How do you tell the flu from a cold or allergies?

You usually notice it as you pour your morning coffee. The guy in the next cubicle or office doesn’t sound so good. He’s coughing and sniffling as he types away, hoping you won’t notice. You ask him if he’s doing OK even though you know what he’s going to say.

“I’m great. It’s just allergies,” he says with a hoarse voice in between coughing fits.

Those “allergies” turn out to be the flu and before you know it you’re burning four sick days (or worse, vacation days) because Larry couldn’t self-diagnose and refused to go to the doctor.

Don’t be that guy.

It’s important to get your annual flu shot and to wash your hands regularly Click To Tweet

I asked primary care physician and general internist Dr. Natalie Dryden for advice on how to distinguish between a cold or allergies and the flu – for which you should go to the doctor immediately.

“Distinguishing between allergies, a cold and the flu is not always easy,” she said. “While two are infectious illnesses (colds and flu) caused by viruses and the other is an immune response to some environmental trigger, the body often has overlapping and similar responses, so symptoms can be similar as well.”

Here are five clinical features that may help you tell the difference:

  1. Fever: The flu generally causes high fever fairly consistently, while viral colds don’t often cause fever, and if they do, it’s generally a low-grade fever. Allergies should never cause fever.
  2. Body aches: They tend to be very pronounced with the flu, and while they can occur with a common cold, they are typically mild. Body aches are not a common feature of allergies.
  3. Cough: A flu cough tends to be more severe than with a cold. Like a fever and body aches, a cough is much less common with allergies.
  4. Runny nose: Can occur in all three.
  5. Sore throat: Common with colds and flu. Typically people with allergies report having an itchy throat and not actual pain.

Keeping an eye on the seasons can also help clue you in on what may be going on. While all three conditions can occur year round, flu season typically occurs fall through spring in the United States. If you don’t believe me, just check the Centers for Disease Control and Prevention’s national flu map. Dr. Dryden says to keep in mind that people who travel abroad might be exposed to the flu since flu seasons occur at different times throughout the world.

CDC flu map
The CDC keeps an up-to-date map that shows which states have the highest number of flu cases.

Common colds mostly occur in the winter and allergies occur often with changes in the season depending on what a person is allergic to. Some people (like me, sadly) have then year round. Allergy symptoms tend to last as long as a person is exposed to an allergen or trigger while viral infections will usually last between a few days to two weeks.

It’s important to get your annual flu shot and to wash your hands regularly; especially during flu season.

The next time you feel an itchy throat and dull body aches coming on with a fever, consider what might be ailing you before you go to work and get your co-workers sick. Visit a doctor immediately. Your office mates will appreciate it and you’ll be back on your feet faster.

Tips for avoiding holiday illnesses

It’s often said that the holidays are a time for giving. For me, they seem to be a time for getting … sick, that is. I can’t tell you how many times over the years I’ve spent hard-earned vacation time sick in bed instead of enjoying the time off I’ve scheduled for Christmas and New Year’s because I couldn’t avoid a bug. 

Before I headed out to join the crowds to buy gifts this year, I reached out to Dr. Joshua Septimus, clinical associate professor at Weill-Cornell and Houston Methodist Hospital, for any advice he could give me for avoiding holiday illnesses. But first I asked Dr. Septimus why it seems that people get sick more often during the fall and winter.

Getting sleep, exercising, eating well & washing your hands can help prevent seasonal illnesses Click To Tweet

“We think people get sick more often during the winter months because they are in close quarters and outside less,” Dr. Septimus explained. “Certain viruses also just follow certain seasonal trends that we don’t understand. For example respiratory syncytial virus (RSV) in the fall and influenza (flu) in the winter.”

So perhaps joining the mass of humanity at the mall isn’t the best way to avoid germs. But it’s not always easy to avoid crowds during the holidays, especially when there’s shopping to do and people to visit. However, there are some things that we can do to help prevent getting sick.

“The most important may sound trite but isn’t: wash your hands!” Dr. Septimus says. “This is especially important when touching doorknobs. I always use a tissue to turn off faucets in public restrooms and to open the doors.”

While the advice may seem cliché, it’s something to consider as you reach for that Elsa doll that who knows how many runny-nosed children have handled in the last few days. During the holidays, thousands of shoppers are liable to put their hands on surfaces you’ll come into contact with – and inevitably some of those people will have cooties.

