Dr. Pauline Tan Ngo has been working in the field of pediatrics for almost 20 years. Arriving in Beijing from the Philippines in 2004, she is now the head of the Pediatrics Department at Vista Clinic. As the temperature drops outside and the woolen sweaters come out of the closet, Ngo sat down with beijingkids to talk about our common winter foes, the cold and flu, and how we can help keep them at bay.
What is the difference between a cold and a flu?
We often use these two terms interchangeably, [but]they are not the same. Although both are caused by viruses, the common cold is caused by a wide variety of viruses. Flu, on the other hand, is caused by three influenza viruses: A (virulent), B (mild) and C (non-virulent). A drippy and congested nose is the primary symptom for a cold, and may be associated with coughs and a sore throat, but fever is mild and the disease may last two to 14 days. For the flu, nasal symptoms are not prominent, but fever may be higher and last longer. Body aches and headaches are quite prominent, a sore throat is common and the disease may last longer than the common cold.
How do they spread?
They spread from person-to-person either directly through respiratory droplets when one sneezes or coughs, or indirectly when one touches surfaces with these viruses and then touch their nose, mouth or eyes. The latest flu research showed that the flu is more common in colder winter months because the virus is more stable and stays in the air longer when air is cold and dry.
How can people prevent spreading a cold or flu?
According to the Centers for Disease Control (CDC), the single best way to prevent the flu is to get the flu shot yearly. It states that all people 6 months and older should get it. There’s no vaccination against colds. Preventive measures include washing hands and avoiding sick people. However, the latter is not a 100 percent guarantee since a person may start to spread virus before showing symptoms.
How do you know when a cold or flu needs medical attention?
The flu can manifest from mild to severe illnesses. As a general rule, I advise my patients to see the doctor if fever is high-grade and lasts more than three days, the child is not eating or playing, the child is debilitated and would rather lie down, or when symptoms rapidly worsen – for example, the child has breathing difficulties or an increased respiratory rate.
When is the best time for children to start taking medications?
When prescribed, antiviral medications are best taken during the first 48 hours of illness and taken for five days. There are only two medications approved for use by the US FDA: Tamiflu (Oseltamivir) and Relenza (Zanamivir). The mainstay of treatment, however, is still supportive care: take adequate fluid, get lots of rest during the day, and stay at home to avoid infecting others and getting a superimposed bacterial infection. Use an antipyretic (like Tylenol) to lower the fever, relieve a headache or body pain. [Using a] humidifier when the air is too dry is also helpful. Antitussives, decongestants, expectorants, antihistamines and large doses of vitamin C have no role in the treatment of colds and flu.
Why are children more susceptible to catching colds and the flu?
Because colds are caused by a wide variety of viruses (as many as 200) to which children haven’t been exposed to yet and therefore don’t have immunity. Younger children may get respiratory infections as often as six to eight times per year. Parents often complain that as soon as the child enters preschool or joins a playgroup he or she starts to have these colds. As they grow older and get exposed to more viral infections, they develop immunity and therefore get sick less often.
Are antibiotics over-used in China?
Antibiotics fight against bacteria [but]do not kill viruses. Doctors should take time to evaluate their patients and prescribe antibiotics judiciously. Antibiotic abuse is not only prevalent in China but also in other parts of the world. China’s State Food and Drug Administration bans the sale of antibiotics over the counter, but they are still obtainable. Patients self-medicate, and some Chinese doctors are coerced by patients to prescribe antibiotics. Chinese health authorities are aware of this problem and have taken steps to train doctors to curb the abuse. However, education is one thing [and]implementation is another. This is a public health issue that will have dire consequences as antibiotic resistance develops.
Besides medication, are there other effective ways to avoid getting colds and the flu?
A healthy lifestyle that includes balanced nutrition, regular exercise and adequate sleep is always helpful. Avoiding sick people and staying away when one is sick is also practical. Attending to one’s personal hygiene, [such as]frequent hand washing cannot be overemphasized.