FAMILY MEDICINE® COLUMN

By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

HIGH FEVER, BODY ACHES AND FATIGUE TELLTALE SYMPTOMS OF FLU

Question: How do I know if I have the flu or a cold? When should I go to the doctor? Everyone at work is sick. They all seem to have the same symptoms, but each one says they have a different thing. Also, if this is the flu, is there anything the doctor can do about it?

Answer: This is a timely question because we are right in the middle of flu season. While you can come down with influenza at any time of the year, it is most common in the United States from December to March -- give or take month or so. During some winters it can reach epidemic proportions.

There are three types of influenza virus: A, B and C. Two of these -- A and B -- are usually the most severe and contagious. These viruses are constantly mutating and the strains that circulate around the world change every year. It’s hard for the body's defense mechanisms to keep up with these changes. That’s why it’s important to get a flu shot each year.

The flu vaccine is generally made to cover the A and B viruses. This is because C usually produces only very mild symptoms, if its presence is even noticed at all. It does not produce epidemics and is not a public health concern.

Type A and B influenza attack the nose, throat, and lungs. The symptoms usually come on suddenly and may include high fever, headache, cough, sore throat, nasal congestion, body aches and fatigue.

With a cold, the onset is more gradual, the fever is usually low grade if present, and the symptoms are primarily in the upper respiratory tree -- head, nose and throat. It’s much less common to have high fever, body aches and fatigue with a cold.

Both the flu and colds are spread by air-borne droplets from coughing, sneezing and even talking by an infected person. You may be infected and spreading the virus for several days before you have symptoms of illness. The virus can live on surfaces, like the phone, the counter top, the door handle and the remote control. If you touch a contaminated item and then rub your nose, mouth or eyes, you can give yourself the virus.

There is a rapid test for influenza that your physician may do in his or her office. It is a nasal swab that in about 15 minutes can determine if you have influenza type A or B. This can help the physician determine if antiviral medications should be used. Antiviral medications shorten the length of the viral illness and help to lessen the symptoms as well.

Though anti-viral medications are being developed for the common cold, none have been approved by the Food and Drug Administration at this time. If you don’t have the flu, the currently available antivirals will not be of much help.

If you get the flu and your doctor rules out anti-viral medication, you should try the standard old-fashioned treatments. These include bed rest, drinking plenty of fluids, and taking medication, like acetaminophen (Tylenol), to manage the fever and body aches. If you have a cold, the treatment is somewhat similar: bed rest, fluids and ibuprofen or acetaminophen. If you have a scratchy or sore throat, you may also find it helpful to gargle with warm salt water or use throat sprays or lozenges.

For both colds and influenza, the best treatment is, of course, prevention.
Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.