Wednesday February 26, 2020

Common cold and swine flu: Some common tips


By Dr JK Bhutani

Our respiratory system is formed by the airways or air passages and the lungs. The airways play an important role in the conditioning of air to the appropriate healthy temperature in a variety of environments. The airways also humidify, filter and remove various particulate pollutants and pollen present in the air. The lungs work best when the airways are able to provide a clean, conditioned, warm and humid air for them.

COMMON COLD – Every year before the onset of winter, the human body prepares itself for the harsh ‘cold-dry-wintry’ air by shedding the old respiratory airway mucosa and other defense cells and getting a new set. The nature perhaps helps, by sending some common viruses, (Rhino and Adeno Viruses) to hasten this process of changeover. This intervention by the nature sometimes leads to issues like sneezing, running-stuffy nose (rhinorrhoea), sore throat, cough, low-grade fever, headache and body aches. The term ‘common cold’ refers to such mild upper respiratory viral infections which, in a way, are the nature’s way of shedding the old cells and rejuvenating the respiratory airways with the new army of defence cells to last for adverse onslaughts of winter weather. Such ‘non-Influenza’ viral respiratory infections are innocuous and require simple common-sense tips on the part of the patient to manage the same.

1. Symptomatic treatment remains the mainstay of common cold treatment. In the absence of convincing evidence of a secondary bacterial infection, antibiotics are not effective in the treatment of the common cold and should be avoided. Even analgesics (pain-killers) and anti-pyretic (fever medicine) can be avoided and adequate rest, hot-fluids, steam and good

nutrition must be the preferred way to go. Most patients do not require any intervention as the illness is brief (3-5 days) and self-limiting. The role of the medical personnel / help should be of a facilitator of the natural healing and s/he must ensure renewal of ability of the human organism in such settings.

2. The common over-the-counter available ‘decongestants-anti-histamine’ combinations (Vikoryl, Recofast, Coldrin etc.) generally hamper the clearance of secretions and nasal debris of cells and should be best avoided. They may block or thicken the secretions, thus predisposing to super-added bacterial infections of throat, sinuses and the ear.

3. PREVENTION of common cold – No vitamin, nutritional supplements, probiotics, Face-masks or herbal product have been shown to impact the incidence or the outcomes of common cold. Additionally, Adenovirus vaccines have not been found effective in protecting against the common cold. Hygienic measures such as hand washing and clean unclogged airways can hasten recovery and prevent the spread of respiratory viruses in closed environs.


Swine-Flu or H1N1 influenza (‘swine influenza’) is another respiratory viral infection which strikes like a ‘common-cold’ infection but is more sinister in symptoms and the outcomes. The influenza virus mutates extremely fast and is highly infectious. The typical symptoms of Swine-flu are cough, sore-throat, fever, headache chills and fatigue. The severe infections, especially in patients who have co-morbid conditions like Diabetes, Heart disease, Asthma/COPD, compromised immune system and old age, may also include blue lips, blood in sputum, difficulty in breathing, pneumonia and respiratory failure.

The spread of Swine-Flu is very rapid and epidemic. The people having flu infection, on move or at home, often cough or sneeze, thus spraying tiny drops of the virus into the air. When a person comes in contact with these drops or touches a surface (such as a wall, door, tap, sink or any articles like phone/keyboard etc) that an infected person has recently touched, the infection spreads.

Despite the name, one cannot catch swine flu from eating bacon, ham, or any other pork product.

The diagnosis of swine flu is often on strong suspicion, after contact with a proved patient and when the severity of cold symptoms is turning worse and ominous. The H1N1 influenza virus detection by polymerase chain reaction (rRT-PCR) or culture is the only proven method used by the government approved labs. Certain rapid influenza antigen tests are also commercially available which can give result in 4hrs.

Treatment – The milder infections in apparently healthy individuals can be managed with bed rest, warm fluids, proper nutrition and symptomatic treatment with analgesics (pain-killers) and anti-pyretic (fever) drugs. The mainstay is to isolate the patient at home for mild cases and in hospital for the serious cases, to halt the spread of disease. Proper hand-nose hygiene and the disposal of wipes containing nasal secretions are equally important. The use of the antiviral drugs like Oseltamivir (Tamiflu) is avoided in milder cases and should be best guided by the medical personnel’s advice. The close contacts of the proved Swine flu cases and the vulnerable exposed people can have prophylactic treatment in up to 48 hrs of exposure, after medical advice. Excessive use of such drugs when not required is already causing drug resistance and should be best avoided. The serious patients having pneumonia or other complications are best managed in hospital setting.

Prevention – The best treatment for Swine-flu is to have the vaccine before the onset of the winter season. The CDC and other national bodies recommend the vaccine for use in ages 6 months to the elderly (65 plus) including pregnant woman. High-risk individuals, their close contacts, and healthcare workers should remain high-priority populations in vaccination campaigns. The vaccine is safe, effective and has minimal side effects at the time of delivery. The vaccine can be administered in the muscle (intra-muscular injection), skin (intra-dermal injection) or the nasal inhalation route. The popular vaccines available in India are Fluair, Nasovac, Fluarix, Influvac  and Vaxigrip. The choice of vaccine formulation depends upon several factors, including age, comorbidities, pregnancy and risk of adverse reactions and the options should be discussed with the physician.

