Viral Infections of The Cold Season

As the cold season arrives, the common cold, flu and covid become more prevalent in Canada. According to the public health agency of Canada, the peak times for colds are at the start of school in the fall, in mid-winter and again in early spring. This article will explore the symptoms and complications of viral infections during the cold seasons, as well as tips for preventing and treating these illnesses. 

Cold, Flu or Covid, what is the difference?

A common cold is a mild infection of upper respiratory tract (Nose and throat) that is caused by a virus. A large number of viruses can cause common cold and these viruses usually belong to a group of viruses called “Rhinoviruses”. Almost all the times this infection is harmless even though at times it might not feel that way. As it is suggested by the name a common cold is more likely to be had in cold seasons but it can be had all throughout the year. adults may have two or three colds each year. Infants and young children may have colds more often. Most people recover from a common cold within 5-7 days without need of any medication. It may last longer in smokers and people who have comorbid diseases such as immunodeficiencies.

 Symptoms of common cold often -but not always- include:

• Mild fever that is more prominent in children
• Runny or stuffy nose
• Sore or scratchy sore
• Dry Cough
• Sneeze
• Slight body ache
• Feeling unwell

Flu (short for its formal name “influenza”) on the other hand is also an infection of upper respiratory tract that is caused by a virus. This virus belongs to the “Influenza viruses” and has a handful of variations such as H1N1. Compared to common cold, symptoms of influenza start more rapid and are more severe. Influneza often involves other parts of the body such as lungs, Gastrointestinal system and even Brain and the tissue surrounding it.

Influenza almost exclusively strikes in the cold seasons and a person with a competent immune system usually gets influenza once a year. symptoms usually last 7-10 days and often -but not always- include:

• Moderate to high degree fever
• Chills
• Headache
• Severe Body ache
• Dry and persistent cough
• Shortness of breath
• Tiredness
• Weakness
• Runny or stuffy nose
• Sore or scratchy throat
• Painful red eye
• Gastrointestinal symptoms like Nausea, Vomiting and diarrhea

A mild flu can be managed by the help of home remedies and over the counter medications such as Acetaminophen, but as we mentioned above Influenza can have severe complications especially in obese people (BMI>40), Pregnant women and people who have chronic illnesses, such as asthma, heart disease, kidney disease, liver disease and diabetes.

Covid-19 just like common cold and flu is a contagious viral infection that most of the time involves the upper respiratory tract. Covid-19 is caused by “severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2 for short)” which is a virus that belongs to the family of “Coronaviruses”. Covid-19 symptoms, similar to influenza, can vary from very mild to very severe. Again, similar to influenza SARS-CoV-2 often can involve other parts of the body, and most importantly lungs. Symptoms may go away in 7-10 days and often -but not always, include:

• Mild, moderate or even high degree fever
• Chills
• Headache
• Mild, moderate or severe body ache
• Cough
• Chest pain
• Shortness of breath
• Tiredness
• Weakness
• Runny or stuffy nose
• Sore or scratchy throat
• Painful red eye
• Gastrointestinal symptoms like Nausea, Vomiting and Diarrhea
• Rash

Children with covid have similar symptoms to adults and generally have milder illness.

As you can see without sufficient laboratory testing it will be very hard and challenging to differentiate between a common cold, flu and covid-19, Especially in milder cases. And because most of the mild cases of all these conditions get better on their own with a help of simple home remedies and some OTC medications, our suggestion is that it would better to manage mild cases in home and to be aware of the conditions that may need immediate referral to emergency department or a doctor’s office.

10 Home remedies to reduce symptoms of mild Cold, Flu and Covid

• Using warm salt water to treat stuffy nose

One of the most annoying symptoms of a viral upper respiratory tract infections is congested nose. Salt-water rinsing helps break up nasal congestion while also removing virus particles and bacteria from your nose. Here's a popular recipe:

Mix 1/4 teaspoon salt and 1/4 teaspoon baking soda in 8 ounces of distilled, sterile, or previously boiled water. Use a bulb syringe or nasal irrigation kit to squirt water into the nose. Hold one nostril closed by applying light finger pressure while squirting the salt mixture into the other nostril. Let it drain. Repeat two to three times, then treat the other nostril.

• Staying warm and rested

Resting allows your body to focus its energy on immune system. Also, cold makes immune system weaker so stay warm can help boost immune system.

• Gargling

Gargling 4 times per day using warm water and a teaspoon of salt has anti-microbial effect and it will moisten your child’s throat and help relieve the pain. 

• Drinking Hot liquids

Children need to drink lots of liquids when they are sick with a cold or the flu to keep them from getting dehydrated. Hot liquids such as tea or the old standby, chicken soup, are particularly good for relieving nasal congestion and soothing the uncomfortably inflamed membranes that line nose and throat.

• Taking a steamy shower

The warmth and humidity from a steamy shower can moisturize nasal passages and may help relaxation.

