cold vs flu: a special post from Primary Care

Flu and cold are on the rise in New York and in our community, so we’ve invited Dr. Marjorie Seidenfeld, the Primary Care Health Service’s medical director, to share some info about cold and flu, and how to tell the difference:

Is this a cold or should I be worried about flu?

In winter, viruses flourish, especially those that cause both the common cold and the flu (Influenza virus). We often intermix the terms, but it actually is important to distinguish between the two, because the severity, the treatment options, and the potential complications are actually quite different.

Here are the basics on the common cold:

Symptoms: Gradual onset of mild sore throat, runny nose, sneezing, congestion, mild sinus pressure, watery eyes, clogged ears, mild cough. Generally, no fever, although there may be a mildly elevated temperature and the feeling of being “feverish.” It generally lasts a few days to a week.

Treatment recommendations include: REST, drinking a lot of fluids, using a humidifier, using a decongestant and possibly acetaminophen/ibuprofen for headache or sore throat.
No antibiotics are indicated, as they will not do anything to improve the symptoms or quicken the recovery (and they have side effects).

Potential complications: Sinus infections may occur, although this is not as common as many believe. Ear infections are also possible, but occur much more often in younger patients.

How can you prevent getting a cold? Since you live in a very close community, this is challenging; however, washing your hands and not sharing drinks or food can strongly reduce your chance of catching a cold.

Here are the basics on the flu:

Symptoms: Sudden onset of sore throat, fever (temperature greater than 100.5°F), cough, nasal congestion, body aches, headache, fatigue, weakness, malaise (feeling awful). Symptoms can last up to 10 days.

Testing: We can do a rapid flu test in the Primary Care Health Service to help in diagnosis of the flu.

Treatment: If caught within the first 2 days from the onset of symptoms, it can help to take a medicine that slows down the replication of the virus – generally the one used is Tamiflu (oseltamivir). It is taken twice a day for 5 days. It does not cause immediate improvement – rather it decreases symptoms somewhat and may shorten the course of the illness by a day or 2. It does usually mitigate some of the more severe complications of the flu, though, especially if you have an underlying illness like asthma or diabetes. Otherwise, medication involves treating the symptoms – cough suppressants, decongestants, acetaminophen/ibuprofen. Do not take aspirin if you have the flu! The most important treatment with flu, though, is rest and drinking fluids. If you try to work through it, the illness will only last longer, so it’s worth taking the time to rest.

Potential complications: Pneumonia (infection in the lung) is the most common complication of the flu, and this can be dangerous. If a cough does persist, if phlegm production increases, if fever dissipates and then returns, it is important to see a health care provider and possibly get an x-ray of your chest to see if there is pneumonia. You may require an antibiotic and even hospitalization for this if it is serious. If you have asthma, you are at higher risk for this particular complication. Other potential, serious complications include neurological problems and heart problems, although these are less common.

How can you prevent the flu? Come in to the Primary Care Health Service and get a flu shot! Also, look out for our flu shot clinics on campus. This is the best way to prevent what could be a serious illness! And of course, frequent hand washing and avoiding sharing food or drinks also reduces your chances of getting the flu.

And always, getting enough sleep, eating a balanced diet, and exercise will also boost your immune system to enable you to fight off both of these infections.

And to add just a word about herbal remedies… There are many herbal treatments that are touted as having being able to reduce symptoms, particularly of the common cold. Most have been demonstrated to have only minimal effect and have potential side effects, and so are not generally recommended. The one that has been shown to have some clinical benefit is zinc; however, there is a risk of zinc causing permanent anosmia (inability to smell), making the risk outweigh the benefit.

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