Sweater weather is here and seasonal colds, flu and other respiratory illnesses are sure to follow. These infections start to become more frequent in the late fall and peak during the winter months (October to February), threatening to put a damper on our holiday gatherings and vacation plans. It's hard to predict when the season will officially end (it can last as late as May), but knowing what to watch for and how to protect yourself and your family can help you prepare for the months ahead.
Dr. Doron shares simple ways to reduce your chances of becoming sick.
"Keeping your immune system in shape is important year-round, but especially as we head into prime cold and flu and respiratory illness season," she said. "It's important to get enough rest and exercise, eat healthy, reduce stress and manage medical conditions to lessen the impact of seasonal illnesses."
Common respiratory illnesses
Common Cold
What is it?
A respiratory infection of your nose, sinuses and throat. Colds are caused by viruses that spread from person to person. You can "catch" a cold by inhaling air containing the virus after someone sneezes or coughs, or by touching a surface with virus droplets and then touching your eyes, nose or mouth.
Symptoms
Colds have a range of symptoms that can be different for everyone and include:
- Runny nose
- Sneezing
- Headache
- Sore throat
- Cough
- Congestion
Symptom duration varies. Some colds last 1–3 days, and others take longer to resolve. It is not unusual to have a prolonged cough or fatigue after a cold, and it does not mean you are still contagious. You are most contagious the first 3 days when symptoms appear.
Who should get tested /treated?
Since there's no treatment for the common cold, it is generally not recommended that you seek testing to confirm the presence of a common cold virus.
You can speed up your recovery by getting plenty of rest, drinking lots of fluids and treating your symptoms with over-the-counter medications like analgesics and decongestants. Call your doctor if your symptoms worsen or don't go away within 2 weeks.
Vaccination
There is no vaccine for the common cold.
Influenza (also known as "flu")
What is it?
Millions of people in the U.S. get influenza each year. Influenza, or the "flu," is a contagious respiratory illness caused by the influenza virus. Like the common cold, you "catch" it by inhaling air containing the virus after someone sneezes or coughs, or by touching a surface with virus droplets and then touching your eyes, nose or mouth.
Symptoms
Flu symptoms usually come on suddenly. Generally, people feel feverish and achy for 3–5 days; other symptoms, like coughing, can last up to 6 weeks. People are the most contagious during the first three days of getting the flu. If you have the flu, you may have some or all of the following symptoms:
- Fever/chills
- Cough
- Sore throat
- Runny/stuffy nose
- Muscle or body aches
- Headaches
- Fatigue
- Vomiting/diarrhea (this is more common in children)
Who should get tested/treated?
Because most people recover from the flu without medical care or medication, testing is only recommended for people at the highest risk for complications of flu, who should also receive treatment. Talk to your doctor about whether you qualify to receive an antiviral prescription, which you should start within 72 hours of symptom onset or sooner for maximal effectiveness.
Vaccination
The CDC recommends that everyone 6 months and older get a flu vaccine every season. While anyone can get the flu, some people are at a higher risk for developing serious complications, such as people 65 and older, people with chronic medical conditions such as asthma, diabetes or heart disease, pregnant people and children younger than 5.
The CDC recommends that people get vaccinated for flu by the end of October.
Respiratory syncytial virus (RSV)
What is it?
RSV is an infection of the lungs and respiratory tract that causes cold-like symptoms. Anyone can get RSV, but severe disease causing hospitalization is more common in infants and toddlers as well as people over 75 years of age. According to the CDC, most children will get RSV before their second birthday.
Symptoms
Most people with RSV will have mild symptoms. Common symptoms include the following:
- Runny nose
- Decrease in appetite
- Coughing
- Sneezing
- Fever
- Wheezing
RSV can lead to severe infection in infants and premature infants, older adults, people with heart and lung disease, people with weakened immune systems and people who live in nursing homes or long-term care facilities. In severe cases, the virus can spread and cause pneumonia or bronchiolitis.
Who should get tested/treated?
For children less than 5 years old, and especially those less than 2 years old who are very sick, RSV testing in an urgent care center or the emergency room can help determine the need for hospital admission.
Testing is rarely recommended in adults and older healthy children because no specific treatment is available. Like the common cold, over-the-counter medications can be used to treat symptoms.
Vaccination
The 2024 CDC guidelines recommend that adults aged 75 and older and those over 60 years of age with certain medical conditions receive a single dose of the RSV vaccine. A single dose of RSV vaccine is also recommended for pregnant people between 32 and 36 weeks of pregnancy to prevent RSV in their baby.