• Applying hot or cold packs around congested sinuses

Either temperature works. You can buy reusable hot or cold packs at a drugstore or make your own. You can apply heat by taking a damp washcloth and heating it for 55 seconds in a microwave (test the temperature first to make sure it's not too hot.) A small bag of frozen peas works well as a cold pack.

• Sleeping with an extra pillow under head

Elevating your child’s head will help them relieve congested nasal passages. If the angle is too awkward, try placing the pillows between the mattress and the box springs to create a more gradual slope.

• Eating infection-fighting foods

Here are some good foods to eat when your child is battling cold, flu or covid:

• Bananas and rice to soothe an upset stomach and curb diarrhea
• Vitamin C-containing foods, such as bell peppers
• Blueberries curb diarrhea and are high in natural aspirin, which may lower fevers and help with aches and pains
• Carrots, which contain beta-carotene
• Chili peppers may open sinuses and help break up mucus in the lungs
• Cranberries may help prevent bacteria from sticking to cells lining the bladder and urinary tract
• Mustard or horseradish may help break up mucus in air passages
• Onions and garlic contain phytochemicals that may help the body clear bronchitis and other infections
• Black and green tea have catechin, a phytochemical that may have natural antibiotic and antidiarrheal effects

• Taking supplements

Some supplements such as vitamin c, vitamin d, and zinc will boost immune system. Consult with your health care provider before taking them.

• Using over the counter medications

Over-the-counter (OTC) medications such as pain relievers (acetaminophen for example), decongestants and cough suppressors.

How to prevent taking cold, flu and covid

As we discussed earlier, Cold, Flu and Covid-19 are all viral contagious respiratory illnesses that easily get transmitted from person to person, especially during the cold season. Here we mention some tips to prevent your children from catching these illnesses:

• Encourage good hygiene: Teach your children to wash their hands often. It is best to use soap and water if available but a good alcohol-based hand sanitizer will get the job done. A good hand rub will take around 20 seconds of time. Teach them to cover their mouth and nose when coughing or sneezing using a tissue. Teach them to not touch their faces with dirty hands.
• Avoid close contact with sick people: keep your children away from people who are sick. Especially if they seem to have symptoms like fever, cough or a runny nose.
• Keep your children vaccinated: Flu has a vaccine that needs to be redone each year right before the cold season. Flu shots prevent almost all cases of severe influenza. Keep contact with your health care providers about covid-19 vaccination protocols in your area. Just like the flu shots, a covid vaccine will prevent most of the severe cases of covid. As of now all children 6 months of age and older are eligible for COVID-19 vaccines in Canada.
• Maintain a healthy lifestyle: make sure that your children get enough sleep, eat a healthy diet, and exercise regularly. A healthy lifestyle can boost immune system.
• Avoid crowded places: crowded places like shopping malls, movie theaters and public transport system where you are in close contact with strangers that might be sick can be breeding ground for spread of respiratory viruses.
• Wear masks: because respiratory viruses spread through droplets that are suspended in the air wearing a mask will protect you from inhaling those droplets in.
• Use humidifiers in cold season: Cold air can dry your child’s nose and throat making them more prone to a viral infection.
• Keep you home clean: regularly disinfect surfaces that are frequently touched by your children.
• Use a diet that will boost immune system: Citrus fruits and red bell pepper are rich in vitamin c that has a very important role in boosting immune system. Broccoli is packed with vitamin A, C, and E as well as fiber and many other antioxidants. Garlic and ginger have immune-boosting properties.

Pneumonia and other complications

Pneumonia is the infection of alveoli (air sacks in lungs where the blood exchanges gas with air). It is considered a type of lower respiratory tract infection. It can be caused directly by influenza or covid viruses or it can be caused by an opportunist bacterium and/or fungi after the immune system gets weakened by the virus. Viruses that cause common cannot cause pneumonia.

Having a tight chest and rapid breathing are the most common signs of developing pneumonia. Children with pneumonia need hospitalization. Other symptoms of pneumonia could be:

• A cough that is accompanied by mucosal discharge
• Chest pain
• Painful coughs
• Tiredness and weakness
• Loss of appetite
• High degree fever

Other serious complications of influenza and covid are very rare but very serious. Acute respiratory distress syndrome (ARDS), Myocarditis, Encephalitis and meningitis are some of the serious and deadly complications of flu and covid. Keep your heads up for red flags that we will mention in the next paragraph and refer to an emergency care department as soon as you notice them.

When to see a doctor?

Most cases of cold and flu don’t require a doctor’s visit. However, you should see a doctor if your child develops a fever that is above 38 degrees Celsius, a painful throat that is accompanied by mucosal discharge, painful sinuses accompanied by colored nasal discharge and extreme tiredness or weakness. You should also seek emergency medical attention if your child experiences severe vomiting, difficulty breathing (including abnormal breathing sounds), rapid breathing, blue or darkened lips and skin tone, extreme headache, excessive drooling and inability to swallow, lethargy, or little or no urine output. Please consult your mental health advisor if any other symptom is severe or persists more than a few days.

Authored By:
Dr. Alireza Sarmadi
Family Physician
Iran