Cold & Flu

Not everyone with a stuffy nose has the flu and not everyone with a cough has bronchitis. Upper respiratory infections can make a person miserable but learning how to treat symptoms can bring some comfort. Does this sound familiar?

Feeling miserable? Stuffed up? Throat hurts? Coughing? Runny or stuffy nose? Generally feeling miserable?

You may have an upper respiratory infection.  Here are commonly asked questions:

What is an Upper Respiratory Infection?
How can I stay healthy and keep my immune system strong?
How do I take care of myself if I do get sick?

When should I get medical attention?
What about medication?
How do I avoid spreading my germs?

What is an Upper Respiratory Infection?
Upper Respiratory Infections (URI’s) are caused by viruses, which usually resolve within 7-10 days. URI’s attack the lining of the nasal passages, which react by swelling and increasing mucous production. This results in nasal congestion, stuffy, or runny nose. Sometimes, the Eustachian tube to the ear becomes congested or clogged by mucous which causes a sensation of fullness in the ears or popping. Other symptoms may include sore throat, sneezing, coughing, mild headache, mild body aches and fatigue.
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How Do I Stay healthy and Keep my Immune System Strong
• Exercise regularly.
• Get adequate rest and sleep.
• Eat nutritionally balanced meals.
• Keep the humidity up in your house or room.
• Avoid tobacco use and second-hand smoke.
• Wash your hands regularly and avoid touching your face.
• Use your own eating utensils or cups – don’t share beverage containers or utensils.
• Wash your hands before eating or preparing food, after using the bathroom, after blowing your nose or coughing into your hands. Better yet – cough into your arm instead.
• Get an annual flu shot.

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How do I take care of myself if I do get sick?
Because most infections are viral, it is important to take steps to relieve your respiratory symptoms and support your body’s natural ability to fight infections. While antibiotics are not effective against respiratory viruses (they are only effective against bacterial infections), there are many self-care strategies that can help.

