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Is it a Cold or is it the Flu?

           The common cold is a short-term viral infection involving the upper respiratory tract.  It is very easily spread and easily contracted.  The common cold is one of the most common short-term illnesses that affect humans.  Adults generally get about one to three colds a year, while infants typically average 6 to 8 colds per year because their immune systems are not fully developed.  The droplets of cold virus on an infected person’s hand can be transmitted during a handshake; therefore hand-to-hand contact is a likely mechanism for viral transfer.   The virus enters the body of an uninfected person when their hands touch their eyes and rub their nose. 

The “flu” is also a short-term viral infection but it tends to involve the entire body not just the upper respiratory tract.  Influenza is contracted by coming into contact with the respiratory secretions of a person with the virus.  Symptoms of the “flu” occur very rapidly.  In North America, the flu almost always strikes from October to March. 

·        Drink plenty of fluids (drinking hot liquid increases nasal mucus flow)

·        Eat nutritious foods (low fat, whole grains, fruits and vegetables)

·        Deliver moisture into the air. Humidifiers produce a cool mist, which can be used for hay fever and allergies.  A cool mist is also important to use when a child has a fever.  Vaporizers produce a warm stream, which can be used for cough and cold symptoms.  Both allow vapours to go into the nose to relieve congestion.

·        Plenty of rest

·        Wash hands frequently

·        Avoid rubbing nose and eyes

For anyone who is taking prescription or non-prescription drugs, consult your pharmacist to avoid drug interactions.

Children (it is best to use products containing one ingredient)

Caution: Never use ASA (acetylsalicylic acid, Aspirin® ) in children and teenagers.  The combination of influenza or chicken pox and ASA is linked to Reye’s syndrome, a rare but serious condition affecting the brain and liver.  ASA should not be used during the last 3 months of pregnancy as it may cause problems in the unborn child or complications during delivery.

Analgesic and antipyretic (fever-reducing):

                       Acetaminophen: 10-15 mg/kg every 4 to 6 hours      

    3 months or younger: 40 mg/dose every 4 to 6 hours

                            4-11 months: 80 mg/dose every 4 to 6 hours

     12-23 months: 120 mg/dose every 4 to 6 hours

      2-4 years: 160mg/dose every 4 to 6 hours

Ibuprofen: if temperature is > 39 C, recommended dose is 10 mg/kg

                  If temperature is < 39 C, recommended dose is 5mg/kg

Nasal congestion:

Pseudoephedrine: 6 kg (13.2 lbs): 3.75 mg every 4 to 6 hours

                   9 kg (19.8 lbs): 7.5 mg every 4 to 6 hours

                   13 kg (28.6 lbs): 11.25 mg every 4 to 6 hours

                    2-4 years: 15 mg every 4 to 6 hours

Saline drops and a nasal aspirator can be helpful especially when the baby is breast-feeding.  This allows the baby to breathe easier.   

Runny nose:

Antihistamines should not be used in children under 2 years old. Children older than 2 years can use 12.5-25 mg every 4 to 6 hours (1.25 mg/kg). 

Dry cough:

a child’s cough should not be suppressed, as a cough is a protective mechanism to remove a foreign object.

Dextromethorphan: Children older than 2 years can use 7.5mg every 6 hours (1mg/kg/day).

Diabetics

Caution: oral decongestants for nasal congestion.  Oral decongestants can inhibit insulin production and can also increase production of glucose; therefore glucose meter readings may go up. 

Treatment options: saline spray, nasal decongestant, vaporizer, menthol rub or menthol nasal inhaler

Patients with hypertension

Caution: oral decongestants for nasal congestion.  Oral decongestants can cause an increase in blood pressure. 

Treatment options: nasal decongestant if blood pressure is well controlled, saline spray vaporizer, menthol rub or menthol nasal inhaler.

Asthmatics

Caution: antitussives or cough suppressants (codeine, dextromethrophan) for a cough.  Antitussives can cause a histamine release therefore possibly inducing bronchospasm and it can also depress respiration. Additionally, the use of cough suppressants can mask the aggravation of asthma symptoms, which are often characterized by cough.  It is best to first treat the cough as an asthma episode using bronchodilators (salbutamol, terbutaline, etc.) before considering a cough suppressant.  Consult your pharmacist or physician before using cough suppressants.

Although decongestants such as pseudoephedrine are considered safe, antihistamines are not recommended unless it is for the control of allergy symptoms.   In cold remedies, antihistamines are added for their drying effects and therefore for the treatment of runny nose symptoms.  Unfortunately, this same drying effect can also dry mucous secretions in the bronchials and lungs which is a counter productive and dangerous effect for asthmatics.  Antihistamines should therefore be avoided when treating cold symptoms.

·        If a child is less than 2 months old or has a fever > 40.5 C (no matter how old the child is), see a physician immediately.  A physician should be seen the next day if the temperature is > 38.5 C for more than 24 hours.

·        If acetaminophen or ibuprofen has brought a child’s fever down for a couple of hours but fever has come back, and child's temperature is 40 C or 103 F or greater..

·        If acetaminophen or ibuprofen does not reduce fever, see doctor immediately.

·        Rapid onset of a painful sore throat, high fever

·        Persistent cough (with or without congestion), shortness of breath, wheezing

·        If a child has a persistent, dry cough especially at night

·        Earache with/following cold, fever

·        Purulent sputum/nasal discharge, chest discomfort/pain

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