H1N1 influenza vaccine is already popular as FLU-SHOT in the west and shall soon have universal acceptance in India too. The governments are trying to bring down the costs (from Rs 600 to 100), to make it affordable for all. The Flu-shot needs to be given annually as the virus of swine-flu is quick to ‘shift and drift’ its structure, necessitating the new vaccine which is made available to the world every year around August-Sept.

Last year’s Swine flu outbreak in India showed inadequate preparedness, poor testing facilities and non-availability of drugs and vaccines. The number of deaths was 2123 out of the total number of 34656 cases reported by the health ministry. This year, the government is geared up and the Delhi government has already provisioned for isolation beds in hospitals (both govt and private), adequate Tamiflu and vaccines stocks and use of media for education/prevention. The government is using media for awareness of hand-hygiene and plans a sanitation awareness drive for a month starting from Oct-15 to Nov-14. The burden of the morbidity and mortality of the Swine flu can be negligible if all the citizens practice good hand-nose hygiene and implement other common sense measures of sanitation. It is not too much to ask for, at least from the Delhi residents who have one of the highest literacy rates in India.

Dr J.K. Bhutani MD is a protagonist of preventive and promotive health care based on austere biology and facilitating self healing powers of human organism.
You can follow him at


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US Health Officials Prepare to Battle Flu Season as Coronavirus Fear Rises

US Prepares for Second Wave of Flu as Coronavirus Fears Rise

While there have only been 15 confirmed coronavirus cases in the United States as of Friday, health officials have expressed concern that if the virus were to spread in the country. Pixabay

U.S. health officials are preparing for a second wave of the winter flu season, complicated this year by similarities between flu symptoms and those of the coronavirus that has killed more than 1,500 in China and spread fear around the world.

A first round of seasonal flu, caused by a strain of influenza B, named B-Victoria for the city in which it was discovered, peaked in the United States in late December and then dropped off, according to the U.S. Center for Disease Control and Prevention.

However, the CDC says a second round of flu began in late January, caused by a strain of influenza A that is related to the swine flu that first appeared in 2009, and cases continue to increase.

Cesar Gonzalez reacts to getting an influenza vaccine shot at Eastfield College in Mesquite, Texas. VOA

While there have only been 15 confirmed coronavirus cases in the United States as of Friday, health officials have expressed concern that if the virus were to spread in the country, it could initially look like the spread of seasonal flu.

Coronavirus testing

In part to address these concerns, U.S. health officials announced they would begin testing some patients who have flulike symptoms for coronavirus in several U.S. cities.

The testing will initially be carried out by public health labs in Los Angeles, San Francisco, Seattle, Chicago and New York, which are already testing for seasonal flu.

Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases, told reporters in a telephone briefing Friday that labs will conduct the coronavirus test on patients who show flulike respiratory symptoms, but who test negative for the seasonal flu.

Both the seasonal flu and coronavirus cause respiratory illness, fever and cough. Other typical flu symptoms include sore throat, muscle aches, runny nose and fatigue, according to the CDC.

While scientists have studied the flu for decades, little is known about this coronavirus, dubbed COVID-19, because it is so new. Health officials are still trying to understand all the symptoms related to the new virus, as well has how it spreads and how often cases are severe. There have been few studies on the symptoms of coronavirus, however, research suggests patients most commonly suffer from fever, cough and shortness of breath and are less likely than flu patients to suffer from a sore throat and runny nose.

To prevent the spread of the coronavirus to the United States, CDC officials have put in place travel restrictions and quarantine policies for people who recently visited China. However, officials say that strategy would change if the virus were to spread quickly in the United States.

Messonnier said if there were an outbreak of coronavirus in the United States, the CDC would call for “social distancing” strategies that would include online schooling, teleworking, and canceling mass gatherings, in an effort to prevent people from spreading the virus.

Passengers arrive at LAX from Shanghai, China, after a positive case of the coronavirus was announced in the Orange County suburb of Los Angeles, California, U.S. VOA

Flu kills 14,000 in US

While health officials put plans in place for any possible outbreak of coronavirus, doctors around the United States continue to help patients battle the seasonal flu. The CDC estimates that 26 million Americans have gotten sick with flu this season and around people 14,000 have died.

Health officials say the first wave of the flu, a B strain, has hit children particularly hard this season, causing 92 deaths in children. B strains are more likely to cause a more severe illness and death in children. Cases of the flu among the elderly have been down this season.

Also Read- Find Out Why You Need to Replace Unhealthy Beverages with Green Tea

The CDC says concern about coronavirus might have prompted more people with flu symptoms to go their doctor for testing this season, although they say there is nothing in their data to confirm this. Messonnier said if more people are going to the doctor that is a good thing. “

People being a little worried and seeking care doesn’t especially worry me, because that’s the point,” she said. (VOA)