Influenza is rampant this winter, crowding both doctor's offices and hospitals. Both the city of Boston and the state of New York declared official states of emergency based on their burgeoning case load. But other illnesses, some of which get confused with what we typically categorize as "the flu" are also making people miserable. These include respiratory syncytial virus (RSV), norovirus, pertussis (whooping cough) and parainfluenza virus.
In Colorado, influenza has resulted in 674 hospitalizations in 36 counties through the week of Jan. 12 with at least three infant deaths. During an average calendar flu season (October through March) we can expect about 750 hospital cases. Colorado's worst year in recent history was the 2009-2010 pandemic when the state saw about 2,000 hospitalizations. Thus far Summit, Park, Lake and Grand counties have not reported any flu-related hospitalizations to the state health department.
Flu symptoms come on rapidly and can hit even otherwise healthy people like a ton of bricks with high fever, chills, coughing and body aches. If caught within the first 48 hours, a drug called Tamiflu may be effective in minimizing symptoms and shortening the overall length of the illness. Otherwise, treating symptoms with cough syrup, aspirin, acetaminophen or ibuprofen for pain or fever (no aspirin for kids), and mucus expectorants such as guaifenesin (Mucinex and others) combined with generous helpings of fluids and rest can help. The CDC continues to recommend vaccinations for everyone over six months of age with some health-related exceptions. The vaccine takes two weeks to become effective but it's not too late to get protected even though we are well into February. Find more information at www.cdc.gov/flu/.
Respiratory syncytial virus is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia, especially in infants. Almost all children are infected with the virus by their second birthday, but only a small percentage develops severe disease. Respiratory syncytial virus can also infect adults. The condition mimics the common cold and can be treated generally with common sense self-care measures. Symptoms are usually mild but can become intense, including high fever and respiratory distress (severe cough, wheezing). Serious cases can result in bronchitis or pneumonia which does require treatment. Infants and anyone with compromised immunity or chronic lung conditions should be monitored carefully.
Sometimes referred to as "winter vomiting disease," norovirus is an infection of the gastrointestinal tract. If you experience a 24- to 48-hour bout of vomiting and/or diarrhea at this time of year, it's probably a norovirus infection. Norovirus is easily spread through contaminated food (as handled by infected people) as well as surfaces like doorknobs, railings, office equipment and more. It thrives on cruise ships (as well as in daycare centers, restaurants, nursing homes, and other close quarters) because it's very hardy, highly contagious and resistant to temperature extremes in water and on surfaces. Repeated cleanings with detergents and bleach are often used to kill this virus. For those afflicted, drinking plenty of fluids to prevent dehydration is critical.
Whooping cough (pertussis) is a bacterial illness experiencing a resurgence in the United States. Once thought to have been largely eradicated, a 2010 outbreak in California killed 10 infants. In Colorado, more than 1,500 cases were reported in 2012 and nationally, 26,000 cases were reported in just the first nine months of 2012. It is difficult condition to diagnose because Stage I looks and sounds like a typical cold during its first two extremely contagious weeks. In Stage II, the coughing becomes dramatically worse with severe hacking events in which breaths often end in a whooping sound. During Stage III symptoms moderate a bit but the entire disease cycle can last six to 10-plus weeks and there is no cure. Whooping cough can be prevented via vaccination regimes that have changed over time. These vaccines combine agents to prevent pertussis, diphtheria and tetanus. Pregnant women and families with infants, toddlers and pre-teens should consult their doctor about an immunization schedule. Antibiotics can reduce the contagiousness and some of the symptoms of pertussis, but only if caught early. Pertussis can affect both children and adults year round but can be easily confused with some of the conditions we associate more closely with winter.
Next is the parainfluenza virus. Although it has "influenza" in its name, it's a different bug altogether. It most commonly causes upper and lower respiratory disorders such as croup - that kind of barky cough that children get, but in adults, it can cause laryngitis, pneumonia and a prolonged cough. Again, self-treatment is effective unless symptoms worsen.
There are very practical ways to prevent many of these illnesses. Here are some easy tactics to consider:
> If you are sick, please stay home from work to avoid infecting others. Employers should be increasingly accommodating as business losses from multiple staff member infections are significant.
> Get vaccinated. You are helping yourself and others through a phenomenon called herd immunity in which you are protecting members of the larger community whose constitution may not be as hardy as yours.
> Avoid spending time with people who are ill.
> Sneeze into tissues and cough into the crook of your arm. Both these techniques can reduce the spread of infected droplets in the air.
> Wash your hands frequently. Using soap and warm water, sing the "Happy Birthday" song twice while scrubbing your hands.
> Clean all surfaces on a regular basis: your mobile phone, computer keyboard, tables, bathroom surfaces, doorknobs and more. Carry and use antibacterial gels regularly.
> Consider using a humidifier to combat our dry mountain air.
> Take hot showers to unclog airways and soothe sore throats.
> Get plenty of rest and stay well hydrated.
> See your doctor if symptoms worsen or if you suspect the flu.
Dr. Gary Gaede provides a complete spectrum of family care including pediatrics, adolescent, gynecological and adult care. He has a special interest in minor surgeries including vasectomy, preventive medicine, and men's health issues. Dr. Gaede practices family medicine at High Country Healthcare Silverthorne.