Viral Infection/ Cold/ Flu

What is flu? Its a viral respiratory illness caused by influenza virus. Symptoms: High Fever, runny nose, cough, body ache, tiredness, headache, diarrhea/ vomiting. Highly contagious, one can spread it 1 day before they got sick to 7 days after. Fever can last from 2-7 days.

Complications: mainly small children and elderly patients, get coughing with breathing problem. Mainly due to flu pneumonia or association with other bacterial infections.

Common cold: Viral infection other than by influenza virus. Mainly present as runny nose, sore throat and cough

Season: From late October to early March is a time frame when most of people get sick from flu or other viruses.

Why in winter? Its a myth that flu is caused by cold temperature. Cold is only favoring factor, but it is caused by a influenza virus.
- Influenza virus survive longer on surface in cold & dry temperature. they love cold and dry weather. 
- Lack of sunlight or staying more indoor decrease our immunity( ability to fight infection)
- Lack of fresh air circulation in house due to closed door and windows cause high possibility of spread of infection from one to another.

What helps to avoid flu?
- Stay warm and hydrated
- Use Humidifier 
- Go out in sunlight
- Open doors and window for few minutes during day time every day 
- Flu vaccine: Helps to avoid complications of flu, it takes a week or two to get its effect. So take flu shot early in cold season.
- Frequent hand washing and covering mouth while coughing help decrease its spread

Who need treatment with antivirals? 

High risk individuals, Children<5 years or people>65 year, people with diabetes, heart disease or asthma. Antivirals shortens course of disease by couple of days and may help prevent complications/ hospitalization

Weather its influenza or corona virus or other respiratory virus, not all the people who get exposed get symptomatic. Why? because they had flu vaccine/ they are more active, hydrated and stay more in sunlight or in area with good fresh air movement. This is true with any virus or bacteria. Get vaccine if available, and stay in sunlight with fresh air circulation.


Other sources of reading:

https://www.cdc.gov/flu/symptoms/symptoms.htm

http://sitn.hms.harvard.edu/flash/2014/the-reason-for-the-season-why-flu-strikes-in-winter/

https://www.cdc.gov/flu/highrisk/pregnant.htm

Headache

Headache is a feeling of pain/heaviness in the head.

Types of Headache, causes and modality to help reduce it:

Most Common type of Headache: 

1. Tension Headache:

Mild to Moderate pain that comes and go over time. Mainly felt pain / heaviness over frontal region. Its most common type of headache. Occurs mainly due to
- Emotional Stress
- Fasting
- Lack of sleep
- strong smell : ex.perfume, smoking, smoke
- noise
- weather change
- gas trouble/ certain food
- overuse of phone, TV,laptop
*Try avoiding situation that gives you headache. Coffee+ Tynelol might help.

2. Migraine Headache:

Throbbing headache lasting couple hours to days, and reappears few times every month. Usually associated with sensitivity to light, noise or smell.  Sometime patient may experience paralysis like symptoms with migraine headache.

*Avoid triggers such as fasting, lack of sleep, noise. Tynelol extrastength, Ibuprofen / other medicine recommended by physician can help


3. Cluster Headache:

Intense peircing pain behind the eye. Associated with tear, red eye. last for 15min-2hours, for 2- 3 times a day for many days. May associated with sweating. Comes at the same time each day. Triggers: trigeminal neuralgia/smoke/ allergies/sinusitis. *Avoid / treat triggers.

Other Causes of Headache:

1. New / change in Eye number/glasses

It usually causes bitemporal (on side) headache. It is usually associated with difficulty reading small letter from distant/ headache after reading books. Mainly caused by refractive errors.
*Mostly patient need new glasses and check up with ophthalmologist.

2. Drug withdrawal:

ex. Missing a daily dose of Alcohol, Coffee, Tea. Nitrate withdrawal(medicine to treat angina).

3.  Hormonal changes/ cyclic headache

Women may experience headache couple of days before starting of menstrual period every month. *Ibuprofen might help.

4.  Infection in sinus/denture:

A. Frontal sinusitis following cold, or other upper respiratory diseases. *Needs antibiotic treatments under physician's direction
B.: Dental infection: associated with dental pain. *Need antibiotics and dental check up

5. Dehydration: 

Drink water, and Oral re-hydration solution with electrolytic powder helps.

6. Fever: 

Tynelol/ controlling fever helps.



Causes of Headache that needs immediate medical attention: 

1. High blood pressure:

Patient known to have blood pressure on medicine, complain of headache in the middle of the head/vertex (pounding headache). H/o skipping medicine or + of pedal edema. This kind of headache usually is caused by high blood pressure. + very high blood pressure(>180mmhg) with nausea suggest developing encephalopathy. *Blood pressure control is needed under physician guidance.

2. Glucoma:

High fluid pressure in eye chamber can damage optic nerve. Associated with vision changes, halos, eye pain, and nausea and headache. Immediate opthalmologist / eye dr. attention needed to prevent blindness. Eye drops and medicine to decrease fluid production/ increase drainage in eye chambers helps. 

3. Intracranial causes: Headache is always associate with nausea and or vomiting

A: Meningitis: infection of covering of brain. Associated with fever, neck stiffness and nausea/vomiting. *Treated with intravenous antibiotics.
B: Intracranial Bleeding (Subarrachnoid hemorrhage): These are the worst headache of one's life, associated with nausea /vomiting, later neck stiffness. Usually patient has history of high blood pressure. *Patient is usually admitted to ICU for care.
C: brain mass/ tumor: Associated with nausea, vomiting and weight loss. *Surgical removal needed depend on type of mass.
D: ventricular enlargement (hydrocephalus): Due to blockage of CSF drainage due to mass or bleeding. Associate with nausea, drowsiness and gait changes/fall. *Surgeon usually puts a EVD(type of tube to drain excessive fluid)
E: blocked vain in head, stroke 
*Medical care with neurologist/ neurosurgeon needed for all intracranial issues

4. Post Lumber puncture Headache:

This occurs post spinal tap due to CSF leak. Severe Headache occurs on getting up from bed. Lying down in bed helps. *Usually complete bed rest for few days and or placing a patch in the leak needed.

5. Inflammation of temporal artery:

Headache on temporal region with thick pulsatile artery. Associated with loss of appetite, fever, pain in jaw on chewing and vision changes. It needed immediate attention as it can lead to blindness. * Need treatment with steroids.

Referances: 
https://www.medicinenet.com/headache/article.htm
https://www.webmd.com/migraines-headaches/migraines-headaches-basics#1
https://www.health.harvard.edu/pain/headache-when-to-worry-what-to-do