We are now entering a challenging time of year, in which there is an increased incidence of respiratory infections.   There is a tendency for all of us to spend more time inside, generally in closer proximity to others at work and at home.  Respiratory viruses are spread through coughing or by touching surfaces contaminated by droplets and transferring the viruses to mucus membranes.

The most common viruses and bacteria that we can pick up (and potentially spread to others around us) include the common cold, influenza, COVID-19 and respiratory syncytial virus (RSV).  Other common respiratory conditions include bronchitis, pneumonia, pinkeye (conjunctivitis), sinus infections, strep throat and norovirus. 

The time to recover from each type of infection will vary depending on whether the person has received prior immunizations, undergone bed rest and maintained good hydration.  In situations when the person is not recovering as anticipated, the health care provider may want to review the medical history, reexamine the patient, and run other tests to confirm the diagnosis.  

For common colds, usual signs include runny nose, sore throat, cough, fatigue, congestion, mild aches and malaise, and a low-grade fever (below 100.4 degrees Fahrenheit). 

Flu comes with a moderately elevated temperature, sweats, headaches, a dry cough, shortness of breath, runny nose and congestion—and vomiting and diarrhea for children. 

COVID-19 features fever, chills, cough, shortness of breath, loss of taste and smell, headaches, diarrhea, and nausea and vomiting. 

Respiratory syncytial virus has a similar presentation as the common cold and COVID, and can lead to life-threatening bronchitis and pneumonia.

If the child or adult is not getting better, your doctor or pharmacist might recommend a home testing kit or an office visit. There are a number of at-home COVID-19 + Flu + RSV test collection kits available. Again, it is important to notify your physician or health care provider if your symptoms are not improving.

Each infection has a slightly different presenting profile.  If there is a concern that the clinical signs and symptoms are more severe, your doctor can do some screening tests in the office or emergency room to identify what is the predominant virus.  Rarely, a person can have more than one virus.

Preventing the spread of respiratory viruses

General advice to follow if you come down with a viral infection include (information from the Cleveland Clinic):

Cough or sneeze into the crook of your elbow, not your hand.

Do not share utensils, cups, toothbrushes or other personal items.

Stay at home until symptoms improve.

Use soap and warm water often and hand sanitizers intermittently.

Disinfect countertops, door knobs and the TV remote control.

Who should get flu and other types of vaccines:

Everyone over 65 years old.

Those in contact with family members aged six months to 65 years, or with chronic diseases.

Persons living with people who are immunocompromised.

Frontline health and social care workers.

All children aged six months and older.

All pregnant women, to protect their pregnancy and their newborn.

All adults over the age of 75 are recommended to get a single RSV vaccination.

A note regarding COVID-19: People six months and older are eligible for the vaccine, but it is recommended to consult your family doctor or public health clinic.

 General care suggestions for caring for yourself or a family member with a respiratory infection include limiting contact with family members who are not symptomatic and staying hydrated.  Drink warm liquids like tea, which can be soothing for a sore throat and congestion.  Using a humidifier is also recommended. Use acetaminophen to lower body temperatures below 100 degrees Fahrenheit.

A word about using Tylenol/acetominophen

Using Tylenol/acetaminophen to lower temperature and control minor discomfort has been a controversial discussion topic recently. As with many medications available over the counter, it is important to read the label and stay within recommended dose ranges. Starting this fall, an acetaminophen warning will be printed in caps saying, “CONTAINS ACETAMINOPHEN” and “ALWAYS READ THE LABEL.” The FDA has released guidelines on the use of acetaminophen to help avoid problems:

Read the “Drug Facts” label to check for acetaminophen—some meds say acetaminophen while others say APAP, which stands for acetaminophen.

Do not exceed the recommended dosage. To be extra cautious, look for medicines that contain 325 mg of acetaminophen (or less) per tablet.  Excessive dosages can lead to liver damage.

Don’t take two different medicines that both contain acetaminophen. Taking an acetaminophen drug for a headache and then a different one for a cold, for example, can increase your liver-damage risk.

If you consume three or more alcoholic drinks a day, talk to your doctor before taking any medication with acetaminophen, as taking even the recommended acetaminophen dose can do more liver damage. Drinking alcohol while taking drugs containing acetaminophen also ups your health risk.