You’re sniffling. Your throat hurts. You feel miserable.
Is it the flu, or a cold? Is it time to see the doctor, or should you just curl up in bed?
As a longtime family physician, Emi Chiusano has seen it all.
Now an area director for MedExpress Urgent Care, she is based in Cherry Hill and oversees 12 of its centers in New Jersey, from Hamilton Township to Vineland and Pennsville. She spoke to us recently about how to navigate winter ills.
Colds. Influenza. Both are caused by viruses.
As for upper-respiratory viruses — the colds — most people catch these every year, often several ones. Symptoms can include a sore throat, stuffy or runny nose, a cough. The person also might have a low-grade fever and fatigue. They can have one or two of these symptoms, or all of them. Colds tend to come on slowly. Typically, you’ll start to feel rundown, then you start to get a sore throat, then your nose gets stuffy and runny. It gets worse for about the first four to five days, and on average, it takes 10 to 14 days to go away. You’re low-grade miserable for close to two weeks. If you have a dry cough, that can even last two to three weeks.
With influenza, the symptoms tend to be much worse. It usually comes on suddenly. You may be fine in the morning and in the afternoon, you’re not. It usually comes with a high fever — 101 and up. You’re achy all over. You might have a little dry cough, sore throat, and a runny nose, but not the kind of miserable stuffy, runny nose that you get with a cold. You may also have headaches, vomiting and diarrhea.
Influenza is the one we always worry about, because depending on the person, it can be very severe. Patients who are at high risk of complications should, first, get the flu shot, if possible. But if you didn’t get one, or you have symptoms anyway, you should get to your doctor right away. There are antiviral medicines we can use, but they need to be started as quickly as possible.
The ones at highest risk for complications from the flu are children younger than age 5, people ages 65 and older, people with heart problems, kidney problems, liver issues, diabetes, anyone on immune-suppressing medication. Pregnant women are at high risk. Interestingly, American Indians and native Alaskans also are at high risk. It is a long list, so, really, for anyone young or old or with chronic medical problems, if they suspect they are getting the flu, they should see a doctor right away.
In a young, healthy person — a 25-year-old or 35-year-old with no medical conditions — we usually tell them to stay home, take ibuprofen, drink lots of fluid,s and don’t go to work until the fever has been gone for 24 hours. Stay out of public places.
Many people automatically think that if they get an antibiotic, they’ll feel better. A lot of doctors don’t like to say no. That’s one of the reasons we have such a problem with antibiotic overuse in this country. But antibiotics won’t cure the common cold or influenza.
However, sometimes if you have a cold and it kind of drags on for a while, it can turn into something else, such as a sinus infection. If you have green mucus coming out of your nose and pain in your sinuses — in the cheek and forehead area — that doesn’t get better in 10 days, it may be more than a cold. When the mucus stays in your sinuses for days and days, bacteria can grow there. Now, you have a bacterial sinus infection. And that’s when you need an antibiotic.
Another condition that can mimic colds and influenza is bacterial pneumonia. You will usually have a cough with colored mucus, a fever of at least 100.6, maybe chest pain when you take a deep breath. If someone has a really bad cough and is feeling terrible, and if they’re short of breath, they should go to a doctor. We would diagnose bacterial pneumonia with a physical exam and a chest X-ray, and prescribe an antibiotic.
Strep throat is another illness that’s pretty common. It’s a sore throat, but it’s caused by a bacteria, group-A streptococcus. Usually, the patient has a very sore throat and swollen glands, maybe a little nasal congestion but usually no cough. The tonsils may be swollen. You need a test to tell this apart from other types of sore throat. This needs to be treated with an antibiotic.
Get the flu shot. Practice good hand-washing. Any time you go out, and you touch something, as soon as you get back home, wash your hands thoroughly with soap and water. Also, if you’re out, try not to touch your face. If the virus is on your hands, you can infect yourself. Generally, drink plenty of fluids. Make sure you’re getting enough sleep and rest so you’re not rundown.
If you’re coughing and wheezing and having shortness of breath, you should definitely go see a doctor. Or, if you’re an asthmatic and the wheezing isn’t getting better with your regular medications. Also, if you have a fever of 102 or more. A cough that doesn’t go away after two weeks. And, any time you just feel really terrible and you just know that something’s not right, it’s probably better to go see a doctor and get checked out.
If it feels like a normal cold — stuffy runny nose, dry cough, generally feeling blah — I would say to just stay home and rest and see how you feel in a few days.
For kids, schools are pretty specific about that. However, each school seems to have a different policy for children who have been diagnosed with influenza. Some schools want the kids to be out for at least five days. But generally, they should have no fever for at least 24 hours with any type of illness.
If it’s an adult and a work situation, the guideline is to have 24 hours with no fever before coming back to work. Yes, people with bad colds often do go to work and risk infecting their coworkers. But once you start staying out for a cold, you’re going to have so many people out of work every day. So, mostly, you should wash your hands frequently and cover your mouth. But if you feel really lousy, stay home.
Flu season peaks between December and February. So the good news is that, by summer, it will be gone.