Colds and the Flu - Diagnosis

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Pertussis. Pertussis (whooping cough) was a very common childhood illness throughout the first half of the century. Although immunizations caused a decline in cases to only 1,730 in the U.S. in 1980, the incidence has risen recently, with nearly 17,000 cases in 2009. Many more cases are reported worldwide.

Nearly half of pertussis cases now occur in people 10 years of age or older, perhaps due to waning immunity in adolescents and adults. Up to 25% of adults who see a doctor for persistent cough may actually have pertussis. It may go undiagnosed, however, because their symptoms are usually mild, and adults are unlikely to have the classic "whooping" cough. This is of some concern because such adults may unknowingly infect unvaccinated children. The younger the patient with pertussis, the higher the risk for severe complications, including pneumonia, seizures, and even death. Children younger than 6 months are at particular risk because protection is incomplete, even with vaccination.

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Pertussis vaccines safe for older children and adults are now available.

Other Causes of Sore Throat

In addition to common cold viruses, other, less frequent causes of sore throat include the following:

• Strep throat
• Foodborne and waterborne infections (Streptococcus C and G)
• An uncommon organism called Arcanobacterium haemolyticum (infection with this bacterium can mimic strep throat and may even cause a rash)
• Infectious mononucleosis ("mono")
• Herpesvirus 1

What is Strep Throat?

Group A Streptococcal bacteria is the most common bacterial cause of the severe sore throat known commonly as "strep throat." It occurs mostly in school age children, but people of all ages are susceptible. (Strep throat constitutes about 12% of all sore throat cases seen by doctors.)

The symptoms of strep throat include the following:

• A sudden onset of severe sore throat
• Difficulty in swallowing
• Fever
• Headache
• Stomach pain
• Vomiting

Only about half of patients with strep throat have such clear-cut symptoms. Furthermore, half of people who have these symptoms do not actually have strep throat.