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Cold and Flu – Which is Which & What to Do

Colorado along with much of the United States is experiencing a high level of influenza-related illness. Vail Valley Medical Center have seen about five percent more patients testing positive for the flu than last year with tests showing that the 2009 H1N1 strain is most often identified among our patients. Flu patients have ranged in age from four months to 86 years old with most less than 50 years of age.

But is it a cold or the flu? When you get the sniffles or a cough it's sometimes hard to tell the difference if it's the cold or the flu. Because there are literally thousands of viruses that cause the common cold many strains of the flu as well as variations in how people respond to them there can be considerable overlap in the symptoms and severity of these two entities. It can be virtually impossible to tell the difference. It can be important however because unlike the common cold the flu can result in pneumonia hospitalization and death. There are however some guidelines that can help you determine when you should see a doctor.  

Flu Symptoms and Treatment
Symptoms of the flu are typically sudden and severe and may include some or all of these symptoms:  Fever (frequently over 103 degrees) uncontrollable dry cough extreme fatigue or weakness headache and body aches. Mild runny nose and sore throat may also be present and children may have stomach upset vomiting and diarrhea. Sometimes I can tell immediately when a person has the flu. They feel so bad they just don't care. They can tell me the exact date and time when they got sick can't stop coughing and it hurts to touch them almost anywhere. They prefer to lie down most of the time.

If you have the flu you should be aware that it can be life-threatening. If you have any other underlying medical problems such as heart or lung disease diabetes or if you are over 65 years old you should get medical attention if symptoms are severe. Once you have the flu it can last anywhere from a few days up to two weeks.  If you catch it within the first 48 hours of onset you can go to the doctor and possibly get antiviral medication that can help reduce the severity and duration of symptoms. Doctors are encouraged to prescribe this medication only for people at high risk of complications for whom it can be potentially life-saving. Antibiotics do not help the flu. Treatment is largely supportive and symptomatic. You should increase your intake of fluids to avoid dehydration which would magnify the symptoms of weakness and fatigue. You should take a medication like Tylenol ibuprofen or naproxen as frequently as recommended on the package to help with body aches and headaches (note you should NOT take aspirin containing medications). You can try over the counter cough preparations and most importantly you should stay home and rest as much as possible to prevent you from infecting others. 

Cold Symptoms and Treatment
Typical cold symptoms are much milder and more gradual. They include stuffy or runny nose sore throat sneezing cough mild fatigue and mild fever (under 100 degrees). Patients report that their symptoms may come and go. They probably have not missed work. If you suspect that you have a cold treatment is symptomatic and can usually be accomplished with over the counter medications.

If your cold symptoms are still present and severe after 10-14 days or if you have developed localized sinus or ear pain you may want to see your doctor to see if you have another illness such as a sinus or ear infection.

Avoiding the Cold and Flu
The best thing to do during cold and flu season is to take steps to avoid getting sick altogether. Here are a few things you can try. 

1. Get the flu shot. The Centers for Disease Control and Prevention (CDC) recommends everyone over the age of six months get the vaccine which is available throughout our community at: pharmacies Eagle County Public Health and medical offices. The most common strain of the flu seen in our area is the H1N1 strain which is covered in the 2013/2014 flu vaccine. All of the employees at Vail Valley Medical Center than are eligible for the vaccine have received it.  Please join Vail Valley Medical Center in protecting yourself and your loved ones against the flu.
2. Get enough sleep. Studies have been done where they actually spray cold viruses up the nose of two groups of people. The first group gets an adequate amount of sleep 8-9 hours per night. The second group is sleep deprived getting only 5-6 hours per night. The ones who are sleep deprived get sick twice as often as the ones who have had adequate sleep.   
3. Exercise (but not too much). Studies show that regular exercise even just walking for 30 minutes a day can reduce your chances of upper respiratory illness by 50-75%. Unfortunately exercising vigorously for over an hour per day is associated with INCREASED chance of illness.  
4. Hand hygiene. Hand washing or use of hand sanitizer is associated with 20-50% decreased incidence of respiratory infection. This has been studied in school classrooms college dorms and military barracks but remember it doesn't take place of getting the flu shot.  
5. Reduce stress. A high stress level is hard on your immune system and has been linked to increased incidence of upper respiratory illness.  
6. Water gargling? Two studies out of Japan show that simple water gargling decreases incidence of colds by about a third. One of these studies included 20000 preschoolers. Unlike many medical interventions it's cheap free and harmless.  
7. Probiotics. Since 70% of your immune system is concentrated around the GI tract some early studies indicate that there may be some benefit to probiotics. However over 50% of probiotic supplements are shown to be inactive when examined by labs. Other Supplements? Unfortunately no supplement has ever been proven effective to prevent the common cold in the general population including vitamin A C D E Echinacea Garlic Zinc or any combination of any supplement. That being said there are studies that indicate supplementation with Vitamin C and beta-glucan (found in mushrooms and brewers yeast/nutritional yeast) can reduce incidence of respiratory infections in people doing extreme endurance sports (i.e. marathon runners).   

Decoding cold-related medicines:

• Tylenol ibuprofen or naproxen for pain.
• Pseudoephedrine is good for congestion if you don't have high blood pressure.
• Afrin nasal spray can also help on a very short-term basis.
• Salt water gargles throat lozenges and saline nasal spray can also help relieve symptoms. 
• Antihistamines may help with sneezing runny nose and watery eyes but can cause sedation.
• Over the counter cough preparations have not been proven to do much. 
• Zinc lozenges were once thought to reduce cold duration and symptoms but repeat studies have failed to show benefit and in fact have shown potential harm.
• Your doctor is not much help with a cold.  The most we can do is prescribe a nasal spray that can help dry out your nose if your runny nose is truly intolerable.
• Antibiotics do not help with a cold and in fact can make your recovery take longer. 

About Dr. Dennis Lipton - Internal Medicine  | (970) 926-6340
Dennis Lipton MD is a board-certified internist trained in the essentials of primary care and disease prevention and can help ensure patients receive the proper medical screening tests and immunizations. 

For more information on the flu visit www.colorado.gov and search “flu” or www.cdc.gov/flu.