Newborns whose mothers did not receive the vaccine during pregnancy, and some high-risk older babies should receive an injection of antibody against RSV. This antibody has been in short supply.
COVID-19
What is it?
COVID-19 is a contagious disease caused by the SARS-CoV-2 virus. Like other illnesses that affect the respiratory system, it is spread through droplets that are exhaled or expelled by an infected person and enter another person's body by landing in their eyes, nose or mouth. COVID-19 can be spread even with minimal or no symptoms.
Symptoms
People most at risk for severe symptoms include adults aged 65 or older, people who are not vaccinated or are out of date with their vaccines and people with certain chronic medical conditions such as lung disease or heart disease or who have compromised immune systems.
COVID-19 symptoms appear 2–14 days after exposure and can range from mild to severe and include:
- Fever or chills
- Cough
- Shortness of breath or difficulty breathing
- Sore throat
- Congestion/runny nose
- Fatigue
- Muscle or body aches
- Headache
- Nausea or vomiting
- Diarrhea
Who should get tested/treated?
It's especially important for those at high risk for severe COVID-19, who are over the age of 65 or with underlying medical conditions that increase their chances of getting extremely sick, to get tested in order to be started on antiviral treatment, which is more effective the earlier it is given. Read more about COVID-19 treatment on the CDC's website.
There are several types of tests, including ones that can be performed at home. Find out which is right for you by visiting the CDC website.
Vaccination
The CDC recommends everyone 6 months and older get the updated 2024-2025 COVID-19 vaccine. It's especially important to be vaccinated if you're 65 and older, are at high risk for severe symptoms due to underlying medical conditions or have never received a COVID-19 vaccine.
Because COVID-19 has not yet settled into a predictable seasonal pattern, it is difficult to know when the optional time for vaccination is. Some experts recommend getting vaccinated in October or November for protection throughout respiratory virus season. However, if you are at high risk, you may want to get vaccinated sooner. Contact your doctor if have questions about the right timing for you.
Pertussis
What is it?
Pertussis, also known as whooping cough, is a highly contagious respiratory illness caused by a bacterial infection that spreads easily from person to person through coughing or sneezing. In Massachusetts, pertussis is most common among children over 10 years old whose protection from their childhood vaccines has lessened over time.
Symptoms
People can spread the bacteria from the start of symptoms and are most contagious for 3 weeks after the cough begins. Symptoms of pertussis are similar to a cold, but people can develop uncontrolled coughing fits lasting up to 10 weeks. Babies and children who are not fully vaccinated are more likely to have serious complications.
Pertussis symptoms appear 7 to 10 days after infection and include the following:
- Mild fever
- Runny nose
- Cough
- Red, watery eyes
- Sore throat
- Nasal congestion
Symptoms worsen 1 to 2 weeks after they first appear and may include:
- Vomiting during or after coughing fits
- Coughing fits that cause a red or blue face and/or a whooping sound
- Extreme fatigue
- Difficulty breathing
- Rib fracture
Infants may struggle to breathe or stop breathing, a symptom called apnea, and may not develop a cough at all. In addition to apnea, babies younger than 1 year old may experience the following:
- Pneumonia
- Convulsions
- Encephalopathy (brain disease)
Who should get tested/treated?
Pertussis can be hard to diagnose because it mimics other common respiratory illnesses which generally do not require testing. When cough is severe and prolonged, testing can help pinpoint the cause of your symptoms and avoid more invasive tests. Once the diagnosis is made, antibiotics can decrease the period of contagiousness, but they do not improve symptoms. Close contacts will also be treated with antibiotics to prevent infection.
Vaccination
The CDC recommends vaccines for infants, children, adolescents and pregnant women early in the third trimester (between weeks 27 and 36). Like most vaccines, vaccination doesn't reduce the risk of infection to zero but can help prevent severe disease. We recommend a booster vaccine every 10 years for adults.
While we can't prevent every respiratory illness, remembering the basics and taking steps to reduce your risk will mean a happier and healthier fall for you, your family and our community. The best way to prevent severe disease from respiratory illnesses is to stay up to date on your vaccines. Any of the vaccines mentioned above can be received on the same day as any others. You can also prevent the spread of the infection by frequently washing your hands, staying away from people who are sick and covering your cough and sneezes.
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