The terms “cold” and “flu” are often used synonymously, however they are actually 2 very different infections.
What is a Cold?
Other names:
• Acute coryza
• Upper Respiratory Tract Infection
Aetiology:
• The common cold refers to a viral infection of the upper respiratory tract. It is caused by a group of viruses called the Picornaviruses.
• The infection causes an inflammation of the mucous membranes lining the upper respiratory tract, resulting in an increase in the mucous production.
Symptoms:
• The onset of the symptoms is typically rapid, and the first symptom to develop is usually a sore throat.
• This is followed by itching or burning of the nose.
• Sneezing and rhinorrhoea (discharge of mucous from the nasal cavity, a “runny nose”), is usually the last symptom to develop.
• The discharge is typically watery and clear or white in colour during the first few days, however as the infection progresses the mucous becomes thicker.
• Children also often present with a cough. This may be a result of a postnasal drip irritating the larynx or due to increased mucous production within the lungs.
• The majority of children will appear fatigued and irritable during the infection as the body uses energy to fight the virus.
• Symptoms of the common cold last roughly a week.
• Lymphadenopathy is uncommon in viral infections.
Risk factors
• Contrary to popular belief, exposure to cold does not appear to have a significant effect on the chances of contracting a cold. However, there are a few factors which have been shown to increase a person’s susceptibility to developing symptoms in response to a Picornaviruse infection.
• Previous exposure to the virus or to a similar strain of the virus reduces the chances of developing symptoms in response to the infection. The immune system of a child is still developing and has not been exposed to as many pathogens as the immune system of an adult. Thus children are more susceptible to “catching a cold” than adults are.
• A lack of sleep and increased stress levels has also been shown to increase the risk of catching a cold.
• Children who are prone to allergic disorders, such as seasonal allergies, allergic asthma or allergic dermatitis, are at an increased risk of catching a cold.
Treatment
• Treatment for patients with the common cold is largely supportive.
• Nasal congestion and sinus pain may be managed by using nasal decongestants, however it is important to remember that a large majority of these have a rebound effect after prolonged use.
• Vapour rub products, are often used to help clear the airways.
• Sore throats or sinus headaches can be treated with mild analgesics.
• Avoid strenuous physical activity and encourage the caretakers to keep the child indoors and allow the child to rest and recuperate.
• A change in temperature and exposure to environmental allergens (such as dust and pollen), may aggravate the symptoms.
• Dairy appears to increase the mucous production, and should therefore be avoided during infection.
• Most importantly, the child needs to be carefully monitored in order to detect any secondary bacterial infection which may require antibiotics or further medical treatment.
Complications
• In immunosuppressed or weak individuals who are unable to fight the virus, the infection may spread to the lower respiratory tract.
• Secondary bacterial infection may develop and is characterised by a purulent discharge and the development of a fever.
• Children with asthma and respiratory disorders are at risk of complications associated with a flare up of respiratory systems, such as an asthmatic attack.
What is the Flu?
Other names:
• Influenza
Aetiology:
• Influenza is caused by the Influenza virus type A, B or C.
• The influenza virus results in inflammation of the lower respiratory tract.
• Outbreaks of influenza type A and B are most common during the autumn and winter months.
• Type C infections occur throughout the year, however the symptoms caused by type C are slightly different to those caused by types A and B.
• The Influenza virus is highly mutanogenic, in other words, it is able to mutate and evolve relatively quickly. This results in slightly different variations of the virus appearing each year.
• Unfortunately this means that one exposure to the virus does reduce the chances of developing symptoms after the next exposure.
• This also means that vaccinations are seldom effective for longer than a year as each new strain requires a new vaccination.
• The use of vaccinations against the Influenza virus is therefore debateable. However children at risk of infection, whose health is compromised or in whom the virus has the potential to do more damage, are likely to benefit from annual Influenza vaccinations, when available.
Symptoms:
• The incubation period is around 2 days, after which the following symptoms begin to develop:
Chills and fever with hot, moist and flushed skin.
Pain and aching in the muscles and joints.
Fatigue
Headache
Sore, itchy throat
Irritating and non-productive cough.
The eyes may appear red with inflamed conjunctiva and photophobia.
• As the infection progresses, lower respiratory tract symptoms, such as a persistent and productive cough, become more pronounced. The cough may become suffocating and painful and in severe cases blood may be visible in the sputum.
Treatment
• Again, treatment is largely supportive and includes pain management.
• It is important to keep the child hydrated and warm and allow plenty of rest and recovery time.
• Severe cases of the flu may be fatal and whilst the flu is common, it should not be taken lightly.
• All children should be closely monitored for any signs of complications.
• Should the symptoms not begin to clear within 5 days, or should there be any signs of secondary infection, encephalitis or pneumonia, then it is vital that the child receives prompt medical care by a suitably qualified healthcare practitioner.
Transmission of the Viruses:
• Both viruses are transmitted via droplets of respiratory secretions or via contaminated hands or fingers. Thus the following measures are helpful in reducing the spread of infection:
Washing hands after sneezing
Blowing the nose on disposable tissue paper and discarding the used tissue paper in the rubbish.
Covering the nose and mouth during coughing and sneezing.
• Children should be encouraged from a young age to follow the above guidelines.
• It is also advisable that children remain at home whilst contagious (symptomatic) to prevent the spread to other children in the class or day care.
Dr. Carrie Minnaar (M.Tech Hom.)
References
Dolin R. (2005) Influenza in Harrison’s Principles and Practice of Internal Medicine 16th Edition Edited by Kasper D.L., Braunwald E., Rauci A.S., Huaser S.L., Longo D.L. and Jameson J.L. London: McGraw-Hill, pp: 1066-
Merck Manual Seventeenth Edition (2005) Viral Infections Edited by Beers M.H. and Berkow R. Published by Merck Research Laboratories U.S.A. Pp: 1277-1289
Prescott C.J. (2006) Ear, Nose and Throat Disorders in Handbook of Paediatrics for Developing Countries Sixth Edition Edited by Harrisen V.C. Published by Oxford University Press, South Africa, Pp: 109-111