If you don’t have the opportunity to wash your hands, alcohol-based hand sanitizer also works well when you’re out and about, according to Dr. Septimus.

While some people gobble up things like vitamin C or products that claim to boost your immune system, Dr. Septimus says those things don’t really work. Instead, he recommends a more common sense approach to staying healthy.

“Get plenty of sleep, eat a balanced diet, and exercise regularly,” Dr. Septimus says, as these things really will boost your immune system. One more thing that you can do is to get a flu shot as the fall and winter are flu season.

Staying healthy during the holidays may take a little work, but it’s not impossible. But if you want to avoid any possibility of catching a bug in the next few months you could also consider doing all your shopping online. With my track record, I might catch a computer virus.

Protect your child from RSV (photo credit: CDC)


H1N1 flu, ECMO and lungs: Crystal’s story

The 2013-14 flu epidemic reached alarming levels in Houston. Because of the damage the H1N1 flu inflicts on the lungs, many patients were placed on extracorporeal membrane oxygenation (ECMO), a lifesaving technique that oxygenates the blood outside of the body. Most ECMO patients are sedated to give their lungs time to heal. That’s why I was so surprised when I walked into Crystal Johnson’s room in the Cardiovascular Intensive Care Unit (CVICU) at Houston Methodist Hospital – she was awake and watching TV.

Crystal was 21 when we met in early January 2013. When she was 14, Crystal had received chemotherapy that would cause severe damage to her lungs to treat a cancerous tumor on her liver. After Crystal and her mother, Tracy, moved from Opelousas, Louisiana, to Houston in 2012, Crystal’s lungs began to decline and she dealt with a series of collapsed lungs. Crystal didn’t get a flu shot, so she had no immunity to the virus when she was around family members recovering from the flu. Upon her return to Houston, Crystal tested positive for H1N1 and was admitted to Houston Methodist Hospital.

Extracorporeal membrane oxygenation (ECMO), is a lifesaving technique that oxygenates the blood outside of the body. Most ECMO patients are sedated to give their lungs time to heal.

Since Crystal was still testing positive for H1N1 at my first visit, I stopped at the doorway to gear up – a plastic gown, mask and gloves. I can still remember her labored breathing, SpongeBob blanket, and half-finished Duck Dynasty puzzle. I met Cindy, a CVICU nurse, who had become so attached to Crystal that they texted – even when Cindy was off duty. While Crystal’s body was receiving enough oxygen via ECMO, her lungs still labored to breath, so it was hard for her to talk. That first day, she mostly listened while Tracy and Cindy told me her story.

On my way home from work that night, I cried. I cried because I was so incredibly blessed, while this amazing young lady spent every moment fighting to breathe and live. My problems didn’t seem so big anymore.

After several weeks in the hospital, Crystal finally tested negative for H1N1, but the damage was done. She was immediately placed on the lung transplant list as one of the most severe cases in the nation. One day, I stopped by for a visit and Tracy told me a transplant coordinator had called early that morning with the news that Crystal might have donor lungs. I spent the day waiting with them for news. Crystal was nervous that she wasn’t going to get lungs that day. We reassured her that lungs were coming – the doctors were checking to make sure the lungs were just right for her.

Then, it was time. Cindy gave Crystal a hug and a kiss on the forehead. Tracy shed a few tears. In the moment Crystal knew she was getting lungs, she was peaceful.

All of Tracy’s family was in Louisiana, and I couldn’t leave her alone. So, after a long day of waiting for news, Tracy was called back to see the doctor. The doctor said the surgery had gone well and that Crystal was going to be fine.

After surgery, Crystal returned to the CVICU for monitoring as she adapted to her new lungs. I continued to stop by with the latest issue of a celebrity news magazine or to chat about the latest episode of Duck Dynasty and the crazy antics of Crystal’s favorite Robertson – Uncle Si. It was during a conversation about Skittles that it struck me – we were actually talking. Until then, our conversations consisted of me asking questions and Crystal writing answers or Cindy translating for me.

That was the last time I saw Crystal in the hospital. When I went back to the CVICU for a visit, they told me Crystal had gone home. Now that she isn’t fighting to breathe, Crystal finally has a chance to live her life.