The incubation phase lasts about a day for influenza and may be just a few hours for the common cold. During this time, someone can spread infection, but because there are no telltale symptoms, there is little we can do to protect ourselves. We shake hands, spend time together in enclosed spaces, and do all manner of things that unwittingly increase the risk for disease transmission.

During the symptomatic/infectious phase, symptoms like coughing and sneezing serve as a warning sign to avoid direct contact with a sick person, and especially to avoid exposure to respiratory secretions. The symptomatic/infectious phase lasts about five to seven days for flu and about three days for the common cold. Beware, however, that some people, including those who have been vaccinated against the flu, may have only very mild symptoms but can still be contagious.

The recovery phase begins within about a week. During this time patients may still have symptoms like cough or fatigue but are no longer infectious to others.

So if your friend says, “I may sound bad, but I feel fine. I know I’m not contagious,” don’t take her word for it.

Do you have a health question? Ask Well

How long am I contagious?

How long should I stay home after being sick? Often, this question comes with an internal back and forth about whether you—or your children—should stay home or not. Whether a child or an adult, Alison Pittman, PhD, RN, CPN, CNE, clinical assistant professor at the Texas A&M College of Nursing, gives some basic guidelines on how to tell if you should stay home with a short-term, possibly contagious illness.

Am I contagious with a fever?

“People need to be fever free for 24 hours without the help of a fever-reducing medication before they return to work or school,” Pittman said. According to the Texas Department of State Health Services, school nurses are advised to send children home that have a temperature of 100.4 degrees or greater. The same rule of thumb goes for adults too. “You need to stay home if you have had a temperature of 100.4 degrees in the past day.”

A low-grade fever is any temperature above 98.6 degrees but below 100.4 degrees. Pittman says low-grade fevers are a good thing, because your body is actively fighting an infection.

“If you have a low-grade fever, and you feel fine, you can participate in your usual day-to-day activities, but you need to listen to your body.” She recommends if you start to feel achy, begin to sweat or develop a headache, then take your temperature again, then go home. The same recommendation goes for children.

How long am I contagious after the flu? After I take Tamiflu?

The Centers for Disease Control and Prevention (CDC) recommends people with the flu to stay home until 24 hours after they are fever free without the use of a fever-reducing medication. “Depending on your place of work, you may need to check company policy,” Pittman said. “For example, many health care settings require their employees to stay home seven days after the onset of symptoms.”

Pittman notes individuals with the flu can be contagious for up to three weeks after the onset of symptoms. “In many cases, just because you or your children are fever free and can return to work or school does not mean you are no longer contagious. Proper handwashing goes a long way to prevent the spread of germs.”

The same rules apply even if you have taken a flu antiviral drug like Tamiflu. Stay home until you are fever free for 24 hours without the help of a fever-reducing medication.

How long am I contagious after a cold?

“Most people are contagious with a cold a day before they notice symptoms until about a week after the onset of symptoms,” Pittman said. “The CDC’s recommendation is to stay home until you are fever free for 24 hours without the help of a fever reducer.”

Because you are still contagious after the fever subsides, Pittman emphasizes the importance of handwashing and taking extra care to contain your cough or sneeze.

The CDC recommends to call your primary care provider if cold symptoms last longer than 10 days, or if a child younger than three months of age is showing symptoms.

How long am I contagious after starting antibiotics?

“If you are sick with a bacterial infection, then your health care provider may prescribe you antibiotics,” said Pittman. “The likelihood of spreading infection severely decreases 24 hours after you begin antibiotics.” Some common bacterial infections are conjunctivitis or pink eye, strep throat and meningitis.

Viral infections like colds and upper respiratory infections usually need to run its course. Depending on your health care provider’s suggestions, you may take medications to temporarily ease symptoms but your provider will not suggest antibiotics.

Because it can be hard to tell which illness is viral and bacterial, Pittman suggests calling your health care provider for guidance if your symptoms do not start to improve after two to three days. The long length of symptoms can be a sign you have a bacterial infection, which will need antibiotics.

“You should always seek a healthcare professional if you or your child has symptoms that are severe or unusual, such as shortness of breath or a high temperature, especially in children under six months of age,” said Pittman.

How long am I contagious after a stomach bug?

“Any time you have had diarrhea—regardless how often—or if you vomited twice in the past 24 hours, then you need to stay home,” advised Pittman. “If you vomit two or more times in one day, then that likely means you did not throw up because of something you ate or because you got too hot outside.”

The stomach flu or a stomach bug is often called viral gastroenteritis, and it is highly contagious. It spreads through contact with an infected person’s stool or vomit.

“Some viruses, such as norovirus, can live on surfaces for more than 24 hours, and it spreads very quickly, especially with children,” said Pittman. “If symptoms last more than 24 hours or if you or your children start to feel dehydrated, then call your primary care provider.”

Is my rash contagious?

“If you have a rash, you should always seek a health care provider’s recommendation. Many rashes can be symptoms of contagious illness like meningitis or measles,” said Pittman. “Do not return to work or send your children with rashes to school until your provider gives you the go ahead.”

Rashes can be a symptom for many things like allergic reactions, chicken pox, impetigo, hands foot and mouth, and shingles. Pittman notes if you have a rash in conjunction with a fever that the combination is often a sign of a more serious illness.

