’Tis the season ... for upper respiratory infections
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We’re in a particularly bad season of upper respiratory infections (URIs), which starts in the fall and peaks in the winter months. URIs, as the name suggests, are illnesses associated with usually viral, occasionally bacterial, infections of the nose, sinuses, throat, and bronchus. Over 200 viruses from dozens of families can cause URIs, including rhinovirus (the most common culprit), adenovirus, enterovirus, coronavirus, respiratory syncytial virus (RSV), and influenza A and B. SARS-coV-2, the causative agent of COVID, is the newest member of the coronavirus family.
Most of the time, an infection with these viruses results in the constellation of symptoms we recognize as the “common cold.” Some viruses trigger more systemic reactions with body aches and high fevers. RSV can cause breathing difficulties, especially in infants and young children. Early in the COVID pandemic, many people developed pneumonia and inflammation affecting multiple organs, but with immunization and subtype mutations, infections now often resemble a cold. Because we’ve been taking pandemic precautions of masking, hand washing, and social distancing over the last few years, incidences of the common cold, RSV, and flu have been at an all-time low. This year, as restrictions relaxed, the URIs came back as we returned to schools and offices. The “triple threat” of COVID, RSV, and flu has been a major concern for children who have been filling up pediatric wards nationally.
Previous column:How to talk to doctors who don't listen
If we’ve learned anything during the pandemic, we know that prevention is the key to fighting these viruses. It’s not too late to get a flu shot or the COVID vaccine and/or booster. Vaccination may not completely block COVID transmission but can greatly decrease the severity of symptoms and the risk of long-haul illness. Flu seasons are notoriously unpredictable; the flu shot has been generally only 40-60% effective in the past several years, but with the fierce onset we’ve seen so far this year, even partial protection can help. Although there’s no vaccination for RSV or other cold viruses, the hygiene habits we nurtured in the pandemic still work to reduce transmission – wash hands frequently, wear a mask in crowded public spaces, stay home if you feel sick, cover your cough and sneeze into your elbow.
A typical URI lasts 7 to 10 days. If you develop symptoms, it’s advisable to get tested for COVID and influenza early because the antiviral medications, nirmatrelvir/ritonavir (Paxlovid, for COVID) and oseltamivir (Tamiflu, for the flu), can lessen the severity and duration of illness but must start days after infection. Over-the-counter cold medicine can be useful for symptom management, but it won’t shorten the overall duration of the cold. Read the labels carefully when selecting these OTC products because they’re usually a combination of drugs containing multiple ingredients (e.g., fever reducer, pain killer, decongestant, cough suppressant, and antihistamine. You risk overdosing if you take meds with overlapping ingredients (e.g., Dayquil and Tylenol both have acetaminophen). Most OTC meds aren’t suitable for young children, so consult your pediatrician before administering any to your little ones.
Most of us when we come down with a URI will just “ride it out” and bounce back after a couple of weeks, but some aren’t so lucky. Babies, the elderly, people suffering from chronic diseases like asthma or diabetes, and people with a compromised immune system, can develop complications and become very sick. Seek medical care promptly if you feel it’s difficult to breathe, have high fevers (>102F) that don’t resolve with meds, or can’t take in water or food to stay hydrated.
Earlier column:Why doctors don't listen to patients
About 15-20% of URIs have superimposed bacterial infections, which may manifest as pneumonia, tonsillitis, sinusitis, or otitis. Although antibiotics are useless and even harmful for purely viral URIs, they can be lifesaving when a bacterial infection is present. Look out for steroids, which can alleviate airway inflammation in asthma and bronchitis but worsens bacterial infections.
On average, an adult has two to three URIs a year; a preschool toddler has as many as six or eight. Despite being “common,” URIs are far from tame. It's a disease we cannot cure or eradicate, and it just takes a new subtype of one of the many causative viruses to grind our world to halt.
Qing Yang and Kevin Parker are a married couple living in Springfield. Dr. Yang is an anesthesiologist. She received her medical degree from Yale School of Medicine and completed residency training at Massachusetts General Hospital. Parker has helped formulate and administer public policy at various city, state, and federal government entities, including the Illinois Department of Innovation and Technology and the Illinois Emergency Management Agency. This column is not intended to substitute for professional medical advice, diagnosis or treatment. The opinions are those of the writers and do not represent the views of their employers.
This article originally appeared on State Journal-Register: 'Tis the season ... for upper respiratory infections
