Cold & Flu Prevention: Common-sense remedies for preventing, fighting off, and treating the common cold and flu.

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By Dawn Bialy • September 20, 2018

TABLE OF CONTENTS

Introduction
1. Cold vs Flu
2. Cold and Flu Prevention
3. All About Flu Vaccines
4. Dangerous Complications
5. Cold and Flu Remedies

INTRODUCTION

If you’re among those who end up getting a bad cold or a case of the flu almost every year, take heart: There are all kinds of strategies that can help you prevent these illnesses.

The best place to begin is with some cold and flu facts. By knowing more, you’ll be in a better position to take preventive action.

Colds and Flu: The Basics

Colds and flu are both caused by viruses—microorganisms that invade normal cells and reproduce. You can have viruses (and many other microorganisms) in your body and not become ill; however, if your immune system cannot fight off the virus before it begins changing or damaging healthy cells, you will develop an infection.

Rhinoviruses are the most common cause of colds. They result in an infection of your nose and throat.

In humans, the flu may be caused by two strains of viruses, influenza A and influenza B. Each of these viruses have subtypes, so there may be several types of viruses circulating at any given time.

Although most of us think of colds and flu primarily as winter illnesses, they’re actually most common in the late fall, winter, and early spring, although both can occur at any time of the year.

A cold virus is contagious the day before you start having symptoms, and you are contagious as long as your symptoms last. Some experts believe that you may still be contagious for a week or so after your symptoms have cleared up. Cold symptoms usually last for a week to 10 days; symptoms may last longer if you smoke or have a weakened immune system.

If you have the flu, you may be contagious for five to 10 days, including the day before your symptoms begin. Worried about spreading the virus to others? It’s best to stay home if you think you have the flu. Flu symptoms usually persist for three to five days in people who are otherwise healthy. Symptoms may last longer in young children, pregnant women, adults over age 65, and people with chronic diseases such as cancer, heart disease, diabetes, asthma, COPD, and HIV.

Flu Seasons Can Vary in Severity

Some flu seasons are worse than others. The 2017-18 flu season—Oct. 1, 2017 through May 19, 2018—took a huge toll on the nation’s health. It was classified as a “high severity” season, according to the Centers for Disease Control and Prevention (CDC). The classification of severity is based on percentages of visits to outpatient clinics, hospitalizations, and deaths that occurred due to flu or flu-related illnesses, such as pneumonia.

Another notable feature of the 2017-18 season was a high level of activity in nearly all 50 states that lasted for several weeks. Usually, the level of activity differs from region to region at various times in the season.

One thing you can do to give yourself a better chance of preventing colds and flu is to stay informed about the number of illnesses in your area. If you know there are high activity levels for colds and flu in your community, you can be more vigilant and take extra precautions to avoid infection.

Flu surveillance reports for the U.S. are posted weekly on the CDC’s website (https://www.cdc.gov.flu/weekly).

The Weather Channel’s website has a “Cold & Flu Tracker” that provides information about the levels of cold and flu activity in your area based on your zip code; go to https://weather.com, click on the “More Forecasts” tab in the upper right corner, choose “Cold & Flu,” and enter your zip code. If you do get a cold or the flu, you can report it on the website to help them more accurately “forecast” the levels of illness in your community.

1. Cold vs. Flu

Since colds and flu are both caused by viruses, you can “catch” or contract them in the same ways. A virus can enter your body through your mouth, nose, or eyes.

Viruses travel in droplets that go airborne when an infected person coughs, sneezes, or talks. These droplets may remain infectious for several hours, depending on where they fall. Viruses generally remain active longer on hard surfaces, such as stainless steel, than on soft surfaces, such as fabric. Other factors, such as the temperature and humidity of the environment, also play a role in how long cold and flu viruses stay active.

If you are within 6 feet of an infected person, it’s possible that you can inhale droplets that are expelled. Hand-to-hand contact also increases the chance of infection. Touching objects contaminated with the virus, such as utensils, TV remotes, computer keyboards, and toys, also increases your risk.

Is It a Cold or the Flu?

Many symptoms of colds and flu are similar, so it can be difficult to figure out which type of illness you have. In general, flu symptoms are more intense, and they tend to come on more abruptly than symptoms of a cold, which are usually milder.

Flu symptoms include a fever, chills and/or sweats, aching muscles (especially in the back, arms and legs), fatigue, weakness, and dry cough. The flu also may produce a headache, nasal congestion, or a sore throat. Some people describe their symptoms as feeling like they’ve been “run over by a truck.”

