Cold and Flu Help

Common Cold
Overview
Sneezing, scratchy throat, runny nose—everyone knows the first signs of a cold, probably the most common illness known. Although the common cold is usually mild, with symptoms lasting 1 to 2 weeks, it is a leading cause of doctor visits and missed days from school and work. People in the United States suffer 1 billion colds each year, according to some estimates. According to the Centers for Disease Control and Prevention (CDC), 22 million school days are lost annually in the United States due to the common cold.

Children have about 6 to 10 colds a year. One important reason why colds are so common in children is because they are often in close contact with each other in daycare centers and schools. In families with children in school, the number of colds per child can be as high as 12 a year. Adults average about two to four colds a year, although the range varies widely. Women, especially those aged 20 to 30 years, have more colds than men, possibly because of their closer contact with children. On average, people older than 60 have fewer than one cold a year.

The cold season
In the United States, most colds occur during the fall and winter. Beginning in late August or early September, the rate of colds increases slowly for a few weeks and remains high until March or April, when it declines. The seasonal variation may relate to the opening of schools and to cold weather, which prompt people to spend more time indoors and increase the chances that viruses will spread to you from someone else.

Seasonal changes in relative humidity also may affect the prevalence of colds. The most common cold-causing viruses survive better when humidity is low—the colder months of the year. Cold weather also may make the inside lining of your nose drier and more vulnerable to viral infection.

Cause
The viruses

More than 200 different viruses are known to cause the symptoms of the common cold. Some, such as the rhinoviruses, seldom produce serious illnesses. Others, such as parainfluenza and respiratory syncytial virus, produce mild infections in adults but can lead to severe lower respiratory tract infections in young children.

Rhinoviruses (from the Greek rhin, meaning “nose”) cause an estimated 30 to 35 percent of all adult colds, and are most active in early fall, spring, and summer. Scientists have identified than 110 distinct rhinovirus types. These agents grow best at temperatures of about 91 degrees Fahrenheit, the temperature inside the human nose.

Scientists think coronaviruses cause a large percentage of all adult colds. They bring on colds primarily in the winter and early spring. Of the more than 30 kinds, three or four infect humans.

The importance of coronaviruses as a cause of colds is hard to assess because, unlike rhinoviruses, they are difficult to grow in the laboratory.

Approximately 10 to 15 percent of adult colds are caused by viruses also responsible for other, more severe illnesses: adenoviruses, coxsackieviruses, echoviruses, orthomyxoviruses (including influenza A and B viruses, which cause flu), paramyxoviruses (including several parainfluenza viruses), respiratory syncytial virus, and enteroviruses.

The causes of 30 to 50 percent of adult colds, presumed to be viral, remain unidentified. The same viruses that produce colds in adults appear to cause colds in children. The relative importance of various viruses in pediatric colds, however, is unclear because it’s difficult to isolate the precise cause of symptoms in research studies of children with colds.

The weather
There is no evidence that you can get a cold from exposure to cold weather or from getting chilled or overheated.

Other factors
There is also no evidence that your chances of getting a cold are related to factors such as exercise, diet, or enlarged tonsils or adenoids. On the other hand, research suggests that psychological stress and allergic diseases affecting your nose or throat may have an impact on your chances of getting infected by cold viruses.

Common Cold
Transmission
You can get infected by cold viruses by either of these methods.
Touching your skin or environmental surfaces, such as telephones and stair rails, that have cold germs on them and then touching your eyes or nose
Inhaling drops of mucus full of cold germs from the air

Common Cold
Symptoms
Symptoms of the common cold usually begin 2 to 3 days after infection and often include

Mucus buildup in your nose
Difficulty breathing through your nose
Swelling of your sinuses
Sneezing
Sore throat
Cough
Headache
Fever is usually slight but can climb to 102 degrees Fahrenheit in infants and young children. Cold symptoms can last from 2 to 14 days, but like most people, you’ll probably recover in a week. If symptoms recur often or last much longer than 2 weeks, you might have an allergy rather than a cold.

