Issue date: January 28, 2001

In this article: Winter sickness: how to tell what you have

It's the height of cold and flu season, and I know what you're wondering.

Sniffing out answers

Here we are, right smack in the middle of winter, settled into routines and waiting for spring. Then it happens: Your child comes home from school with sniffles. Nagging questions enter your mind. Is it a cold? The flu? Is it from a kid at school? Will we all get it? Do I need to take her to the doctor? Will she need antibiotics? Should she miss school? Will I miss work?

As I see it, three questions about respiratory infections are important.

Q: How do I keep from getting sick?

First, keep your body shipshape so you can fight off any germs you are exposed to. Eat at least five servings of fruits and vegetables every day; the more the better, especially those rich in such antioxidants as vitamin C. Regular exercise is important for general health, but remember that excessive exercise has been shown to weaken the immune system, increasing your risk of infection. And stay calm: Studies show an increased risk of infections among stressed-out people.

Second, wash your hands! That's how my father -- a retired ear, nose and throat doctor who saw scads of people with respiratory infections -- stayed well. Use any good soap; don't fret over "antibacterials." And don't touch your own face after contact with a sick person. Touching delivers germs near your mucous membranes, helping the bug get into your system.

A myth: Cold weather does not cause infections. Yes, most colds occur in winter, but that's because we stay indoors, exposed to others who are sick. Plus, typically dry cold weather removes moisture from our airways, making them more susceptible to infection.

Q: If I get sick, how can I feel better?

When it comes to treating a cold, the sooner the better! New prescription-only drugs shorten viral infections but must be taken in the first 24 hours of developing symptoms. And while some small studies indicate that colds can be shortened a bit by the over-the-counter supplements vitamin C, zinc and echinacea, they also must be used early on.

The mainstay treatment for colds still is over-the-counter medicine for the symptoms. That means aspirin or Tylenol for headaches; antihistamines for sneezing and itchy eyes, throat or nasal passages; decongestants for nasal stuffiness; and cough suppressants. These medicines make you feel better while the infection goes away by itself.

Listen to your body and give it the rest it needs. A tried-and-true rule of thumb: Don't exercise if your symptoms are more than minor or are below the neck (muscle aches, stomachache, a cough). If the symptoms are limited to nasal congestion and other complaints above the neck, limited exercise is OK.

Get plenty of fluids, particularly hot, steaming fluids such as chicken soup! Other ways to soothe tissues: Gargle with warm salt water, use nasal washes or take cough drops.

Q: When should I see the doctor?

Fortunately, most people recover from infections on their own in a few days. But certain people are at higher risk of complications, including very young children, the elderly, people in hospitals and nursing homes, and people whose immune systems are weak. In general, if your symptoms are severe or prolonged, diagnostic tests are needed. Your doctor will evaluate the severity of your illness and check for possible complications and the presence of other illnesses that mimic colds (such as asthma, sinusitis and allergies).

Folks, we're not out of the woods with infections this winter. Keep your guard up. An ounce of prevention is worth a pound of Robitussin.

What do I have?

A tip sheet on identifying 5 common respiratory infections

1. Common cold
Technically called nasopharyngitis, it can be caused by dozens of viruses. Symptoms occur fast and furiously! This is how the story usually goes: feeling normal, stuffy nose and scratchy throat, sneezing, slight fever, headache, muscle aches. All in several hours, with mild symptoms. Most people can continue to work, but their energy drops. Drainage from the nose and throat is usually clear and runny, lasting two or three days. Then it may thicken slightly, become a bit yellow or green and last a few more days. People usually feel much better by day five, but coughing and nasal drainage may last two weeks.

2. Strep throat
This serious bacterial infection is technically streptococcal pharyngitis. It requires an antibiotic. Key signs: severe sore throat, fever, difficulty swallowing. Strep lacks other cold symptoms, such as nasal stuffiness. See a doctor.

3. Acute bronchitis
This is an infection in the tubes (bronchi) that connect the throat and lungs. Mucus congests these airways; a hallmark of bronchitis is a cough that produces phlegm. It's usually caused by viruses; sometimes, by bacteria. Symptoms usually improve in two to three weeks, but some people cough for more than a month.

4. Influenza
Often patients tell me they have the flu, but it's really a cold. Anyone unfortunate enough to have had true influenza knows the difference! Flu and cold infect the same tissues, but flu is severe, usually with headaches, muscle aches, significant fatigue, fever above 102 degrees and a significant cough. Get bed rest.

5. Pneumonia
When viruses or bacteria infect lung tissue itself, it's a serious health threat. Key symptom: coughing. Check with a doctor if the cough is severe, if you have a fever above 102 degrees or significant weakness, or if phlegm is bloody, thick, green or brown. You may need a chest X-ray.