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Cold, Pneumonia or Flu? What to Do?

Contact: Tia Trivison, Mgr., Marketing & PR for Clinic Services (740) 593-9572

ATHENS, Ohio (November 14, 2000) -- Your nose is running. You're coughing and sneezing. Your throat is raw, and you generally feel terrible. It's easy to forget how miserable a cold can make you feel. Or, do you have something more serious?

No one ever died of a cold. But the flu is a similar viral infection with similar symptoms, and the flu is a notorious killer. The Spanish flu epidemic of 1918 infected about half the world's population, claiming 20 million lives-greater than the toll of World War I. Even today about 40,000 Americans die each of the flu and its complications -- most commonly pneumonia.

A cold, pneumonia or the flu? Dr. Daniel Marazon, Medical Director at the University Osteopathic Medical Center warns that it's important to know the differences so you can take early action to protect yourself.

NURSING A COLD: A cold typically begins slowly, with a scratchy throat that you may attribute to thirst or dry air. By the time you notice other symptoms such as a runny nose, sore throat and sneezing, you know you've got a cold, but there's nothing you can do about it.

"With a cold, you may have a slight fever, headache and a cough," said Dr. Marazon. "You may feel so bad that you don't want to eat. But with rest, plenty of fluids and some over-the-counter medications to relieve the symptoms, you'll be feeling better in about a week."

Dr. Marazon notes some of the over-the-counter (OTC) remedies that can be used to make the symptoms of the cold more bearable:

  • nasal decongestants - taken orally or in the form of sprays or drops, to ease the stuffy nose; although decongestants should be avoided by those with hypertension

  • expectorants - taken orally, to loosen the mucus and make your throat feel better

  • if you're coughing, antitussives or cough suppressants. These include drugs taken orally, cough lozenges and ointments to be rubbed on the chest or used in a vaporizer

None of these products will heal the cold or make it go away any sooner, but they'll make you feel better in the meantime. Antihistamines are often present in over-the-counter cold medications, but they are approved at this time for hay fever and other allergies rather than nasal infections.

It's important to remember that children with cold or flu symptoms are at risk of Reye's syndrome, a rare but potentially fatal condition, if they are given aspirin or products containing aspirin or salicylate.

A cold is an infection by one of about 200 cold viruses. Because there are so many of these attackers, it's virtually impossible to develop immunity. And because they're viruses, antibiotics are ineffective against them. A cure for the common cold may some day be a reality, but it's not a high priority since a cold will go away in a short time even without treatment.

PREVENTING THE FLU: Influenza, or the flu, is also caused by a virus that attacks the nasal passages. But it's a different family of viruses, and it produces more severe and longer lasting symptoms.

According to Dr. Marazon, "If you have the flu, there's usually little doubt. You feel miserable almost immediately with a splitting headache, aching muscles, a dry cough, chills and a fever high enough to send you to bed."

Dr. Marazon adds that the fever, which can reach 104, will start to subside after two or three days at which time the nasal congestion and sore throat may get even worse. Fatigue and weakness can linger for weeks.

One thing the flu rarely causes is stomach upset. Although you may have heard of "stomach flu" or "intestinal flu," these are actually another illness-gastroenteritis.

Since the flu is a viral illness, antibiotics won't help, but you can relieve symptoms with the OTC medications recommended for a cold. In addition, Dr. Marazon notes that two new prescription antiviral drugs-zanamivir (Relenza) and oseltamivir (Tamiflu)-can reduce the severity and duration of symptoms.

Two other prescription drugs-amantadine (Symmetrel) and rimantadine (Flumadine) can shorten the duration of symptoms for influenza A and are 70 to 90 percent effective for prevention.

The best approach, however, is to get a yearly flu vaccination - particularly if you're over age 50. The Centers for Disease Control recently lowered the recommended age from 65 to 50 because about a third of people in this age group have a chronic medical problem (such as diabetes, heart disease, lung or kidney disorders) that puts them at high risk of developing severe flu-related complications.

One study of 233 heart patients found that yearly flu shots not only protected against the flu but reduced the risk of a heart attack by 67 percent.

If you're younger than 50, yearly flu vaccination might also be a good idea, particularly if you're around other people a lot during the flu season. While vaccination is no guarantee against the flu, it's 70 to 90 percent effective in healthy young adults and tends to reduce the severity in those who do get the flu. Persons who are allergic to eggs should not be vaccinated since the vaccine contains a protein derived from eggs.

The flu vaccine ordinarily becomes available in early October but has been delayed this year due to manufacturing difficulties. This vaccine is now being administered in Athens county by the OU-COM mobile health unit, the health department and other local health providers.

HEADING OFF PNEUMONIA: With either the flu or a cold, about all you can do is persevere through the illness while trying to head off further complications. According to Dr. Marazon, one of the most serious complications of either the flu or a cold is pneumonia.

"Instead of getting better, symptoms may suddenly start to get worse, typically with a dry, hacking cough, headache, fever, aching muscles and fatigue," Dr. Marazon added. "Pneumonia can also occur on its own without prior illness."

Pneumonia, caused by either a virus or a bacteria, is an infection or inflammation of the bronchial tubes and air sacs (alveoli) of the lungs. Bacterial pneumonia must be treated with antibiotics. Drugs are also available to treat viral pneumonia, but these require further study for effectiveness.

For either kind, it's important to get early diagnosis and treatment. Dr. Marazon points to a study published in the Journal of the American Medical Association [February 9, 2000] that found that patients getting timely treatment, following management guidelines, had a lower risk of being admitted to the hospital and, if they were admitted, had shorter stays.

A safe, effective vaccine is available to prevent pneumonia caused by the pneumococcal bacteria. This vaccine is recommended at least once every 10 years for persons aged 65 and older and for others who might have weakened immune systems.

If you're at all typical, you'll probably get at least one cold this winter. That's nothing to worry about, and you can head off serious problems by getting your yearly flu shot and making sure you're immunized against pneumonia.

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