Colds, Pneumonia, Influenza

Common Cold

What Causes Colds?

Most colds are caused by invisible droplets called rhinoviruses that are in the air you breathe or on things you touch. More than 100 different rhinoviruses (whose name comes from "rhin," the Greek word for nose) can infiltrate the protective lining of the nose and throat, triggering an immune system reaction that can make your throat sore, your head ache, and can make it hard for you to breathe through your nose.

No one knows for sure exactly why you may become infected with a cold at certain times. No matter what your parents say, shrugging off a jacket or sweater when it's chilly, sitting or sleeping in a draft, or going outside while your hair's wet won't cause you to catch a cold.

But air that's dry - indoors or out - can lower your resistance to infection. So can allergies, lack of sleep, stress, not eating properly, or hanging out with someone who is smoking.

Of course, being around your friends or others with colds make you more likely to catch one yourself. Rhinoviruses can stay alive as droplets in the air or on surfaces and may be able to make you sick for as long as 3 hours after someone who has a cold has coughed or sneezed. If you touch your mouth or nose after touching skin or some other surface that's been contaminated by one of these viruses, you'll probably catch a cold. If you already have a cold, you can make it worse if you don't wash your hands after you cough or sneeze.

How Long Do Colds Last?

Cold symptoms usually appear 2 or 3 days after you've been exposed to a source of infection. You are most contagious for the first 3 or 4 days after the symptoms appear and may be contagious for up to 3 weeks.

Going to school probably won't make you feel any worse, but it will increase the likelihood that your cold will spread to classmates, teachers, or friends. You may want to put some of your everyday activities on the back burner until you're feeling better.

Although about one of four colds lingers for as long as 2 weeks, most clear up within a week.

People who smoke are more likely to catch a cold than people who don't - and their symptoms will probably be worse, last longer, and are more likely to lead to bronchitis or even pneumonia.

"Like all viruses, the viruses that cause colds have to run their course," says Catherine Lamprecht, MD, an infectious disease specialist. "If your symptoms are tolerable, getting plenty of rest and drinking plenty of fluids can do as much good as medication."

Whether you feel like sleeping around the clock or just taking things a bit easier, it's a good idea to pay attention to what your body is telling you. A warm bath or heating pad can soothe your aches and pains, and the steam from a hot shower can help you breathe more easily. Cough and sneeze into a disposable tissue and wash your hands with warm water and soap each time.

What Kind of Medicine Will Help?

Over-the-counter cold medicines may alleviate some of your symptoms, but they won't prevent you from catching a cold. If you do get sick, they won't help you get better any sooner, and they may upset your stomach or make you dizzy, tired, or unable to sleep.

Ask your parents (who can consult with a doctor or pharmacist) what medicine you should take. Dr. Lamprecht recommends acetaminophen (like Tylenol) for aches, pains, and fever. Sometimes antihistamines and decongestants help to relieve congestion and stuffiness associated with a cold.

If you have a cold, you shouldn't take aspirin (or any medication that contains aspirin) unless your doctor says so. Use of aspirin or aspirin compounds by teens or kids with colds or other viral illness is thought to cause Reye syndrome. Reye (pronounced: rye) syndrome is a rare but serious condition that can cause liver failure or even be fatal.

Colds are considered benign and self-limiting, which means that someone who has a cold usually isn't very sick and doesn't need medical attention. However, there are important exceptions.

When Should I Go to the Doctor?

If your symptoms last for more than a week or appear at the same time every year or whenever you're exposed to pollen, dust, animals, or some other substance, you could have an allergy.

If you have trouble breathing or wheeze when you catch a cold, you could have asthma.

And if your symptoms get worse instead of better after 3 days or so, you could have strep throat, sinusitis, bronchitis, or some other bacterial infection, especially if you smoke.

You should see your doctor if you think you might have more than a cold, or if you're getting worse instead of getting better.

Other indications that it's time to call your doctor include:

Your doctor won't be able to identify which specific rhinovirus is causing your cold, but he or she will examine your throat and ears and may take a throat culture to make sure your symptoms aren't a sign of another condition. Taking a throat culture is a simple, painless diagnostic procedure that involves brushing the inside of your throat with a long cotton swab. Examining the germs that stick to the swab will help the doctor determine whether you have strep throat and need treatments with antibiotics.

If your doctor does prescribe antibiotics, be careful to take the medication exactly as the doctor or pharmacist says you should. If you stop taking it too soon - even if you start feeling better - the infection may not go away and you can develop other problems.

Pneumonia

What Causes Pneumonia?

