My Doctor Online The Permanente Medical Group

Causes

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Transmission of colds and flu

Cold and flu viruses are contagious and are transmitted three ways:

Having direct contact. People carry the cold virus on their hands. If a person with the virus shakes your hand and you then touch your eyes, nose, or mouth, you may infect yourself with the virus.

Touching contaminated surfaces. Some cold viruses can live on surfaces like telephones, door handles, and tables. If you touch a surface that has been contaminated by a person who was ill and you then touch your eyes, nose, or mouth, you may infect yourself with the virus.

Inhaling the cold virus. This may occur when you breathe in air that contains the virus from an infected person who has recently sneezed, coughed, or exhaled into the air.

Neither of these illnesses is caused by being cold.

Symptoms and Diagnosis

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Colds

There is no special test for the common cold. We can make the diagnosis of the common cold based on your symptoms. It takes 1 to 3 days to develop the symptoms after you have been exposed to a person who has been ill or touched a surface contaminated by someone with a cold.

Symptoms may vary, but they typically include:

• Sore throat
• Nasal stuffiness or congestion
• Runny nose
• Postnasal drip
• Sneezing

Cough and muscle aches may occur as well. Sometimes, you may get eye irritation. You may have other symptoms including low-grade fever or chills. We often use the term "upper respiratory infection" (URI) when referring to colds. Usually, the cold will last 3 to 7 days, but it may persist for as long as 2 weeks. If you smoke or have other chronic health conditions, you may have more severe or prolonged symptoms.

Flu

Every year in the United States, on average 5 to 20 percent of the population gets the flu; approximately 200,000 people are hospitalized from flu-related complications, and about 36,000 people die from flu-related causes.

A flu diagnosis can be determined by your symptoms. Typically, if you have the flu, you will report the sudden development of:

• Fever (usually high)
• Headache
• Nonproductive cough (it does not bring up mucus)
• Significant muscle pains, including low-back pain and weakness 

Flu can cause complications such as pneumonia or other major problems for people who have other chronic conditions like heart disease, lung disease, diabetes, active cancer, or immune system problems like HIV. If this is the case for you, it is especially important for everyone who is older than 6 months to get a flu vaccine every year.

The flu is more serious than a cold. Complications from the flu can cause death in some vulnerable individuals including infants and young children up to 5 years old, pregnant women, the elderly, and those with chronic illnesses. Because of the nature of their job, healthcare workers are also at higher risk for getting the flu.

While you usually will see improvement in 2 to 5 days, the illness can last for a week or more. Some individuals may continue to feel weak and tired for several weeks. 

We may diagnose flu either by your symptoms or by taking a sample of your nasal mucus and testing it for the influenza A or B virus. We often do this early in the winter, before the flu season begins. Once there is a flu outbreak and many people have already been diagnosed and we know the range of symptoms, the diagnosis is made based on your symptoms alone.

Other Preventive Measures

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Preventing cold and flu

The best way to decrease your chances of developing a cold or flu is to:

Avoid touching your eyes, nose, or mouth, as these are the entry points for the virus into your body.

Wash your hands regularly and thoroughly with soap and warm water or use an alcohol-based hand gel.

Take these steps regularly, especially if you have encountered someone who is ill.

To prevent the spread of cold or flu:

• Cover your mouth and nose when you cough and sneeze.
• Sneeze or cough into your elbow rather than your hand.
• Wash your hands thoroughly.
• Avoid close contact with people who are already sick.
• Stay home from work and school and avoid public places if you're feeling sick to help prevent others from getting the flu.

Adults with flu can spread it to other adults for up to 5 days after symptoms start. Kids may be contagious for longer periods.

The Flu Vaccine

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The best way to avoid catching the flu is to get a flu vaccination every year.

The Centers for Disease Control and Prevention (CDC) and Kaiser Permanente strongly recommend that everyone older than 6 months get a seasonal flu vaccine when available. It will help prevent you from getting the flu and infecting others. To keep you healthy, Kaiser Permanente will send you a reminder to get the vaccine.