A flu virus usually does not cause nausea, vomiting, or diarrhea; these symptoms are more likely due to viral gastroenteritis (e.g., “the stomach bug”), which is often caused by a norovirus or rotovirus. But some people do experience these symptoms when they have the flu, and they are more common among children than adults. If you have vomiting and/or diarrhea but no other flu symptoms, you may have a virus or a bacterial infection, but you do not have the flu.

Cold symptoms include a runny or stuffy nose, sore throat, sneezing, cough, and congestion. Some people may experience a low-grade fever or a mild headache or body aches.

Dangers of Severe Cold or Flu

In the vast majority of cases, colds and flu come and go without causing any harm. However, complications that can cause serious illness and even death are possible.

Sometimes, complications arise because your weakened immune system is more vulnerable to other types of infections, such as those caused by bacteria. The flu also may cause a worsening of various medical conditions, including asthma, chronic obstructive pulmonary disease (COPD), diabetes, and multiple types of heart disease, including heart failure.

The most common complications of colds and flu include pneumonia (lung inflammation sometimes accompanied by infection), sinusitis (sinus infection), ear infections, and bronchitis (lung infection).

Other possible complications from flu include inflammation of the heart (myocarditis), brain (encephalitis), or muscles (myositis, rhabdomyolysis). The flu also can lead to sepsis, a condition in which an infection enters the bloodstream and spreads throughout the body.

2. Cold and Flu Prevention

Can lifestyle choices keep colds and flu away? In fact, there are ways you can stop the spread of germs, starting with the most basic—frequent hand-washing—and extending into lifestyle patterns, as we’ll discuss below.

Hand-Washing Away the Germs

Many experts believe that the single most effective action you can take to prevent colds and flu is to wash your hands. While you probably know that hand-washing is important, you may not know how to wash your hands properly to reduce your risks.

Per the Centers for Disease Control and Prevention (CDC), here are instructions on hand-washing:

1. Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
2. Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, and under your nails.
3. Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
4. Rinse your hands well under clean, running water.
5. Dry your hands using a clean towel or allow them to air dry.

What if there’s no soap and/or water? Use an alcohol-based hand sanitizer that contains at least 60 percent alcohol. However, keep in mind that hand sanitizers kill some, but not all, types of germs. When using a hand sanitizer, place the amount of product as directed by the label in the palm of one hand and then rub your hands together—covering all areas of your hands—for at least 15 seconds, or until they’re dry. Then, when you do have access to soap and water, make hand-washing your first priority.

Here are the CDC’s instructions for when to wash your hands:

• Before, during, and after preparing food
• Before eating food
• Before and after caring for someone who is sick
• Before and after treating a cut or wound
• After using the toilet
• After changing diapers or cleaning up a child who has used the toilet
• After blowing your nose, coughing, or sneezing
• After touching an animal, animal feed, or animal waste
• After handling pet food or pet treats
• After touching garbage

Disinfecting Your Environment

Since viruses can end up on virtually any surface, cleaning surfaces with a product that kills viruses—especially in high-traffic locations and on frequently handled objects—can significantly cut your risk of infection.

To kill viruses, use a “disinfectant” product registered with the EPA for hard, non-porous surfaces, such as doorknobs, tables, floors, some countertops, toilets, and sinks. Products registered with the EPA have labels indicating they kill viruses. EPA-registered chlorine bleach/hypochlorite solutions also are effective against viruses. Make sure you follow label instructions when using disinfectants.

If you don’t have a disinfecting cleaner or wipes on hand, use a bleach solution. The CDC recommends mixing ¼-cup of chlorine bleach with one gallon of cool water.

Wash linens with laundry detergent and tumble-dry on hot settings. Wash dishes and utensils either in a dishwasher or by hand with soap and hot water. Consider washing kids’ toys and other items in the dishwasher to sterilize them. You can put soft plastic items and other more delicate items on the top shelf.

For items on which you can’t use a disinfectant, clean them with soap and water or a sanitizer. Soap and water doesn’t kill viruses, but it removes them from surfaces, and sanitizers kill some, but not all, germs.

Skip “antibacterial” cleaners and soaps; they don’t kill viruses. In fact, triclosan, the ingredient in many antibacterial products, has been banned from hand soaps and body washes by the U.S. Food and Drug Administration (FDA). However, other products, including some toothpastes, may contain triclosan. Triclosan was shown to be an endocrine disruptor in animal studies, and its use may contribute to antibiotic resistance.

