Medical Fun Facts Podcast

MFF0009: Man flu

Okay, let me unpack this. I’m not a fan of the contraction flu, I much prefer the proper name influenza, however, in this instance man flu is probably okay given more often than not man flu is not caused by an influenza viral infection.

So today while at work I start getting a sore throat (or pharyngitis). Soon after my nose started running with thin snot (or rhinorrhoea).

I know a lot of people have been unwell at work and I also know there has been some rhinovirus circulating in Canberra.

What is remarkable is that people still ask if I’m going to take antibiotics. I mean, why would I?

If only there was a cheap and accurate near patient test to distinguish between a bacterial and viral infection. You know what though? Most of the time a simple sore throat, runny nose and headache is just a common cold, albeit in men is can be devastating! Given I live alone, I plan to stay in bed, keep warm and eat ice cream.

It still amazes me that people don’t understand the difference between bacterial and viral infections. It also amazes me that people don’t understand that viral infections, won’t respond to antibiotics. What I get really annoyed by is the comment by some medical practitioners that they will prescribe antimicrobials in case of secondary bacterial infection.

In this day and age of global awareness of antimicrobial resistance, we should be doing more to focus on getting an accurate diagnosis if someone is not improving from what should be a self-limiting upper respiratory tract infection. Refer the patient to a pathologist, collect an appropriate specimen and seek a diagnosis for what is causing the infection.

I’ve heard some people go on about how we should be more concerned about what is happening in agriculture. It’s true that we should be taking a One Health approach and it’s equally true that antimicrobial use in agriculture should be optimised to reduce antimicrobial resistance, however, we cannot escape the fact that we must do everything possible to reduce unnecessary use of antimicrobials in humans.

On a slightly related topic, I hear people talk about bacteria developing immunity to antimicrobials, I hear this from educated people. Bacteria develop resistance while animals with immune systems develop immunity to foreign antigens.

Fortunately, many bacteria remain susceptible to simple cheap antimicrobials. For example, with the exception of meningitis and septicæmia, the pneumococcus remains susceptible to standard doses of penicillin. Even in severe infections, it’s likely high sustained levels of penicillin will be effective. By sustained, I mean concentrations above the minimum inhibitory concentration. Likewise, spirochætal bacteria like TreponemaBorrelia and Leptospira remain susceptible to penicillin-class β-lactam antimicrobials. They do not seem to develop resistance.

Anyway, sorry about the sniffing during this podcast. Remember everyone, infection prevention and control begins at home with good handwashing, cough etiquette and staying away from others if you’re sneezing and/or coughing.

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