Amid a surge in viral cases, how to differentiate between H3N2, Covid-19, H1N1, common cold, and flu?

Given that all of them are viral respiratory conditions, how do we distinguish between them and seek treatment?

Notably, H1N1, previously called swine flu, is a virus similar to the influenza viruses that cause illness in pigs. On the other hand, flu, or the common cold, is quite frequent during seasonal changes and is, often, harmless. “There are more than 200-300 viruses that may cause the common cold. In each virus type, there can be subtypes and variants. The majority of the common colds are caused by rhinoviruses, respiratory syncytial viruses, influenza type A and type B viruses, etc,” Dr Anantha Padmanabha, consultant, internal medicine, Fortis Hospital, Nagarbhavi told indianexpress.com in an earlier interaction. Covid-19, on the other hand, is caused by the SARS-CoV-2 virus and is considered highly infectious.

“Current spread and intensity of flue especially its variant H3N2 are very concerning. Medically, it is a double whammy as Covid-19 cases have started surfacing once again,” said Dr Manisha Arora, senior consultant, Internal Medicine at Sri Balaji Action Medical Institute.

While some may experience mild to moderate respiratory illness and recover without requiring special treatment, others may become seriously ill and require medical attention, especially older people and people with low immunity, or have co-morbidities.

Some common symptoms that are common in both infections are fever, body ache, fatigue, headache, cough, and sore throat, said Dr Bhavini Shah, head of clinical microbiology at Neuberg Supratech.

Dr Ravi Shekhar Jha, director and head, Pulmonology, Fortis Hospitals, Faridabad told indianexpress.com that all viral respiratory illnesses have similar symptoms. “Clinically, it is difficult to differentiate if it is Covid or flu. However, there are some features, which can help in differentiating,” said Dr Jha.

*H3N2 can cause hoarseness of voice, while in Covid-19, symptoms start with fever or stuffy nose.
*In flu, body ache or myalgia is too much
*Flu causes severe dry cough which lasts for a longer period than usual (up to 3 weeks)

Dr Shah added that some of the differentiating symptoms of Covid-19 that are rare in the influenza A virus are loss of smell and taste, and rashes on the body.

Covid testing must be done (Express Photo by Amit Mehra)

Diagnosis

Both Covid-19 and swine flu are diagnosed with the help of a nasopharyngeal swab, an oropharyngeal swab and a nasopharyngeal wash. Rapid tests are also available for both Covid-19 and the flu. “At times, the patient poses the symptoms of H1N1, and H3N2 and it might be confused with Covid19. Hence, it is then advised to go for Covid-19 test which will come out to be negative. H1N1 test will also cover H3N2 and a separate Covid-19 test as the sample collection for both is the same,” Dr Shah said.

What to do

Experts recommend medications to help relieve the symptoms of the flu, such as fever, cough, and congestion. These include painkillers, nebulizers, cough suppressants, and other decongestants.

Adequate rest and recovery are advised at home with simple home-cooked, fresh food, and proper hydration.

Dr Jha recommended:

*Follow covid-appropriate behaviour which will also protect you from the flu.
*Annual influenza vaccination again helps in reducing flu-related complications.
*Drink plenty of water and avoid unnecessary antibiotics, Dr Jha said. Concurring, Dr Arora said that due to a lack of awareness, people take antibiotics that are not effective against the flu, as it is a viral illness, not a bacterial infection. “Moreover, taking antibiotics unnecessarily can lead to antibiotic resistance and other harmful side effects. Superadded secondary infections which are diagnosed by well-trained physicians only need antibiotics,” Dr Arora noted.

World Health Organization, too, recommends that the most effective way to prevent infection with any virus is to get vaccinated and follow prevention measures: “Maintaining at least a 1-metre distance from others, wearing a well-fitted mask when keeping your distance is not possible, avoiding crowded and poorly ventilated places and settings, opening windows and doors to keep rooms well ventilated and cleaning your hands frequently.”

It also advises that people should follow the advice “of your local authorities on getting influenza and Covid-19 vaccines“.

Noting that influenza viruses, including H3N2, can mutate and evolve rapidly which makes it difficult to develop a vaccine that provides complete protection against all strains, Dr Arora said that nevertheless, vaccinations are a critical tool in the fight against infectious diseases. “It can help particularly those who are at higher risk of severe illness, such as young children, older adults, and people with weakened immune systems,” said Dr Arora.

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