Virus Prevention: What to Clean

When you’re trying to protect yourself and your family from viruses, don’t forget these places and objects:

• Handles of car doors, refrigerator doors, sliding glass doors, cupboards, drawers
• Remotes for TV, lights, fans, and thermostats
• Phones, tablets, computer keyboards and mice, and other electronic devices
• Faucets, handles, and surfaces of toilets, sinks, tubs, and showers, as well as shared grooming, hygiene, and styling products
• Purses, handbags, backpacks, and briefcases (handles and exterior surfaces, as well as contents)

Diet and Nutrition: Flu Prevention Advice

Food is the fuel your body needs to keep its organs and systems working properly. Inadequate calorie and nutrient intake is associated with a weaker immune system. Deficiencies in a variety of nutrients, including zinc, selenium, and vitamins A, C, and E, have been linked to changes in immune function in lab studies.

Inadequate nutrient intake is surprisingly common in the general U.S. population; for example, many people age 65 and older are low in vitamin D, B12, folate, magnesium, calcium, or selenium. Don’t confuse calorie intake with nutrient intake; just because a person’s diet is high in calories doesn’t mean that it is high in nutrients. To boost your nutrient intake, skip foods low in nutrients (especially highly processed foods, foods high in sodium, beverages made with added sugar, and refined grains) and choose foods rich in immune-boosting vitamins and minerals.

The vitamins and minerals that play critical roles in immunity include vitamins A, C, D, E, B6, and B12, folate, zinc, iron, selenium, and copper.

Foods that provide theses nutrients include fruits, vegetables, legumes (beans, peas, and lentils), nuts, seeds, whole grains, fish, shellfish, poultry, eggs, and beef. Some top choices include:

• Salmon, tuna, mackerel, and sardines
• Beans of all types (black, pinto, cannellini, kidney, navy, white, garbanzo, lima, and soybeans)
• Spinach, kale, broccoli, Brussels sprouts, and leafy greens
• Carrots, sweet potatoes, winter squash, tomatoes, garlic, mushrooms, and red peppers
• Citrus fruits, strawberries, blueberries, and avocados
• Walnuts, almonds, Brazil nuts, and pistachios
• Pumpkin, sunflower, and sesame seeds

In addition, plant foods contain a wide array of phytochemicals (plant compounds), such as flavonoids, polyphenols, lignans, and organosulfides, that have antiviral and other health-promoting properties.

Probiotics for Cold and Flu Prevention

Probiotics are “friendly” bacteria that help maintain a healthy balance of microorganisms in your intestines, or your “gut.” About 70 percent of your immune system is located in your gut, so it’s easy to understand that gut health affects immune function.

Some studies have shown that taking probiotics reduces the risk of viral infections, including colds and flu, but findings are mixed, and there’s currently no strong evidence that probiotics are an effective deterrent. That said, probiotic supplements are widely used, and side effects are rare.

There are many different strains of probiotic bacteria. If you decide to take a probiotic, ask your doctor or pharmacist what bacterial strains are thought to be most effective. Studies that have linked probiotics with protective effects against viruses have used the strains L. plantarum, L. paracasei, L. rhamnosus, B. lactis, and B. subtilis.

If you want to take a probiotic to support gut health and general wellness, find a product that contains multiple strains and contains a minimum of 10 billion colony-forming units (CFUs); you can find this information on the label.

Or, add foods that contain probiotics to your diet. Probiotic bacteria, which are produced naturally during the process of fermentation, are found in some types of yogurt (check the label), kefir (a drink made from milk), sauerkraut, kimchi (a Korean dish that includes cabbage and other vegetables), and tempeh (fermented soybeans).

Do Vitamins, Minerals, and Supplements Help Prevent the Flu?

Several vitamins and minerals, as well as herbal remedies, are touted to help prevent or treat flu, but there’s no evidence to support these claims, according to the National Center for Complementary and Integrative Health (NCCIH). However, the NCCIH says that some complementary approaches may help prevent colds.

Here’s the rundown on some supplements that are said to boost immune system function.

