We have experienced a truly awful upper respiratory virus for the past two months or so. It has afflicted close to two dozen members, and even got by my doctorly viral defenses. The syndrome lasts at least two weeks, has some initial fever and chills and unremitting cough that may persist even longer. We have tested and it is not influenza A or B. Nor is it bacterial, since chest X-rays have been clear, despite the severe coughing. It most likely is a rhinovirus, but a particularly nasty one. I regret we have not learned the identify of this virus. We offer moderately effective symptomatic therapy, but typically not antibiotics since they seem irrelevant.

This note is just informational. I believe the frequency of this infection is diminishing and the risk is passing, but I personally suffered with this for over two weeks and even canceled several days in the office, which I have not done this millennium.

Influenza, “Flu” or Rhinovirus

Most adult respiratory infections are rhinoviruses, a large class of viruses that produce the common cold, sinusitis, mild bronchitis, and most of the pot-pourri of upper respiratory conditions that are commonly called the “flu.” Usually fever is modest, there is some sore throat, probably nasal congestion, and lots of coughing with sometimes off-color phlegm. There might be some muscle aches and chills, but usually mild and brief. Flu vaccine does not affect rhinovirus infection, nor do antibiotics.

True influenza is a most more virulent infection that is distinguished by its severity, including high fevers (102-104F), persistent chills, back pain, muscle aches, severe weakness and cough. You want to take to your bed. You are ill, not just annoyed or inconvenienced by the illness. Office tests can confirm influenza virus infection. Influenza A is the winter version, while Influenza B is the closely related springtime version. Both are substantially prevented by influenza vaccines each fall. There can be some modest help from an antiviral drug called Tamiflu if taken within a day or two of the start of the infection. Antibiotics (Zpak, Augmentin, doxycycline) are of no help for the virus itself.

As noted above, what we had this springtime is likely a severe rhinovirus. It is not influenza. And we have no specific therapy.

Here’s to better virology information and therapy as medical science advances.

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