Monday, July 15, 2013

Series Post: Ask Dr. Dina - Infection Part II: Viral

DISCLAIMER: I am not a doctor, nor do I play one on TV. I do not hold a current medical license or certification (I let them lapse because I no longer work in the medical field and don't intend to ever again). What I do have is an extensive medical background in various fields. Everything you read here is the result of either education, training, research and interpretation, or personal experience. The information in this post is not to be taken as a substitute for professional medical advice or examination. Seriously, if you're having an immediate medical problem and you're reading this blog for help, get off the damned computer and call an ambulance! 



We've come now to the infection portion of our "Ask Dr. Dina" series. This piece is going to be broken into a few parts because there are many, many different types of infection and I'm not going to write a book on the subject.

These parts will be –

I – Bacterial
II – Viral
III – Fungal
IV – Treatment

Now last time we covered different types of bacterial infections. There are a lot more of them than I touched on, but the gist was there. I'm going to do the same for this part on viruses. I'm not going to get all technical and differentiate viruses into whether they're RNA or DNA viruses, but I will note here that there are different types of them. Also, I'm just going to cover some of the ones that affect humans, because viruses that mainly affect animals (like parvo) is a whole other arena, and would be another post in itself. Having said that, let's go on.

The flu. HIV. The common cold. There are a LOT of viruses out there. Some are mild. Some are nasty. Some will kill you. Some just make you really uncomfortable. Some are curable. Some you just have to suffer with. Let's talk about a few of these, shall we?

Let's start with a cold. If you aren't aware of it by now, there's a difference between having a cold and having the flu. Many, many people aren't aware there is one and think they should be treated the same (with antibiotics, which is wrong, and we'll discuss this in Part IV – Treatment). I've got news for you – NO.

No, and I'll tell you why.

(Now I'm going to generalize here, but this is for the purposes of torturing your character with your writing and being medically accurate. THE INFORMATION BELOW IS NOT to be used for diagnostic purposes as stated in the disclaimer above.)

Your character is sick in bed with some kind of respiratory thingy and praying for the sweet release of death from their misery. Should you call it "a cold" or "the flu?" Remember it this way – if there is FEVER (over 100F/37.7C) = FLU. No/low fever, it's a COLD. Get it? NOT HOT (no fever) = COLD. Easy mnemonic. There are exceptions, of course, especially in small/young humans, but again, this is in general. Don't believe me? Here. Have a link to people who say the exact same thing.

Now, both colds and flu are caused by viruses, and viruses don't respond to those antibiotics people expect the doctor to prescribe for their sniffles. Fortunately the majority of doctors have gotten it through their thick fucking skulls these days that prescribing antibiotics to every yahoo with a runny nose is a Very Bad Thing and have stopped giving everyone who walks through their door with a cough a prescription for amoxicillin, much to the bitchery of said yahoos. But you know what? MOST YAHOOS AREN'T DOCTORS, or even loosely affiliated with the medical profession and think Google gives them a fucking medical degree. Yes, I realize that when you're sick enough to go to the doctor you want them to Do Something To Make It Better Because That's Their Job And You Are Sick, but the answer is NOT antibiotics when you get a cold or even the flu, despite what you may have read on some forum written by a housewife in Bumblefuck, Assholestate.


See above. Antibiotics DO NOT WORK on cold and flu viruses. Matter of fact, they don't work on viruses, period, (antivirals sometimes do, depending on which and what for) which is what makes viruses Very Bad Things.

Now, if your cold develops into something bacterial like pneumonia (lung infection) or your sinuses/ears get infected from all that drainage, THEN you can think about antibiotics. NOT BEFORE. Antibiotics are for bacterial infections, but I'm getting ahead of myself. This isn't the Treatment part of this infection portion of our series. (I'm kind of militant when it comes to treatment and patient whinage, which is part of the reason I left the medical profession, but I digress yet again.)

Just please don't send your character to the doctor for a cold and have them fill a prescription for antibiotics. THIS IS STUPID AND WRONG and believe it or not, perpetuates the incorrect belief that this is what you do when you've got a cold. STOP THE INSANITY!

Where were we? Oh yes. Colds vs. flu. Now, most colds are caused by a wily little fucker called a Rhinovirus. (Go ahead and laugh. Rhinovirus is used to being laughed at. That's probably why it's such a bitch.) It's a pretty little thing under the microscope, looking like it's wearing a boutonniere. It has to dress fancy like that so your immune system lets it into the party, where it proceeds to get drunk and make an ass out of itself as it takes over everything and makes you feel like utter shit until it gets shown the door by the BAMFs in your immune system known as, I shit you not, Killer T cells. These guys eat viruses for breakfast, but they're kind of busy doing shit and you may have to cope for a couple days before they can get the party-crasher Rhinovirus out of the living room. Rhinovirus is an opportunistic bastard, though, and he's the ultimate couch-surfing moocher. He keeps coming back year after year, maybe wearing a new suit or sporting a spiffy new haircut, but it's always him. Nothing you can do to get rid of his dumb ass but take some over-the-counter cold meds (and there are some awesome ones out there now) to make you feel better until the Killer Ts have time to get to him. They're busy, remember, doing all kinds of other shit, and it will take them a bit to get to Rhinovirus and all the little friends he brought with him. Rhinovirus is an asshole, so try not to invite him to your party. I'll tell you how to discourage him later in the Treatment part of this portion of our series.

Now, the flu. Again. Nothing you can do about this guy. You've heard of swine flu (this was the big H1N1 strain of 2009, and while it was a type of virus known to be associated with swine, actually wasn't THE swine flu, of which there have only been about fifty human cases), Spanish flu (also the H1N1 subtype, also called the 1918 flu), Russian flu (yet again, H1N1), Hong Kong flu (H2N2), bird flu (H5N1) and others. All are types of a virus called…wait for it…Influenzavirus. Now if you want to get all fancy and scientific, the Influenzavirae are types of Orthomyxoviruses, named, stunningly, A, B, and C.