There are 2 ways you can receive your flu vaccine: the flu shot—given as an injection in the upper arm—or the  nasal spray—given as a mist sprayed into the nose. Both are highly effective ways of preventing the flu. Besides the way that the vaccine is given, the main difference between the two is that the flu shot contains inactive (dead) virus, while the flu nasal spray contains live attenuated virus that has been weakened so it cannot make you sick. The shot cannot cause the flu, and the spray has not been shown to spread the weakened virus.

The flu shot is safe for adults and all children who are older than 6 months. The shot is safe for healthy people, pregnant women, and people with long-term health conditions like asthma, diabetes, and heart disease. The flu nasal spray is safe for healthy people between 2 and 49 years of age who are not pregnant and who do not have long-term medical conditions.

The flu vaccine is usually available in September. Call the flu shot hotline, 1-800-573-5811 (1-800-KP-FLU-11) or visit the flu clinic page to find the closest Kaiser Permanente facility and where and when to get a flu vaccination. Flu vaccinations are free to all Kaiser Permanente members.

Prevention using Complementary and Alternative Medicine

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In addition to good hygiene and flu vaccinations, there are other approaches that may help prevent colds and flu. They include:

Physical activity. Some research suggests that regular moderate-intensity exercise like brisk walking for 30 minutes each day for 1 year may decrease the number of colds per year. 

Vitamin C. Research shows that vitamin C at a dose of 500 mg daily may help prevent colds. It has not been shown to help when you already have a cold.

Echinacea. Research shows no benefit.

Treatment

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Unfortunately, there is no cure for a cold or flu. For flu, if diagnosed within the first 48 hours of illness, there are some antiviral drugs that can be effective at reducing severity and length of symptoms.

For colds, the best treatment is home care and allowing the virus to run its course. The good news is that there are some home remedies as well as over-the-counter medications that can lessen your symptoms as you wait to get better. 

• Get extra rest. You can return to work once symptoms have improved and you are no longer running a fever, but slow down and try to take it easy.
• Drink lots of noncaffeinated fluids. Hot herbal tea, warm water and chicken soup is especially good for congestion (runny or stuffy nose).
• Take over-the-counter medication to soothe your cold and flu symptoms.

Use caution. If you decide to use a multisymptom cold medication, be sure to read the active ingredients section. Many times, individuals mistakenly take acetaminophen for fever or muscle aches without realizing that it is included in the multisymptom cold remedy. Too much medicine is not safe.

Antibiotic medications

Antibiotics do not help with a common cold since they are effective only against bacterial infections-they do not treat viral infections. Taking antibiotics when they are not needed can cause bacteria to become resistant to the drugs. These medications also can have side effects, which in rare cases can be serious.

Antiviral medications

There are no antiviral medicines available for colds.

There are antiviral prescription medications for flu that may be used in certain circumstances. You must start these medications within 2 days of developing symptoms. They may decrease the length of the illness and the severity of symptoms. As with all medications, there are side effects to consider.  We can help determine whether you might benefit from antiviral treatment for flu.

If you're pregnant

We know that pregnant women have a greater chance of developing complications from flu. Be on the lookout for flu symptoms: fever, cough, sore throat, body aches, headache, chills, and fatigue. If you're pregnant and catch the flu, you may be eligible for treatment with antiviral medication. This can make your flu milder and make you feel better faster, and may prevent complications. To be most effective, antiviral treatment should start within 48 hours of first symptoms or exposure to someone with the flu.

Complementary and Alternative Medicine Treament

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General recommendations for relief. Get plenty of rest. Drink plenty of fluids. Hot herbal tea, warm water, and chicken soup are helpful with runny nose or stuffy nose symptoms.

Smoking. If you smoke, cut down or, even better, quit. Ask us. We can help.

Heated humidified air. Research shows that this may reduce symptoms. You can use a humidifier or steam from a hot shower.

Saline sprays. Research shows no benefit. The spray may cause irritation and make symptoms worse. However, saline nasal rinses can be helpful.

Vitamin C. Research does not show any benefit for treatment; however, it may be helpful for prevention.

Zinc. Research shows little if any benefit. The lozenges may cause a metallic taste. The inhaled form may cause permanent loss of smell.

