Do I have the Cold? Flu? or Strep Throat? Answers for People in Detroit Michigan

Do I Have the Cold, the Flu, or Strep Throat?

Dr. Paul Thomas and Dr. Raquel Orlich are family medicine physicians in Detroit Michigan. Their office is called Plum Health DPC and it’s located on Michigan Avenue in the beautiful Corktown Neighborhood of Detroit, MI.

Many people want to know if their sore throat, body aches, chills, fever, stuffiness, runny nose, or other symptoms are related to the cold, the flu, or strep throat. So, in this blog post and associated YouTube video, we’ll explore the differences between these clinical entities.

How Do I Know if I Have The Common Cold?

People with the common cold have a runny nose, a stuffy nose, congestion, sneezing, and a sore throat. Common cold viruses prefer to affect the back of the throat - these viruses have a predilection for the posterior pharyngeal tissues. This causes your mucus membranes to swell up, which causes fluid to leak out or what you experience as a runny nose or congestion, post-nasal drainage, etc… These symptoms tend to come on gradually.

For this viral pharyngitis or viral upper respiratory system or common cold, antibiotics are not indicated. Antibiotics do not work for the common cold, because the common cold is caused by a virus that mutates rapidly and is difficult to treat. Antibiotics are indicated for bacterial infections, like strep throat and pneumonia.

How Do I Know if I Have Influenza?

Influenza usually presents with extreme fatigue, muscle aches, and a fever. Sometimes we say that there’s an associated “pajama sign” - sometimes people are so weak and so tired that they can’t even change their clothes before coming to the doctor’s office, thus they come to the office in their pajamas. There can also be chest discomfort, chills, and a headache. There is often an abrupt onset to these symptoms. The symptoms of the flu are often more severe, and sometimes fatal unfortunately. This is why we worry more about the flu and why we recommend that everyone gets the flu shot.

If you are positive for an influenza infection, treatment with oseltamivir (Tamiflu) should be started within 24 to 48 hours of your symptoms. It must be started within this timeframe to be effective in shortening the duration of flu symptoms and decreasing the severity of the flu virus.

It’s the Middle of February - Will the Flu Shot Still be Effective?

Yes. We’re still in the influenza season, and the flu shot has been shown to be 40 to 50% effective in preventing the influenza virus from taking hold. So, we strongly recommend getting the flu shot if you haven’t done so already. The flu shot costs $20 at our office and about that price at most pharmacies ($15 - $30). And it’s very important to get the flu shot, not only to protect yourself, but also to protect your loved ones. If you get the flu shot, you’ll be less likely to transmit the flu to a more vulnerable person in your life, like a newborn in your family or circle of friends, or an elderly relative or elderly neighbor. Getting the flu shot helps to protect these more vulnerable people with less strong immune systems from getting the flu.

How Do I Know if I Have Strep Throat?

When people come to our office concerned about a sore throat, it’s hard to tell if it’s a viral pharyngitis or if it’s strep throat (a type of throat infection caused by a bacteria). Strep throat is an infection of the tonsils in the back of the throat by a bacteria, Group A Streptococcus. The “strep” in strep throat comes from a shortening of the bacteria name, Streptococcus. The strep bacteria infects the tonsils and causes localized pain and swelling as well as purulent discharge, ie a discharge of pus from the tonsils.

There’s also a diagnostic criteria for Strep Throat called the Centor Criteria. You get a point for having each of the following symptoms:

• fever

• tonsillar exudate (pus coming from the tonsils)

• absence of a cough (no cough)

• anterior cervical lymphadenopathy (swollen and often tender lymph nodes in the front part of the neck)

• age younger than 14 years

Kids with a sore throat are more likely to have Strep Throat because they have larger tonsillar tissue when they’re younger. As people age, the lymphatic tissue, like tonsils, shrink in size. This makes it less likely for adults to get strep throat. Of note, the tonsils are like a sponge and they take up large amounts of bacteria and viruses and show it to the rest of our body to make sure that our immune system can respond appropriately to these foreign invaders.

Because Strep Throat is caused by a bacteria, it is appropriate to use antibiotics for this condition. We often use Amoxicillin 500 mg for adults and Amoxicillin with weight-based dosing for children. Fortunately, we carry this inexpensive medication in our office, which is convenient for our patients with Strep Throat.

I live in Detroit, Am I more likely to get the flu or the coronavirus?

You are much more likely to get the flu than the coronavirus if you’re living in the United States.

As of 02/21/2020, there have been 34 documented cases of the Coronavirus in the United States.

Now compare that to the flu or the influenza virus. According to the Centers for Disease Control and Prevention, there have been:

• 29,000,000 to 41,000,000 flu illnesses

• 13,000,000 to 19,000,000 flu medical visits

• 280,000 to 500,000 flu hospitalizations

• 16,000 to 41,000 flu deaths

We know that the Coronavirus is scary because it’s new and different, and coming from a foreign country. However, the best thing that you can do to prevent getting sick this year is to wash your hands, cover your cough, don’t share drinks or eating utensils, stay home from work when you’re sick so you don’t infect other people, and get your darn flu shot.

Thanks for reading and thanks for watching

-Drs. Paul Thomas MD and Raquel Orlich DO of Plum Health DPC