Flu Isn’t the Only Bug in the Air

By Nichole Aksamit

You can’t stroll through the office, school, church, store or day- care center without hearing a chorus of coughs and achoos.

Yet by official measures of both influenza and temperature, it’s been a mild winter in the Midlands so far.

What gives?

In short: While flu steals the headlines, lots of lesser-known bugs come knocking this time of year.

Indoor allergies and bacterial infections sometimes are to blame. But the culprit often is a virus with a less famous name.

According to the National Institute of Allergy and Infectious Diseases, which is part of the National Institutes of Health, more than 200 viruses besides influenza have been shown to cause flulike symptoms.

“And we can’t test for most of them,” said Dr. Nancy Cornish, director of microbiology at Methodist and Children’s Hospitals in Omaha.

While such viruses typically don’t cause severe illness in healthy adults — and drugs don’t exist to treat them even when they do — all can rev up mucus production and knock us out for days.

Read on for an introduction to some of the most common common- cold offenders:

Rhinoviruses — They’re named for the Greek word for “nose,” perhaps because they seem to grow best at 91 degrees, the temperature inside the human schnoz. They come in more than 110 varieties and cause 30 percent to 35 percent of colds in adults, according to the allergy and infectious disease institute. They are most active in early fall, spring, and summer and can’t be ruled out in a mild winter.

Respiratory syncytial virus — Say that four times fast. Or just call it RSV. It’s the leading cause of bronchiolitis and pneumonia among infants under 1 year. And, according to a study last year in the New England Journal of Medicine, it hospitalizes and kills nearly as many elderly and high-risk adults as the flu. It is most common in winter and early spring.

You can’t treat it, but you can monitor for and treat the secondary bacterial infections, respiratory problems and pneumonia that RSV sometimes leads to. “We are seeing quite a lot of RSV,” said Dr. Archana Chatterjee, a pediatric infectious disease specialist who teaches at the Creighton and University of Nebraska Medical Centers.

Adenoviruses — They infect glands like the tonsils and adenoids and come on like the common cold. But they also can cause sore throat, pink-eye, croup and pertussis-like coughing, as well as predispose a body to ear infection. Cornish said she got an adenovirus last year and was “sick as a dog for three weeks.”

Coronaviruses — Only a few of the 30-and-counting known kinds infect humans. The one you’ve probably heard of causes SARS. But less-nasty sorts just cause the sniffles. Scientists from the allergy and infectious disease institute suspect coronaviruses cause up to 20 percent of colds, particularly in winter and early spring.

Parainfluenza — It causes flulike symptoms and upper respiratory problems. It’s a major cause of croup in children and can cause pertussis-like coughing, Cornish said.

Pertussis: Also known as whooping cough, it’s caused by a bacterium, not a virus. That means antibiotics can be used to treat it and prevent spread. Characterized by a persistent and (in children) whoop-sounding cough, it is highly contagious. It can last for weeks (and spread to lots of people in the meantime). “It’s often mistaken for a really bad cold that just won’t go away,” said Chatterjee.

Strep throat: Like pertussis, it’s caused by a bacterium, so you can seek treatment. Cornish said antibiotics help prevent it from causing rheumatic fever, heart and kidney disease. It usually starts with a severe sore throat. Dr. Sharon Stoolman, a pediatrician and director of undergraduate pediatrics at UNMC, said she’s seeing “a ton of it” lately.

For many of these bugs, prevention and treatment are more common- sense than high-tech: Washing your hands, covering your cough, resting, drinking lots of liquids, taking over-thecounter medications to reduce fever and congestion, and waiting it out.

Cornish, Chatterjee and Stoolman said it’s probably time to consult a doctor if fever rises rapidly or isn’t controlled with acetaminophen or ibuprofen; if you’re dehydrated (can’t or won’t drink, aren’t urinating as much as usual, have vomiting or diarrhea); if you have difficulty breathing; or if coughing or other symptoms worsen or persist for more than a week.