Question: I
recently saw my doctor after a bout of what I thought was
“the flu.” She told me that I had “a cold,” and that a virus
caused it. She didn’t recommend antibiotics, even though I
had been sick for five days. How can I tell when I have “the
flu” vs. “a cold” and when do I need antibiotic treatment?
And why do these infections happen most often in the winter?
Answer: There is always a lot of confusion about
winter infections! First of all, both “a cold” and “the flu”
are caused by VIRUSES. Viruses DO NOT respond to
antibiotics.
Antibiotics are used to treat infections caused by BACTERIA,
which are completely different organisms. Sometimes it is
hard to distinguish between viral and bacterial infections,
so it is important to give your doctor a complete history of
your illness and the symptoms. This will help ensure the
right diagnosis.
There are over 200 viruses that can cause “a cold”, which is
an infection of the nose and throat. Colds usually last
three to five days, although symptoms can persist up to 14
days. The signs and symptoms of “a cold” are listed in the
chart on page 15. Compare these with signs and symptoms of
influenza, or “the flu”. This is also caused by a virus –
the INFLUENZA virus, which comes in three strains: A, B and
C.
Influenza is a much more serious illness than a cold, and
can be deadly for a frail young or elderly person.
Unfortunately, antibiotics are not of any use, but we do
have a VACCINE to prevent influenza. Every year, scientists
make a vaccine against the strains of influenza that are
most prevalent for THAT YEAR. To be protected, you need a
new flu vaccine every year, since different strains of the
influenza virus emerge to cause the flu each year.
We DO NOT have a vaccine against the common cold, because
there are so many different viruses (each with many strains)
that can cause a cold. There is NO TREATMENT for a cold,
except to let your body’s defenses – your immune system –
rid the body of the offending virus.
Stomach symptoms, (vomiting, diarrhea and nausea - the
“stomach flu”) are NOT part of influenza or “a cold”, though
these ARE also caused by a separate large group of viruses.
Stomach viruses often occur in the winter for the same
reasons, though they are spread by hand-to-hand contact and
not by droplets. BACTERIAL infections occur more frequently
in the winter as well, for all of the reasons listed
earlier, AND because bacterial infections may occur as
COMPLICATIONS of viral infections.
The body’s defenses, weakened by fighting off a virus, may
be unable to prevent a bacterial infection from developing.
This is called SUPERINFECTION.
Bacterial infections are usually LOCALIZED, affecting a
single organ or area of the body and causing severe symptoms
in only that area. This is in contrast to viral infections,
which affect multiple areas (i.e., the head, nose, throat,
chest and muscles) with less severe symptoms.
For example, both a viral cold and a bacterial infection may
produce a cough. A viral cough will usually be accompanied
by other symptoms, such as a stuffy head, runny nose and
sore throat.
A bacterial cough, such as bronchitis or pneumonia, however,
will not involve the nose or throat, but will have other,
more severe respiratory symptoms accompanying it, such as
green or yellow sputum, severe chest pains, fever and
shortness of breath.
Similarly, a virus and a bacteria may both cause a headache
and runny nose, but a bacterial infection, such as
sinusitis, would also include fever, green or yellow nasal
discharge, dizziness, nausea and facial pain, which would
not be part of a viral cold.
Suspect a viral infection
(“a cold”) when:
-
Symptoms develop gradually.
-
Fever is absent, or low-grade
(<100.5), and occurs early in the course of the illness.
-
Symptoms affect multiple organs or
systems and are mild and not disabling.
-
Symptoms improve over three to seven
days, and resolve completely after about 14 days.
Suspect a
bacterial infection when:
-
Symptoms develop suddenly, or worsen
after initially improving.
-
Fever is present, especially if high
(>100.5), persists more than two to three days or
develops late in the course of the illness.
-
Symptoms affect primarily one organ
or system and are severe and disabling.
-
Symptoms do not improve after five to
seven days, or new, more localized symptoms develop
after four to five days of generalized symptoms.
Protect
yourself from winter infections (both viral and bacterial)
by getting a flu vaccine, minimizing exposure to large
groups of people, especially in enclosed surroundings and
practicing good hand washing and hygiene. |
