The winter chill is in the air and everyone around you is sneezing. What can you do to steer clear of cold and flu viruses this season?
The best medicine is prevention.
The first step is to avoid getting sick in the first place. Here are my tips:
- Wash and sanitize your hands frequently. This is the best way to avoid getting sick. In the hospital there are Purell dispensers in front of every patient room and sinks easily accessible. I sanitize my hands before and after every patient encounter. I also wash my hands before eating or before touching my face. I carry hand sanitizer in my purse and in my car.
- In fact, I avoid putting my hands near my face unless freshly washed. (This is no easy task for a former nail biter!)
- Avoid people who are sick, especially if you are immunocompromised. If you must come in to close contact with someone who is sick (e.g. your child), wash your hands after any contact with them and before eating or putting your hands near your face. Consider wearing a mask.
- If you are in close contact with someone with documented influenza, discuss with your PCP whether you should take prophylactic oseltamivir (Tamiflu) medication.
- GET YOUR INFLUENZA VACCINE! Everyone. Even if you have never had the flu. Even if you are otherwise healthy. I cannot stress this enough to my patients. The influenza vaccine saves lives. Some myth busting:
- You cannot get influenza from the injected influenza vaccine. You may develop a day or two of malaise and even a low-grade fever as your body creates antibodies to the vaccine. However, you cannot develop influenza.
- Vaccines do NOT cause autism. More on this in a later post, but read this for more.
- The vaccine is not 100% effective (nothing is in medicine). However, it significantly reduces the incidence of influenza.
- See the CDC website for more.
- Get your pneumococcal (“pneumonia”) vaccine if you meet criteria (eg. if you are above the age of 65 or if you smoke, have diabetes, or a variety of other chronic illnesses). This will help protect you from one of the common causes of bacterial pneumonia. Discuss with your PCP.
But why should I care about avoiding getting a respiratory infection in the first place?
- According to the CDC, about 36,000 people die of influenza each year.
- In my ICU rotation my intern year, I took care of an otherwise healthy 45 year old man who developed acute respiratory distress syndrome from the flu and was on a ventilator for 5 weeks.
- I personally got the H1N1 flu in 2009 and, though I was otherwise perfectly healthy at the time, I was completely out of commission with a high fever for 11 days. This was followed by another week of so of pneumonia and a pleural effusion. The flu is no joke!
- It’s bad for the economy. No, seriously. According to the CDC, influenza alone causes workers in the US to lose up to 111 million workdays, totaling to an estimated $7 billion per year in sick days and lost productivity.
- Even a simple “cold” (a viral upper respiratory infection) can be fatal for people with chronic conditions such as asthma and COPD, people who are immunosuppressed (eg. people with cancer on chemotherapy, people with autoimmune disorders on immunosuppressing medications, people with HIV/AIDS).
- You can pass it on to other people, including people with the above conditions.
- It’s a hassle! Whether you are the one who is sick or your child, spouse, or loved one is, respiratory infections are a nuisance.
I’ve caught a cold (or flu)! Now what?
- If you have a fever (temp > 100.5F), consider getting tested for influenza with your PCP or at an urgent care center, as you may qualify for receiving oseltamivir (Tamiflu). You must present within 48hr of symptoms to have any benefit from Tamiflu. This medication can reduce symptoms and shorten duration of illness by 1-2 days.
- If you have fever and cough productive of sputum (of any color), or symptoms that do not get better within a week, seek medical examination as you could have a lower respiratory infection such as pneumonia.
- For all other viral upper respiratory infections (symptoms such as sore throat, runny or stuffed nose, runny eyes, sneezing), no medication is needed. You may take supportive medications (i.e., medications to make you feel better). Your body will fight the virus on it’s own.
- Get rest, drink plenty of fluids, and avoid close contact with other people in order to prevent passing the virus on.
- If you have malaise, muscle aches, headache, or fever, ibuprofen (the active ingredient in Advil and Motrin) and/or Acetaminophen (the active ingredient in Tylenol) can help relieve those symptoms.
- Discuss with your doctor whether these medications are safe for you. For example, those with kidney problems and those at increased risk of bleeding should not take ibuprofen without OK from your doctor. Those with liver problems should check with doctor before taking acetaminophen.
- Seek medical care if you have a severe headache, especially if you do not typically have headaches or if it is the worst headache of your life.
- If you have a stuffy or runny nose, consider saline nasal spray or using a Neti Pot. Decongestants such as DayQuil can help (contains 3 ingredients: acetaminophen, a cough suppressant, and a nasal decongestant) though I personally never use these myself. Ask your doctor before using decongestants (ingredients such as phenylephrine) especially if you are prone to a racing heart, high blood pressure, or glaucoma.
- If you primarily have phlegm and a productive cough, you may benefit from a cough suppressant such as Mucinex (tablets) or Robitussin (liquid). I order them frequently in hospitalized patients.
Using these tips I have avoided getting sick so far this season (knocking on wood!). Stay healthy and be well!
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