Viruses like the flu

How many times have you dismissed sniffles as “just a cold,” and carried on with a stuffed nose and sinuses assuming that the symptoms would eventually run their course, perhaps a bit more quickly with a few doses of Mom’s homemade chicken soup?
Influenza is another story. The common cold eventually fizzles, but the flu may be deadly. Some 200,000 people in the U.S. are hospitalized and 36,000 die each year from flu complications — and that pales in comparison to the flu pandemic of 1918 that claimed between 20 and 100 million lives. The best defense against it: a vaccine. Yet barely 30 percent of 4,000 U.S. adults surveyed said they’d been inoculated this season, despite a record supply of flu shots, according to a new RAND Corp. survey. (GlaxoSmithKline, which makes flu vaccine, helped pay for the survey.)
So what is the difference between a cold and the flu – and how can you be sure which one you have?
We asked Jonathan Field, director of the allergy and asthma clinic at N.Y.U. Langone Medical Center/Bellevue Hospital in New York. Following is an edited transcript of our interview with him.
What causes the flu? How is it different from a cold?
The flu is a viral infection caused by the influenza virus, a respiratory virus. The common cold is also a viral infection caused by the adenovirus or coronavirus and there are many, many subsets with a lot of variability. That’s why it’s said there’s no cure for the common cold there’s no real vaccine. The flu is known to be from influenza and is preventable with vaccination.
Colds tend to produce runny nose, congestion, sore throat. Influenza is more pronounced in that it infects the lungs, the joints and causes pneumonia, respiratory failure and even death. It tends to infect the intestinal tract more in kids, with diarrhea and vomiting. Because of the relative immaturity of the gut, they may absorb more virus and that wreaks more havoc on the intestines. Flu causes epidemics and pandemics with the potential for mortality, whereas the common cold is a nuisance for us.
How can someone who’s feeling ill distinguish between cold and flu, or an allergy?
Flu typically starts in early November and can go until March. The peak time is now — November to January. Allergy is typical in spring or fall, and cold more so in winter.
The body can respond in only so many ways, but there are things you can use to differentiate. Allergic symptoms are similar to those of a cold, but your immune system responding to something benign. Usually there’s no fever, and there’s an allergic manifestation of itch in the back of the throat or the ears. It’s unlikely with allergy to have body aches. With a cold, there’s sometimes a low-grade fever.
You can tell the difference by the length and severity of the illness and whether you’ve had a similar experience in the past. Both colds and flu usually last the same seven to 10 days, but flu can go three to four weeks; the flu virus may not still be there, but you have symptoms long after it’s left. Allergy can last weeks or months.
Are the treatments for these illnesses different?
For any of these things, if it affects the nose or sinus, just rinsing with saline that gets the mucus and virus out is a first-line defense. It’s not the most pleasant thing to do, but it works very well. There are classes of medicines that can help the flu — Tamiflu and Relenza — antivirals that block viruses’ ability to reproduce and shorten the length and severity of the illness. But they have to be taken within 48 hours or the cat is proverbially out if the bag the virus has done the most of its reproduction. For a cold or flu, rest and use decongestants and antihistamines, ibuprofen, acetaminophen, chicken soup and fluids.
Zinc supposedly helps the body’s natural defenses work to their natural capacity and decrease the severity and length of a cold. Cells need zinc as a catalyst in their protective processes, so if you supply them with zinc, it helps them work more efficiently. You should also withhold iron supplements. Viruses use iron as part of their reproductive cycle, so depriving them of it blocks their dissemination.
The majority of these infections are not bacterial and do not require antibiotics. My rule of thumb is that a viral infection should go away in seven to 10 days. If symptoms persist after that, you’d consider if it’s bacteria like Strep or Haemophilus influenzae. Those bacteria cause illnesses that are longer lasting.
Is that treatment approach the same for kids?
In general, the same rules apply: Most children will have six to eight colds a year in their first three years of life, and most are viral. It’s very easy to test for strep and for that you should have a culture .
Are the strategies for avoiding cold and flu different?
Avoidance is very similar: Strict hand washing, not sharing drinking cups or utensils, and avoiding direct contact with people who are sneezing. As long as someone has a fever, they have the possibility to transmit infection. After they’ve had no fever for 24 hours, they’re not infectious.
The U.S. Centers for Disease Control and Prevention (CDC) now recommends that just about everyone get the flu shot: kids 6 months to 19 years of age, pregnant women, people 50 and up, and people of any age with compromised immune systems. Is the shot beneficial to anyone who gets it?
Unless you have a contraindication, there’s no reason not to get it. Contraindications would include egg allergy (because the vaccine is grown from egg products), any vaccines within a last week or two, and active illness at the time of your vaccine.

Flu – symptoms and diagnosis

Flu (influenza) is a severe infection caused by a virus. The flu virus infects your lungs and upper airways.

Flu is unpredictable. If you are young and healthy, you will usually feel unwell for a week but, you will not need to see your GP. Most flu can be treated at home.

Antibiotics do not work on flu. Getting lots of rest and drinking plenty of liquids will make you feel better.

Most people who think they have the flu usually just have a cold.

The real flu tends to happen during the winter. It usually spreads between October and April.

Some people are at risk of the serious complications of flu.

People at risk of complications include:

  • people aged 65 and over
  • pregnant women
  • people with a long term medical condition

You can see a list of other at-risk groups here.

If you have flu and you are at risk of the complications of flu, you should contact your GP. You may need special anti-viral medicines. These work best if started within 48 hours of flu symptoms.

Symptoms

Flu symptoms come on very quickly and you get muscle aches and a high fever. Headache is very common. You will feel extremely weak and may find it hard to even get out of bed. After a few days, you may develop a cough.

Flu symptoms can also include:

  • sore throat
  • difficulty sleeping
  • loss of appetite
  • diarrhoea or tummy pain
  • nausea and vomiting

The symptoms are similar for children. But they can also get pain in their ear and may be less active than usual.

Diagnosis

It is useful to know the difference between a cold and the flu.

Flu symptoms:

  • come on suddenly
  • start with a fever, muscle aches, headache, weakness and fatigue

Cold symptoms:

  • usually come on gradually
  • start with a sore throat and a blocked or a runny nose.