• Vitamin C. Taking vitamin C has not been shown to prevent colds in the general population, although people taking vitamin C may have a slight reduction in the duration of cold symptoms. The exception is people who have been exposed to extreme physical stress, such as marathon runners; among these people, vitamin C does appear to prevent colds about half the time. The recommended amount of daily vitamin C is 75 milligrams (mg) for women and 90 mg for men. Taking large doses of vitamin C can cause stomach cramps, diarrhea, and nausea. The upper limit—the maximum daily amount considered safe—for vitamin C is 2,000 mg.
• Echinacea. An assessment of echinacea research found no convincing evidence that echinacea helps prevent colds. However, the echinacea products used in the studies varied greatly, and some studies on individual products suggest that it can have a slight preventive effect.
• Zinc. Studies on zinc have produced mixed results. In studies that linked zinc with a reduction in cold symptoms, zinc lozenges appeared to be most effective when taken within 24 hours of symptom onset. Avoid using nasal sprays that contain zinc; they have been associated with a loss of smell that may be permanent. Long-term use of zinc is not recommended.

According to the NCCIH, there is insufficient evidence that these products or supplements help prevent colds or relieve symptoms: andrographis, Chinese herbal medicines, garlic, green tea, vitamin D, and vitamin E.

The bottom line on supplements: If you have had good results with echinacea, zinc, or other supplements, there’s usually no harm in taking small doses for short periods of time. However, if you take any other medications, including over-the-counter products, get your doctor’s approval before taking a supplement to avoid potentially serious consequences.

Exercise to Fight Off the Flu

Some studies suggest that exercising regularly can help ward off cold and flu viruses, and that people with sedentary lifestyles are at higher risk of getting colds. Beyond that, being physically active is a key element of a healthy lifestyle.

Getting the recommended amount of weekly exercise—150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise—is associated with many health benefits, including lower blood pressure, blood glucose levels, and cholesterol levels, a lower risk of heart disease, diabetes, depression, and many other chronic conditions, a healthier weight, and less stress. All of these effects will benefit you if you do get a cold or flu.

Sleep: Keep Fatigue at Bay

The amount and quality of sleep you get can affect your immune system. Research has shown that people who don’t get quality sleep or enough sleep are more likely to get sick after being exposed to a cold virus, and their symptoms last longer than people who got enough quality sleep. Some research suggests that not getting enough sleep can reduce the effectiveness of vaccines.

You may think of the time you’re asleep as a period of inactivity, but, in reality, some of your systems are very active. While you’re asleep, your immune system produces cytokines, antibodies, and other substances that are involved in fighting viruses and decreasing inflammation. Getting less sleep means a reduced production of these important disease-fighters.

Sleep deficiency also has been linked with a higher risk of high blood pressure, stroke, diabetes, heart disease, obesity, and depression. If you’re not sleeping well, you have frequent insomnia, or you feel tired after getting seven to eight hours of sleep, talk to your doctor. An evaluation may reveal that you have obstructive sleep apnea (frequent interruptions in breathing while you’re sleeping) or another type of sleep disorder that can be treated.

3. All About Flu Vaccines

How effective is the flu vaccine? According to statistics, it can be up to 70 percent effective. In other words, as many as seven out of 10 people who receive a flu shot may not get the flu.

The vaccine’s effectiveness, however, varies from year to year. For example, the 2017-18 vaccine’s effectiveness was estimated at 36 percent, meaning that just over one-third of people who were vaccinated received a protective effect from the vaccine.

The flu vaccine protects against three or four strains of flu viruses. Each year, the vaccine is formulated based on World Health Organization scientists’ predictions of which viruses are likely to be most active during the upcoming flu season. These predictions are based on data from more than 100 countries.

It’s possible that by the time the next flu season begins in the U.S., the strains will have changed or mutated. Flu vaccines, however, have already been prepared and distributed throughout the country, and there isn’t time to produce a new vaccine in a large enough quantity that can protect against the newly identified strains.

Even so, the Centers for Disease Control and Prevention (CDC) urges everyone to get the flu vaccine.

“Vaccination can offer substantial benefit and reduce the likelihood of severe outcomes, including hospitalization and death,” according to a CDC statement issued in 2018. “For example, during the 2016–17 season, vaccination averted an estimated 5.29 million illnesses, 2.64 million medical visits, and 84,700 influenza-associated hospitalizations.”

A study conducted in collaboration with the CDC and published online Aug. 1, 2018 by the journal Vaccine revealed several benefits of getting a flu vaccine. The study, based on data collected during four flu seasons from 2012 to 2015 in New Zealand, showed that flu vaccination among adults reduced the risk of being admitted to the hospital with flu by 32 percent and reduced the risk of being admitted to an intensive care unit (ICU) with flu by 82 percent.

