Spontaneity is a fabulous trait in lovers and friends. But it's a dangerous and dastardly one in viruses. Once they start mutating their genetic structures, it's a shell game we can barely keep up with.

All of us risk exposure to a new strain of flu each year because of this ongoing quick-change artistry in the germ world. And the numbers are increasing, warns Charles D. Ericsson, M.D., professor and clinical director of Infectious Diseases at The University of Texas Medical School at Houston and director of the UT Travel Medicine Clinic.

It is the successful prediction of the next year's mutating strains by germ sleuths at the World Health Organization (WHO) that gives us effective flu vaccines. SARS (severe acute respiratory syndrome) was the new virus on the block last year, and waiting in the wings now is the killer "bird flu." More about that later.

Even though the influenza or flu season started early last fall, it will continue into March. If you did not get vaccinated, either with a shot or nasal spray, keep washing those hands.

Mistaken Identity

Traveling under several aliases-flu bug, bad cold, the crud—and poorly lumped together by the advertising industry, "cold and flu" are often considered the same thing by sufferers.

So not true.

A bad cold is a miserable experience and usually belongs to the rhino virus family. The flu, also a virus, is serious and can have life-threatening complications. Other than vaccines and a few anti-viral medications for only a few types of viruses, there are no cures for viral infections.

Antibiotics will not kill a virus. Those weapons are reserved for bacterial infections. This sometimes happens when a viral illness leaves the back door open for other opportunistic infections. But at least bacteria have a shot at being killed.

A Virus by Any Other Name is Still...Sickening

Colds and flu have three things in common: they are both viral and both respiratory infections and both mutate. We do not have treatments for many viruses, but we humans typically manage viruses on our own with the notable exceptions of the deadlier kind-HIV, small pox, SARS, Ebola, Lassa fever, to name a few.

Successful vaccines for malaria, polio, hepatitis, among others, have changed the outcome of these serious diseases. But, a vaccine is not a cure. It is a preventive measure. "Viruses can cause trouble," says Ericsson. And they're changing all the time.

Cold and flu symptoms are different from one another. The common cold rarely includes a high fever and stunning headache. It does foster mild muscle aches, tiredness, weakness, coughing, runny nose, sneezing and sore throat.

Flu, on the other hand, comes on like a stealth bomber. It presents with a fever, often 102-plus, which lasts three to four days. Sudden aches in the head and muscles can be extreme. There is also profound exhaustion and usually a deep, spastic and severe cough.

Once you've had the flu, you rarely confuse it with a cold. And sadly, once you've had a flu or cold, you're just as likely to catch its mutated version down the road.

When it IS the Flu

"It is imperative to start therapy as soon as you feel you might have the flu. Newer products like Tamiflu (oseltamivir) treat both influenzas A and B and shorten the illness. This could mean getting back to work sooner and not suffering as much. If you wait a few days, the drug will not work as well," says Ericsson.

The flu patient needs to stay home, get plenty of rest, avoid contact with people, alcohol and tobacco. Copious fluid-drinking is a must-stay hydrated. "Urinating at least every four hours means you are drinking enough fluids," observes Ericsson.

Often, though, sick people don't know when to ask for medical help. It is time to call the doctor if:

• you are having trouble breathing—shortness of breath or rapid, shallow breathing
• bluish tinge to the skins, lips
• woozy, dizzy and can't stand up without feeling faint
• confusion, feeling disoriented
• fever of 102 or higher
• uncontrollable cough.
• Phlegm brought up from a cough that is gray, green, bloody or brown and thick. The cause may be a bacterial infection, and an antibiotic can be useful. Phlegm itself is the body's way of trapping germs. Don't panic in the presence of whitish phlegm, but keep an eye on it for changes.

The Centers for Disease Control and Prevention (CDC) estimates that annually 10-20 percent of U.S. residents get the flu, 114,000 people are hospitalized for flu-related complications and 36,000 Americans die from those complications.

"Bird Flu" New Concern

More and different flu variations are appearing all the time. The latest one in the news is the killer avian or "bird flu" presenting itself in Asia, specifically Vietnam , South Korea, Taiwan, Cambodia, Indonesia, Thailand, Laos Pakistan  and Japan where huge numbers of chickens are infected with a virus unknown to humans.

Six people in Vietnam and one person in Thailand have died (at this writing) after catching it following direct contact with the birds. About eight other deaths are suspected. Now observers wait to see if this flu learns to spread itself from person to person. That would happen if a person with an already existing strain of flu also contracted the bird flu and passed it to others.

"We know about new outbreaks early because the WHO and our own CDC are doing better jobs than ever before and because we are more sophisticated in our epidemiological surveillance," explains Ericsson. "We must be more vigilant because, as more viruses occur, we have the ability to spread those germs around the world quickly through travel."

Last Updated: 2-02-2004

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