Where I live, North America, we’ve just observed the first day of fall, also known as the autumnal equinox. And especially in healthcare, we unofficially view it as the start of the “cold and flu” season. To those of you in the southern hemisphere, happy spring. You also have a respiratory illness season during fall/winter.
Respiratory infections
By “cold and flu” we means acute respiratory infections caused by a variety of viruses including
- influenza
- respiratory syncytial virus (RSV)
- adenovirus
- rhinovirus
- coronavirus
and less often several bacteria, most commonly
- Streptococcus
- Mycoplasma
- Haemophilus
- Legionella
- Pertussis (whooping cough)
These cause diseases called by various names including
- colds/flu
- influenza
- pharyngitis (throat infection)
- otitis media (ear infection)
- bronchitis
- sinusitis
- pneumonia
- laryngitis
- COVID-19
- whooping cough
- bronchiolitis-infants and children
- croup-mostly children
This year’s cold/flu season is complicated by a new player- COVID-19, caused by the SARS-CoV-2.
Acute vs chronic
We call these illnesses acute because they (usually) come on fairly suddenly, run their course within a few days to sometimes a few weeks, and then resolve. Sometimes they don’t resolve and become chronic.
Some underlying factor may prevent healing. There may be a chronic condition that is out of control, or has not been previously diagnosed. You may need a doctor’s evaluation to determine whether it’s “just a cold” or perhaps asthma, COPD ,or allergic rhinitis.
Many of these illnesses tend to occur seasonally, such as influenza and RSV. Others can occur year round. So far we don’t know if COVID-19, due to the SARS-CoV-2 , will be year round or seasonal. Unlike influenza, it did not abate during the summer this year.
What are respiratory symptoms?
Symptoms of respiratory illness involve some combination of the nose, sinuses, ears, throat, larynx (voice box), trachea, bronchus, and lung
- Sneezing, stuffy or runny nose,
- Sinus pain, pressure
- coughing, wheezing, shortness of breath
- sore throat, hoarseness
- ear pain, fullness
often along with systemic symptoms such as
- fever and/or chills
- body aches, fatigue,
- nausea, vomiting, diarrhea
- headache
- loss of appetite
Coping with respiratory illness
Although these infections make us miserable and can temporarily disable us from work and school, most otherwise healthy people recover uneventfully, even from COVID-19. Nevertheless, we should take them seriously.
Don’t panic.
Fever ,especially in children, alarms parents. Don’t ignore it but don’t panic either. Reading this post should help you keep calm about fever .
Some people are at risk of developing severe symptoms and serious complications from respiratory illnesses, so seek medical help sooner, rather than later. These include
- Infants, especially under one month old
- Older adults,starting at about age 50, with risk increasing with age, especially combined with chronic disease
- Those with chronic lung disease, like asthma, COPD, emphysema, cystic fibrosis
- People who smoke cigarettes or vape
- People on medications or with diseases that suppress the immune system
- Serious chronic diseases – diabetes, liver disease, kidney disease, heart disease, cancer
- Obesity (a risk factor for COVID-19 complications)
- Pregnancy
If you are not sure if you fit into one of these categories, ask your doctor.
Stay home.
These illnesses spread person to person, so minimize contact.
Keep your kids home from school and stay home from work, at least the first few days, when you are the most contagious. When there is widespread illness in your community, avoid crowds and public gatherings.
Resting, getting extra sleep, drinking fluids and staying warm and dry make staying at home therapeutic.
Wash hands.
Speaking of person to person contact, the best way to avoid getting or giving germs is to wash your hands often, but especially after being with others ,using a restroom, and before cooking or eating. Cleaning household surfaces helps too, as well as clothing and linens. Don’t forget to clean your cell phone, tablets, and keyboards too. Use hand sanitizer if hand washing can’t be done.
Wear a mask
You probably remember that early on in the pandemic, the CDC did not recommend wide spread wearing of masks. I suspect this was to prevent hoarding of masks (remember toilet paper? ) and because they did not know how widely the virus was circulating in the United States.
But that has changed; when experts learn new information they reassess and update recommendations. Whenever you expect to have close contact with people outside your household wear a mask that covers your nose and mouth. In some situations, eye coverings are also warranted but that is not universally recommended now.
Use medication wisely.
Some of these illnesses have a specific medication that clear it faster- strep throat, influenza, pneumonia. The others will “run their course” and meds are used to help relieve symptoms.
Many people assume that any illness with fever, sore throat and cough will improve with an antibiotic. The fact is, most will not. Antibiotics only treat infections caused by bacteria, and most of these are caused by viruses. To learn more read about
These illnesses cause the greatest overuse of antibiotics, contribute to the cost of health care, and the development of antibiotic resistance. Please do not insist on an antibiotic if the doctor says you don’t need it; if offered an antibiotic, ask why.
Be patient
The “24 hour virus” is for the most part a myth. Expect to be ill anywhere from 3 to 10 days; some symptoms, especially cough, can linger for weeks. If you are a smoker, this is a great time to quit.
But if after 7-14 days you are not getting better or are getting progressively worse, something more may be going on, so it’s wise to seek professional medical help.
Is it flu or is it COVID?
The arrival of COVID-19 this year creates a dilemma since symptoms overlap other respiratory infections and the possible outcomes run the gamut of no symptoms to death.
So this year, if you develop respiratory symptoms, healthcare clinicians will likely test you for COVID-19 , both to guide your care and to protect your family, co-workers, and healthcare workers.
Please do not assume your illness is “just the flu” ; this could have serious, perhaps fatal consequences for you and your loved ones.
Prevention of respiratory infections
Respiratory infections don’t have to happen. We know that they are mostly spread person to person, so what we each do matters. So what can you do?
- Stay home when you are ill.
- Observe physical distancing when disease is spreading in your community.
- Wear a mask when recommended by public health professionals.
- Practice careful hygiene on hands and surfaces.
- Get available vaccinations.
exploring the HEART of respiratory illness
I would love for you to share this information (but not your germs) on your social media pages.
helps with cough and congestion.
watercress words by Dr Aletha 
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