Colds occasionally can lead to bacterial infections of your middle ear or sinuses, requiring treatment with antibiotics. High fever, significantly swollen glands, severe sinus pain, and a cough that produces mucus may indicate a complication or more serious illness requiring a visit to your healthcare provider.

Common Cold
Treatment
There is no cure for the common cold, but you can get relief from your cold symptoms by

Resting in bed
Drinking plenty of fluids
Gargling with warm salt water or using throat sprays or lozenges for a scratchy or sore throat
Using petroleum jelly for a raw nose
Taking aspirin or acetaminophen—Tylenol, for example—for headache or fever
A word of caution: Several studies have linked aspirin use to the development of Reye’s syndrome in children recovering from flu or chickenpox. Reye’s syndrome is a rare but serious illness that usually occurs in children between the ages of 3 and 12 years. It can affect all organs of the body but most often the brain and liver. While most children who survive an episode of Reye’s syndrome do not suffer any lasting consequences, the illness can lead to permanent brain damage or death. The American Academy of Pediatrics recommends children and teenagers not be given aspirin or medicine containing aspirin when they have any viral illness such as the common cold.

Over-the-counter cold medicines
Nonprescription cold remedies, including decongestants and cough suppressants, may relieve some of your cold symptoms but will not prevent or even shorten the length of your cold. Moreover, because most of these medicines have some side effects, such as drowsiness, dizziness, insomnia, or upset stomach, you should take them with care.

Questions have been raised about the safety of nonprescription cold medicines in children and whether the benefits justify any potential risks from the use of these products in children, especially in those under 2 years of age. Recently, a Food and Drug Administration panel recommended that nonprescription cold medicines not be given to children under the age of 6, because cold medicines do not appear to be effective for these children and may not be safe.

Over-the counter-antihistamines
Nonprescription antihistamines may give you some relief from symptoms such as runny nose and watery eyes, which are symptoms commonly associated with colds.

Antibiotics
Never take antibiotics to treat a cold because antibiotics do not kill viruses. You should use these prescription medicines only if you have a rare bacterial complication, such as sinusitis or ear infection. In addition, you should not use antibiotics “just in case,” because they will not prevent bacterial infections.

Steam
Although inhaling steam may temporarily relieve symptoms of congestion, health experts have found that this approach is not an effective treatment.

Common Cold
Prevention
There are several ways you can keep yourself from getting a cold or passing one on to others.

Because cold germs on your hands can easily enter through your eyes and nose, keep your hands away from those areas of your body
If possible, avoid being close to people who have colds
If you have a cold, avoid being close to people
If you sneeze or cough, cover your nose or mouth, and sneeze or cough into your elbow rather than your hand.
Handwashing
Handwashing with soap and water is the simplest and one of the most effective ways to keep from getting colds or giving them to others. During cold season, you should wash your hands often and teach your children to do the same. When water isn’t available, Centers for Disease Control and Prevention(CDC) recommends using alcohol-based products made for disinfecting your hands.

Disinfecting
Rhinoviruses can live up to 3 hours on your skin. They also can survive up to 3 hours on objects such as telephones and stair railings. Cleaning environmental surfaces with a virus-killing disinfectant might help prevent spread of infection.

Vaccine
Because so many different viruses can cause the common cold, the outlook for developing a vaccine that will prevent transmission of all of them is dim. Scientists, however, continue to search for a solution to this problem.

Unproven prevention methods
Echinacea
Echinacea is a dietary herbal supplement that some people use to treat their colds. Researchers, however, have found that while the herb may help treat your colds if taken in the early stages, it will not help prevent them.

One research study funded by the National Center for Complementary and Alternative Medicine, a part of the National Institutes of Health, found that echinacea is not effective at all in treating children aged 2 to 11.

