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Name That Sneeze

By Bethany Lawrence, M.D.

It’s that time of year again. People everywhere struggle with the common cold, sinus infections, the flu, and other respiratory illnesses. As physicians, we certainly encourage patients to seek medical attention if they are feeling poorly, but here are a few clues to help you understand the important differences between common illnesses. Many of the symptoms overlap, and there is not always a definitive test to give us a solid answer.

About the Flu
Let’s start with the flu. It is caused by the influenza virus and typically occurs in outbreaks mostly during the winter months. Symptoms are abrupt in onset and usually include fever, muscle aches, headaches, fatigue, and a dry cough. It may also cause clear nasal discharge and sneezing. The major complication of this virus is pneumonia, which usually occurs in people with a suppressed immune system. It is easily spread from person to person in respiratory droplets that are transmitted through coughing and sneezing. If given within the first 72 hours, there are effective anti-viral treatments that can shorten the course of the disease and lessen the chances of more serious complications. Not everyone is a candidate for the medication. It is important to note that antibiotics do not treat influenza. In addition, people often mistakenly refer to gastrointestinal illness as the “stomach flu.” Influenza does not directly affect our digestive systems and, therefore, does not cause vomiting and diarrhea that you see with a GI virus.

About the Common Cold
Now on to the common cold. This is actually a disease caused by several groups of viruses that include over 200 types. It is most commonly caused by the rhino virus. It shares many symptoms with the Influenza virus and, therefore, is not always easy to distinguish without performing a flu test. However, one way to distinguish between the two diseases is by the timing and character of the symptoms. For example, as I spoke of previously, Influenza symptoms start rather abruptly and usually begin with muscle aches, fever, headache, and dry cough. The common cold typically begins with clear nasal drainage and congestion, sneezing, and a scratchy throat, with pain that often improves throughout the day. It is less likely to cause a fever in adults, but this may occur more often in children. The cough from the common cold often does not occur for several days after the onset of the illness, as the nasal symptoms  begin to improve.

The symptoms usually last 7-10 days, and slowly begin to improve by about day 5. Antibiotics do not treat the virus that causes the common cold. The mainstay of treatment is symptomatic relief with various decongestants and cough medications that can be purchased over the counter. You need to consult your doctor or pharmacist while using these medications and be especially careful if you have high blood pressure, heart disease, kidney, prostate, or liver disease.

About Sinus Infection
Lastly, we will discuss acute sinusitis (sinus infection), which is inflammation and infection of the sinus cavity. It is most commonly caused by a virus, but can also be due to bacteria. Either can occur following the common cold or upper respiratory infection as described above. The hallmark symptoms of a sinus infection are facial pain, yellow or green nasal discharge, upper tooth pain, headache, fever, and sometimes ear fullness or pain. Antibiotics only treat infection caused by bacteria but not viruses. It is difficult to distinguish between the two causes in the first 10 days of the illness after which time, a viral infection usually resolves on its own. A bacterial infection is suspected if the symptoms don’t improve after 10 days, there is a fever over 102 degrees, or the symptoms occur after a cold that was resolving.

All of the above infections are harder to catch if you practice good hand washing!

The University of Tennessee
Family Medicine Center
294 Summar Drive, Jackson, TN 38301

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