How long should I stay home after getting a nuisance disease like lice/ringworm/pinworms?

“People with head lice should not return to school or work until treatment has begun,” Pittman said. “Pinworms and ringworm are also incredibly contagious, especially for children, but they usually do not require someone to miss school or work. Always follow the health policies at your school or workplace.”

Head lice has over-the-counter treatments you may purchase at your local drug store. Ringworm and pinworms typically require a visit to your primary care provider’s office to get the appropriate prescription.

General rules of thumb

“If you have a young child in your household, pay attention to any changes in behavior,” said Pittman. “Behavioral changes are often the very first signs your child is coming down with something.”

If you are still unsure how long you should stay home or keep your children home, then ask your primary care provider. They are available to answer any questions and give you the support and resources you need to help you and your family get better.

— Mary Leigh Meyer

Cold vs. Flu: The Lowdown on Upper Respiratory Infections

“Upper respiratory infections” is how many physicians refer to the type of illness that is the No. 1 reason for Americans missing school or work. The rest of us refer to these ailments as the common cold, and in more serious cases, the flu (influenza).

The primary difference between the common cold and the flu usually has to do with the severity of symptoms. The symptoms of flu can include fever or feeling feverish/chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches and fatigue (tiredness).

Cold symptoms are usually milder than the symptoms of flu. People with colds are more likely to have a runny or stuffy nose. Colds generally do not result in serious health problems.

Upper respiratory infections, colds and flu cases, represent the most frequent reason for a doctor visit in the U.S., with varying symptoms ranging from runny nose, sore throat and cough, to breathing difficulty, lethargy, fever and general malaise.

When to See a Doctor
See a doctor or visit an urgent care center promptly if you are at high risk of serious flu complications and you get flu symptoms, says the U.S. Centers for Disease Control and Prevention (CDC). People at high risk of flu complications include young children, adults 65 years of age and older, pregnant women, and people with certain medical conditions such as asthma, diabetes and heart disease.

If you get sick with flu, antiviral drugs are a treatment option. Antiviral drugs are prescription medicines (pills, liquid, an inhaled powder, or an intravenous solution) that fight against flu viruses in your body, says the CDC. You can only get them if you have a prescription from a healthcare provider. Antiviral drugs are different from antibiotics, which fight against bacterial infections.

“Antibiotics are rarely needed to treat upper respiratory infections, unless your doctor suspects you have a bacterial infection,” said Hanif Williams, M.D., a primary care physician with Baptist Health Primary Care.

Most people get over the common cold in a few days without the need for prescribed medication. Antibiotics do not fight infections caused by viruses. And that includes colds, most sore throats and bronchitis cases, and some ear infections. U.S. and world health officials are concerned about the overuse of antibiotics and how that trend can promote antibiotic-resistant infections in the future. Up to one-third to one-half of antibiotic use is either unnecessary or inappropriate, according to the U.S. Centers for Disease Control and Prevention (CDC).

Cold vs. the Flu: Potential Complications

The common cold and flu are both contagious viral infections of the respiratory tract. Although the symptoms can be similar, the flu usually produces more serious symptoms that last longer. The CDC says colds generally do not result in serious health problems, such as pneumonia, bacterial infections, or hospitalizations. But the Flu can have very serious associated complications, the CDC says.

Most people who get influenza will recover in several days to less than two weeks. But some people will develop complications caused by a viral flu infection affecting the upper respiratory tract (nasal passages, throat) and lower respiratory tract (lungs). Contact your primary care physicians if symptoms persist. Flu activity usually peaks between December and March, but can last as late as May. Everyone 6 months of age and older should have gotten a flu vaccine by the end of October, if possible, the CDC says.

“Because colds and flu share many symptoms, it can be difficult (or even impossible) to tell the difference between them based on symptoms alone,” the CDC said. “Special tests that usually must be done within the first few days of illness can tell if a person has the flu.”

Patients with a minor illness or injury can hold their place in line with “Save My Spot,” an online reservation system for all of Baptist Health’s Urgent Care and Urgent Care Express locations across South Florida.

Tags: antibiotics, flu, infection control

Cough and Chest Congestion

  • Antihistamine/decongestant combo (e.g., brompheniramine/pseudoephedrine)
  • Cough suppressant: Dextromethorphan (Delsym)
  • Expectorant (mucus thinner): Guaifenesin (Mucinex, Robitussin)
  • Gentle hot tea (chamomile, licorice root, peppermint, thyme) with or without honey or lemon juice; Traditional Medicinals “Throat Coat” or “Breathe Easy” teas.
  • Honey (1 tablespoon of raw honey 1 to 3 times daily). Note: honey is not safe for infants under 12 months.
  • Steam inhalation: Boil 1 inch of water in a pot, remove from the stove, add 5 drops of eucalyptus oil if desired, and inhale slowly for a few minutes twice daily with a towel over your head.

Sore Throat

  • Pain relievers: Ibuprofen or naproxen (Advil, Motrin, Aleve), acetaminophen (Tylenol). It’s OK to use the maximum dose for 1 or 2 days while your symptoms are at their worst. Follow directions on the packaging.
  • Cooling or numbing medicines: Chloraseptic spray, lozenges, gargle echinacea tincture in water.
  • Saltwater gargles throughout the day: 1 tablespoon of salt in a glass of warm water.
  • Warm tea with honey, Traditional Medicinals “throat coat” or “breathe easy” teas, “sore throat tea“.
  • Chicken soup or other clear broth.