Vitamin C
Many people are convinced that taking large quantities of vitamin C will prevent colds or relieve symptoms. To test this theory, several large-scale, controlled studies involving children and adults have been conducted. To date, no conclusive data has shown that large doses of vitamin C prevent colds. The vitamin may reduce the severity or duration of symptoms, but there is no clear evidence of this effect.

Taking vitamin C over long periods of time in large amounts may be harmful. Too much vitamin C can cause severe diarrhea, a particular danger for elderly people and small children.

Honey
Honey has been considered to be a treatment for coughs and to soothe a sore throat. A recent study conducted at the Penn State College of Medicine compared the effectiveness of a little bit of buckwheat honey before bedtime versus either no treatment or dextromethorphan (DM), the cough suppressant found in many over-the-counter cold medicines. The results of this study suggest that honey may be useful to relieve coughing, but researchers need to do additional studies.

You should never give honey to children under the age of one because of the risk of infantile botulism, a serious disease.

Zinc
Zinc lozenges and zinc lollipops are available over the counter as a treatment for the common cold; however, results from studies designed to test the efficacy of zinc are inconclusive. Although several studies have shown zinc to be effective for reducing the symptoms of the common cold, an equal number of studies have shown zinc is not effective. This may be due to flaws in the way these studies were conducted, or the particular form of zinc used in each case. Therefore, additional studies are needed.

Common Cold
Complications
Colds occasionally can lead to bacterial infections of your middle ear or sinuses, requiring treatment with antibiotics. High fever, significantly swollen glands, severe sinus pain, and a cough that produces mucus, may indicate a complication or more serious illness requiring a visit to your healthcare provider.

What is influenza?

Influenza, commonly called "the flu," is an illness caused by RNA viruses that infect the respiratory tract of many animals, birds, and humans. In most people, the infection results in the person getting fever, cough, headache, and malaise (tired, no energy); some people also may develop a sore throat, nausea, vomiting, and diarrhea. The majority of individuals has symptoms for about one to two weeks and then recovers with no problems. However, compared with most other viral respiratory infections, such as the common cold, influenza (flu) infection can cause a more severe illness with a mortality rate (death rate) of about 0.1% of people who are infected with the virus.

What are flu symptoms?

Typical clinical features of influenza include

fever (usually 100 F-103 F in adults and often even higher in children),
respiratory symptoms such as
cough,
sore throat,
runny or stuffy nose,
headache,
muscle aches, and
fatigue, sometimes extreme.
Although nausea, vomiting, and diarrhea can sometimes accompany influenza infection, especially in children, gastrointestinal symptoms are rarely prominent. The term "stomach flu" is a misnomer that is sometimes used to describe gastrointestinal illnesses caused by other microorganisms. Novel H1N1 infections cause more nausea, vomiting, and diarrhea than the conventional (seasonal) flu viruses.

Most people who get the flu recover completely in one to two weeks, but some people develop serious and potentially life-threatening medical complications, such as pneumonia. In an average year, influenza is associated with about 36,000 deaths nationwide and many more hospitalizations. Flu-related complications can occur at any age; however, the elderly and people with chronic health problems are much more likely to develop serious complications after the conventional influenza infections than are younger, healthier people. However, the novel H1N1 virus has initially developed a different pattern of infection. Unfortunately, the pattern of infection is similar to that of the 1918 "Spanish flu" pandemic in which young people (pregnant individuals, infants, teens, and adults through age 49) are the most susceptible populations worldwide.

What is the key to flu prevention?

