It’s that time of year when a small tidal wave of coughing, sniffling, sometimes feverish folks are filing into the office.  And you, my readers, would rather not be among them.  So what can you do?

Well first let’s take a moment and consider what we’re dealing with.  Most of these respiratory infections are viruses.  On the milder end are your typical colds – not a lot medical doctors can do for those, just a few hints that you probably already know – rest, fluids, long hot shower in the morning where you try to blow and cough everything out from the night before, avoid passing it on to others (more on that shortly), and possibly some very slight benefit from things like vitamin C, zinc and andrographis.

Beyond that you look for signs that it is going into a secondary bacterial infection such as bacterial sinusitis, pneumonia, otitis (ear infection), or bronchitis.  Clues to this would be symptoms that are not improving after more than a week, or actually begin to worsen after initially improving.  A trend over several days of thicker, more colored mucous or an increased fever or new ear pain would be other signs that the initial virus may be evolving into a secondary bacterial infection where antibiotics would be appropriate.  If these happen, a trip to your doctor is worthwhile.

Then there’s the flu. Often we get a little blasé about it.  It’s good to remember that the Spanish flu epidemic of 1918 killed about 40 million people worldwide, including over half a million people in the U.S.   In an average year, deaths from complications of the flu range from 5 to 50 thousand per year and about 200,000 are hospitalized in this country.  So, overall it can sometimes be a pretty big deal.  If you’ve got a cough or congestion coupled with fever and body aches it’s good to come in to the doctor sooner rather than later since treatment with something like Tamiflu is mostly effective if started within 48 hours of symptom onset.

All in all there are hundreds of respiratory viruses along with some bacteria that also cause respiratory infections.  How can we improve the odds that we won’t catch one?  The ways to do this are mostly well known but worth reviewing:

  • Wash your hands frequently, especially if you’ve shaken hands with someone
  • Keep your hands away from your mouth, nose and eyes as this transfers viruses from the hands to infect these places
  • Get adequate rest as sleep deprivation temporarily reduces your immunity
  • Avoid getting chilled. The truth about “catching a cold” is that studies have shown that if you get chilled and are exposed to a virus you are more likely to be infected by the virus than if you hadn’t been chilled.
  • Don’t smoke as this makes you and those in your household much more prone to respiratory infections.
  • If you have a cough, cough into the inside of your elbow, not into your hand (only to be transferred to whatever you touch next)
  • If you use Kleenex throw it away immediately so it doesn’t infect someone else
  • Keep well hydrated
  • If you get sick, stay out of circulation until fever is gone for at least 24 hours and the cough and congestion are gone or very minimal.
  • Get flu shots and pneumonia shots when indicated.
  • Get regular aerobic exercise as (among lots of other benefits) it’s been shown to reduce respiratory infections, presumably by boosting the immune system.

If despite all your efforts, you catch one of these respiratory infections, watch for signs that it could be the flu, a bacterial respiratory infection, or just a more severe respiratory infection with high fever or shortness of breath.  Those are the ones that benefit from a doctor visit.  The others that just involve sneezy, sniffly cold symptoms you can weather at home.  Best of all, here’s hoping you completely avoid the viral tidal wave this season!