Symptoms of a cold are generally mild compared to flu.

Complications

For most people, flu is just a bad experience. But for others, it can lead to more serious illness. Some complications of flu can be life threatening.

If you are aged 65 years or older, pregnant, or if you have a long term medical condition are on medication, you have an increased risk of serious complications from the flu. You may need special anti-viral medicines. These work best if started within 48 hours of flu symptoms.

The most common complication is pneumonia. Other complications include bronchitis and ear infections.

Flu can also worsen existing conditions such as:

  • asthma
  • chronic obstructive pulmonary disease (COPD)
  • heart failure

Related topic

Vaccines needed during pregnancy – flu vaccine

Worried About Catching The New Coronavirus? In The U.S., Flu Is A Bigger Threat

Making sure to frequently give your hands a thorough scrub — with soap and for about as long as it takes to sing the “Happy Birthday” song a couple of times — can significantly cut your chances of catching the flu or other respiratory virus. Mandel Ngan/AFP via Getty Images hide caption

toggle caption Mandel Ngan/AFP via Getty Images

Making sure to frequently give your hands a thorough scrub — with soap and for about as long as it takes to sing the “Happy Birthday” song a couple of times — can significantly cut your chances of catching the flu or other respiratory virus.

Mandel Ngan/AFP via Getty Images

If you live in the U.S., your risk of contracting the new strain of coronavirus identified in China is exceedingly low.

So far, the only people infected in the U.S. have been those who have traveled to the region in China where the virus first turned up in humans. And though that could change, one thing is for certain: Another severe respiratory virus that threatens lives — the influenza or flu virus — is very active in the U.S. right now.

Already this flu season (which generally begins in the U.S. in October and peaks during winter months), the Centers for Disease Control and Prevention estimates that more than 15 million people in the U.S. have gotten sick with flu. More than 150,000 Americans have been hospitalized, and more than 8,000 people have died from their infection. And, this isn’t even a particularly bad flu year.

“Last year, we had 34,000 deaths from flu,” says epidemiologist Brandon Brown of the University of California, Riverside. On average, the flu is responsible for somewhere between 12,000 and 61,000 deaths each year. “And this is just in the United States,” Brown says.

A flu shot is your best way to protect yourself against getting the flu, and it’s still not too late to be vaccinated this season.

There’s another very effective strategy for fending off the flu virus — one that could also help protect against the novel coronavirus if it were to spread within the U.S, Brown says.

His top tip is remarkably simple, effective — and familiar. Ready for this? Wash your hands. You need to lather up and wash for at least 20 seconds to make this work, according to the CDC’s tips for proper hand-washing. The time it takes to hum the song “Happy Birthday’ twice is about right duration.

“Our hands are one of the main ways we can transmit a virus,” Brown says. As a reality check, begin to notice everything you touch in a day. “We shake other people’s hands, we touch surfaces, open doors,” he says.

In addition to inhaling airborne particles from a neighbor’s cough or sneeze, touching your hand to a contaminated surface and then to your eyes, nose or mouth is how the virus most often gets inside you.

There’s still a lot to learn about the new coronavirus, but respiratory illnesses in general — whether the flu, a cold or a virus that humans haven’t encountered before — can spread via little respiratory droplets when an infected person sneezes or coughs.

That’s why we teach our kids to cover their coughs and to sneeze into an elbow. Each of us can help prevent the spread of viruses, and good hygiene habits are key.

Another important reminder: The CDC recommends a pneumococcal vaccine for children under 2, for adults who are 65 or older, for people who smoke and for those who have certain medical conditions.

It’s not that this vaccine will directly fight the pneumonia caused by influenza or the new coronavirus; the pneumococcal vaccine actually revs the body’s defenses against a different microbe — the common bacterium Streptococcus pneumonia – that also causes pneumonia.

However, one of the main reasons some people get very sick from flu is that, once infected and weakened by the influenza virus, they are extra vulnerable to getting a secondary infection from bacteria — and often, it’s the pneumococcal bacteria.

For an historical perspective: It was actually bacterial pneumonia that caused the most deaths during the 1918 influenza pandemic, according to the National Institutes of Health.

By fending off those bacteria, the pneumococcal vaccine can be an important part of a flu defense — and might also help in fending off the new coronavirus strain.

“We don’t know whether this new coronavirus tends to predispose people toward pneumococcal infection, but many respiratory viruses do,” explains Marc Lipsitch, an infectious disease epidemiologist at the Harvard T.H. Chan School of Public Health.

“It better to be infected with only coronavirus, rather than the coronavirus and a bacterium at the same time,” Lipsitch says.

The science of why that’s true is complicated, Lipsitch says, but in general, when we get a virus, “the immune system is distracted.” It focuses on fighting the virus, and that makes it harder to fend off a bacterial infection. “It’s hard to do both at once.”

7 Illnesses That Cause Flu-Like Symptoms, But Aren’t Flu

Considering that the flu can spread like wildfire among unvaccinated communities, it’s tempting to worry that every cough, muscle ache, and hint of a fever is a sign you caught the flu.

That’s understandable, given that there are a ton of other illnesses that bring on copycat flu-like symptoms, like fever, cough, runny nose, and headaches, among others, per the Centers for Disease Control and Prevention.

“Any overwhelming infection that stimulates our immune system can some of the same symptoms,” explains Cindy Weston, DNP, RN, FNP-BC, assistant professor at the Texas A&M College of Nursing. In other words, “most flu just feels like a regular cold,” Joseph Khabbaza, MD, a pulmonologist at Cleveland Clinic, tells Health.

The only way to know for sure you have the flu is to get tested–but there are subtle clues to help you distinguish between influenza and something else. Here are a few of the many conditions that can cause flu-like symptoms, but aren’t the flu.

RELATED: Why Do Some People Die From the Flu?

Colds

Both colds and influenza are viral illnesses, they both tend to occur in the same seasons, and they have many overlapping symptoms, like a sore throat and a stuffy nose.

The main difference is how quickly the symptoms come on. “A cold typically gradually progresses symptom by symptom over days,” says Keri Peterson, MD, an internist at Lenox Hill Hospital in New York City. “With the flu, the constellation of symptoms of high fever, cough, muscle ache, and severe lethargy comes on in 24 to 48 hours.”