Flu vaccine

Much of the illness and death caused by influenza can be prevented by annual influenza vaccination. Flu vaccine (influenza vaccine made from inactivated and sometimes attenuated [non-infective] virus) is specifically recommended for those who are at high risk for developing serious complications as a result of influenza infection. These high-risk groups for conventional flu include all people aged 65 years or older and people of any age with chronic diseases of the heart, lung, or kidneys; diabetes; immunosuppression; or severe forms of anemia. However, with the novel H1N1 flu, the CDC has listed these groups listed below as being at high risk and should obtain the novel H1N1 vaccine as soon as it is available to them:
pregnant women,
people who live with or care for children younger than 6 months of age,
health-care and emergency-services personnel,
people between the ages of 6 months through 24 years of age and children 5-18 years of age who have chronic medical problems, and
people from 25-64 years of age who are at higher risk for novel H1N1 because of chronic health disorders or compromised immune systems.
Other groups for whom conventional flu vaccine is specifically recommended are residents of nursing homes and other chronic care facilities housing patients of any age with chronic medical conditions and children and teenagers who are receiving long-term aspirin therapy and who may therefore be at risk for developing Reye syndrome after an influenza virus infection. Influenza vaccine is also recommended for people who are in close or frequent contact with anyone in the high-risk groups defined above. These people include health-care personnel and volunteers who work with high-risk patients and people who live in a household with a high-risk person.

Because the flu is easily spread among children and because many children require hospitalization with the flu, the CDC now advises that all children 6-59 months of age receive a yearly conventional flu vaccination

What are some treatments an individual can do at home for the flu?

First, individuals should be sure they are not members of a high-risk group that is more susceptible to getting severe flu symptoms. Check with your physician if you are unsure if you are a higher risk person. Home care is recommended by the CDC if a person is normally healthy with no underlying diseases or conditions (for example, asthma, lung disease, pregnant, or immunosuppressed).

Increasing liquid intake, warm showers, and warm compresses, especially in the nasal area, can reduce the body aches and reduce nasal congestion. Nasal strips and humidifiers may help reduce congestion, especially while trying to sleep. Some physicians recommend nasal irrigation with saline to further reduces congestion; some recommend nonprescription decongestants. Fever can be treated with over-the counter acetaminophen (Tylenol) or ibuprofen (Motrin and others) (read labels for safe dosage). Cough can be suppressed by cough drops and over-the-counter cough syrup. If an individual's symptoms at home get worse, their doctor should be notified.

Where can I find additional information about the flu?

During a flu pandemic, guidelines and situations can change rapidly. People are advised to be aware that several sources are available to them to keep current with developments. The Web sites below are frequently updated, especially when a pandemic is declared. The first Web site contains an update written for the public and caregivers; the government and WHO sites provide detailed information that are updated as guidelines and developments occur.

http://www.medicinenet.com/swine_flu/article.htm

http://www.cdc.gov/flu/weekly/

http://www.who.int/en/

http://www.cdc.gov/h1n1flu/

http://www.pandemicflu.gov/

http://www.cdc.gov/h1n1flu/clinician_pregnant.htm

http://www.fda.gov/BiologicsBloodVaccines/vaccines/QuestionsaboutVaccines/ucm070430.htm

Flu (Influenza, Conventional and H1N1) At A Glance
Influenza, commonly called "the flu," is caused by viruses that infect the respiratory tract.
Influenza viruses are divided into three types, designated A, B, and C.
Most people who get the conventional or seasonal flu recover completely in one to two weeks, but some people develop serious and potentially life- threatening medical complications, such as pneumonia.
Much of the illness and death caused by conventional or seasonal influenza can be prevented by annual influenza vaccination.
Influenza A undergoes frequent antigenic changes that require new vaccines to be developed and people to obtain a new vaccination every year.
In April, 2009, a new flu virus termed novel H1N1 swine flu developed in Mexico, rapidly spread worldwide, and has caused the WHO to declare flu pandemic.
Like the influenza virus, drug treatments are constantly changing and improving, but currently, timely vaccination is still considered to be the best defense against the flu.
People should be aware that flu pandemics can cause severe flu symptoms and sometimes death in many individuals who may be more susceptible to the pandemic flu than the conventional flu.
Individuals should check with their doctors to determine if they are considered to be at higher risk of getting severe flu symptoms than the normally healthy population.