cough, cold an the flu .....

Colds and Flu: Upper Respiratory Infections

On this page:

• Symptoms of cold, flu, pneumonia or meningitis
• When to seek medical care
• Tips for treating yourself
• Non-prescription (over-the-counter) medications
• Prescription medications
• Alternative treatments for colds and flu
• Tips for academic success while sick
• Prevention

Symptoms of colds, flu, pneumonia and meningitis Symptoms of colds, flu, pneumonia and meningitis can be similar. Mistaking one for the other could mean an extended illness and serious complications. So how do you know what you have?

You can print a poster of this information for easy reference.

Colds are inconvenient but usually not serious and can be treated at home (see Tips for treating yourself for treatment suggestions). Symptoms may last 4-14 days and may include:

• Runny nose and/or sneezing
• Coughing
• Sore throat
• Head and body aches
• Low fever (less than 101° F)
• Congestion of the ears, nose, throat and head

Flu typically hits in Michigan December-March. Acute symptoms last 3-4 days, and cough may linger for 3 weeks. Gastrointestinal symptoms are rare. Your clinician may prescribe an anti-viral medication. Complications are not common in young, otherwise healthy adults. Symptoms include:

• Rapid onset of symptoms
• High fever (greater than 101° F)
• Severe body aches and/or headache
• Dry cough
• Extreme fatigue
• Chills

For more information, see Flu and Vaccination

Pneumonia can be serious and even fatal. See a clinician if you experience symptoms, which include:

• High fever (greater than 101° F)
• Cough that produces thick, brown or bloody phlegm
• Chills
• Chest pain while breathing

Meningitis requires immediate medical care. Early diagnosis and treatment is critical. Meningitis can be caused by viruses or bacteria, and bacterial meningitis can be fatal if untreated. If you experience meningitis symptoms, consult your clinician or go to an emergency room immediately. Symptoms include:

• High fever (greater than 101° F)
• Severe, sudden headache accompanied by any of the following:
  • Mental changes (e.g. agitation or confusion
  • Neck or back stiffness
  • Rash on any part of the body (commonly the armpits, groin, ankles)

For more information, see Meningitis and Vaccination

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When to seek medical care

You can print a poster of this information for easy reference.

Symptom:	Consider treating yourself:	Seek medical care:
Sore throat	Scratchy, sore throat Can swallow liquids Minor swelling of neck glands	Difficulty swallowing liquids White or yellow spots in throat Increased pain after 3 days
Fever	Less than 101° F	Greater than 101° F for more than 3 days Fluctuating above 101° F several times a day Shaking chills
Cough	Dry cough	Foul smelling, brown or bloody phlegm Persistant cough Chest pain Wheezing Shortness of breath
Runny nose, sneezing	Relatively clear drainage Mild sinus and/or facial discomfort	Foul smelling, brown or bloody drainage Severe sinus and/or facial discomfort
Headache	Mild pain Pain that improves with non-prescription pain reliever (e.g. acetaminophen, ibuprofen)	Blurred vision, dizziness, nausea or vomiting Neck or back stiffness Mental changes (e.g. agitation or confusion) Severe headache with fever greater than 101° F and rash on any part of the body SEEK MEDICAL CARE IMMEDIATELY!
Body ache	General aches	Persistant pain in abdomen
Fatigue	Genaral tiredness	Excessive fatigue
Earache	Stuffy or clogged ears	Pain or discharge from ears

Tips for treating yourself

Listen to your body. If you feel well enough to exercise, it may help to counter the muscle weakness that often accompanies a cold or flu. Don't overdo it - cut back on the intensity and duration of your usual workout until your muscle fatigue abates, then build up again slowly. Intense activity may increase discomfort and lower your resistance to additional infection.

Drink plenty of fluids. Drink as much water and juice as possible - preferably two quarts per day - to help counter the dehydration that causes much of the discomfort associated with fever. Fluids are also important for loosening and removing secretions and stuffiness from the body. Fluids may also help soothe a sore throat. Alcohol tends to dehydrate, so try to avoid it.

Refrain from smoking. Smoking makes it difficult for your body to eliminate mucous from the lungs and may predispose you to bronchitis or pneumonia. This would be a good time to consider quitting! See Tobacco: You Can Quit!. If you choose not to quit, reduce the number of cigarettes you smoke while sick.

To relieve a sore throat, drink plenty of fluids. Gargle with warm water (you can add salt) to help reduce any inflammation. Keep your throat moist by using a vaporizer or sucking on throat lozenges or ice cubes made from fruit juice.

For congestion, try sleeping on your back with your head raised on two or three pillows. You may find additional relief with oral and/or nasal decongestants (see Non-prescription (over-the-counter) medications).

For sore nose and chapped lips, apply petroleum jelly or emollient lotion. A 0.5-1% hydrocortisone cream applied three times a day may also provide relief to a red, irritated nose.

