Barbara Patz knew the misery season had arrived when she began getting sick on Christmas Day, then spent the rest of the holidays entertaining upper respiratory and stomach bugs. Although she staggered into work -- she swears she has absolutely no recollection of one meeting -- she finally retreated to bed in a sweat suit, clutching a heating pad.
"I'm never sick," insists Ms. Patz, owner and president of Paladin Advertising and Public Relations in Baltimore. "I haven't missed a day of work for nine years. When I called my doctor, he said, 'You must be dead to be calling me.' "
In the misery department, Ms. Patz has plenty of companionship. At this time of year, whole families and offices are hit by stomach viruses, colds and other respiratory infections. Some people drag themselves around like zombies for days, spreading germs. Others call in sick at the hint of a sniffle.
About the only thing that's healthy is the sale of over-the-counter medications.
"It's been as rampant a year of infection as I've seen," says Rob Stoltz, an internist at the Greater Baltimore Medical Center. "The past six weeks, the numbers have been unbelievable. There are two distinctive illnesses: one which is respiratory -- the cough and cold syndrome -- and the GI virus, which brings diarrhea with a lot of vomiting."
Dr. Stoltz, of course, got sick as well.
"I got the upper respiratory infection," he says. "The gastro-intestinal virus seems to last from one to two days. It seems the cough that comes with the upper respiratory can last about a month -- but a cough, in itself, is not worrisome if you're feeling OK."
Many people have gotten both illnesses, he says, because their immune systems were weakened enough by the first virus to fall prey to the second.
"A lot of my patients have gone back to work and then gotten sick again," he reports.
The holiday season made things worse by reuniting people with friends and relatives -- and their germs. In particular, people hugged and kissed a lot of kids.
"One of the biggest risk factors is exposure to people who are carriers. And kids are some of our biggest carriers," says Alan Kimmel, an internist in Roland Park.
Just ask Parkville resident Celeste Morrissey.
A week before Christmas, her year-old daughter, Erin, was diagnosed as having pneumonia and an ear infection, which had developed quickly from a "runny nose" cold. Erin recovered quickly, thanks to antibiotics, but Mrs. Morrissey fell sick. Shortly thereafter, Erin's grandparents and great-grandmother in Bel Air also came down with the bug.
Now Erin's dad, John,is wrestling with it.
"My cold lasted a good week," Mrs. Morrissey says. "I was running a fever and felt really worn out and extremely tired for about a day and a half, then I got the upper respiratory thing.
"Problem is, now Erin has had the stomach thing for the past two or three days. So John and I are just waiting to see if we both get that."
Trading illnesses
"A lot of parents and children seem to be trading illnesses back and forth," says Michael Reichel, a staff pediatrician at Union Memorial Hospital who says he has seen an unusually high number of patients during the past six weeks.
Although many people have suffered from viral infections, the area has not seen a flu outbreak, according to Karen Stott, director of community relations for the Baltimore County Department of Health.
"We've been in some kind of grunge epidemic," Ms. Stott says. "A lot of people are getting what my mother used to call the winter mollygrubs: being sick to your stomach, having a head cold, generally feeling yucky."
However, physicians and health care workers caution that what is merely nasty for most people can be dangerous for some. The elderly, young children and people whose immune systems are compromised by such conditions as cancer or AIDS are particularly at risk for infections such as pneumonia, which can develop from colds.
(People can still get a flu shot to protect against two Type A and one Type B influenza viruses, says Tori Leonard, spokeswoman for the Maryland Department of Health and Mental Hygiene. Since late December, there have been 13 reported cases of flu in Maryland; one in Baltimore and two in Anne Arundel County.)
Though it may seem worse than usual for those hit by illnesses, the misery season is as predictable as the winter solstice.
"At any time from late fall to early spring, approximately 20 percent of Americans have some kind of upper respiratory infection," Dr. Kimmel says. "There's nothing unique about this current bout of sickness, we tend to get one or two of these things every year."
He says patients are often confused about whether they need antibiotics -- drugs that attack bacterial, rather than viral, infections.
"The saying goes: 'If you have a flu and take antibiotics, it will last a week or two. If you have a cold and don't take antibiotics, it will last seven to 14 days. Get my drift?
"A cold or flu does not require antibiotics. Physicians usually use antibiotics to treat an infection that includes colored sputum -- yellow or green mucus -- signs of sinusitis, bronchitis or pneumonia.
Water is best
"The main treatment overall is large quantities of fluids -- of which the best is water -- rest; acetaminophen, aspirin or ibuprofen for fever and muscle aches; tepid baths; saline (saltwater) sprays or drops; decongestants such as pseudoephedrine [such as Sudafed] or phenylpropanolamine [such as Dimetapp].
"GI things are virtually always viral and best treated with fluids, over-the-counter anti-diarrheal medicines, and, if there is a lot of nausea and vomiting, a prescription medicine such as Compazine."
Fine. But is there anything you can do to keep from getting this stuff in the first place?
"WASH YOUR HANDS, with exclamation points!!" Dr. Kimmel says. "You catch colds from germs that get on your hands or from germs you inhale if someone sneezes or coughs in your face. I'm around sick people all day but I wash my hands between patients. I don't get colds from my patients, I get colds from my kids."
Which is presumably where Dr. Kimmel acquired his latest sniffle.
"I started out with a sore throat and a little stuffiness and hoarseness," he says. "I am now treating myself with frequent glasses of water and some ibuprofen and some Sudafed. Usually, my colds settle in the old schnoz and stay there for a week or two."
Meanwhile, back at her Charles Street office, Ms. Patz has declared herself "well" after 17 days."
"I don't know why I got sick -- I must have been real bad last year or something," she speculates. "It hit me like a ton of bricks, but now I'm done. This is it. For the next 10 years, being sick is out of my vocabulary.
"The only thing that's been great," she adds, "is that I've lost eight pounds."
Cold vs. flu
During the misery season, people love to debate whether their particular illness is just a common "cold" or whether it is the "flu." Internist Alan Kimmel has prepared a chart that may shed some light on the viruses in question:
.. SYMPTOMS .. .. .. COLD .. ... ... ... ...FLU
1. fever .. .. ... ..absent or low grade ...prominent, often quite high
2. headache .. ... ..sometimes .. ... ... . prominent
3. aches, pains .. ..sometimes .. ... ... ..prominent
4. fatigue, weakness sometimes .. ... ... ..common
watery eyes .. ...sometimes .. ... ... ..sometimes
6. sore throat .. ...common .. ... ... ... .sometimes
7. nasal stuffiness .prominent .. ... ... ..uncommon
sneezing .. ... ..prominent .. ... .... .uncommon
9. cough .. ... ... .common .. ... ... .... prominent