Nasal Congestion and Sinus Pressure

  • Oral decongestants: Pseudoephedrine (Sudafed) is the most effective choice, but you have to ask for it at the pharmacist counter and show ID. Avoid decongestants if you have poorly controlled high blood pressure.
  • Nasal spray decongestant: Oxymetazoline (Afrin). Don’t use this for more than 3 days, or your congestion will come back even worse.
  • Pain relievers: Ibuprofen or naproxen (Advil, Motrin, Aleve), acetaminophen (Tylenol). It’s okay to use the maximum dose for 1 or 2 days while your symptoms are at their worst. Follow directions on the packaging.
  • Nasal steroid spray: Flonase, Nasonex, Nasacort
  • Nasal irrigation twice daily with warm salt water (neti pot, NeilMed Sinus Rinse, Nasaline)
  • Steam inhalation: Boil 1 inch of water in a pot, remove from the stove, add 5 drops of eucalyptus oil if desired, and inhale slowly for a few minutes twice daily with a towel over your head.
  • Moist heat compresses over your sinuses for several minutes a few times a day.
  • Herbs: Goldenseal, Bi Yan Pian, Sinupret

Runny Nose

  • Oral decongestants: Pseudoephedrine (Sudafed) is the most effective choice, but you have to ask for it at the pharmacist counter and show ID. If you have high blood pressure, avoid pseudoephedrine or take care to monitor your blood pressure while you take it.
  • Nasal spray decongestant: Oxymetazoline (Afrin) can be used for a short time. Don’t use this for more than 3 days, or your congestion will come back even worse.
  • Antihistamines: Allegra, Zyrtec, Claritin, Benadryl (all available in generic formulas) are all effective. Benadryl (diphenhydramine) will make you sleepy; the others won’t. Antihistamines tend to work better for runny noses from allergies, but they can help a bit, and they come in some of the combination cold/flu products.
  • Saline nasal spray
  • Steam inhalation: Boil 1 inch of water in a pot, remove from the stove, add 5 drops of eucalyptus oil if desired, and inhale slowly for a few minutes twice daily with a towel over your head.

Fever

  • Fever reducers: Ibuprofen or naproxen (Advil, Motrin, Aleve), acetaminophen (Tylenol)
  • Drink lots of water.
  • Take a warm or cool shower.
  • Warm tea (chamomile, peppermint)

Headache and Body Aches

  • Pain relievers: Ibuprofen or naproxen (Advil, Motrin, Aleve), acetaminophen (Tylenol). It’s okay to use the maximum dose for 1 or 2 days while your symptoms are at their worst, as long as there are no contraindications. Follow directions on the packaging.
  • Moist heat compresses or cold packs.
  • Rub on Tiger Balm.
  • Take a nap.
  • Take a warm bath with Epsom salts.

How Long Should I Wait After the Flu or a Cold to Hang Out with People Again?

RELATED: This Is Exactly When You’re More Likely to Catch the Flu

Though no one wants to spend the holidays on the sidelines, do your friends and coworkers a favor and take one for the team, advises Dr. Rohr: “In an ideal world, it would be best to avoid social activities for five to seven days after the onset of symptoms. For returning to work, I usually suggest waiting until 24 hours fever-free. If you feel lousy or you’re sneezing and coughing significantly, just stay home.” And controlling your fever with acetaminophen or ibuprofen doesn’t count, either: You’re still contagious even if you’re using meds to lower your temperature, says Dr. Rohr.

If you absolutely have to show your face while you’re recuperating, at least come with good cold/flu etiquette. Pack your travel-size Kleenex (from $4; amazon.com), and cover your mouth when you sneeze or cough. “Best in a disposable tissue, second best in your elbow,” says Dr. Mossad. “Don’t cough or sneeze into your hand.”

RELATED: 5 Signs You’re Too Sick to Go to Work

Remember to wash your hands frequently, especially after touching your eyes, nose, or mouth, and particularly before coming in for a tight hug with Aunt Jane. And steer well clear of the crudité so you don’t get cold or flu particles on the food. “When a sick person sneezes or coughs, the virus can be sent up to 6 feet away,” notes Dr. Rohr.

And if you find yourself on the other side of the equation, warily shaking hands with a nose-runner at the office holiday fete and then realize you’re sniffling and sneezing the next morning? Rest up, but try to temper your instinct to assign blame: It actually takes two to three days, and sometimes up to a week, from time of exposure to developing symptoms, Dr. Rohr explains. So you probably picked it up from someone else earlier in the week. Grrr.

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How long should you stay away when you have a cold or the flu?

Symptoms of the flu generally develop more quickly and are more severe than the common cold. Credit: txking/

Most adults get around two to three colds a year, and children get even more. In terms of the flu, there are around 3-5 million severe cases of influenza worldwide each year and 290,000 to 650,000 deaths.

The symptoms of a cold and the flu are similar, so it’s hard to tell the difference. But the flu is usually more severe and develops more quickly than a cold.