Pneumonia (pronounced: noo-mo-nyuh) is inflammation of part of the lung. Inflammation is the immune system's response to a foreign invader or injury, often due to infection with germs, such as bacteria or viruses. When a person has pneumonia, lung tissue can fill with pus and other fluid, which makes it difficult for oxygen in the lung's air sacs to reach the bloodstream. With pneumonia, a person may have difficulty breathing and have a cough and fever. Sometimes a person may have abdominal pain and vomiting, too.

Pneumonia is most commonly caused by viruses, such as the influenza virus (flu) and adenovirus. Other viruses, such as respiratory syncytial virus (RSV), are common causes of pneumonia in young children and infants. Bacteria such as Streptococcus pneumoniae can cause pneumonia, too, although bacterial pneumonia is less common than viral. People with bacterial pneumonia are usually sicker than those with viral pneumonia, but can be effectively treated with antibiotic medications.

You may have heard the terms "double pneumonia" or "walking pneumonia." Double pneumonia simply means that the infection is in both lungs. It's common for pneumonia to affect both lungs, so don't worry if your doctor says this is what you have - it doesn't mean you're twice as sick! Walking pneumonia refers to pneumonia that is mild enough that you may not even know you have it - basically you may be able to walk around with this type of pneumonia. Walking pneumonia, which is also called atypical pneumonia because it's different than the typical bacterial pneumonia, is common in teens and is often caused by a tiny microorganism known as mycoplasma. Like the typical bacterial pneumonia, walking pneumonia can also be treated with antibiotics.

What Are the Signs and Symptoms?

There are many symptoms of pneumonia, and some of them, like a cough or a sore throat, are associated with many other common infections. Often, people get pneumonia after they've had an upper respiratory tract infection like a cold.

Symptoms of pneumonia can include:

The symptoms of pneumonia vary from person to person, and few people experience all of them.

When pneumonia is caused by bacteria, the person tends to become sick quickly and develops a high fever and has difficulty breathing. When it's caused by a virus, symptoms generally appear more gradually and may be less severe.

A person's symptoms can help the doctor identify the type of pneumonia. Walking pneumonia, for example, often causes headaches and sore throats in addition to the symptoms listed above

Can I Prevent Pneumonia?

The routine vaccinations that you probably received as a child help prevent certain types of pneumonia and other infections. If you have a chronic illness, such as sickle cell disease, you may have received additional vaccinations and disease-preventing antibiotics to help prevent pneumonia and other infections caused by bacteria.

People whose immune systems are weak (due to HIV infection or chemotherapy, for example) may also receive antibiotics to prevent pneumonia that may be caused by organisms they are especially susceptible to. In some cases, antiviral medication may be used to prevent viral pneumonia or to lessen its effects.

Because pneumonia is often caused by contagious germs, a good way to prevent pneumonia is to keep your distance from anyone you know who has pneumonia or respiratory infections. Use separate drinking glasses and eating utensils, wash your hands frequently with warm, soapy water, and avoid touching used tissues and paper towels.

You can also stay strong and help avoid some of the illnesses that may lead to pneumonia by eating as healthily as possible, getting plenty of rest, and avoiding smoking. Although most teens don't need a flu shot, some should have one. If you have certain illnesses like kidney disease, diabetes, or asthma, most doctors will recommend that you get a flu shot every year to protect you from complications like pneumonia.

How Long Before Symptoms of Pneumonia Appear?

The length of time before symptoms appear depends on many factors, particularly the type of pneumonia you have. With influenza pneumonia, for example, a person may become sick in as few as 12 hours or as long as 3 days after exposure to influenza virus. But with walking pneumonia, a person may not have symptoms until 2 to 3 weeks after exposure to the virus.

With proper treatment, most types of pneumonia are cured within a week or 2. In severe cases of pneumonia, it may take longer to completely recover.

The viruses and bacteria that cause pneumonia are usually found in the fluids in a person's nose and mouth. Sneezing or coughing may spread the infection to others, so if you have pneumonia, be careful not to share drinking glasses or eating utensils with other people. Dispose of used tissues and wash your hands frequently.

When Should I Call My Doctor?

If you think you may have pneumonia, let an adult know so he or she can help you get an appointment with a doctor. Be especially aware of your breathing; if you have chest pain or trouble breathing or if your lips or fingers look blue, you should go to your doctor's office or to a hospital emergency department right away.

Influenza

What Is the Flu?

Flu is the common name for influenza (pronounced: in-floo-en-za), a virus that attacks the respiratory system.

There are three different types of the flu virus. Types A and B can cause widespread flu outbreaks (although type B usually causes less severe symptoms than type A). Type C is fairly rare and causes only mild symptoms.

