McLane Children’s Hospital encourages the community to take steps to prepare for and prevent influenza, especially in children. The microbiology lab at Scott & White Memorial Hospital – Temple, which serves 30 Central Texas counties, confirmed over 2,600 positive cases of flu last season, between September and December 2014. With falling temperatures, the potential for sore throats, coughs and nasal congestion may increase. Fortunately, some of these ailments can actually be initially managed without having to see your doctor.
Sara E. Sultz, MD, a pediatrician at McLane Children’s Scott & White Clinic – Belton, offers the following advice to help determine if it’s a cold, the flu, or something else, and suggests the best treatment methods for each.
The Common Cold
The “common cold” is caused by various viruses, and has an incubation period of one to two weeks. The virus is transmitted by airborne droplets from sneezing or coughing, or direct contact with infected secretions. Symptoms include fatigue, fever, sneezing, congestion, sore throat and cough. According to Dr. Sultz, respiratory symptoms will typically last around seven to 10 days, and there is no evidence-based treatment to shorten the duration of the illness.
The best way to prevent contracting a cold is through frequent hand washing, covering your nose and mouth when sneezing or coughing and reducing exposure to infected individuals.
If you do get sick, you can treat the symptoms through prescription or over-the-counter medications including:
- Decongestants (like Sudafed or Mucinex D) or expectorants (like Mucinex) for congestion. These medications are not recommended for children younger than six years old. Dr. Sultz also suggests using saline nasal irrigations (neti pots) to relieve congestion.
- Acetaminophen (like Tylenol) and/or ibuprofen (like Advil) for fever.
- Dextromethorphan (like Mucinex DM, Robitussin DM or CF, or Delsym) for cough. These medications are not recommended for children younger than six years old.
The Flu (Influenza)
Influenza (flu) usually appears between the months of September and March, but there have been a few cases this past summer. The incubation period is one to two weeks and the virus is transmitted the same way as the common cold. The flu usually lasts 10 to 14 days.
In addition to following the same hygiene measures as those recommended for the common cold, influenza vaccines (both in injectable and nasal forms) are also available. Vaccines consist of anticipated strains of influenza administered mid-September through the end of flu season, although, they provide more protection the earlier they are obtained. Injectable flu vaccines contain a killed virus, and cannot transmit the flu. Nasal vaccines have a live, but weakened, virus, which can give you a milder form of the disease, and are not recommended for those with pre-existing respiratory conditions, such as asthma or chronic obstructive pulmonary disorder (“COPD.”).
Flu symptoms are the same as those of the common cold, with the addition of higher fever, chills and body aches for three to five days. Recommended treatments include those symptomatic treatments used for a cold, with the possible addition of antiviral medications (like Tamiflu). Dr. Sultz cautions, however, that these medications must be started within 48 hours of the onset of symptoms to be effective, and most only shorten the course of the illness by a day or two.
Bronchitis (Chest Cold)
Most cases of bronchitis, or chest cold, are caused by viruses. However, there are rare occasions of bacterial bronchitis, one strain of which can be caused by the Pertussis bacteria (also known as whooping cough). Patients who smoke, or who are around second-hand smoke, are more at risk for bacterial bronchitis infections. Bronchitis is transmitted and has the same symptoms as the common cold, with the possible addition of wheezing or a productive (phlegm-producing) cough that will produce green, yellow or brown sputum. Bronchitis coughs may last up to three weeks.
In addition to following the same preventative measures as for the common cold, a Tdap vaccine that immunizes against Pertussis is also available for patients age 11 and older. If you contract bronchitis, follow the recommended treatments for symptoms of the common cold. If you are wheezing, see a physician, who may prescribe an inhaler.
Dr. Sultz says that antibiotics will not change the course or length of bronchitis, except for patients with asthma or chronic obstructive pulmonary disorders, such as emphysema, or those with weakened immune systems.
Sinusitis (Sinus Infection)
Sinusitis is caused by viruses and allergies. An individual will usually experience other allergic symptoms, such as itching of the eyes, nose or throat, in addition to nasal congestion, sinus pain and pressure in the cheeks, upper teeth or forehead. If symptoms persist for 10 days and are accompanied by discolored nasal discharge, the sinusitis may be bacterial.
Frequent saline nasal irrigations (using a neti pot) two to five times a day will help relieve congestion. Nasal steroid sprays (like Flonase, Nasacort or Nasonex) prior to, and through, peak allergy seasons (fall and spring) will also help minimize symptoms. Dr. Sultz also suggests using a decongestant or expectorant (such as Sudafed non-drying formula or Mucinex D), but it is not recommend for children younger than six years old.
Antibiotics are usually reserved for individuals who have had sinusitis symptoms for 10 days or more, despite the use of decongestant medications. Dr. Sultz notes that scientific studies have shown equal relief with frequent saline nasal irrigations plus decongestants, compared with antibiotics.
Strep throat is caused by the bacteria streptococcus pyogenes, or group-A beta hemolytic strep, and actually causes only nine percent of all sore throats. A majority of sore throats are caused by viruses. Strep throat seems to be most common during the beginning and end of the school year.
The major symptom is a severe, abrupt sore throat, usually accompanied by fever, chills, headache, stomach upset and bad breath. Strep is less likely to be the cause of your symptoms if you have a cough.
Penicillin is the best antibiotic for treating strep throat, according to Dr. Sultz. If an individual is allergic to penicillin, then an appropriate substitute can be prescribed. Dr. Sultz stresses that, while symptoms usually improve within 48 hours, individuals should take the full 10-day course of antibiotics to prevent a rare complication known as rheumatic fever. Acetaminophen, ibuprofen and chloraseptic can be used for throat pain.
“When taking medications for any of these conditions, be sure to take them as directed and review warnings prior to consumption,” Dr. Sultz said. She also offered the following advice on when individuals should seek an appointment with their physician:
- Recurring high fever greater than 101 degrees orally or development of sudden fever and/or chills after a period of feeling better during a respiratory illness.
- Wheezing or shortness of breath.
- Pleurisy – pain in your chest — when taking a deep breath.
- Severe sore throat or ear pain.
- Cough lasting more than three weeks and not responding to regular treatment.
- Sinus pain and congestion lasting more than 10 days and not responding to regular treatment (specifically, decongestant medications).
- Symptoms worsen after a two-to-three-day period of improvement.
Dr. Sultz advises visiting your nearest hospital emergency department or calling 911 if symptoms are serious.
For more information about our upcoming flu clinics and new drive-thru flu clinic visit our website.