Researchers also found that, among adults who were admitted to the hospital with flu, those who had received a flu vaccine were 59 percent less likely to have very severe illness resulting in ICU admission than those who had not been vaccinated. And, among flu patients admitted to the ICU with flu, patients who had been vaccinated spent an average of four fewer days in the hospital than patients who did not get a flu vaccine.

Who Should Get a Flu Shot?

The CDC recommends that everyone ages 6 months and older receive a flu vaccine annually, with rare exceptions. Exceptions include severe, life-threatening allergies to any ingredient in the vaccine.

Some people with a history of Guillian-Barré syndrome (a severe illness that can cause muscle weakness and paralysis) should not get the vaccine. The CDC recommends that anyone who has had Guillian-Barré syndrome talk to his or her doctor before getting a flu vaccine.

There are two vaccines specifically for adults age 65 and older because CDC studies estimate that 50 to 70 percent of flu-related hospitalizations and 80 to 90 percent of flu-related deaths occur in this population. The vaccines are Fluad and Fluzone High-Dose.

The CDC recommends getting a flu vaccine by the end of October if possible, but, as long as flu viruses are circulating—in January or later—a vaccine still may help reduce your flu risk.

Types of Flu Vaccines

There are several different types of flu vaccines available; your doctor or pharmacist can advise you which is the best choice for you. Here are some basic vaccine terms and facts:

• Inactivated vaccines contain inactivated forms of the virus and cannot cause flu. Side effects may include pain, redness, and swelling at the injection site, and fever, malaise (general weakness, fatigue, or discomfort), headache, and body aches. Rarely, they may cause a severe allergic reaction. Brand names of inactivated vaccines include Afluria, Fluarix, FluLaval, Fluzone, Flucelvax, Fluvirin, and Flublok.
• All inactivated vaccines are either trivalent, meaning they contain three strains of the flu virus, or quadrivalent, meaning they contain four strains.
• The majority of flu vaccines are grown in chicken eggs. Basically, a live flu virus is injected into eggs and allowed to replicate (grow or multiply) for a few days. Then, the virus is extracted from the eggs, killed, purified, and made into the vaccine.
• Cell culture-based vaccines are made by growing viruses in mammalian cells. The fluid containing the virus is extracted, killed, and purified. Flucelvax is currently the only type of this vaccine available in the U.S.
• Recombinant vaccines are made by isolating a protein from a flu virus and combining it with portions of another virus. The combination is mixed with insect cells and allowed to replicate, and the protein is then harvested from these cells and purified. Currently, the only FDA-approved recombinant vaccine is Flublok.
• Adjuvanted inactivated vaccine contains an added ingredient, squalene oil, designed to elicit a stronger immune response. It is for adults age 65 and older. Fluad is the only vaccine of this type currently available in
  the U.S.

A live vaccine does contain a live virus, but it is attenuated (weakened), and it cannot cause the flu. It is administered via nasal spray (FluMist), and is approved for use in people ages 2 to 49. In previous years, FluMist was found to be less effective than other vaccines, but the manufacturer has changed the formula of the vaccine, and evidence suggests that the vaccine will be more effective during the 2018-19 season.

The nasal spray vaccine is most commonly administered to people who cannot or will not have an injection. The live vaccine should not be given to:

• People who are allergic to eggs
• Children ages 2 to 7 taking aspirin
• Pregnant women
• People with immunodeficiency diseases or who are in an immunosuppressed state and people who are caregivers for those with severely immunosuppressed systems
• Children ages 2 to 4 who have asthma or have had a wheezing episode in the past 12 months
• People who have taken antiviral medication for flu within the past 48 hours

Mercury-Free Vaccines

The ingredient in vaccines that contains mercury is thimerosal, a preservative used in vials that contain more than one dose of a vaccine. The Centers for Disease Control & Prevention says, “There is no evidence of harm caused by the low doses of thimerosal in vaccines, except for minor reactions like redness and swelling at the injection site.

However, in July 1999, The Public Health Service agencies, the American Academy of Pediatrics, and vaccine manufacturers agreed that thimerosal should be reduced or eliminated in vaccines as a precautionary measure.”

Single-dose vaccines that contain no thimerosal include Afluria, Fluad, Fluzone, Fluzone High-Dose, Fluarix, and Flucelvax. Vaccines that do contain thimerosal include multi-dose vials of Fluvirin, Afluria, FluLaval, and Fluzone.