And even though so many symptoms overlap, colds typically don’t come with chest pain or body aches, which are more characteristic of the flu, adds Dr. Peterson.

RELATED: 11 Signs It’s More Serious Than the Common Cold

Strep throat

The flu and strep throat share many symptoms, but there are two you may find in the flu but never in strep: cough and nasal congestion.

Strep throat may also bring swollen lymph nodes, swollen tonsils, a skin rash, or white blotches on the tonsils. None of these is typical of the flu.

If your doctor suspects strep, he or she will probably swab your throat and test for the bacteria. If the test comes back positive, you’ll likely get antibiotics, which can usually clear up the symptoms quickly.

RELATED: 7 Signs You Could Have Strep Throat

Pneumonia

Pneumonia can come separately from the flu or it can be a secondary complication of getting sick. You may even look like you’re over the flu and then bang–you’re stricken with another infection. “People are getting the flu and maybe even riding it out, and a week or so later, they’re coming in with pneumonia,” Weston says.

Normally, pneumonia that comes with or after the flu is caused by bacteria and can be treated by antibiotics. With this type of pneumonia, “the cough is pretty persistent and unrelenting and often associated with chest pain,” Weston says. “The fever could be low grade or higher. A lot of times there’s no appetite with pneumonia, and there can be some body aches.” A pneumonia cough also has mucus in it.

Pneumonia that’s not related to the flu is often viral; viral pneumonia is also typically milder than the bacterial kind. You may also have some congestion, coughing, and fatigue, all of which could point to the flu–but in this case, they’re simply flu-like symptoms.

Doctors can listen for telltale signs of pneumonia by putting a stethoscope to your chest, says Dr. Peterson.

RELATED: 8 Signs Your Cough Could Actually Be Pneumonia

Mononucleosis

Mono is also called the “kissing disease” because it can be passed through saliva (along with coughing, sneezing, and sharing utensils).

Mono is usually caused by the Epstein-Barr virus. It tends to hit teens and young adults more than other age groups.

Symptoms often come on slowly, but they can mimic the flu; you might feel really, really tired, spike a fever, or have a sore throat and body aches. But other symptoms can help differentiate mononucleosis from the flu, including a swollen liver or spleen.

Mono also drags on longer than the flu, often lasting two to four weeks–but sometimes six months or longer.

RELATED: 14 Reasons You’re Always Tired

Meningitis

Meningitis is inflammation of the membranes (meninges) that cover the brain and spinal cord.

Like pneumonia, meningitis can be caused by either a viral or a bacterial infection. Viral meningitis is more common and milder, but the symptoms of both are similar and look a lot like the flu: headache, fever, and fatigue. Meningitis, though, also comes with a stiff neck and sensitivity to bright light.

Viral meningitis is like colds and the flu in that most people recover on their own in a week or so. Bacterial meningitis, however, can cause brain damage and even death if it’s not treated promptly with antibiotics.

RELATED: 11 Things You Need to Know About Meningitis

Bronchitis

Acute bronchitis not only has cold- and flu-like symptoms, it’s even caused by many of the same viruses.

“Bronchitis has a lot of overlap–productive cough with mucus, lethargy, and a sore throat,” says Dr. Peterson. The main difference is that bronchitis doesn’t come with a high fever. Bronchitis symptoms also tend to center on your chest and throat, instead of the full-body aches common with the flu, she adds. The nagging cough of bronchitis can last up to three weeks, longer than a cough from the flu.

There’s no test for bronchitis like there is for the flu, so doctors usually diagnose it by asking about symptoms and examining you. Bronchitis treatment consists of rest, drinking lots of fluids, and taking meds that can relieve symptoms.

RELATED: 8 Possible Reasons You Can’t Stop Coughing

Respiratory syncytial virus

Respiratory syncytial virus or RSV has symptoms that can also be mistaken for the flu (or a cold). “It can cause runny nose and cough,” says Afif El-Hasan, MD, a spokesperson for the American Lung Association and a pediatrician with Kaiser Permanente.

Unlike the flu, though, RSV symptoms usually appear gradually. They typically go away on their own as well–you just need to drink plenty of fluids and rest.

Similar symptoms come from infection with what are called parainfluenza viruses. “They are like the flu, but they’re not as bad,” says Dr. El-Hasan.

RELATED: The Truth About Drinking Fluids When You’re Sick

When should you contact your doctor?

“If you suspect you have the flu, then you should see the doctor within 48 hours because medicine has to be taken very quickly,” Dr. Peterson says. “Err on the side of caution.”

Dr. Khabbaza says that if you’re unable to go about your normal routine, you should consider heading to the doctor. Also, if certain symptoms escalate, this could be an indication of flu, not just a chest cold, and you, again, should consider getting checked out ASAP. (For example, if body aches progress “to the point you can barely move around,” or if your symptoms are causing difficulty breathing, it’s definitely time to head to the doctor, says Dr. Khabbaza.)

Most viral infections, including the flu, tend to go away on their own. But be on the alert for signs of trouble such as shortness of breath, chest or abdominal pain, dizziness, or dehydration. If you’re experiencing any of these in addition to your flu-like symptoms, call your doctor or head to an emergency room.

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  • By Amanda Gardner
  • By Maggie O’Neill

Cancer symptoms

The early warning signs of cancer may be difficult to detect because the symptoms may be similar to less serious conditions, such as the flu. Also, some cancers, such as lung or pancreatic cancer, may not show warning signs in early stages. Many cancers share common early warning signs, while some are specific to certain cancers. General early warning signs of cancer include:

  • Fatigue
  • Unexplained weight loss/gain
  • Fever
  • Pain that does not go away
  • Loss of appetite
  • Nausea, vomiting
  • Skin changes, such as a rash, redness, tenderness or swelling
  • Blood in the stool, urine, semen or sputum
  • Persistent cough or hoarseness
  • Difficulty emptying the bowel or bladder

Many symptoms share characteristics of other, non-cancerous conditions. If you experience persistent symptoms or other changes in your health, it’s important to see a doctor as soon as possible.