Colds and flus can be easily passed from person to person through the air, when an infected person coughs or sneezes, and touch, when a person touches an infected surface or object like doorknobs and light switches.

So what’s the difference between colds and flus, and how long should you stay away?

Colds

Cold symptoms include a sore throat, cough, runny or stuffy nose, tiredness and headache.

Most people become contagious with cold symptoms one to two days after exposure to a cold virus. These symptoms usually peak two to four days later. The common cold usually lasts about ten days.

There is nothing you can take to shorten the duration of a cold, and most people will get better without needing to see a doctor. But some over-the-counter medications can help alleviate the symptoms. These include anti-inflammatories (to reduce inflammation or swelling), analgesics (to reduce pain), antipyretics (to reduce fever) and decongestants (to relieve nasal congestion).

But be careful you follow the instructions and recommended dosage for these medications. A recent study of US adults who used paracetamol, the active ingredient in many cold and flu medicines, found 6.3% of users exceeded the maximum recommended daily dose. This mostly occurred during the cold and flu season.

Natural products such as vitamin C and echinacea are sometimes recommended to prevent and treat a cold, but there is limited evidence to support their effectiveness.

The flu

Common symptoms of the flu include fever (a temperature of 38°C or higher), cough, chills, sore throat, headache, runny or stuffy nose, tiredness and muscle aches.

An infected person can spread the flu for five to seven days after becoming infected. The infectious period can begin 24 hours before the onset of symptoms. This means you can spread the flu without even knowing you’re sick.

Influenza viruses can cause mild to severe illness in people of all ages. Most people will fully recover within one to two weeks and won’t require any medical attention. Similar to a cold, people can take some over-the-counter medications and other remedies to help alleviate symptoms.

But some people can become acutely unwell with the flu. They may require antiviral medication and, in severe cases, hospitalisation. Those at high risk include pregnant women, children, the elderly, and people with certain medical conditions such as HIV/AIDS, asthma, diabetes and heart and lung diseases.

The flu virus strains that circulate usually change every year, so the best way to prevent getting the flu is to get the annual flu vaccine. The vaccine is moderately effective and recommended for adults and children over the age of six months. Some common side effects may occur, such as temporary soreness, redness and swelling at the injection site, fever, headache, muscle aches and nausea.

Avoid passing it on

If you feel unwell, stay home from work or school and rest (and get plenty of fluids) until you feel better. If you’ve had a fever, stay home for at least 24 hours after the fever has broken.

When you go back to work or school, you may still be infectious, so avoid passing the virus on by:

  • regularly washing your hands with soap and water for at least 20 seconds and drying them properly – if soap and water are not available, use an alcohol-based hand sanitiser
  • practising good cough and sneeze etiquette: cover your mouth and nose with a tissue or your upper shirtsleeve when you cough or sneeze, and throw away used tissues immediately
  • not touching your eyes, nose and mouth
  • frequently cleaning the surfaces and objects you’ve touched.

Explore further

How to fight the flu this season Provided by The Conversation

This article was originally published on The Conversation. Read the original article.

Citation: How long should you stay away when you have a cold or the flu? (2018, July 23) retrieved 1 February 2020 from https://medicalxpress.com/news/2018-07-cold-flu.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.

How Long Is a Cold Contagious?

Q: How long are you contagious when you have a cold?

A: As a general rule, adults with a cold will be able to infect others one day before symptoms appear, and up to five days or so after becoming sick. Infants and children are able to transmit these viral infections for seven days or longer. The precise number of days for transmission can vary from person to person. Those in poor health tend to get infected more easily. Children are also more likely to catch (and transmit) colds.

Cold viruses, abundant in nasal and throat secretions, are mainly transmitted via hands. When you blow your nose, touch your face, or wipe your eyes, the virus transfers to your hands, and then to whatever or whomever you touch. If you contaminate a telephone, the next person who uses it may catch your cold. To avoid spreading or catching a cold, the most important precaution is to wash your hands often and well. Hand sanitizers are a good option when you’re not near a sink.

Coughing and sneezing can also spread the virus, of course. If you don’t have a tissue, instead of sneezing or coughing into your hand, do it into your arm or shoulder, thus avoiding contaminating your hand.

If you think you are getting sick, limit your contacts. Don’t hug and kiss. If you’re around someone who is sick, stay at least six feet away—cold viruses can’t be propelled much farther than that before falling to the ground. Don’t share drinking glasses, utensils, phones, or towels.

Flu viruses may not travel in exactly the same way as cold viruses, but your best bet is to take these same precautions to avoid transmitting or catching the flu.

Also see Can Supplements Fight Colds?

Medical myth busting: Separating fact from fiction about colds and flu

7. Hands are bad, right?

Washing your hands or using alcohol-based hand gel is a cornerstone of respiratory virus prevention. Your hands touch elevator buttons, public transport rails, all the different places you go on a daily basis, then you touch your face hundreds of times a day. I have a bottle of hand gel with me at all times. You can’t stop yourself all the time, but be more aware of whether your hands are clean before you start rubbing your eyes.