Influenzavirus A is the one responsible for all the fancy different types of flu you hear about. H1N1, H2N2, H5N1, everything. No matter the subtype, it's a member of the Influenza A family.

Now, I know what you're thinking. "I get my flu shot every year!" Good for you! Dr. Dina thinks flu shots are BULLSHIT for the most part. Why? Because the flu changes every year. It's not like measles or hepatitis or any other virus that has an effective vaccine that prevents it. Every year Those In The Know pull a random number out of their ass and say things like "we're due for this strain and this strain and this strain…gonna be a heavy year for those…let's use those in the vaccine this year!"

Now that might seem belittling to those scientific types who I am sure put a vast amount of work into making flu shots, but seriously. Dr. Dina wants more than just 60% efficacy in her vaccine, thank you. Another issue I have with the flu vaccine is that its peak effectiveness is only two to four weeks, after which its protection drops by 50% over the next six months. I would like a little more than a month to half a year's protection from my vaccine, thanks. Though the protection from that vaccine is in theory supposed to last three years, you're encouraged EVERY FLU SEASON to get a flu shot. Why? Because no two seasons have the same flu shot. Does that seem right to you? The shot changes every year because they're never certain from year to year which strain is going to be the one running around with its clothes off at the party that year.

Now, the flu vaccine does benefit some people a great deal. Kids, seniors, people with HIV/compromised immune systems…lots of people benefit from that 60% efficacy guesswork. I'm not saying you shouldn't get a flu shot. I'm saying I, personally, think they're bullshit for me, and I'm a former HCP (health care professional). I was the type that was encouraged to get one because I had direct contact with the people who needed them most. Now while I've never had a flu shot and never intend to get one, I'm all for vaccination against disease. Militant about it, in fact. Ever heard of "herd immunity?" Yeah. That. THAT IS A GOOD THING. Get your vaccinations, people. Whether or not you want to get a flu vaccine is up to you. It's not for me, personally, as I don't consider the flu to be a disease, let alone one I need vaccinating against. It's not pertussis. My former HCP husband gets them every year.

And yet still gets the flu every year. Huh. Must not be lucky enough to acquire one of the strains he was vaccinated against.


Let's talk about something other than colds and flu. Let's talk about…HERPES! Yeah! That's a fun one. The technical name for this viral infection is Herpes Simplex. Now, there are two subtypes, creatively called 1 and 2.

Cold sores/fever blisters are herpes lesions on the mouth and lips (sometimes below the nose and other parts of the face, including the eyes) and are caused by Type 1 and generally called Herpes labialis. (Fun fact! If you have a cold sore and perform oral sex on someone, you can give them genital herpes. Don't try this at home, kids! Practice safe sex and don't perform oral if you have a cold sore. Also don't let anyone with a cold sore perform oral sex on you.)

Genital Herpes can be caused by Type 1, but is generally Type 2.

Herpes can also infect the fingers, throat and brain. In fact, there's a thought that HSV-1 is responsible for Alzheimer's disease.

I could go on and on about different types of viral infections. I'm sure you've heard of HIV. This is the abbreviation for Human Immunodeficiency Virus. It's the virus (called a lentivirus, a type of retrovirus that develops slowly) that leads to AIDS (acquired immunodeficiency syndrome).

Ebola. You've heard of that one? It's a filovirus that causes a hemorrhagic fever. There are currently five different types of Ebola, plus a similar hemorrhagic fever disease called Marburg in the same family.

Hepatitis. Viral infection. A, B, C…all are viral.

Polio. Meningitis. The types of viral infections is enough to fill a hundred books. There's even a field of study dedicated to it called Virology. Viruses were a passionate field of study for me back in the late 1990s. (I blame the movie And The Band Played On, the AIDS epidemic in the 1980s and Richard Preston's The Hot Zone for this.)

There are a hundred ways to torture your character with viruses. Have your adventurer traipsing through the jungles of the Africa? Infect him with Ebola or other nasty. (Lassa fever is fun!)

Is your heroine finding herself in the desert southwest? Toss a little Hantavirus in there. (Yes, this is a real thing. It's carried in mouse pee. No, really. I promise.)

Most locales have some happy little virus hanging around. A lot of viruses are named after the places they're discovered or expected to be. Medical types call this "endemic." You don't have to be somewhere exotic for this to happen, either.

Now, you sci-fi writers can have a shitload of fun with this. Firefly did. ALIEN did. There are loads of examples of Really Weird Shit Infecting The Populace, and not just in sci-fi. Have a ball with it. Just remember if you're going to make some fancy new virus up, be sure and base it in science and back it up with your world-building.

This concludes part II of the Infection Sequence of the "Ask Dr. Dina" series. Join us in a couple weeks for part III – Fungal.

Questions about medical issues with your writing? Leave them in the comments below and I'll get back to you as soon as I can. (THESE MUST APPLY TO FICTIONAL SITUATIONS ONLY. I AM NOT YOUR DOCTOR, NOR A SUBSTITUTE FOR ONE.)


  1. I absolutely LOVED The Hot Zone. Such a good book!

    1. Me too. I wasn't so thrilled with "The Cobra Event," but still own it.

  2. After I read the Hot Zone I didn't want to leave my house again...ever. Awesome book, and awesome post. Not nearly as "ew" as your warning suggested. ;)

    1. Robin Cook's "TOXIN" put me off meat for two years. Instant vegetarian. Yeah, that lasted....


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