Cancer symptoms in men and women

Although men are more likely to develop cancer than women, many common cancers, such as lung, colorectal, bladder, melanoma, leukemia and lymphoma, and their symptoms may occur in either gender. Certain cancers, however, are gender specific and may cause unique symptoms.

Cancer symptoms in men

Cancers unique to men affect the male reproductive system—the prostate, testicles and penis. Symptoms of these cancers include:

  • Difficulty urinating
  • Painful urination or ejaculation
  • Blood in the urine or semen
  • Lumps, growths or physical changes in the penis or testicles
  • Pain in the groin, abdomen or lower back

Learn more about men and cancer

Cancer symptoms in women

Breast cancer and cancers specific to women may affect the breasts and the female reproductive system. Symptoms of these cancers include:

  • A lump or growth
  • Red, itchy or swollen breasts
  • Changes in the appearance of the breasts
  • Nipple discharge
  • Vaginal discharge or bleeding
  • Abdominal pain
  • Pain during intercourse
  • Difficulty urinating
  • Bloating or a feeling of fullness

Learn more about women in cancer

Specific cancer symptoms

The following are symptoms typically associated with certain cancer types:

Breast: Common symptoms of breast cancer may include physical changes in one or both breasts—such as swelling, redness, flaky skin, nipple discharge, a lump or growth, pain, swelling or tenderness under the arm.

Colorectal: Common symptoms of colorectal cancer include constipation and/or diarrhea, blood stool or bleeding from the rectum, cramps or abdominal pain, a bloated or full feeling, and thin, ribbon-like stool. other common gastrointestinal cancer symptoms include gas pain, changes in bowel/bladder habits, anemia and/or jaundice.

Prostate: Common symptoms of prostate cancer include difficulty urinating, burning or pain during urination, incontinence, blood in the semen or urine, difficulty getting an erection, and painful ejaculation.

Gynecologic: Common gynecologic cancer symptoms include abnormal vaginal bleeding (after menopause, between periods, following sexual intercourse), pain during intercourse, pelvic/back pain, pain on urination, and/or watery, white or pinkish vaginal discharge.

Head and neck: Common symptoms of head and neck cancers include persistent pain, difficulty swallowing, voice changes, mouth sores, dry mouth, changes in appearance, and/or taste changes.

Hematologic: Common hematologic cancer symptoms include flu-like symptoms, fever, chills, joint/bone pain, anemia, night sweats, lymph node swelling, itching, persistent cough, shortness of breath, abdominal discomfort, headaches, easy bruising or bleeding, and/or frequent infections.

Skin: Common skin cancer symptoms include a change in a mole’s size, shape and color in the form of asymmetry, border or color irregularities or diameter (larger than 1/4 inch), itchiness, pain and/or oozing around the affected area.

Lung: Common symptoms of lung cancer include a persistent cough, pain in the chest area, shortness of breath, hoarseness, wheezing, coughing up blood, blood in phlegm or mucus, neck or facial swelling, and/or headaches.

Metastatic cancer symptoms

If you have been diagnosed with cancer, cancer cells may spread to other parts of the body. This process is called metastasis, and it may occur before your initial diagnosis or during or after treatment.

Many cancers, including melanoma, breast, lung, prostate, colorectal and other common cancers, have a tendency to metastasize in certain cases. The most common locations for metastatic cancer to spread are the liver, lungs, bone and brain. When cancer spreads to a new location, it is still named for the location of the primary tumor. For instance, breast cancer that has spread to the brain is called metastatic breast cancer to the brain.

How do I know if my cancer has spread?

Symptoms of metastatic cancer may depend on where in the body the cancer has spread. For instance:

  • If the cancer has spread to the bone, symptoms may include joint pain or fractures.
  • If the cancer has spread to the brain, symptoms may include headaches, speech difficulties, blurred vision or dizziness.
  • If the cancer has spread to the liver, symptoms may include jaundice, and bloating or swelling in the stomach.
  • If the cancer has spread to the lungs, symptoms may include shortness of breath or a persistent cough.

An accurate diagnosis is critical to determining whether your cancer has spread and to developing a personalized treatment plan designed to meet your needs.

Learn more about metastasis

Diagnosing cancer

It’s important to consult with a medical professional if you are experiencing symptoms of cancer. A doctor will conduct a medical evaluation, including diagnostic tests to first confirm the presence of disease and then, if relevant, to identify the correct tumor type, location, extent and stage. An accurate cancer diagnosis helps doctors determine an appropriate treatment approach.

Is It Really Flu? How Adenovirus Mimics Influenza

Milder Than Flu, But Still Poses a Health Risk

Adenovirus infections are typically mild and do not pose the same health threat as influenza. During the last flu season, more than 80,000 people died from influenza-related complications.

“The damage that the flu can cause is on a different scale than basically any other virus that we know,” says Dr. Adalja. (He notes, however, that this season’s predominant strain of flu, H1N, tends to be milder than the H3N2 strain that dominated last season.)

People who die from adenovirus are usually immunocompromised, according to Adalja. They may have had an organ transplant or condition that weakens their immune system.

“Influenza can take a perfectly healthy young adult or child and put them in the emergency room in 24 hours,” Dr. Schaffner says. “This is not likely to happen with adenovirus infections, unless you have a compromised immune system.”

In the fall of 2018, adenovirus took the life of an 18-year-old freshman at the University of Maryland and infected at least 30 other students, according to an article published December 7, 2018, in the Baltimore Sun. The student who died had been taking medication for Crohn’s disease, which may have compromised her immune system.

In November 2018, 11 children with underlying medical conditions died in an adenovirus outbreak at a healthcare facility in Haskell, New Jersey, according to an article published November 19, 2018, by CNN.

Is There a Vaccine for Adenoviruses?

Although a vaccine exists for both viruses, only the flu vaccine is available to the general public. The CDC recommends that everyone over the age of 6 months get a flu vaccine, yet only 37 percent of adults got it last year.

The adenovirus vaccine is only approved for military personnel between 17 and 50 years of age, and the U.S. Department of Defense recommends that new military recruits get vaccinated.

“When you see these outbreaks, like at the University of Maryland and New Jersey, however, you wonder if the vaccine for adenovirus should be broadened,” says Adalja.