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Non-prescription (over-the-counter) medications for colds and flu

The UHS Pharmacy 734-764-7387 sells a variety of non-prescription cold and flu medications.

Some overall tips:

• It's usually best to take a single medicine targeted for a particular symptom rather than an all-in-one preparation.
• Generic versions are as effective and usually cheaper than brand-name versions.
• Use caution when combining medications. If you're taking more than one medication, consult your pharmacist or clinician.
• Be sure to read warning labels, follow instructions and use medications only when necessary.

Analgesics reduce body aches, headaches and fever.

• Acetaminophen (e.g. Tylenol, Panadol) is a painkiller and fever reducer. Doesn't irritate the stomach. Safe for people allergic to aspirin.
• Aspirin is a painkiller, fever reducer and anti-inflammatory with relatively few side effects. May irritate stomach, so take with food. Not recommended if under age 19 due to association with Reye's syndrome.
• Ibuprofen (e.g. Advil, Nuprin) is a painkiller, fever reducer and anti-inflammatory. May irritate stomach, so take with food.
• Ketoprofen (e.g. Orudis, Actron) is a painkiller, fever reducer and anti-inflammatory. Has same effect as ibuprofen at a much lower dose. May irritate stomach, so take with food.
• Naproxen sodium (e.g. Aleve) is a painkiller, fever reducer and anti-inflammatory. Pain relief lasts 8-12 hours, about twice as long as other painkillers. May irritate stomach, so take with food.

Antihistamines (e.g Benedryl, Chlortrimeton, Tavist-1) dry mucous membranes and make breathing easier.

• May cause dryness of the nose and mouth.
• Often cause drowsiness, so should not be used while driving or operating machinery.

Decongestants (e.g. Sudafed, Afrin Nasal Spray) shrink swollen nasal membranes and make breathing easier.

• May act as a stimulant in some people.
• Most effective when taken orally but may also be taken as nose drops or sprays.
• Should be used with caution by people with high blood pressure.
• Nasal drops/sprays are not advised for more than 3 days because they may actually increase congestion (called "rebound effect").

Cough expectorants (e.g. Robitussin) may loosen secretions and make coughs more productive.

Cough suppressants (e.g. Diphenhydramine syrup, Hold DM) reduce sensitivity to the cough reflex so you cough less. Good for coughs that prevent sleeping.

Lozenges and throat sprays (e.g. Chloraseptic, Cepastat, Halls) temporarily relieve the pain of a sore throat. Dissolve lozenges slowly in the mouth. Continuous use may cause nausea.

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Prescription medications for flu

Antiviral drugs, available by prescription, may decrease the severity and duration of illness if taken within 48 hours of onset of symptoms.

Antiviral drugs may also be used during a local outbreak to prevent influenza in people who are at high risk of complications and who have not been previously vaccinated.

Anitbiotics are not effective against the viruses that cause colds and flu. Viruses multiply within the body's cells where antibiotics generally cannot reach. And unnecessary antibiotic use disrupts the body's natural balance of organisms and increases resistance. For more information, see Antibiotics: Less is More.

Alternative treatments for cold and flu include chicken soup, echinacea, zinc lozenges and vitamin C. These treatments may reduce duration and severity of cold symptoms but their effects are not proven and they are not regulated by the US Food and Drug Administration, so purity and dosage of products is not ensured.

UHS offers the following cautions:

• If you use zinc lozenges, make sure to reduce intake down to Recommended Daily Allowance (15 mg for men and 12 mg for women) after your cold. Over the long term, too much zinc (more than 50-100 mg per day) may weaken your immune system, interfere with absorption of other minerals and lower your HDL ("good") cholesterol.
• If you take vitamin C supplements, be aware that more than 500 mg per day may lead to cramps, diarrhea and kidney stones. Chewable vitamin C also erodes tooth enamel.

Please consult your clinician or the following resources for more information about alternative treatments:

• Office of Dietary Supplements, National Institutes of Health
• National Center for Complementary and Alternative Medicine, National Institiutes of Health
• Enerchihealth.com

Tips for Academic Success While Sick

Prevention Stop the spread of germs that make you and others sick! And now you can print a poster of Cover Your Cough prevention tips.

• Cover you nose and mouth with a tissue every time you cough or sneeze. Throw the used tissue in a wastebasket.
• If you don't have a tissue, sneeze or cough into your sleeve.
• Clean your hands with soap and water or an alcohol-based hand cleaner.
• Avoid touching your eyes, nose or mouth
• Do not share eating utensils, drinking glasses, towels or other personal items.
• Stay home when you are sick.
• Avoid close contact with people who are sick, if possible.
• Get vaccinated. See Flu and Vaccination and Meningitis and Vaccination.