8. How far does avoiding touching bathroom doors get you?

Although it’s probably less critical for respiratory viruses, it is important to prevent the spread of other diseases such as Norovirus, a gastrointestinal virus that leads to diarrhea and vomiting and is aptly known as “Winter Vomiting Disease.” You never know whether the person before you washed their hands or not. If you ever watch anyone wash their hands, it can be quite cursory. Sometimes they don’t even use soap or take just three seconds. Whenever you can, when you’re washing your hands, use a paper towel to turn off the sink, open the door, and then toss the towel away. That’s the ideal.

9. How long should you wash your hands? I’ve heard you should sing “Row, Row, Row Your Boat,” but I suspect I sing it too fast.

Try “Happy birthday to you.” Sing it twice. Most people rub two hands together and think they’re done. We miss our thumbs, our wrists, under rings and jewelry, under fingernails, the backs of our hands. There are multiple steps. There are videos out there that show you how to wash your hands. It’s the same with hand gel. Make sure you get enough hand gel to cover your hands.

10. What about facial masks? Do they help at all?

Although you often see people wearing a mask in public places to avoid getting the flu, it’s not clear that it provides a lot of benefit. We recommend that patients with active symptoms wear them in the clinic to prevent spreading respiratory droplets. But you have to wear them correctly. And their effectiveness is limited once they get wet from coughing, sneezing or the humidification in airways.

11. Why do people often get a cold after flying on a plane?

When you’re sitting in close proximity to others for 12 hours, you’re more likely to be exposed to respiratory droplets. It’s really limited to the seats around you, not the whole plane. I sat next to somebody with a cold, and I was as careful as I could be — washing my hands, using hand sanitizer. After a 10-hour flight I was sure I was going get a cold — and I did.

12. In what way is having kids like flying on a plane?

The majority of people get colds and flu from being in close proximity to someone with an active cold, who’s sneezing and coughing. That’s why with young kids in a family, the cold goes through the whole family. Also, kids are viral factories: They often have viral loads that are higher than adults. They often don’t cover their nose and mouth, don’t have good hand hygiene, they hang out together at daycare and school. They’re the starting and ending place for lots of respiratory viruses during the cold season. We see the season happening in kids first.

13. How can you tell if you’ve got a cold or the flu?

Runny nose, sore throat, fever, sneezing, cough and muscle pain are common symptoms seen in a whole host of viral infections. But influenza is different from a bad cold. It often includes a fever and a feeling of malaise or muscle pains. You feel really wiped out. If you are concerned, see your doctor for a quick test to see if you have flu or if it’s beneficial to get treated. Certainly, if you are a cancer patient, see your doctor even if you have minor symptoms.

14. What about the ‘stomach flu?’

That’s not influenza. Really young kids can get nausea and vomiting with influenza, but there are always respiratory symptoms. When you hear “stomach flu,” nausea and vomiting, think Norovirus. It is very contagious so oftentimes it will run through the whole family.

15. Any idea what kind of flu season it’s going to be this year?

Sporadic cases have been seen, but it is not really spreading dramatically in the U.S. yet. It usually starts on the East Coast and moves West. Getting your flu shot now is ideal because you need two weeks to develop a full immune response.

16. So it’s a good idea to get a flu vaccine?

It is the best way to protect yourself from getting the flu. It isn’t perfect but it can often cut your chances of getting influenza by about 50 percent (depending on the season). Unfortunately, we don’t have vaccines for other respiratory viruses. But I get my flu shot every year, as do all the physicians at the Seattle Cancer Care Alliance — we all know how important getting the vaccine is to protecting our families, our friends and our patients. SCCA and Fred Hutch provide free flu vaccine for our staff. In addition, we provide vaccine for patients and give it free to family members and caregivers when they come with patients to the clinic.

17. What about the high-dose vaccine?

A high-dose flu vaccine has been shown in studies to provide better protection for people 65 years and older. I recommended it to my own parents — who both get vaccinated. The one down side is it only covers three strains of influenza while the normal vaccine covers four. Future studies should help us better understand whether high-dose vaccine is beneficial for cancer patients.

18. Why did the CDC stop recommending flu mist for children?

The flu mist, or live-attenuated flu vaccine, is a weakened form of the influenza virus that can be given through the nose. It was thought to work well in kids, but recent data suggests that it may not provide enough immune response to some strains of influenza. The CDC does not recommend it as an option for vaccination this year. The only option is the flu shot.

19. Can you get the flu from the flu vaccine?

Absolutely not. The vaccine has components of the inactivated virus, but it’s not the virus. Minor side effects can be a little aching or arm swelling, but it lasts a day or two at most. As one of the most utilized vaccines in the world, it has one of best safety profiles of anything we do in healthcare.

20. What about claims that vaccines are linked to autism?

This has been well studied and there are no links. We need to move away from blaming vaccines for a very serious illness when science has, again and again, shown this not to be the case. Unfortunately, many still believe this discredited link. As for Guillain-Barre syndrome (a rare neurologic illness), you are more likely to get it if you get the flu than if you get the vaccine. Vaccines are well studied and very safe. I get mine every year and so does everyone in my family.

21. Does drinking orange juice or taking vitamin C help prevent colds and flu? What about Airborne products or zinc?

There’s not great data. Is it vitamin C that provides the benefit or drinking lot of orange juice? Probably the liquids. Eating healthy foods and getting lots of rest are important, however.

