During the winter months respiratory tract infections with a variety of viruses are more common. Often these go by the name of ’flu, although, strictly speaking this refers to infection by the influenza virus. Most of these infections cause the familiar symptoms of a runny nose, headache, sore throat, cough and fever.

With this pattern of symptoms, it is pretty certain that the infection is caused by a virus, of which there are unfortunately many thousands of strains. The viruses are spread by coughing and sneezing and a single person running a fever and sneezing can transmit the infection to many others. After inhaling droplets suspended in the air the infection settles on the lining of the nose, throat, windpipe and tubes in the lungs causing inflammation, catarrh and cough. Personal hygiene is important in preventing spread of the infection. Avoiding sneezing and coughing in public; wash your hands and use your own towels to prevent spread.

Viral infections improve without treatment

Fortunately, these infections are not usually serious, although the symptoms can be unpleasant. Your symptoms will begin to improve after a few days of paracetamol treatment. Most often the fever, sore throat and runny nose settle first. It is not uncommon for people to be left with a residual cough that indicates some inflammation of the lining of the windpipe and tubes in the lungs. This cough can be a nuisance, particularly at night when it can keep the whole family awake. It is not unusual for the cough to persist for 3-6 weeks, gradually improving with time. It does not need treatment.

Antibiotics are not helpful

Your body develops immunity to each virus after a few days and stops the virus infection. Upper respiratory infections do not require treatment in normally healthy people. In fact, studies on patients attending general practitioners with symptoms of cough following upper respiratory tract infections have demonstrated that patients do not settle more quickly if given antibiotics. Given this we would rather allow self limiting infections to get better by themselves without exposing you to the risk of antibiotic side effects. Over using antibiotics also leads to resistant strains of bacteria that can cause other illnesses to emerge. Patients with asthma should follow their asthma plan (if you do not have one, see the nurse in the asthma clinic) and increase their inhaled steroids.

Post viral pneumonia

Exceptionally, people can develop a pneumonia after a ’flu like infection. Typical symptoms would include shortness of breath, fever, productive cough and chest pain that is worse with deep breathing. We would usually treat pneumonia with antibiotics since it is more likely to be due to a bacterial infection. Whereas the common cold/’flu viruses are not killed by antibiotics, bacteria that cause pneumonia are and in this case using an antibiotic helps you to get better quicker.

Influenza

Influenza is a particularly nasty virus that in addition to fever and cough causes chills, headache, muscle pains and a more severe illness. The onset is usually rapid. Most people are better after a week, although the elderly and those with heart and lung disease may subsequently develop a complicating pneumonia. Every year one or more dominant strains emerge in the world and approximately every 10-15 years a major epidemic occurs.

We can boost your immunity to influenza by giving a ’flu jab every October and this is currently recommended for certain patients; those with respiratory, heart or kidney problems, diabetes, and those patients taking long term treatment with drugs that suppress immunity such as steroids. We also recommend the ’flu jab to patients over the age of 65 as influenza in the elderly can be severe. The ’flu jab will not protect you against the majority of upper respiratory viruses that go by the common name of ’flu.