If you are concerned about mercury, tell your doctor or pharmacist that you want a vaccine that does not contain thimerosal.

4. Dangerous Complications

The flu is considered potentially serious among people who are at high risk for flu-related complications. This includes infants younger than 12 months, pregnant women, people with heart, kidney, liver, or lung diseases, and people who have immunodeficiency disorders or a compromised immune system due to chemotherapy or other medications. If you fall into any of these groups, see your doctor as soon as you start experiencing flu symptoms.

Other people whose symptoms should be closely monitored include children younger than 5 and adults age 65 or older. If you have the flue and experience any of the following symptoms, seek immediate medical attention:

• Difficulty breathing or shortness of breath
• Persistent fever
• Pain or pressure in your chest or stomach
• Dizziness or lightheadedness
• Confusion
• Severe vomiting/inability to keep fluids down

In general, no improvement in symptoms in five days for adults and three days for children warrants at least a phone call to your doctor.

Is the Flu a Killer Disease?

It can be, in some cases: The term used by the CDC is “influenza-related deaths,” since the deaths usually result from complications caused by flu rather than as a direct result of flu. (For example, if flu complications led to pneumonia and the patient died, pneumonia would be considered the cause of an influenza-related death.)

Last year, flu-related complications resulted in the deaths of at least 170 children and thousands of adults. Among the children that died from flu during the 2017-18 season, only 22 percent had been vaccinated. The most recent estimates, based on the 2010-11 through 2013-14 seasons, ranged from 12,000 to 56,000 flu deaths per year. Since the 2017-18 season was severe, with high numbers of outpatient visits and hospitalizations for flu-related illnesses, it’s likely that the death toll was high.

The Flu and Your Heart

You know that the flu attacks your respiratory system, but does it have any effect on your heart health? Research suggests that it does.

A study conducted in Ontario revealed that the risk of having a heart attack rose by as much as 600 percent among patients who were diagnosed with flu. Among flu patients, the incidence of heart attacks was highest during the first seven days after they were diagnosed with flu.

The researchers theorized that infectious illnesses such as the flu may cause blood vessels to become narrowed and inflamed, which increases blood pressure and the risk of heart attack and other cardiovascular events, such as stroke. Another study found an association between getting a flu vaccine and having a lower risk of heart disease, stroke, heart failure, or death from
cardiac causes.

5. Cold and Flu Remedies

We’ve discussed ways to avoid cold and flu viruses (Chapter 2) along with flu vaccines (Chapter 3) and serious complications of the flu (Chapter 4). But what happens when you do get hit with a cold, fever, or flu? Here are your treatment basics.

Medications

Antiviral drugs, which are available by prescription only, can reduce the severity of flu symptoms, speed recovery by one or two days, and help prevent serious complications. They need to be given soon after the onset of symptoms—within 48 hours is best.

If you think you have the flu and are at high risk for flu-related complications, call your doctor right away. Depending on your symptoms, some doctors may prescribe flu medications over the phone. This allows you to stay home and rest, and it lessens the chances of you spreading the virus during your trip to and from his or her office.

There are tests that can detect the flu virus, but some don’t have a high level of accuracy, and some must be performed in specialized labs. If your doctor knows the virus is active in your community and your symptoms are similar to those of other patients, he or she often will not require testing to reach a diagnosis of flu.

The three antiviral drugs approved by the FDA for flu are oseltamivir (Tamiflu), zanamivir (Relenza), and peramivir (Rapivab), which is given intravenously to patients with severe symptoms.

Over-the-counter (OTC) products that may help relieve cold and flu symptoms include:

• Pain relievers and fever reducers, such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol).
• Decongestants, which may help clear your nasal passages, stop your runny nose, and allow you to breathe easier. Pseudoephedrine (Sudafed) and oxymetazoline (Afrin nasal spray) are common decongestants.
• Cough medicines. Try a cough suppressant (dextromethorphan) for a dry cough and an expectorant (guaifenesin) if your cough is wet and produces phlegm or mucus. If you have high blood pressure, choose medicines that do not contain the decongestants pseudoephedrine, ephedrine, phenylephrine, naphazoline and oxymetazoline; these drugs narrow blood vessels, which can increase blood pressure.
• Multi-symptom formulas. Some cold/flu/sinus formulas contain three or four medications; they may include a pain reliever, a cough suppressant, a decongestant, and/or an antihistamine, which can help relieve congestion, runny nose, sneezing, and inflammation in nasal passages.