22. Is there any treatment for a cold or flu?

If you have influenza, there’s Tamiflu, or oseltamivir . We don’t recommend them for everyone but we do suggest them for people with chronic health conditions, cancer or for a transplant patient at risk for complications. I prefer that you never need medications — get the vaccine instead. For most other respiratory viruses, there are no treatments, so prevention and limiting transmission are key.

23. Is there anything you can do to treat a cold?

The best things you can do are rest and get adequate fluids. Take it easy, don’t exert yourself. Cover your coughs and sneezing. And stay home so you limit exposing others to the infection.

24. What about chicken soup?

If nothing else, it provides a variety of nutritional benefits, a fair amount of liquids, and it can be very soothing to take something warm. I know I love it when I feel sick — along with ginger ale. It reminds me of when I was a kid. There are no downsides to it.

Have you been hit by a cold or flu this season? Tell us about in on Facebook.

We ask the experts to settle common questions we’ve all wondered about.

QUESTION

If I’ve had a cold for a week, am I still contagious?

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ANSWER

First, you should make sure you have a cold and not something more severe like influenza – commonly known as the flu. They may be hard to tell apart, but with a cold, you usually get a sore throat, nasal congestion or runny nose, sneezing and coughing, with or without a fever. With influenza, which can be life-threatening if you are older or have a weakened immunity, typical symptoms are fever, cough, tremendous fatigue, and muscle aches and pains.

Although you can prevent influenza to some degree with a vaccine, there is no long-lasting immunity to the common cold. There are many viruses that cause the common cold, such as rhinovirus, coronavirus and adenovirus to name a few. This may account for the differences from one cold to another, and may also explain why there is no lasting immunity.

On average, an adult may get one to three colds a year. Children tend to catch more colds. A healthy child gets three to six of them a year.

The typical cold lasts four to seven days. When a contagious individual coughs or sneezes, respiratory droplets containing infectious viral particles can spread to others. You “catch” the cold from close exposure to these droplets (usually within one metre of a cough or sneeze), or by touching a surface with these virus droplets on it, then directly transmitting the virus from your hands to your nose or eyes.

Generally, you are most contagious, or at the highest level of transmitting the cold virus, during the first one to three days of your cold or of having symptoms. Some transmission risk still remains on the fourth and fifth days, and by the sixth and seventh days there is virtually no risk.

If you are otherwise healthy and catch a cold, the most important thing to remember is to avoid visiting those family members and friends who are in hospitals, nursing homes or living with other immune-compromised, vulnerable individuals. A simple cold may further weaken their systems, allowing for the development of a more serious infection.

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Dr. Andrew Simor is chief of Microbiology and Infectious Diseases at Sunnybrook Health Sciences Centre. A University of Toronto professor, Dr. Simor is co-chair of the Canadian Nosocomial Infection Surveillance Program.

The common cold: How sick is too sick to work?

By Jessica Stevenson, M.D.
Hallmark Health Medical Associates

Dr. Jessica Stevenson

Getting a cold is pretty miserable. You have to miss out on fun with family and friends, and you may feel compelled to stay home from work. But the good news is taking a sick day may not be necessary.

The common cold is one of the most common reasons for missing work across the United States. According to the Centers for Disease Control, Americans suffer millions of cases of the common cold each year.

According to @CDCgov, Americans suffer millions of cases of the common cold each year.

I see many people in my office each week who took the day off to come see me for a common cold. A new Massachusetts law, which went into effect in July 2015, allows workers in companies of 11 employees or more to earn paid sick leave to help ease the financial burden of illness.

But how do you know if you should use your paid sick time? The tips below can help you decide whether you should tough it out at work or take it easy at home.

Regular cold symptoms

American adults typically come down with two to three colds per year. If you have asthma or COPD or if you take steroids for a medical condition, you have an increased risk of complications from the common cold.

Many people come see me because they’ve had a sore throat for a day or two. But that’s how many colds start, and it’s often nothing to worry about.

If you’re experiencing these symptoms and fewer than 10 days have passed since you started feeling sick, you’re likely experiencing a common cold and not something worse:

  • Sore throat and nasal congestion
  • Mild body aches
  • Low-grade fever (below 100.4)
  • Cough

Unfortunately, the common cold is viral, with rhinovirus the most common culprit. This means that, unlike bacterial infections, the only way to get rid of a cold is to let it run its course.

The only way to get rid of a common cold is to let it run its course.

You can treat your symptoms with over-the-counter products to help you feel better, but it won’t shorten the duration of your illness. It’s really about focusing on symptom based therapy, meaning that you can treat the cold symptoms that are the most bothersome for you.

There are three common over-the-counter cold remedies I often recommend:

  • Nasal spray: There are several kinds. Afrin (oxymetazoline) offers the fastest relief for nasal congestion. It works by constricting the blood vessels to reduce swelling, but if used for longer than 3 days, it can cause rebound congestion. A nasal steroid spray such as Flonase or fluticasone takes longer to work but helps if you are having post-nasal drip (mucous dripping down the back of your throat). Lastly, nasal saline is a safe option for all ages and can be used for any length of time to help cleanse the nasal passages.
  • Pseudoephedrine: Oral decongestants can help relieve the pressure in your sinuses. I often recommend the medication that is kept behind the counter at the pharmacy as it is the strongest. If you have high blood pressure, check with your physician before purchasing pseudoephedrine.
  • Neti pot: This treatment may look and feel weird, but it’s very effective for cleaning out your sinuses to help with congestion and sinusitis. You use a little pot of warm water with powder dissolved in it to physically flush mucous out of your sinuses.