Usually when you're sick with a virus, your body builds up a defense system (which involves making antibodies) against the virus, so you don't get that particular strain of virus again. Unfortunately, flu viruses mutate (change) each year, so you aren't protected from the disease forever. Some years the change in the flu virus is slight, so even if you get the flu it's a mild case because the antibodies give you partial protection. But every 10 years or so the flu virus undergoes a major change, and many people get severe cases. These large-scale outbreaks are called epidemics. If the flu spreads worldwide, it's called a pandemic.

How Is the Flu Spread?

Looking for a good reason to miss school this winter? Tell your parents that you're afraid of catching the flu there! The flu virus spreads through tiny droplets of respiratory fluid. This means that when infected people cough, sneeze, or even talk they may be sending out the virus to others. People who are carrying the virus can be contagious 1 to 4 days before their symptoms appear, so they can pass it before they even know they're sick.

Flu epidemics often start in schools and then move quickly through a community as students "take" the virus home, spreading it to family members and people around them. During bad outbreaks, as many as 20% to 50% of the people in an area can become sick. Community leaders may close schools or cancel public meetings to stop the spread of the illness.

How Do I Know if I Have the Flu?

Flu symptoms - headache, fever, chills, and dry cough - appear anywhere from 1 to 4 days after you've been exposed to the virus. Your temperature can get as high as 104 degrees Fahrenheit (40 degrees Celsius). You'll probably feel achy and exhausted and you may lose your appetite.

The fever and achiness usually disappear within 2 to 3 days, but then you may get a stuffy nose or a sore throat. The stuffy nose, sore throat, and a feeling of tiredness may linger for a week or more.

The flu can sometimes cause vomiting, abdominal pain, and diarrhea in addition to the more common symptoms mentioned above. If you do not have flu symptoms and have only vomiting and diarrhea, you probably have gastroenteritis (pronounced: gas-tro-en-tuh-rye-tuss), an illness that is caused by different viruses or bacteria (such as Salmonella and E. coli).

Although you may feel miserable with the flu, complications like pneumonia or bronchitis are rare in healthy teens. Older adults (over age 65) and young children (under age 5) are more likely to become seriously ill with the flu; many elderly people die from the flu or its complications each year.

What to Do When the Flu Bugs You

When you get the flu the best thing to do to take care of yourself is rest in bed and drink lots of liquids like water, fruit juice, and noncaffeinated drinks. You should stay home from school until you are feeling better and your temperature has returned to normal.

You probably don't need to contact your doctor unless you develop complications or you have a medical condition such as diabetes or heart or lung problems such as asthma or cystic fibrosis that may cause you to become sicker with the flu.

You can take acetaminophen (such as Tylenol) or ibuprofen (such as Motrin) to relieve your fever and achiness. Avoid aspirin or any products that contain aspirin because these put you at greater risk of developing Reye syndrome, a very serious illness that can lead to liver failure that sometimes follows infection with the flu virus.

Because antibiotics don't work on viruses, they can't cure the flu. Sometimes doctors can prescribe medicine (either amantadine or rimantadine) to reduce the length of the illness. These medicines are effective only against the type A flu virus and must be taken within 48 hours of the appearance of flu symptoms to be effective. Because of potential side effects, doctors usually only use this medicine for people who are at risk for serious complications, especially elderly patients.

Vaccine to the Rescue?

There are some precautions you can take during flu outbreaks. Avoid crowds whenever possible. Wash your hands frequently. If you do catch the flu, use tissues whenever you sneeze or cough to avoid spreading the virus.

Your doctor may recommend that you get a flu shot. Each year, scientists develop a flu vaccine (flu shot) that consists of the inactivated (killed) flu viruses that are most likely to infect people that year. By injecting you with the killed viruses, your body develops the flu antibodies before you catch the live virus.

Most doctors recommend that people over age 65, babies and children between 6 to 23 months of age, and people - including teens and children - with medical conditions such as cystic fibrosis, asthma, heart disease, or sickle cell disease should get the flu vaccine every year.

Other teens who may benefit from the vaccine are those who are infected with the HIV virus and those who have diabetes, kidney problems, or other chronic (long-term) medical conditions.

If you get a flu vaccine, you may have a mild reaction, such as a fever, sore muscles, and tiredness, but most people don't have any reaction and the flu shot will help prevent you from getting sick later on. The flu shot is given 4 to 6 weeks before flu season begins. Anyone allergic to eggs should not get a flu shot because the viruses for the vaccine are grown in chicken eggs.

If you do get the flu this season, take care of yourself. And try to remember, even when you're feeling your worst, that you'll be back to your normal activities before too long.

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