Flu and Cold Symptoms: Insights from Taiwan's Experience

Influenza Issues

Hello, I would like to ask you about the issues related to influenza and the common cold.
I am from Taichung and have just moved to Keelung two months ago, working in Taipei.
I don't know if I was just lucky before, but I have never had influenza and only catch a common cold once or twice a year.
However, I contracted a gastroenteritis-like flu in June and then an A-type flu (as suspected by the doctor) in July.
Although I went to see a doctor, they couldn't definitively confirm it was the influenza virus; they could only make an educated guess (the rapid test seems to have only about a 60% accuracy rate, and the doctor did not recommend that I take it).
The main reason is that all my symptoms are typical of influenza (body aches, fatigue, sore throat, nasal congestion, diarrhea, etc.), yet my fever has only been around 36.8 to 37 degrees Celsius.
Some doctors suggested that it might be early symptoms and that I would develop a high fever later, but in the end, I never had a fever above 37.5 degrees.
Although my fever is not high, the body aches are so painful that I can hardly get out of bed, and I also can't sleep at night.
I wonder if this is an issue with my constitution or if this is considered a normal occurrence?

Lai, 20~29 year old female. Ask Date: 2019/07/09

Dr. Hong Yuanbin reply Internal Medicine

Hello, the symptoms you described, such as body aches, weakness, sore throat, nasal congestion, and diarrhea, are all indicative of cold symptoms.
There are many causes for these symptoms, including influenza virus, parainfluenza virus, adenovirus, and various other types.
According to statistics from the Centers for Disease Control, the pathogens responsible for cold outbreaks vary each time, and typically, the influenza virus causes the most severe symptoms, which is why rapid influenza testing is commonly performed.
However, even if one has influenza, the symptoms can vary greatly among individuals, making it impossible to definitively diagnose influenza based solely on symptoms.

In terms of treatment, it does not significantly differ; most viral infections mentioned do not have specific antiviral medications and are treated symptomatically, relying on the immune system for recovery.
The only exception is influenza, for which antiviral medications like oseltamivir (Tamiflu) can be used.
However, given your immune system's strength, even if you have influenza, you would likely recover without antiviral treatment.

Cross-infection of various viruses in the office is quite common, so it is recommended to rest, stay hydrated, maintain a regular routine, and keep up with exercise.
Additionally, getting the influenza vaccine annually is advisable.
Thank you for your question.

Reply Date: 2019/07/09

More Info

Understanding flu and cold symptoms can be quite challenging, especially when experiencing atypical presentations. In your case, it seems you have encountered both gastrointestinal flu and A-type influenza, which can indeed present with a variety of symptoms.
Flu (influenza) and the common cold are both respiratory illnesses caused by different viruses. The flu is typically more severe than the common cold and can lead to serious health complications, especially in vulnerable populations. Common symptoms of the flu include high fever, chills, body aches, fatigue, cough, sore throat, and sometimes gastrointestinal symptoms like diarrhea and vomiting, particularly in children. On the other hand, the common cold usually presents with milder symptoms such as a runny or stuffy nose, sneezing, and a sore throat, without the high fever or severe body aches associated with the flu.

In your situation, the symptoms you described—such as body aches, fatigue, sore throat, nasal congestion, and diarrhea—are indeed consistent with flu. The fact that your fever remained low (36.8–37.5 degrees Celsius) is interesting, as many people with the flu experience higher fevers. However, it is not uncommon for some individuals to have a lower fever or even afebrile (no fever) presentations, particularly in cases of atypical flu or in individuals with certain underlying health conditions or immune responses.

The variability in fever response can be attributed to several factors, including individual immune system differences, the specific strain of the virus, and even the timing of when you measure your temperature. Some people may have a robust immune response that leads to higher fevers, while others may have a more subdued response. Additionally, factors such as hydration status, medications, and concurrent infections can influence fever patterns.

Regarding your experience with the doctors, it is true that rapid tests for influenza can have variable accuracy, and clinical judgment often plays a significant role in diagnosis. If the symptoms align closely with flu, even in the absence of a definitive test result, treatment may still be warranted, especially if symptoms are severe or worsening.

As for your concern about whether this is a reflection of your body’s constitution or a normal response, it is essential to recognize that everyone’s immune response can differ. Some individuals may be more susceptible to certain viral infections or may experience atypical symptoms. If you find that you frequently experience severe symptoms with viral infections, it might be worth discussing with a healthcare provider to rule out any underlying conditions that could be affecting your immune response.

In conclusion, while your symptoms align with flu, the low-grade fever does not negate the possibility of influenza. It is essential to monitor your symptoms closely and seek medical attention if they worsen or if you experience difficulty breathing, chest pain, or other concerning symptoms. Staying hydrated, resting, and managing symptoms with over-the-counter medications can help alleviate discomfort. If you continue to have recurrent infections or unusual symptom patterns, consider discussing this with a healthcare provider for further evaluation and management.

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