I used a neti pot for the first time last year, and it felt like water going up my nose. That said, it was quite effective. You literally can see the gunk coming out of your sinuses, so it’s obvious that it’s working. People with chronic sinus infections can really benefit from this over-the-counter treatment.

/wp-content/uploads/2015/11/Dr.-Stevenson-neti-pot.wav Dr. Stevenson discusses the neti pot treatment for colds.

Cough is the symptom that tends to linger for the longest time (up to 3-4 weeks). Honey (2 tsp every 6 hours) has been shown to be as effective as many over the counter cough suppressants. I also recommend a humidifier or steam to help ease chest congestion. For generalized muscle aches, over the counter anti-inflammatory medications such as ibuprofen or acetaminophen are very helpful and can be alternated.

When to see your doctor

For most people, cold symptoms will last up to 10 days. If your symptoms persist longer than that without any improvement, you may have a more serious infection.

If you experience any of these symptoms, it may be time to cash in a few sick days:

  • A cough that lingers for a month or more
  • A fever of 100.4 degrees Fahrenheit or higher, especially one that doesn’t go down with Tylenol or Advil
  • Severe muscle aches
  • Trouble taking in fluids
  • Difficulty breathing
  • Coughing up mucous with blood in it
  • Feeling incredibly sick with no improvement in symptoms

If you’re struggling to feel better after 10 days, your doctor can help you determine the best treatment options for you. But don’t expect to automatically get antibiotics. Antibiotics treat specific bacteria. They aren’t going to make you feel better any faster if you have a virus, and they’re not going to help your immune system. In fact, if you take antibiotics and you don’t need them, you can develop bacteria that are resistant to those antibiotics and as a result, they may not help you in the future.

Even worse, you may contribute to widespread antibiotic resistance which can make it harder to treat illnesses in others. Additionally, antibiotics can cause yeast infections, nausea, vomiting, diarrhea, and abdominal pain. It’s not worth taking antibiotics unless you really need them.

Taking an antibiotic if you have a virus isn’t going to help you get better faster.

Instead of antibiotics, your doctor likely will suggest that you take off a day or two from work to get more sleep and drink plenty of fluids. It’s really important to get the rest you need so that your body can fight the infection. If you have a fever, it’s best to stay home until you’ve gone 24 hours without one, without having to take medication.

Every time I get a cold, I think, “Wow, this is actually awful!” I forget how terrible it is and how sick a cold can make you feel. But I know it’s just a virus and I’m going to feel better in a few days.

If you’ve had cold symptoms for 10 days or fewer and you’ve been fever-free for 24 hours, you’re probably safe to go to work. Keep your tissues, over-the-counter remedies, and hand sanitizer close by, and try to remember that even though you’re miserable now, you’ll likely feel better in a few days.

At what point is my cold contagious?

When the winter months hit, it can often seem like everyone you know is struck down with a cold. And if you use public transport or work in an office, it seems like there is no way to avoid catching one.

Colds are the most common cause of illness in adults and children. Adults may get between 2 to 4 colds each year. You know the signs — coughing, headaches, sneezing, a blocked or runny nose. While the symptoms are usually mild to moderate, you can feel pretty awful for several days.

So how do you spread a cold and at what point is your cold contagious? Read on to find out.

How does a cold spread?

Despite its name, you won’t catch one just by being cold. Rather, a cold can be caused by over 200 different viruses. It’s also called the ‘common cold’ for a reason; it spreads very easily. If you’re infected, every time you talk, cough or sneeze, you send small infectious droplets into the air, which may infect people nearby.

Those nasty germs can also spread indirectly through everyday contact with other people or common surfaces. When someone infected with a cold shakes hands, turns a door handle or uses the office fridge, they could be at risk of passing on the virus. And if you’re one of the unlucky ones that touches your nose, eyes, or mouth after being in contact with the virus, even indirectly, there is a chance you may get sick.

MORE: The difference between cold and flu

How long is a cold contagious?

Interestingly, you may be infected with the a cold virus up to three days before experiencing any symptoms. Generally, you’re contagious from around one day before symptoms show and for the first five days that you’re sick. For some people, you may even be contagious until all symptoms are gone. And some viruses can survive for several days on surfaces.

What can I do to avoid catching a cold?

Maintaining good hygiene is your best bet at avoiding a cold when it starts to affect your colleagues, friends or family members. Here are our top 6 tips to prevent a cold this winter:

  • Keep your distance: Avoid direct and indirect contact with sick co-workers.
  • Keep your hands clean: Viruses that cause colds can live on your hands, and regular hand-washing can help protect you from getting sick. Try to avoid touching your eyes, nose and mouth with your hands.
  • Use hand sanitiser: This will help to keep your hands free of germs. Try to use it regularly throughout the work day.
  • Disinfect your environment: Clean surfaces such as your keyboard, telephone and door handles regularly.
  • Use your own items: Don’t share cups, plates or cutlery at the office.

I’ve got a cold. Now what?

