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    Even with today’s modern medical technology, most of us can’t avoid the occasional  respiratory infection.  Without strict adherence to sanitary protocol, it would be very easy in a collapse situation for your entire community to come down with colds, sinusitis, influenza or even pneumonia.  Most respiratory infections are spread by viral particles, and the organisms that cause these infections can live for up to 48 hours on common household surfaces.  Contagious viral particles can easily travel 4 to 6 feet when a person sneezes.

    Types of Respiratory Infections

    Respiratory issues are usually divided into upper and lower respiratory infections.  The upper respiratory tract is considered to be anything at the level of the vocal cords (larynx) or above.  This includes the nose, throat, sinuses, voice box, epiglottis, and even the tonsils and middle ear canal.  The lower respiratory tract includes the lower windpipe, the airways (taken together, called “bronchi”) and the lungs themselves.  Respiratory infections are the most common cause of infectious disease in developed countries.
    Upper respiratory tract infections (URIs) include tonsillitis, pharyngitis (sore throat), laryngitis, sinusitis, some types of influenza, and the common cold. Symptoms can include fever, cough, sore throat, runny nose (also called rhinitis), nasal congestion, headaches, and sneezing.  Symptoms of lower respiratory infections (pneumonia and some bronchitis)  include cough (with phlegm, it is referred to as a “productive” cough), high fever, shortness of breath, and weakness/fatigue.  Most respiratory infections start showing symptoms 1 to 3 days after exposure to the causative organism and last for 7 to 10 days if upper and somewhat longer if lower.
    There are differences between the common cold and influenza that are helpful to make a diagnosis:
    Symptoms                Cold                     Influenza
    Fever                Rare, Low           Common, High
    Headache               Rare                    Common
    Nasal Congestion  Common             Occasional
    Sore Throat            Common             Occasional
    Cough                     Mild                      Severe
    Aches and Pains      Common             Severe
    Fatigue                   Mild                      Severe
    Symptomatic relief will improve most cold symptoms without an issue.  For influenza, the addition of antiviral medications such as Tamiflu or Relenza will shorten the course of the infection.
    Both upper and lower respiratory infections are different than asthma, which is a condition where the airways become constricted in a type of spasm, causing a particularly vocal kind of breathing called a “wheeze”.  Asthma may occur as an allergic response, or may be associated with some respiratory infections, such as childhood “croup”.  The treatment of asthma involves different medicines, such as antihistamines and epinephrine, than those used in treating respiratory infections.
    Most upper respiratory infections are caused by various viruses, although some sore throats may be caused by a bacterium called Beta-Streptococcus (Also known as Strep Throat).  These patients will often have white spots on the back of their throat and/or tonsils, and are candidates for antibiotics.  In most cases, however, it is not appropriate to use antibacterial agents such as antibiotics for upper respiratory infections.  Antibiotics have been overused in treating these problems, and this has led to resistance on the part of some organisms to the more common drugs. 
    There are anti-viral drugs effective against influenza and other viral diseases.  The most commonly used is Tamiflu, which is best utilized in the first 2 days of the illness. It may even be used as a preventative agent upon being exposed to a sick patient.
    The best course of action for upper respiratory infections is treating the specific symptoms.  Decongestants for runny nose, lozenges or gargles for sore throat, and Ibuprofen or Acetaminophen for muscle ache and fever are commonly used to make the patient feel better.  Steam inhalation and good hydration also give some symptomatic relief.  Various natural remedies are also useful to relieve symptoms, which we will discuss in our next article.
    Lower respiratory infections, such as pneumonia, are the most common cause of death from infectious disease in developed countries.  These can be caused by viruses or bacteria.  The more serious nature of these infections leads many practitioners to use antibiotics more often to treat the condition.  Most bronchitis is caused by viruses, however, and will not be affected by antibiotics.  Antibiotics may be appropriate for those with a lower respiratory infection that hasn’t improved after several days of treatment with the usual medications for upper respiratory infections. 
    These patients will appear to have worsening shortness of breath or thicker phlegm over the course of time despite the usual therapy.  There is a school of thought that recommends more liberal use of antibiotics in sick persons over the age of 60 or those with other serious medical conditions. This population has a higher risk of death because of decreased resistance to secondary bacterial infections.
    Effective antibiotics for bacterial infections can be obtained in veterinary form (without a medical license). Good examples are Doxycycline, Keflex, and Amoxicillin.  This information is relevant only in a post-collapse setting; contact a certified healthcare provider for these medications in normal situations.
    Good respiratory hygiene is important to prevent patients with respiratory infections from transmitting their infection to others. This is what needs to be done:
    ·         Sick individuals should cover their mouth and nose with tissues and dispose of those tissues safely.
    ·         Use a mask if coughing.  Although others caring for the sick individual may wear masks (N95 masks are best for healthcare providers), it is most important for the afflicted person to wear one.  
    ·         Have caregivers perform rigorous hand hygiene before and after contact.  Wash with soap and warm water for 15 seconds or clean your hands with alcohol-based hand sanitizers if they do not appear soiled.
    ·         Sick persons should keep at least 4 feet away from other persons, if possible due to droplet spread.
    ·         Wash down all possibly contaminated surfaces with an appropriate disinfectant (dilute bleach solution will do).
    ·         Isolate the sick individual in a specific quarantine area, especially if he/she has a high fever.
    ·         Have medical care providers wear gloves at all times when treating the patient.
    Next time, we’ll look at some natural remedies that have health benefits in cases of respiratory infection.    
    Dr. Bones

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    Respiratory Infections, Part 2: Natural Remedies
    Collapse Eye Care, Part 2