Sunday, February 25 2018 11:52

Colds, Flu, Bronchitis, Pneumonia — The Scourge of Winter

Written by Dr. Charles P. Catania, Gateway Medical Associates

This epic flu season isn’t over yet. What are you suffering from?


Staying healthy in the winter can be challenging! How often have you heard from family members or co-workers that they’ve been sick for weeks or have a cough that just won’t go away? The next thing you hear is that the symptoms got bad enough to send them to the doctor. Now they’ve been diagnosed with bronchitis or walking pneumonia.

Sadly, these situations have become commonplace. Too many of us are working longer hours and running our immune systems into the ground. In winter, our sleep suffers, our diets wander, and we attend many social gatherings held indoors. Add to the mix that simple hand-washing hygiene may be forgotten. All these things leave the door open for the common cold, the flu, bronchitis and even pneumonia—or as we describe them, the scourge of winter.

When talking about these common ailments, it’s key to understand that they are easily transmitted through the air when someone coughs, sneezes or talks, as well as by contaminated surfaces in our surroundings. It’s important that we practice good hand hygiene as studies show that hand-washing could reduce respiratory infections by 16%.

During the winter, it’s equally important to strengthen our immune system by eating nutritious meals, getting regular exercise and adequate sleep, and minimizing our overall stress.

But what should we do if we get sick?


Some Basic Background

A first step is to know which ailment you have.

The common cold is a virus with more than 200 known strains (with rhinoviruses being the most common), making it difficult for a suppressed immune system to guard against. Influenza is also a viral illness and also has many different strains, again making it difficult to avoid becoming infected.

Although the symptoms of the common cold and flu are similar, they generally differ in severity and onset—colds come on slowly and are less severe, while flu symptoms appear more suddenly and are worse.

You may develop upper respiratory problems—a sore throat, runny or stuffy nose, fatigue and headaches with the common cold, which may last for a week to ten days. When influenza is suspected, fever (over 100.4), chills and sweats, body aches (especially back, arms, legs), dry persistent cough and increased fatigue are usually apparent, causing a greater level of misery.

Although similar in symptomology to some viruses, bronchitis and pneumonia also differ in severity. Bronchitis by definition means an inflammation of the lining of the bronchial tubes leading to the lungs and may be acute (sometimes called a chest cold) or chronic (a different type of ailment not addressed here).

The inflammation with bronchitis causes thick mucus and trouble breathing from the inflammatory response within the tube bringing air to the lungs. A sore throat and persistent cough are sometimes accompanied by shortness of breath, slight fever and chills, and chest discomfort. Sometimes developing from a cold, bronchitis is less severe than pneumonia, but the cough can last for weeks.

Pneumonia is also caused by an infection, in this case of the air sacs located inside one or both of your lungs, causing fluid in the lungs. Pneumonia may be bacterial or viral and is often accompanied by a productive cough, fatigue, high fever with chills, chest pain and trouble taking a deep breath. It can range from mild, often called walking pneumonia, to a life-threatening disease, especially for infants and seniors.


What To Do

If you’re unfortunate enough to catch one of these winter ailments, it’s important to know what to do and when to do it. First, try to recognize symptoms as quickly as possible and then react accordingly.

If you’re ever confused about what to do, it’s best to contact your doctor for advice. Often early symptoms can be improved with simple home and over-the-counter remedies.

For both the common cold and flu, the best advice for early treatment is to make sure you’re well rested, well hydrated and well nourished—and yes, chicken soup, as well as other warm liquids, can help. In addition, medicines like acetaminophen and ibuprofen can help with muscle pains, headaches and fevers that accompany the common cold and influenza.

Using nasal saline and decongestants can often improve nasal symptoms, along with salt water gargle and cough syrup for your cough. Even for colds, which generally resolve themselves, see a doctor if you have a fever over 101.3, or lasting more than five days, or severe throat, sinus or head pain.

Even though viruses can last 10 to 14 days, it’s advisable that if symptoms are progressing without improvements between days 3 to 7, you should seek medical attention to ensure you’re not battling something more serious.

Although the flu generally resolves on its own, it can be deadly. Certain groups are at greater risk—kids under 5, adults over 65, pregnant women, those with weakened immune systems or with certain chronic health conditions—so annual flu vaccinations are highly recommended.

It’s also important to seek medical attention within the first 3 days if you have a very high persistent fever, which may indicate influenza. The anti-viral therapy (Tamiflu) can help if administered within the first 48 hours.

If your symptoms are more bronchial or lower respiratory in nature (rather than a head cold), with a persistent or productive cough, chest congestion, difficulty breathing, and sometimes wheezing, then consider the possibility of bronchitis. In contrast, you may be dealing with a mild infection of pneumonia if a fever or chest pain is present.

Bronchitis symptoms could be lessened by using over-the-counter decongestants and mucolytic medications that break up mucous and decrease coughing. If OTC medications don’t help, your doctor may prescribe oral or inhaled steroids. In some cases inhalers to decrease inflammation may also be prescribed.

When there’s a fever or chest pain, your doctor may recommend a chest x-ray to check for pneumonia. If bacterial pneumonia is confirmed, antibiotics are generally prescribed. A vaccine is recommended for adults over 65.


Limited Use of Antibiotics

Note that antibiotic therapy has come up only for pneumonia. Although many patients want a quick fix of a prescription medicine, with most of these ailments it’s recommended to treat symptoms rather than jumping immediately to antibiotic therapy.

When battling these ailments, it important to be vigilant in washing your hands, coughing and sneezing into your elbow or tissues to prevent spreading them to people around you. Another key recommendation is to take time off from work, school or other gatherings if you have a fever or if your symptoms are severe. Again, most of these irritating symptoms improve within 10 to14 days, so you may return to work if you seem to be improving.

In summary, know your body and practice a healthy lifestyle as best you can. The stronger we keep our immune system and the better we are

with hand-washing and hygiene, as well as avoiding those with symptoms, the more successfully we can fend off these unwanted nuisances of winter.


Charles Catania, M.D., is board certified in family medicine and hospice medicine. In private practice since 2010, he is currently in practice with Gateway Medical Associates in West Chester and is a Hospice Medical Director for Willow Tree Hospice, Kennett Square. Named a Top Doc by Main Line Today, he takes pride in bringing a personal and friendly experience when caring for his patients and their families.


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