Last week, while sitting in a doctor's crowded waiting room, I watched the new season of the Winter Flu Olympics.
A sneezing competition was in progress when I arrived. And within mere minutes of taking my seat, I thought I had witnessed the worst sneeze I might ever see in my entire life.
It erupted without warning from a young man, slouched in his chair, tethered to an iPod, staring glassy-eyed at the ceiling. His Vesuvian sneeze rocked the room, spewed a misty cloud of viral detritus throughout our cramped quarters. It was an appallingly effortless performance -- entailing not even the slightest gesture toward covering his mouth.
I was ready to score him a perfect 10 in the category of "most obnoxious sneeze, greatest risk of public contagion." But then an older gentleman came out of nowhere and trumped him. He suddenly stood up, placed his hands on his hips, bent abruptly backward and inhaled deeply. Several of us tried to protect ourselves -- turning away or wrapping scarves across our faces. Alas, like a whipsaw, his body bent violently forward, flinging a wet and turbulent "ahhHHH-CHOooooo!" into the collective airspace.
In other events: Competitive coughing generated comparable infectious excitement within the room. And rivalry remained fierce, running nose-to-nose, for "greatest number of missed tissue-tosses into the wastebasket."
Still, as engrossing as these events may have been, I soon realized that every
I derived meager consolation in considering how the experience might help inform the next revision of my best-selling book, "The Sick Person's Etiquette Guide -- How to Contain Your Own Secretions with Style and Make the World a Healthier Place." Published by the Common Sense Medical Association, it makes for a good read in front of the fireplace during a cold winter's night ... or, actually, just during a cold.
This small sampling addresses some "Frequently Asked Questions" that readers may face during the current flu season that has newly arrived in Northern California.
If I am feverishly ill with a cold or flu, should I go to work and spread my infection by coughing and sneezing all over the office? In the break room? On shared computers and copiers? What about on my customers?
No. No. No. No. And, heavens no! In general, it's advisable to stay home for at least 24 hours after your fever has disappeared, and without the use of fever-suppressing medications like aspirin, acetaminophen or ibuprofen.
What is the current etiquette for coughing and sneezing in public?
Current etiquette rests upon this fundamental norm: Keep all your secretions to yourself! So cover your mouth and nose with your sleeve, a scarf, a tissue -- something, anything! -- to trap the germs and limit exposure to other people. If you must use your hands, make sure to wash them immediately, and before touching other people or shared surfaces in the public common.
Say -- just what is the difference between a "cold" and "the flu"?
There are many different viruses that can cause a similar respiratory illness featured by coughing, sneezing, sniffling, and feverishness -- symptoms shared by colds and flu. While it's not always easy to tell them apart, in colloquial terms a "cold" tends to be less severe than "the flu," which often hits you like a ton of bricks, leaving you with widespread body aches, fevers, and deep fatigue. However, technically speaking, the genuine flu is formally called "influenza" and it is caused by infection with specific "influenza" viruses. Influenza can really run you down and make you more susceptible to other infections like bacterial pneumonia. Each year, influenza claims an average of 36,000 Americans lives.
Yikes! What can I do to stay healthy?
Get a vaccination against the flu -- it's not too late, particularly here in California where the genuine flu season is just beginning. Some people should consult with a physician before getting vaccinated: those with severe allergies to chicken or eggs (no matter which came first) or a severe reaction to a prior influenza vaccination; children younger than 6 months of age; and people with certain immune disorders or febrile illnesses. And because you can pick up cold and flu viruses from the surfaces you touch, wash your hands frequently and keep them away from your eyes, nose, and mouth.
Will that flu shot protect me against all colds and flu?
No. The flu vaccination specifically protects you against influenza viruses -- not all the viruses causing colds and flu-like illnesses. And because flu vaccines typically require about two weeks to fully kick in, and they are never 100 percent effective (this year's vaccine works about 62 percent of the time), it's still important to keep your hands clean (and read my book) even if you've been vaccinated.
Should I demand an antibiotic from my doctor if I get a cold or flu?
No. Antibiotics only treat bacterial infections. They don't kill viruses -- the type of germs that cause colds and flu. There are, however, certain antivirals that your doctor may prescribe for serious episodes of influenza; in general, to be effective, they must be taken within 48 hours of becoming infected.
Kate Scannell is a Bay Area physician and the author, most recently, of "Flood Stage."