If you’re sick with a cold, here are some simple things you can do to avoid infecting your friends and loved ones:

  • Stay at home while you are sick: As tempting as it is to ‘soldier on’, your colleagues will thank you for keeping your germs to yourself.
  • Avoid close contact: Hugging, kissing, or shaking hands should be avoided when you are sick.
  • Watch your sneezes: Cover your mouth and nose when you sneeze, and move away from others as germs can easily spread.
  • Wash your hands thoroughly: After coughing, sneezing, or blowing your nose, wash your hands thoroughly. Also be sure to throw away tissues and wipe down the area they may have been sitting on, to avoid spreading the virus further.

Got other burning questions? Get answers to essential life issues like how often you should shower, or poo, with our Burning Questions guide.

Common Colds: Protect Yourself and Others

Sore throat and runny nose are usually the first signs of a cold, followed by coughing and sneezing. Most people recover in about 7-10 days. You can help reduce your risk of getting a cold: wash your hands often, avoid close contact with sick people, and don’t touch your face with unwashed hands.

Common colds are the main reason that children miss school and adults miss work. Each year in the United States, there are millions of cases of the common cold. Adults have an average of 2-3 colds per year, and children have even more.

Most people get colds in the winter and spring, but it is possible to get a cold any time of the year. Symptoms usually include:

  • sore throat
  • runny nose
  • coughing
  • sneezing
  • headaches
  • body aches

Most people recover within about 7-10 days. However, people with weakened immune systems, asthma, or respiratory conditions may develop serious illness, such as bronchitis or pneumonia.


Help reduce your risk of getting a cold by washing hands often with soap and water.

How to Protect Yourself

Viruses that cause colds can spread from infected people to others through the air and close personal contact. You can also get infected through contact with stool (poop) or respiratory secretions from an infected person. This can happen when you shake hands with someone who has a cold, or touch a surface, like a doorknob, that has respiratory viruses on it, then touch your eyes, mouth, or nose.

You can help reduce your risk of getting a cold:

  • Wash your hands often with soap and water. Wash them for 20 seconds, and help young children do the same. If soap and water are not available, use an alcohol-based hand sanitizer. Viruses that cause colds can live on your hands, and regular handwashing can help protect you from getting sick.
  • Avoid touching your eyes, nose, and mouth with unwashed hands. Viruses that cause colds can enter your body this way and make you sick
  • Stay away from people who are sick. Sick people can spread viruses that cause the common cold through close contact with others.


Practice good cough and sneeze etiquette: always cough and sneeze into a tissue or your upper shirt sleeve, completely covering your mouth and nose.

How to Protect Others

If you have a cold, you should follow these tips to help prevent spreading it to other people:

  • Stay at home while you are sick and keep children out of school or daycare while they are sick.
  • Avoid close contact with others, such as hugging, kissing, or shaking hands.
  • Move away from people before coughing or sneezing.
  • Cough and sneeze into a tissue then throw it away, or cough and sneeze into your upper shirt sleeve, completely covering your mouth and nose.
  • Wash your hands after coughing, sneezing, or blowing your nose.
  • Disinfect frequently touched surfaces and objects, such as toys and doorknobs.

There is no vaccine to protect you against the common cold.

How to Feel Better

There is no cure for a cold. To feel better, you should get lots of rest and drink plenty of fluids. Over-the-counter medicines may help ease symptoms but will not make your cold go away any faster. Always read the label and use medications as directed. Talk to your doctor before giving your child nonprescription cold medicines, since some medicines contain ingredients that are not recommended for children. Learn more about symptom relief of upper respiratory infections, including colds.

Antibiotics will not help you recover from a cold caused by a respiratory virus. They do not work against viruses, and they may make it harder for your body to fight future bacterial infections if you take them unnecessarily. Learn more about when antibiotics work.

When to See a Doctor

You should call your doctor if you or your child has one or more of these conditions:

  • symptoms that last more than 10 days
  • symptoms that are severe or unusual
  • if your child is younger than 3 months of age and has a fever or is lethargic

You should also call your doctor right away if you are at high risk for serious flu complications and get flu symptoms such as fever, chills, and muscle or body aches. People at high risk for flu complications include young children (younger than 5 years old), adults 65 years and older, pregnant women, and people with certain medical conditions such as asthma, diabetes, and heart disease.

Your doctor can determine if you or your child has a cold or the flu and can recommend treatment to help with symptoms.

Causes of the Common Cold

Many different respiratory viruses can cause the common cold, but rhinoviruses are the most common. Rhinoviruses can also trigger asthma attacks and have been linked to sinus and ear infections. Other viruses that can cause colds include respiratory syncytial virus, human parainfluenza viruses, adenovirus, human coronaviruses, and human metapneumovirus.

Know the Difference between Common Cold and Flu

The flu, which is caused by influenza viruses, also spreads and causes illness around the same time as the common cold. Because these two illnesses have similar symptoms, it can be difficult (or even impossible) to tell the difference between them based on symptoms alone. In general, flu symptoms are worse than the common cold and can include fever or feeling feverish/chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches and fatigue (tiredness). Flu can also have very serious complications. CDC recommends a yearly flu vaccination as the first and best way to prevent the flu. If you get the flu, antiviral drugs may be a treatment option.

Cold how long contagious

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