Treatment for Adenovirus Versus the Flu

If a person does get adenovirus, there is no specific treatment other than to rest and stay hydrated.

For the flu, there are four Food and Drug Administration (FDA)–approved antiviral drugs recommended by the CDC: oseltamivir (Tamiflu), peramivir, zanamivir (Relenza Diskhaler), and baloxavir marboxil (Xofluza).

Adalja points out that there are a few other viruses besides adenovirus that cause flu-like symptoms. They include respiratory syncytial virus, coronaviruses, and rhinoviruses, which cause the common cold.

“Flu usually causes chills and body aches and higher fever than some of these other infections, but it’s really hard to tell without doing a test,” says Adalja.

The CDC says that adenoviruses may also cause diarrhea, conjunctivitis (pink eye), bladder inflamation or infection, inflammation of the stomach and intestines, bronchitis, and neurologic disease, which affects the brain and spinal cord.

Both influenza and adenoviruses are easily spread. To protect yourself, the CDC encourages frequent hand-washing; not touching eyes, nose, or mouth with unwashed hands; and avoiding contact with those who are sick.

Learn More About Cold Vs. Flu: How to Tell the Difference In Your Symptoms

Early indications suggest the fatality rate for this virus is considerably less than another coronavirus, MERS, which kills about one in three people who become infected, and SARS, which kills about one in 10. All of the diseases appear to latch on to proteins on the surface of lung cells, but MERS and SARS seem to be more destructive to lung tissue. As of Jan. 31, fewer than one in 40 of the people with confirmed infections had died. Many of those who died were older men with underlying health problems.

Here’s how the new coronavirus compares with other infectious diseases:

Fatality rate

(log scale)

100%

Bird flu

Ebola

MERS

Smallpox

More

deadly

Spanish flu

Polio

SARS

Wuhan coronavirus

Most estimates put the

fatality rate below 3%,

and the number of

transmissions between

1.5 and 3.5.

Spreads faster

Swine flu

Measles

Seasonal

flu

Common

cold

Chickenpox

Average number of people infected by each sick person

Fatality rate

(log scale)

100%

Bird flu

Ebola

MERS

Smallpox

More

deadly

Spanish flu

Polio

SARS

Wuhan coronavirus

Most estimates put the

fatality rate below 3%,

and the number of

transmissions between

1.5 and 3.5.

Spreads faster

Measles

Swine flu

Seasonal

flu

Common

cold

Chickenpox

Average number of people infected by each sick person

Fatality rate

(log scale)

100%

Bird flu

Ebola

More

deadly

Smallpox

MERS

Spanish flu

Polio

Spreads faster

SARS

Wuhan coronavirus

Most estimates put the

fatality rate below 3%,

and the number of

transmissions between

1.5 and 3.5.

Measles

Swine flu

Seasonal

flu

Common

cold

Chickenpox

Avg. number of people infected by each sick person

Note: Average case-fatality rates and transmission numbers are shown. Estimates of case-fatality rates can vary, and numbers for the new coronavirus are preliminary estimates.

The chart above uses a logarithmic vertical scale: data near the top is compressed into a smaller space to make the variation between less-deadly diseases easier to see. Diseases near the top of the chart are much deadlier than those in the middle.

Pathogens can still be very dangerous even if their fatality rate is low, Dr. McGeer said. For instance, even though influenza has a case fatality rate below one per 1,000, roughly 200,000 people end up hospitalized with the virus each year in the United States, and about 35,000 people die.

How long does it take to show symptoms?

Possibly between 2 to 14 days, allowing the illness to go undetected.

The time it takes for symptoms to appear after a person is infected can be vital for prevention and control. Known as the incubation period, this time can allow health officials to quarantine or observe people who may have been exposed to the virus. But if the incubation period is too long or too short, these measures may be difficult to implement.

Some illnesses, like influenza, have a short incubation period of two or three days. People may be shedding infectious virus particles before they exhibit flu symptoms, making it almost impossible to identify and isolate people who have the virus. SARS, however, had an incubation period of about five days. In addition, it took four or five days after symptoms started before sick people could transmit the virus. That gave officials time to stop the virus and effectively contain the outbreak, Dr. McGeer said.

Officials at the Centers for Disease Control and Prevention estimate that the new coronavirus has an incubation period of 2 to 14 days. But it is still not clear whether a person can spread the virus before symptoms develop, or whether the severity of the illness affects how easily a patient can spread the virus.

“That concerns me because it means the infection could elude detection,” said Dr. Mark Denison, an infectious disease expert at Vanderbilt University in Nashville, Tenn.

How much have infected people traveled?

The virus spread quickly because it started in a transportation hub.

Wuhan is a difficult place to contain an outbreak. It has 11 million people, more than New York City. On an average day, 3,500 passengers take direct flights from Wuhan to cities in other countries. These cities were among the first to report cases of the virus outside China.

Passengers flying from Wuhan to other countries

October to November 2019

Russia

United Kingdom

Italy

France

United

States

8,000

Japan

23,000

passengers

CHINA

Turkey

Wuhan

South Korea

Taiwan

U.A.E.

Philippines

Malaysia

Thailand

55,000

Indonesia

5,000

25,000

Australia

50,000

passengers

Russia

United Kingdom

Italy

France

United

States

8,000

CHINA

Turkey

Wuhan

Japan

23,000

passengers

U.A.E.

Philippines

Malaysia

Thailand

55,000

Indonesia

5,000

25,000

Australia

50,000

passengers

Japan

23,000

passengers

United

States

8,000

Wuhan

Thailand

55,000

5,000

50,000

passengers

Note: Map shows passenger volume from October to November 2019, the most recent data available.

Wuhan is also a major transportation hub within China, linked to Beijing, Shanghai and other major cities by high-speed railways and domestic airlines. In October and November of last year, close to two million people flew from Wuhan to other places within China.

