Cough/Cold/Allergy: Cold and Flu Season

There are many OTC products to keep families healthy.

Overview

In the United States, cold season generally occurs from late August through early April, but individuals can get a cold at any time of year. The common cold is a highly contagious acute viral infection of the upper respiratory system and is one of the most common reasons for absence from both work and school.

Influenza, commonly referred to as the seasonal flu, is a very contagious respiratory infection caused by the influenza viruses. Influenza affects the nose, throat, and lungs and can sometimes lead to serious health complications and even death. In the United States, flu season usually occurs between October and May, peaking between late December and March. The elderly, children, pregnant women, and those with certain medical conditions are at high risk for developing flu complications.

Signs and Symptoms

Colds tend to have a gradual onset with symptoms developing over a few days, usually beginning with a sore or irritated throat and low-grade fever (rarely exceeding 100ºF). Conversely, flu symptoms, especially fever, come on quickly (within 3-6 hours). Fever is present in at least 80% of all flu cases. A temperature of 100°F or higher for 3 to 4 days is associated with the flu.

Symptoms

Cold

Flu

Cough

Hacking, productive cough (mucus-producting) often present

Nonproductive cough (does not produce mucus) usually present

Body aches and pains

Slight

Severe

Nasal congestion

Very common; typically resolves spontaneously within a week

Uncommon

Chills

Uncommon

Occur in 60% of cases

Fatigue

Fairly mild

Moderate to severe

Sneezing

Common

Uncommon

Headaches

Uncommon

Occur in 80% of cases

Sore throat

Common

Uncommon

Chest discomfort

Mild to Moderate

Often severe

Causes

More than 200 viruses can cause the common cold, but the majority are caused by rhinoviruses. Rhinoviruses can live up to 3 hours on your skin and up to 3 hours on surfaces and objects such as toys, doorknobs, pens, and telephones.

The influenza virus enters the body via the mucous membranes of your nose, mouth, and eyes. The virus can easily be contracted via airborne transmission of respiratory droplets when someone sneezes or coughs, through direct contact with an infected person, or through contact with contaminated objects (an individual touches the contaminated object and then touches his or her mouth, eyes, or nose).

Tests and Diagnosis

No definitive medical tests exist to diagnose the common cold or flu. Diagnosis is generally based on the patient’s symptoms and/or physical examination findings. If necessary, some doctors may also use a flu test known as the “rapid influenza” test to confirm the diagnosis. This test can provide results in about 15 to 30 minutes.

Prevention

Washing your hands with soap and warm water is considered one of the most effective means of cold and flu prevention. Many health experts agree that the best way to prevent the influenza virus is to receive the annual flu vaccine. If the virus is on your hands, it can easily enter your body through your eyes and nasal cavity, so keep your hands away from your eyes and nose when possible. The following additional measures may prevent or reduce your chances of getting a cold or the flu or transmitting the virus to others:

• The Centers for Disease Control and Prevention recommends using alcohol-based hand sanitizers to disinfect your hands when soap and water are not available.
• If possible, avoid being in close proximity to those who are sick, and avoid being around others if you are sick.
• When you sneeze or cough, cover your nose or mouth.
• Sneeze or cough into your elbow or a tissue instead of your hand.
• Wash your hands after coughing or sneezing.
• Routinely clean environmental surfaces with disinfectants.

Management

While recovering from a cold or the flu, it is important to stay home, get plenty of rest, stay hydrated, and monitor for and treat fever. If your symptoms do not improve or if they worsen, you should immediately contact your doctor to avoid potential complications. This is especially true for young children, the elderly, and those with a chronic medical condition.

Treatment and Care

If you do get the flu, your physician may prescribe an antiviral medication that can decrease the severity of symptoms and reduce the duration of illness. These antiviral medications work best if they are initiated within 48 hours of experiencing flu symptoms.

Currently, there is no cure for the common cold, but many OTC medications are marketed to provide symptomatic relief of both cold and flu symptoms such as sore throat, congestion, cough, and fever. Following are examples of common cough and cold medications:

• Decongestants
• Antihistamines
• Expectorants and cough suppressants
• Antipyretics/analgesics (for fever and body aches)
• Anesthetic and antiseptic products (for pain and discomfort associated with sore throats)

Patients exhibiting signs of worsening infection such as cough or nasal secretions with colored phlegm, high fever, or swollen glands should seek medical attention immediately.

Homeopathic and Alternative Remedies

Many individuals use homeopathic or alterative remedies to prevent or provide for relief from cold and flu symptoms. Several homeopathic/alternative products for colds are available:

• Echinacea
• High-dose vitamin C supplements
• Zinc lozenges, tablets, or oral sprays

According to the National Institutes of Health, the following are examples of homeopathic/alternative products used to alleviate flu symptoms:

• Echinacea
• Elderberry
• Green tea
• Chinese herbal medicine
• North American ginseng
• Oscillococcinum
• Pomegranate extract
• Vitamin C
• Vitamin D

Talk to a pharmacist or doctor before taking these herbs or supplements, to ascertain appropriateness and to avoid potential drug interactions or contraindications.

Self-Care

Several cough and cold and flu medications are available over the counter to provide symptomatic relief. Your best defense in preventing the flu in yourself and your loved ones is to receive the annual flu vaccine. If you have never had a flu vaccine, talk to your doctor to determine what is best for you. Pharmacists can advise you on the best medications to meet your individual needs. You should inform the pharmacist of your medical and medication history to avoid potential drug interactions or contraindications. Nonprescription cough and cold medications should not be given to children under 4 years of age; pediatricians should be consulted for other treatment options.

Resources for Patients

Common Cold and Cough

• American Lung Association
• Medline Plus (National Institutes of Health)
• National Institute of Allergy and Infectious Disease
• Centers for Disease Control and Prevention

Flu

• Flu Facts
• Understanding Flu (National Institutes of Health)
• Centers for Disease Control and Prevention

Resources for Health Care Professionals

Common Cold and Cough

• Centers for Disease Control and Prevention
• National Institute of Allergy and Infectious Disease

Flu

• Centers for Disease Control and Prevention Seasonal Flu Information for Health Professionals
• Flu.gov for Healthcare Professionals