swine flu) is a respiratory infection caused by a virus found in pigs. H1N1 flu can infect humans. For more information, see H1N1 Influenza.

Ways to treat your cold and flu symptoms

  • Get plenty of rest, especially while you have a fever. Rest helps your body fight infection.
  • Stop smoking and avoid secondhand smoke, which can make cold symptoms worse
  • Drink lots of fluids such as water and clear soups. Fluids help loosen mucus. Fluids are also important because they help prevent dehydration.
  • Gargle with warm salt water a few times a day to relieve a sore throat. Throat sprays or lozenges may also help relieve the pain.
  • Avoid alcohol.
  • Use saline (salt water) nose drops to help loosen mucus and moisten the tender skin in your nose.

What’s in over-the-counter cold and flu medicines?

The ingredients listed below are found in many cold and flu medicines. Read labels carefully. If you have questions, talk to your doctor or pharmacist.

Analgesics relieve aches and pains and reduce fever. Examples include acetaminophen, aspirin, ibuprofen, ketoprofen and naproxen. Warning: Children and teenagers shouldn’t be given aspirin because it can cause Reye’s syndrome.

Antitussives (also called cough suppressants) tell your brain to stop coughing. Don’t take an antitussive if you’re coughing up mucus. Warning: Children younger than 4 years of age shouldn’t be given cough medicines.

Expectorants help thin mucus so it can be coughed up more easily.

Decongestant nasal sprays shrink the nasal passages and reduce congestion. Adults should only use these medicines for a few days. Overuse can cause symptoms to get worse when you stop using the nasal spray. Warning: Children shouldn’t use these medicines at all.

A note about vaccines

Sometimes the amount of a certain vaccine cannot keep up with the number of people who need it. Read here about vaccine shortages.

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Questions to Ask Your Doctor

  • How long will I be sick?
  • How long should I keep my child home from daycare or school?
  • What can I do to make myself more comfortable?
  • Are there any medicines you would recommend?
  • Should I get the flu vaccine? Should I have my child vaccinated?
  • When should I call my doctor?
  • How long will I be contagious?
  • I’m pregnant. Is there any danger to my baby from the flu?
  • Will steam help my congestion?
  • Are cough medicines safe for my child?

Citations

  • Appropriate Use of Antibiotics for URIs in Children: Part II. Cough, Pharyngitis and the Common Cold by SF Dowell, M.D., M.P.H., B Schwartz, M.D., WR Phillips, M.D., M.P.H., and The Pediatric URI Consensus Team ( 10/15/98, http://www.aafp.org/afp/981015ap/dowell.html)
  • Evaluation of Pregnant Women Exposed to Respiratory Viruses by John W. Ely, M.D., M.S.P.H., Jerome Yankowitz, M.D., and Noelle C. Bowdler, M.D. ( 05/15/00, http://www.aafp.org/afp/20000515/3065.html)