Beijing

136,000

CHINA

Wuhan

Shanghai

119,000

Passengers flying from Wuhan

to other cities in China

October to November 2019

5,000

25,000

Hong Kong

18,000

Kunming

95,000 passengers

50,000

passengers

Passengers flying from Wuhan to other cities in China

October to November 2019

Beijing

136,000

Wuhan

Shanghai

119,000

5,000

25,000

50,000

passengers

Kunming

95,000 passengers

Hong Kong

18,000

Passengers flying from Wuhan to

other cities in China

Oct. to Nov. 2019

Beijing

136,000

Wuhan

Shanghai

119,000

5,000

50,000

passengers

Kunming

95,000 passengers

Hong Kong

18,000

Note: Map shows passenger volume from October to November 2019, the most recent data available. Destinations with fewer than 1,000 passengers are not shown.

China was not nearly as well-connected in 2003 during the SARS outbreak. Large numbers of migrant workers now travel domestically and internationally — to Africa, other parts of Asia and Latin America, where China is making an enormous infrastructure push with its Belt and Road Initiative. This travel creates a high risk for outbreaks in countries with health systems that are not equipped to handle them, like Zimbabwe, which is facing a worsening hunger and economic crisis.

Over all, China has about four times as many train and air passengers as it did during the SARS outbreak:

4 billion travelers

Passenger traffic has quadrupled, opening more routes for infection.

When SARS broke out, there were about 1 billion travelers.

Train

passengers

Air passengers

’00

’10

Passenger traffic has quadrupled, opening more routes for infection.

4 billion travelers

When SARS broke out, there were about 1 billion travelers.

Train

passengers

Air passengers

’00

’10

Note: Air travel data includes passengers only on Chinese airlines.

China has taken the unprecedented step of imposing travel restrictions on tens of millions of people living in Wuhan and nearby cities. But experts warned that the lockdown may have come too late and limited access to food and medicine. Wuhan’s mayor acknowledged that five million people had left the city before the restrictions began, in the run-up to the Lunar New Year.

“You can’t board up a germ. A novel infection will spread,” said Lawrence O. Gostin, a law professor at Georgetown University and director of the World Health Organization Collaborating Center on National and Global Health Law. “It will get out; it always does.”

How effective will the response be?

The W.H.O. has praised China’s efforts, but critics fear lockdown measures may not be enough.

In addition to closing off transportation, officials shut down a market in Wuhan selling live poultry, seafood and wild animals, which was thought to be the origin of the coronavirus, and later suspended the trade of wild animals nationwide. Schools have been closed, Beijing’s Great Wall is off limits and tourist packages from China have been halted. World Health Organization officials have praised China’s aggressive response to the virus.

But the measures have also had unintended effects. Residents in Wuhan who are unwell must walk or cycle for miles to get to hospitals. There, many complain that they are being turned away because of shortages of hospital beds, staff and supplies that have been made worse by the lockdown.

Until recently, researchers abroad were also concerned by the fact that China was not admitting experts who could help track the virus and prevent its spread.

On Thursday, the W.H.O. declared the outbreak a global health emergency, acknowledging that the disease represents a risk beyond China.

The United States and Australia are temporarily denying entry to noncitizens who recently traveled to China, and several major airlines said they expect to halt direct service to mainland China for months. Other countries — including Kazakhstan, Russia and Vietnam — have temporarily restricted travel and visas. But critics fear that these measures will not be enough.

How long will it take to develop a vaccine?

A vaccine is still a year away — at minimum.

A coronavirus vaccine could prevent infections and stop the spread of the disease. But vaccines take time.

After the SARS outbreak in 2003, it took researchers about 20 months to get a vaccine ready for human trials. (The vaccine was never needed, because the disease was eventually contained.) By the Zika outbreak in 2015, researchers had brought the vaccine development timeline down to six months.

Now, they hope that work from past outbreaks will help cut the timeline even further. Researchers have already studiedthe genome of the new coronavirus and found the proteins that are crucial for infection. Scientists from the National Institutes of Health, in Australia and at least three companies are working on vaccine candidates.

“If we don’t run into any unforeseen obstacles, we’ll be able to get a Phase 1 trial going within the next three months,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

Dr. Fauci cautioned that it could still take months, and even years, after initial trials to conduct extensive testing that can prove a vaccine is safe and effective. In the best case, a vaccine may become available to the public a year from now.

Dog Flu: Symptoms, Treatment, and Prevention

When it comes to the dog flu, it’s important to always be prepared. While most cases are not fatal, the canine influenza virus can make your pup uncomfortably sick, causing him — and you — a lot of stress and time spent at the vet’s office. If you are a dog owner, you don’t need to panic about the dog flu. You should, however, familiarize yourself with the symptoms so that you know what to look for in the event of an outbreak in your area.

What Is Dog Flu?

Dog flu, or canine influenza virus, is an infectious respiratory disease caused by an influenza A virus, similar to the viral strains that cause influenza in people. There are two known strains of dog flu found in the United States:

  • H3N8
  • H3N2

The H3N8 strain actually originated in horses. The virus jumped from horses to dogs, becoming a canine influenza virus around 2004, when the first outbreaks affected racing Greyhounds at a track in Florida.

H3N2, on the other hand, originated in Asia, where scientists believe it jumped from birds to dogs. H3N2 is the virus responsible for the 2015 and 2016 outbreaks of canine influenza in the Midwest and continues to spread throughout the United States.

How Is Canine Influenza Spread?

Like human forms of influenza, dog flu is airborne. Respiratory secretions escape into the environment in the form of coughing, barking, and sneezing, where they are then inhaled by a new canine host. The dog flu also spreads through contaminated objects and environments, like water bowls, collars, and kennel surfaces, or through contact with people who have had direct contact with an infected dog.

Crowded areas like kennels, grooming parlors, day care centers, and dog parks are breeding grounds for diseases like canine influenza. The close proximity of the dogs means that a barking, coughing, or sneezing dog can easily infect canines around him. This is made more dangerous by the fact that dogs are most contagious during the incubation period before they start exhibiting symptoms.

How Long Are Dogs Infected With Dog Flu Contagious?

The incubation period of canine influenza is approximately 2-to-4 days from initial exposure to the dog flu virus. Viral shedding starts to decrease after the fourth day, but dogs with H3N8 remain contagious for up to 10 days after exposure, and dogs with H3N2 remain contagious for up to 26 days. Most vets recommend isolating dogs with H3N2 for at least 21 days to reduce the risk of transmission.

