Cold, flu, sinusitis, or allergies?

October 26, 2004

That's a question I'm often asked. With the flu season upon us, here are some guidelines to help.

Special Alerts

Special alert for people with asthma: Asthmatics who develop the flu are at increased risk of worsened asthma attacks, and they may be at greater risk of developing pneumonia from the flu. On October 18, 2004, the American Academy of Allergy Asthma and Immunology released a Media Alert recommending that all asthmatics sign up to receive the flu vaccine.

This page is provided for general help only. Always contact your physician if your symptoms become severe or last longer than two weeks.

Colds

Colds are caused by a virus. Symptoms can include:

• Sore throat, sneezing and stuffy nose (congestion)
• Watery to thick cloudy or white nasal drainage
• Post-nasal drip
• Often with mild to moderate chest discomfort and hacking cough
• May have low-grade fever, mild body aches and pains, or mild fatigue

See your doctor if you develop an ear ache, thick yellow or green mucous, fever 101 or greater, face pain, or symptoms that last longer than two weeks.

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Flu (Influenza)

The flu is caused by a virus. The flu season usually begins a few months after children start school. In the U.S., the flu season is from November through March. Early symptoms include sudden onset of:

• High fever (102-104) with chills
• Headache
• Extreme exhaustion
• Severe body aches and pains

• Sore throat
• Sneezing, nasal discharge or stuffy nose.
• Moderate to severe chest discomfort and dry, hacking cough
• Mild to moderate fatigue

Initial symptoms of high fevers, headache, extreme exhaustion, and severe aches and pains usually last 2-5 days. The cough and fatigue can last 2-3 weeks or more after other symptoms have subsided.

Complications include severe worsening of asthma and secondary infections such as bronchitis, pneumonia, strep throat, or ear infections. Secondary infections are treated with antibiotics. See your physician if your condition worsens instead of getting better, or if you develop signs of secondary infections such as ear ache or sore throat.

Shortness of breath and a cough may be symptoms of pneumonia and you should contact your physician. If you think you have the flu and your asthma is getting worse, it is especially important to see your doctor.

For prevention, annual vaccination 6-8 weeks before the flu season begins is recommended. If you have allergy to eggs, talk with your allergist first. The flu vaccine is grown in chicken eggs and may contain some egg protein.

Research is ongoing in an effort to prevent or curtail this deadly virus.

The Centers for Disease Control has provided some useful tools for learning about and tracking influenza:

• Flu activity provides a weekly update of flu activity in the U.S. A link to international reports is also provided.
• 2004-2005 Vaccine shortage provides updates and helps.
• Public Service Announcements offer Current flu information provided by the Ad Council, the U.S. Department of Health and Human Services, and the CDC.
• Influenza (Flu) is the CDC's comprehensive site about the flu.

See more links about the flu in the References below.

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Sinusitis

Acute sinusitis is a bacterial infection in the sinuses. Symptoms may include:

• Headache and facial pain or eye pain
• Sinus stuffiness (congestion)
• Pain in upper teeth
• Thick yellow/green nasal discharge
• Post-nasal drip
• Cough, especially at night
• Sore throat
• Fever
• Feeling listless or fatigued

According to the American Academy of Otolaryngology, if a sinus infection recurs frequently or lasts longer than 3 months, it may be chronic sinusitis. Acute sinusitis is often proceeded by a cold or an allergy attack, and can develop quickly. Moisture caused by allergies or poor drainage due to obstruction provides the perfect medium for bacteria to grow, often leading to chronic sinusitis. A chronic condition known as allergic fungal sinusitis is caused by a fungal infection.

See your physician if your symptoms last longer than a few days or if they become severe. Sinus infections often require several weeks of antibiotic therapy. Sinus surgery may be required as well.

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Allergic Rhinitis

Symptoms of allergic rhinitis usually begin immediately after exposure to allergen. Often they are recurrent at same season every year. If allergies are perennial, they will occur year-round. Symptoms last as long as you are exposed to the allergen.

Complications can include chronic sinusitis, throat and ear infections. Here are some of the symptoms you may see with allergic rhinitis:

• Sinus stuffiness (congestion
• Itchy nose and throat
• Watery, itchy eyes
• Sneezing and runny nose with thin, watery discharge.
• Post-nasal drip
• Wheezing, usually associated with asthma. If you have wheezing or asthma, you should always be under the care of a physician and follow his treatment plan carefully.
• Get better or worse depending on the immediate environment or circumstances
• Cold symptoms that last more than 10 days may be allergies
• Does not cause fever. If fever is present, this may be the sign of a secondary infection. See your physician.

Treatment for allergies consists of avoidance of things you are allergic to, medications, and allergy injections.

This comparison of colds, flu, sinus infections, and allergic rhinitis is presented for general information only. Your physician can best determine what is causing your symptoms. Your physician will base her diagnosis on a number of factors, including health history, physical examination, and medical test results.

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Healthy Habits

Droplets from coughs and sneezes can be propelled up to 3 feet. Viruses also can be spread by contact with droplets from another person. Here are some ways to protect yourself and others:

• Wash your hands frequently. This still remains the most important barrier we have against disease. When you touch a contaminated surface then touch your eyes, mouth, or nose, you can easliy become infected with a cold or the flu. The Centers for Disease Control says, "The most important thing that you can do to keep from getting sick is to wash your hands." Scrubbing with soap helps to dislodge the germs and water washes them away.
• Keep your hands away from your face as much as possible.
• Use an alcohol-based gel hand sanitizer between handwashing or when handwashing is impossible (such as in the car). Isopropyl alcohol (common rubbing alcohol) is the main ingredient of most gel hand sanitizers, and it will kill both bacteria and viruses.
• Use a household cleaner that is both antibacterial and antiviral. Rubbing alcohol as well as household bleach are effective against both bacteria and viruses, including the flu virus.
• If you must share a phone or computer keypad with others, especially at work, clean it frequently with a cotton ball or soft cloth moistened with rubbing alcohol.
• Plastic toys can be sanitized by soaking in a 1:10 solution of water and bleach (9 parts water with 1 part household bleach). Rinse thoroughly with plain water. This 1:10 bleach solution can also be sprayed on hard surfaces and wiped with a damp cloth to kill bacteria and viruses. Discoloration may occur on some surfaces, so test a small area first.
• Don’t share your cup or glass with anyone.
• Avoid close contact with people who have a cold or the flu
• Protect others by covering your mouth and nose with tissue when you cough or sneeze, staying home when you are ill, and keeping sick children at home.

Practicing these Healthy Habits will go a long way toward protecting yourself and those around you from these "bugs."

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