  • Hydrate. Drink plenty of liquids (8-10 glasses daily) of water, fruit juice, and soup to help soothe and lubricate your throat. Increasing your usual daily fluid intake will help your body keep the mucous thinner, making it easier to cough it up. Aromatic teas or spicy soups can help clear your sinuses. Chicken soup, bouillon or any salty liquid can help relieve the dizzy feeling that sometimes occurs with head cold symptoms. Hot drinks, like tea or broth, will soothe a sore throat, as will ice chips or Popsicles. Avoid alcohol and caffeine (including energy drinks), which are dehydrating.
  • Rest (at least of 8 hours daily). It is normal for you to need more rest whie you are sick. Rest conserves energy. While it is not necessary to remain in bed, it is important to get adequate sleep, nap if you need to, and generally take it easy.  Listn to your body.
  • Relieve pain. Take 2 aspirin substitutes (Ibuprofen or Acetaminophen), per package directions.
  • Sore Throat. Gargle with 1/2 teaspoon of salt in an 8-oz. glass of warm water every 3-4 hours. This will help soothe a sore throat and reduce the pain and swelling. It will also work as well as any expensive preparation. Tea with honey and lemon, soup, Benzocaine lozengers or sprayes (available at the Rutgers Health Center Pharmacy), and hard candy will also help soothe a sore throat. Contrary to popular belief, gargling with aspirin dissolved in warm water is not advisable as undissolved particles may stick in the throat and irritate the tissues. You need to swallow aspirin for the body to absorb it as a pain reliever.
  • Cool air and humidity will help keep your throat moist and more comfortable. Turn down the thermostat. Humidity provided by a hot shower, a sink filled with hot water, or a cool mist vaporizer increasing the humidity in your room while you sleep can also make you more comfortable.
  • Rest your voice as much as possible. Avoid straining your voice by screaming or loud talking.
  • Avoid smoke from cigarettes, cigars and pipes so that you won’t further damage your irritated bronchial tubes. Smoking also hampers your ability to bring up mucous by paralyzing the tiny hairs that sweep the mucous out of the breathing passages. Smokers have a greater tendency to catch colds and have more trouble getting rid of them. Hard candy or cough drops, cough lozenges or sprays may be temporarily helpful in relieving dry, tickling coughs.
  • Nasal Congestion: Use steam inhalation to help reduce congestion, thin mucous, and open up your sinus passages. You can use steam from a shower, teakettle, sink filled with hot water or a vaporizer in a confined room. Do this for 10 minutes, 3 to 4 times a day. Standing in a warm shower for 10-15 minuts will help too, and also alleviate some of those body aches. If you must fly, using a nasal decongestant spray before your plane takes off may help your sinuses to drain.
  • Cough: Coughing is a reflex action, which occurs in response to irritation of the breathing passages. It is the body’s attempt to get mucous out of the lungs and bronchial tubes. Avoid suppressing a cough that is bringing up mucus. If you have a dry, non-productive cough, take a non-prescription expectorant/suppressant if needed. Shallow raspy coughs are of no value and will irritate your throat further. Sometimes post-nasal drip running down the back of your throat may be the cause of your cough. In that case, a decongestant as well as a cough medicine may help.
  • Sinusitis: Sinusitis is an inflammation of the sinuses. Sinuses are hollow cavities in the skull that lighten the skull and give your voice resonance. They are lined with mucus-producing membranes and cilia (microscopic hairs) that move the mucus through the small passages toward the nose. The movement of this watery mucus keeps the nasal and throat passages moist and clean of dust, bacteria, viruses and other airborne particles. The Infectious Disease Society states that 90%-98% of sinus infections are caused by viruses, so most times, an antibiotic is not necessary.
  • Want to learn more about sinus infections, viruses, and antibiotics? Check out these websites:
    http://www.prweb.com/releases/antibiotics-avoid/sinus-infections/prweb9649802.htm
    http://cid.oxfordjournals.org/content/39/Supplement_3/S151.full
    http://www.ncbi.nlm.nih.gov/pubmed/11385344?dopt=Abstract
  • When you have a cold or an allergic reaction or are exposed to smoke, pollution or other irritants, the sinus membranes may swell. Once they swell, the mucus doesn’t drain and the cilia become less effective, allowing bacteria and viruses to invade through the nasal passages. This is a sinus infection. Sinus pain results when the sinuses are unable to drain due to swollen membranes blocking passages to the nose. Sinusitis usually occurs as a complication of the common cold or allergy. Sinusitis feels like the world’s worst cold. Most colds do not turn into a sinus infection. Want to learn more about the role of antibiotics in treating illness? Go to http://nj.gov/health/cd/mrsa/index.shtml.
  • Symptoms of a sinus infection may include headache or face pain not relieved by Ibuprofen or Acetaminophen; pain in the roof of your mouth or upper teeth; facial swelling on the cheeks or eyes. These symptoms should be evaluated by a health care provider and may indicate a bacterial infection.
  • Many people believe a change in nasal discharge (mucus) color from clear/white to yellow/green means a sinus infection. Research indicates this is not the case.
  • Want to learn more about the role of antibiotics in treating illness? Go to http://nj.gov/health/cd/mrsa/index.shtml and www.cdc.gov/getsmart/campaign-materials/brochures.html.
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    When should I get medical attention?
    Seek Medical Attention When You Have:

    • A fever over 101 F that lasts more than 48 hours.
    • A sore throat that is very severe or has lasted over 3 days.
    • Swollen glands or enlarged tonsils.
    • White mucous patches appear on the surface of the throat or tonsils.
    • Chest pains, shortness of breath, difficulty breathing, or wheezing.
    • A cough that is not improving, lasting a week longer than your other cold symptoms.
    • A productive cough that does not clear and/or pain in the chest or back.
    • An earache or drainage from the ear.
    • A severe headache or facial pain that is not relieved by aspirin substitute.
    • Confusion, lethargy, weakness.
    • Your vision is blurry or changes for the worse.
    • You have visible swelling around the eyes (a large sinus area).
    • Painkillers don’t relieve your sinus headache.
    • Symptoms that are not improving in 5-7 days, or a cold that doesn’t improve after 10-14 days.Back to TopWhat about Medications?
    Over-the-counter (OTC) and prescription medications are used to relieve URI symptoms and reduce the risk of secondary infections. Be sure to read the label carefully and follow package directions. If you have any questions about over-the-counter medications, consult with your pharmacist.
  • Expectorants and mucolytics help to liquefy secretions and relieve a dry cough. The most common expectorant is Guafenesin. It is in over-the-counter products like Robitussin, and Mucinex.
  • Cough suppressants reduce the urge to cough. Since cough is the body’s mechanism to clear the airways, suppressants should be used only when a cough is non-productive or interferes with rest. They should never be used for more than 5 days. Cough suppressants are usually found in combination with expectorants. Dextromethorphan (Robitussin DM, Vicks 44, Duratuss DM) is an effective OTC cough suppressant. Prescription drugs include Tessalon, and narcotics such as hydrocodone (Hycodan) and codeine (Robitussin AC, Phenergan with codeine). These will help to suppress a dry, hacking, non-productive cough and help loosen mucous.
  • Decongestants help reduce mucus production, relieve nasal and facial congestion, ear fullness, nasal discharge, and sore throat from postnasal drip. Pseudoephredrine and phenylpropanolomine (usually found in combinations) are effective, but may disturb sleep. Decongestants help to shrink blood vessels and swollen membranes in the nasal passages, making breathing easier. Decongestants may cause nervousness and insomnia. Check with your health care provider or pharmacist before using if you have high blood pressure, diabetes, heart disease, asthma, or thyroid disease.
  • Nasal sprays are effective decongestants but can cause worse problems if overused, or if used habitually. Nasal spray such as Oxymetazoline HCL 0.05% (Neosynephrine 12 hours, Afrin) provide rapid relief and will not interfere with sleep, but they must not be used for more than 3-5 days. Longer use can result in rebound congestion and increased symptoms. Follow the directions on the container. Saline nasal sprays are also useful in loosening nasal mucus.
  • Antihistamines are primarily used in the treatment of allergies such as hay fever. For this reason, they are not used in cold self-care. Antihistamines are intended to relieve allergy symptoms, but are included in many combination cold preparations because they may help to dry secretions. They can cause sedation. Over-the-counter antihistamines include loratadine, chlorpheniramine, clemastine, diphenhydramine, and brompheniramine. Common antihistamine/decongestant combinations include Claritan D, Contac Continuous Action 12 hour, Tavist D, Drixoral Cold and Allergy.
  • Antipyretics and analgesics relieve fever and general discomfort. Examples include Acetaminophen (Tylenol) and Ibuprofen (Motrin, Advil).
  • Use multi-symptom medication with caustion since it may mask a fever or increase risk of over-medicating when combined with other drugs. Examples of multi-symptom medications include Theraflu (acetaminophen, Dextromethorphan, Pseudoephredrine, and chlorpheniramine), Alka-seltzer Plus Cold and Flu (acetaminophen, Dextromethorphan, phenylpropanolomine, and chlorpheniramine) and Vicks Nyquil (acetaminophen, Dextromethorphan, Pseudoephredrine, and doxylamine succinate).
  • Herbal and vitamin supplements (still under study) that may have benefits in decreasing the severity or duration of viral symptoms include:
    • Vitamin C
    • Zinc gluconate lozenges (Cold-eze)
    • Echinacea standardized extract.
  • All must be started as close to the onset of symptoms as possible, and should not be continued for longer than 7-10 days. Researchers, however, have found that while the herb Echinacea may help treat your colds if taken in the early stages, it will not help prevent them. And while many people are convinced that taking large quantities of vitamin C will prevent colds or relieve symptoms, to date, no conclusive data has shown that large doses of vitamin C prevent colds. The vitamin may reduce the severity or duration of symptoms, but there is no clear evidence.
    WARNING: Avoid drinking alcohol while taking medications. Taking two central nervous system depressants such as antihistamines and alcohol may have very serious side effects.

    Antibiotics must be used as directed in order to be effective. Be sure you know the name of your antibiotic, and that you are not allergic to it. If a particular medication is too costly, talk to your health care provider about less expensive alternatives. Take the prescribed number of doses for the prescribed number of days, and call your health care provider if you have a problem. Expect to feel some improvement in 36-72 hours, although you will need to continue the medication until it is used up.
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How do I avoid spreading my germs?

Cover your coughs and sneezes
with disposable tissues. Wash your hands frequently and avoid touching your face. Keep your drinking glasses and towels separate from other people’s. If possible, avoid being close to people who have colds and if you have a cold, avoid being close to other people. The best way to cover your cough is to cough into the bend of your arm.

Hand washing with soap and water is the simplest and one of the most effective ways to keep from getting colds or giving them to others. During cold season, you should wash your hands often. When water isn’t available, the CDC recommends using alcohol-based products made for washing hands. Cold viruses can live up to 3 hours on your skin. They also can survive up to 3 hours on objects such as telephones and stair railings. Cleaning environmental surfaces with a virus-killing disinfectant might help prevent spread of infection.
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