Almost all dogs that come into contact with the disease will contract it, but not all dogs that become infected show symptoms of the virus. About 20-25 percent of dogs infected are asymptomatic, but these dogs can still spread the disease. If one of your canine companions catches the flu, but the other seems unaffected, remember that he could still have the virus. Talk to your vet about quarantine procedures for all dogs in your household.

Symptoms of Dog Flu

So, how do you know if your pup has dog flu? There are several symptoms all owners should be aware of. Dog flu cases range from mild to severe and, unlike human influenzas, are not seasonal. Keep an eye out for the following symptoms year-round:

  • Coughing (both moist and dry)
  • Sneezing
  • Nasal discharge
  • Purulent nasal discharge
  • Runny eyes
  • Fever
  • Lethargy
  • Difficulty breathing

Dog flu symptoms resemble kennel cough symptoms, which is also an illness you should talk to your veterinarian about as soon as you notice symptoms.

Most cases of dog flu are mild, but severe cases do occur. In those instances, dogs develop pneumonia, difficulty breathing, and a high fever. Luckily, the mortality rate is relatively low, with less than 10 percent of dog flu cases resulting in fatalities.

Treating Dog Flu

The canine influenza virus requires the attention of a veterinarian. In some states, vets are required to report cases of canine influenza to the government to help monitor the spread of the disease.

There is no cure for dog flu. Treatment is supportive, and your veterinarian can advise you on the best ways to keep your dog comfortable during his illness and recovery. Some dogs may require supportive care, such as fluids, to aid their recovery, as well as nonsteroidal anti-inflammatory medications to reduce fevers. Your vet will help you come up with a nutritional plan and may prescribe antibiotics to treat secondary bacterial infections.

Your vet will also inform you about appropriate quarantine procedures to prevent the spread of dog flu, depending on the strain of the virus your dog contracts, and can give you information about disinfectant solutions to use in your home to help kill the virus.

Call your vet ahead of time to let her know that your dog is showing symptoms of a respiratory infection. Both kennel cough and dog flu are highly contagious, and your vet may request that you keep your dog outside until your appointment time to prevent the risk of transmission to other patients in the waiting room.

Preventing Dog Flu

The best way to prevent your dog from contracting dog flu is to keep him away from public places or kennels with recently reported cases. If you come into contact with a dog that you suspect has dog flu or has recently been exposed to it, wash your hands, arms, and clothing before touching your own dog. This will reduce the risk of transmission from you to your dog.

There are vaccines available for both the H3N8 and H3N2 strains of canine influenza. Your vet may recommend the vaccine based on your lifestyle. For instance, if you live in an area with a high incidence of dog flu or if your dog regularly spends time in kennels or travels to shows around the country, then he could be at an increased risk of contracting canine influenza and your vet may recommend the vaccine as a precaution.

Flu Facts

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Flu Season Is October to May

Each year from October to May, millions of people all across the United States come down with the flu. Kids get the flu most often. But people in every age group — including teens — can catch it.

What Is the Flu?

Flu is the common name for influenza. It’s a virus that infects the nose, throat, and lungs.

Often, when you’re sick with a virus, your body builds a defense system by making antibodies against it. That means you usually don’t get that particular type of virus again. Unfortunately, flu viruses mutate (change) each year. So you aren’t protected from getting the flu forever.

Some years the change in the flu virus is slight. So if you do get the flu, it’s mild. The antibodies from having the flu before give you some protection. But every 10 years or so, the flu virus goes through a major change and many people get severe cases. These large-scale outbreaks are called epidemics. If they spread worldwide, they’re called pandemics.

How Does the Flu Spread?

The flu virus spreads through the air when a person who has the virus sneezes, coughs, or speaks. The flu can sometimes spread through objects that someone with the virus touched, sneezed, or coughed on. When a healthy person touches these contaminated items and then touches their mouth or nose, the virus can enter their system.

People carrying the virus can be contagious 1 day before their symptoms start and about 5 to 7 days after they first get symptoms. So it’s possible to spread the flu before you know you’re sick.

Flu epidemics often start in schools and then move quickly through a community as students spread the virus to family members and people around them.

How Do I Know if I Have the Flu?

Flu symptoms start 1–4 days after a person was exposed to the virus. The main symptoms of flu are:

  • headache
  • sore throat
  • a high fever
  • chills
  • muscle aches
  • stuffy nose
  • dry cough
  • feeling very tired
  • loss of appetite

The fever and aches usually stop in a few days. But the sore throat, cough, stuffy nose, and tiredness may continue for a week or more.

The flu also can cause vomiting, belly pain, and diarrhea. But if you have only vomiting and diarrhea without the other flu symptoms, you probably have gastroenteritis. Some kinds of

are called the “stomach flu,” but they’re not the same as influenza. Some gastrointestinal infections are caused by non-flu viruses or bacteria.

You may feel miserable if you get the flu, but it’s unlikely to be serious. It’s rare that healthy teens get other problems from the flu. Older adults (over age 65), young kids (under age 5), and people with ongoing medical conditions are more likely to become seriously ill with the flu.

What to Do When the Flu Bugs You

If you get the flu, the best way to take care of yourself is to rest in bed and drink lots of liquids like water and other non-caffeinated drinks. Stay home from school until you feel better and your temperature has returned to normal.

Most people get better on their own after the virus runs its course. But call your doctor if you have the flu and:

  • you’re getting worse instead of better
  • you have trouble breathing
  • you have a medical condition (for example, diabetes, heart problems, asthma, or other lung problems)

Most teens can take acetaminophen or ibuprofen to help with fever and aches. Don’t take aspirin or any products that contain aspirin, though. If kids and teens take aspirin while they have the flu, it puts them at risk for

, which is rare but can be serious.

Antibiotics don’t work on viruses, so they won’t help someone with the flu get better. Sometimes doctors can prescribe an antiviral medicine to cut down how long a person is ill from the flu. These medicines are effective only against some types of flu virus and must be taken within 48 hours of when symptoms start. Doctors usually use this medicine for people who are very young, elderly, or at risk for serious problems, like people with asthma.

What’s the Flu Vaccine?

Everyone older than 6 months should get a flu vaccine.