Your Care with Me

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If you have questions about the seasonal flu shot, call our toll-free Flu Hotline 1-800-KP-FLU-11 (1-800-573-5811).

If you have cold or flu symptoms that concern you, please call our Appointment and Advice line, which is available 24 hours a day, 7 days a week.

We urge you to call under these special circumstances:

• If you have chronic conditions and your usual cold or flu symptoms are worsening or if you have questions. 
• If you have worsening symptoms of shortness of breath or fever that lasts more than 3 days or the fever restarts after you feel better for a while.
• If you experience more shortness of breath than usual.
• If you experience a very sore throat and have trouble swallowing or have severe ear pain.
• If you develop severe pain in your face or forehead for more than 5 to 6 days. This may be due to sinusitis.

The advice nurse will try to identify whether you have a cold, the flu, or another condition. Our advice nurses can give you immediate advice, and our telephone staff can send me a message or book an appointment with me or one of my colleagues, if I am not available.  In addition, the advice nurse may suggest that you get a culture for strep throat, which you can do without an appointment. 24 hours after the test, you can check the results by calling 1-877-391-3391.

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You can connect with me in a variety of ways, depending on the situation and what is most convenient for you at the time. I am available online, by telephone, or in person.

• For nonurgent questions or concerns, you can e-mail me using this site. You can also book an appointment online to see me in person.
• If your concerns are immediate, or you simply prefer to use the telephone, please call our Appointment and Advice line, which is available 24 hours a day, 7 days a week. Our advice nurses can give you immediate advice, and our telephone staff can send me a message or book an appointment for you. 

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How We Coordinate Your Care

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Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology and health education, makes getting your care easier for you.

Another major benefit is our comprehensive electronic medical record system which allows all of the doctors and clinicians involved in your care to stay current on your health status and to collaborate with each other as appropriate.

When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.

If you come to an office visit

• At the beginning of your visit, you will receive information about when you are due for your next test, screening, or immunization.  We can discuss and schedule any preventive tests that you need. 
• At the end of your visit, you may receive a document called the “After Visit Summary” that will summarize the issues we discussed during your visit. You can refer to it if you forget what we discussed, or if you just want to recheck your vital signs and weight. You can also view it online under Past Visits.
• To help you prepare for your visit, please see additional details under Office Visit. 

If I prescribe medications

We will work together to monitor and assess how your medications are working and make adjustments as needed. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you and I will send the prescription electronically in advance of your arrival at the pharmacy.

If refills are needed in the future, you can:

• Order them online or by phone. Order future refills from my home page or by phone using the pharmacy refill number on your prescription label.
• Have them delivered to you by mail at no extra cost. Or you can pick up your medications at the pharmacy. If no refills remain when you place your order, the pharmacy will contact me regarding your prescription.

If lab testing or imaging is needed

For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures we will schedule an appointment with the radiology department. When the results are ready I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.

If I refer you to a specialist

My specialty colleagues are readily available to assist me if I need additional advice about your condition. In some cases, I may contact them during your visit, so we can discuss your care together. If we decide you need a specialty appointment after that discussion, we can often schedule it the same day or soon thereafter.

If you are due for preventive screenings or tests

As part of our commitment to prevention, additional members of our health care team may contact you to come in for a visit or test.  We will contact you if you are overdue for cancer screenings or conditions which may require monitoring.

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Convenient Resources for You

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My goal is to provide high quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.

My Doctor Online is available 24/7 so that you can access and manage your care where and when it is most convenient. From my home page you can:

Manage your care securely

• View and compose secure e-mail messages.
• Manage your prescriptions and schedule appointments.
• View your past visits and test results.
• View your preventive services to see whether you are due for a routine screening or updated immunization.

Learn more about your condition

• Read about causes, symptoms, treatments and procedures.
• Find interactive health tools, videos, and podcasts to help you manage your condition.
• View programs to help you decide on or prepare for a surgery or procedure.

Stay healthy

• Locate health education classes and support groups offered at our medical center.
• Explore interactive programs, videos, and podcasts that focus on helping you stay healthy.
• View your Preventive Services to see whether you are due for a routine screening or updated immunization.

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