Choose your OTC remedies carefully to make certain you’re getting only one dose of each type of medication to reduce your risk for severe side effects. Many products that treat multiple symptoms contain several medications. For example, a cold medicine may contain a decongestant and a pain reliever, so don’t take an additional decongestant or pain reliever along with it.

Natural Remedies for the Cold and Flu

When you have a cold or flu, your body is battling a virus. There are several strategies to help your body get rid of the virus and ease your symptoms; here are some suggestions.

• Stay hydrated. When you have a fever, you need plenty of fluids to help your body fight the infection and to replace fluids lost from sweating (and from vomiting or diarrhea, if you have them). If you’re not eating much, you also need to make up for the fluids you’d normally be getting from foods (many foods are more than 50 percent water). Water, clear broth, and herbal teas are good choices. Fruit juices are another option, but drink them in moderation (a total of 8 to 12 ounces per day) and make sure they contain no added sugar. Avoid alcohol and caffeine; they can have dehydrating effects. Add lemon and/or honey to hot beverages if you prefer.
• Rest. When your body is fighting an infection, it needs to use all of its resources for healing. If possible, take a break from working, cleaning the house, and other normal daily duties, and just rest. If you’re a person who thinks you can’t miss work, think again: You are doing your employer a favor by not passing your illness to your coworkers and/or customers.
• Create a comfortable environment. Keep your room warm but not overheated. If the air is dry, it may irritate your sinuses, nasal passages, and throat; use a humidifier or vaporizer to moisten the air.
• Soothe your throat. Gargling with salt water can temporarily relieve a sore or scratchy throat. Make salt water by dissolving ¼ teaspoon of salt in a 4-ounce glass of warm water.
• Use saline nasal solutions. To help relieve nasal congestion, try saline nasal drops or a saline nasal rinse, such as a Neti pot. You’ll find these products in most pharmacies.
• Eat nutritious foods. When you have a cold or the flu, you may not have much of an appetite. When you are up to eating, it’s tempting to reach for comfort foods, but you’ll get more disease-fighting nutrients from a smoothie made with fruits and/or vegetables, a green salad, or some homemade vegetable or chicken soup. Foods that are heavy, high in fat, and/or fried will require more of your body’s resources to break down and digest.

Take Preventive Action

When cold and flu season gets underway, follow the old adage, ”An ounce of prevention is worth a pound of cure.”

Wash your hands frequently, and keep hard surfaces clean with a disinfecting solution. Use an alcohol-based hand sanitizer when soap and water aren’t available. And, if possible, keep your distance from others who are sick, whether at your home or at work.

Follow a diet that contains plenty of fruits and vegetables, as well as whole grains, lean proteins, beans, nuts, and seeds. Limit your consumption of highly processed foods, fried foods, and foods made with refined grains (white flour) and/or lots of added sugar; these foods don’t provide the nutrients you need to keep your immune system strong.

Get and stay physically active, whether it’s in the gym, yoga or tai chi studio, your basement, or on a walking or biking trail or tennis court. Remember that chores and leisure activities count, too: Vacuuming and mopping, walking the dog, mowing the grass, gardening, swimming, and dancing are all good choices.

And, do all you can to get an adequate amount of high-quality, restful sleep. If you have problems sleeping or you constantly feel tired, let your doctor know.

If you do get a cold or flu, take steps to stop the virus from spreading. These include simple steps such as:

• Coughing into your elbow rather than your hand
• Washing your hands frequently and thoroughly
• Disposing of used tissues
• Avoiding touching communal surfaces at home and at work
• Disinfecting surfaces you have touched
• Refraining from hand-to-hand contact with others.

Continue these practices even if you’re feeling better after a few days; remember, you may still be contagious for as long as 10 days after your first symptoms appear.

You now have the knowledge and the practical strategies to reduce your risk of getting a cold or flu. Keep an eye on the trackers at the CDC, the Weather Channel, or other stations or websites so you’ll know when colds and flu are on the rise in your area, and make good use of the many tools you have to prevent a viral infection. If you do get a cold or flu, use the remedies that are appropriate for you (you’ll find more ideas at UniversityHealthNews.com), and report any severe symptoms to your doctor.

Here’s hoping that you and your family and friends come through this year’s cold and flu season virus-free.