Flu vaccines are available as a shot or as a nasal spray:

  • The shot contains killed flu viruses.
  • The nasal spray contains weakened live flu virus, which can’t actually cause the flu.

Both will make your body create antibodies that fight off infection if you come into contact with the live flu virus, and both work equally well. This flu season (2019-2020), get whichever vaccine your doctor recommends. People with weak immune systems or some health conditions (such as asthma) and pregnant women should not get the nasal spray vaccine.

If you have an egg allergy, get your flu shot in a doctor’s office, not at a supermarket, drugstore, or other venue.

Most people don’t have reactions to a flu shot, although a few may notice a fever, sore muscles, and tiredness. The nasal spray vaccine might cause mild flu-like symptoms.

The flu vaccine is usually given a few weeks before flu season begins to allow the body time to develop antibodies beforehand. It’s best to get it before the end of October. But you can still get a flu vaccine even after flu season starts.

What else can you do? Wash your hands well and often. Avoid sharing cups, utensils, or towels with others. If you do catch the flu, use tissues whenever you sneeze or cough to avoid spreading the virus.

If you do get the flu this season, take care of yourself and call your doctor with any questions or concerns. When you’re feeling bad, remember that the flu usually lasts a week or less and you’ll be back to normal before too long.

Reviewed by: Elana Pearl Ben-Joseph, MD Date reviewed: September 2019

5 Lethal Diseases You Would Totally Mistake For The Flu

Flu season is here, and half the fun of getting sick is calling out from work and imagining how sad everybody would be at your funeral if you died. The fun stops, however, when those “flu-like symptoms” turn out to be just that—flu-like, rather than influenza itself. You see, it isn’t really the virus that’s causing all of the symptoms of “the flu,” but your own immune system going bananas in an effort to kill it.

Unfortunately, your immune system goes bananas in almost the same way regardless of what’s trying to kill you, so quite a few life-threatening illnesses can easily pass through an acute phase (when they might still be treatable) and be written off as a touch of the flu.

So, this flu season, in a continuing effort to turn you into a paranoid basket case who’s afraid to go outdoors, here are five diseases that feel just like the flu, but that will totally kill you if you ignore them.

AIDS

Source: 103FM

Oh yeah, AIDS is the first one on the list. HIV infection usually passes through an acute phase shortly after exposure and produces noticeable symptoms. Here’s a fun experiment—compare this list of flu symptoms with another list of symptoms that signal the onset of HIV infection. One of them is taken verbatim from flu.gov, and the other is from aids.gov. See if you can tell the difference:

  • A 100-degree or higher fever
  • A cough and/or sore throat
  • A runny or stuffy nose
  • Headaches and/or body aches
  • Chills
  • Fatigue
  • Nausea, vomiting, and/or diarrhea

And:

  • Fever
  • Swollen glands
  • Sore throat
  • Rash
  • Fatigue
  • Muscle and joint aches and pains
  • Headache

There. That clears things up marvelously.

If you develop any of these symptoms, you should either stay home, drink plenty of fluids, and eat chicken soup, or you should rush to the clinic and ask for prophylactic doses of the cocktail in an effort to kill off the virus before it progresses to full-blown AIDS. Glad we could help with that.

It’s a dilemma that can baffle even the most seasoned parents: Your child’s miserable with a cough and fever. You don’t want to run to the doctor if a run-of-the-mill virus is the culprit and rest and fluids will do the trick. But you don’t want to delay and risk allowing a more serious condition take hold.

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How do you know when your child’s illness is something serious like the influenza virus (flu), respiratory syncytial virus (RSV) or pneumonia, for instance?

Fever and cough are common symptoms for all three — and for a host of less serious maladies too, says pediatrician Amy Sniderman, MD.

She walks us through common symptoms you should watch for and offers advice on when to check in with your child’s doctor.

Suggested by Cleveland Clinic

How to Keep Your Kids Out of the Emergency Department

Is it the flu?

Common signs of the flu include fever, cough, congestion, body aches and chills.

“Sometimes younger children will have vomiting or diarrhea, but typically it’s more of a respiratory condition,” Dr. Sniderman says.
Call the doctor right away if your child is not eating or drinking, not urinating, or is acting much more tired or irritable than usual, she advises.

It’s especially important to call the doctor when you suspect flu if your child has an underlying medical condition such as asthma or diabetes. Children who have these conditions are at higher risk of developing complications.

Dr. Sniderman recommends getting a flu shot for any child older than 6 months to help head off serious illness.

“The best way to prevent getting the flu is by getting the flu vaccine,” she says. “Even if you get the flu after you get a flu shot, your symptoms won’t be as severe and you’ll be less likely to experience complications such as pneumonia.”

Is it RSV?

RSV is a contagious illness that infects the respiratory tract and can lead to more severe infections like pneumonia or bronchiolitis.

Symptoms of RSV include runny nose, cough, fever, and sometimes trouble breathing or respiratory distress, Dr. Sniderman says.

In older children, RSV can resemble a bad cold. In babies, however, it’s sometimes a serious illness — particularly for those with other medical conditions such as asthma, or those who were born prematurely.

Call the pediatrician right away if your child shows any of these signs:

  • High fever
  • Fever that lasts more than two days
  • Rapid or difficult breathing
  • Extreme irritability or tiredness
  • Decreased urination
  • Dehydration

“RSV tends to produce a lot of mucus, so you can help keep your child comfortable by encouraging him to blow his nose, or by using a nasal suctioning device to remove mucus from your young child’s nose,” Dr. Sniderman says.

Is it pneumonia?

Symptoms of pneumonia in kids can include cough, fever, and fast or difficult breathing.

“With pneumonia, your child will act sicker than with a normal cold,” Dr. Sniderman says.

If you suspect your child has pneumonia, contact his or her doctor.

Usually doctors can diagnose pneumonia by examining the child, but sometimes a chest X-ray is necessary, she says.

When in doubt, call the doctor

Still worried and wondering? Because flu, RSV and pneumonia symptoms can overlap, diagnosis is tricky, Dr. Sniderman says. So don’t feel as though you need to diagnose your child on your own.

“If your child is feeling ill and you are worried about them, you should call their doctor,” she says. “That’s what we’re here for.”

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