Management of a Patient with No Cold/Flu Symptoms and No Sexual History
For patients with no current cold or flu symptoms and no sexual history, routine preventive care is recommended with emphasis on hand hygiene and vaccination when appropriate. 1
Preventive Measures for Respiratory Infections
Hand Hygiene
- If hands are not visibly soiled, use an alcohol-based hand rub for decontamination 1
- If hands are visibly dirty or contaminated with proteinaceous material, wash with either a nonantimicrobial soap and water or an antimicrobial soap and water 1
- Ethyl alcohol hand gel and plain soap and water should be encouraged over antimicrobial soaps 2
Vaccination
- Administer current inactivated influenza vaccine during appropriate seasons to prevent influenza 1
- Vaccination should be promoted as early as possible to reduce viral transmission and promote herd immunity 2
Other Preventive Strategies
- Gargling with water and using nasal saline spray are cost-effective preventive measures with clinical evidence 2
- Vitamin C and D supplementation may be beneficial with a favorable benefit-to-risk ratio 2
- Counseling about good hand hygiene is the best way to prevent transmission of cold viruses 3
Management Considerations in the Absence of Symptoms
For Patients Without Current Symptoms
- No specific treatment is needed in the absence of cold/flu symptoms 4, 3
- Focus on preventive education and health maintenance 2
- Avoid unnecessary use of over-the-counter medications when no symptoms are present 3
If Symptoms Develop Later
- For adults, effective treatments include over-the-counter analgesics (such as ibuprofen), zinc, nasal decongestants with or without antihistamines, and ipratropium for cough 3
- Ibuprofen is as well tolerated as paracetamol and better tolerated than aspirin for cold/flu symptoms 5
- For children, safe and effective treatments include acetylcysteine, honey (for children one year and older), nasal saline irrigation, intranasal ipratropium, and topical application of ointment containing camphor, menthol, and eucalyptus oils 3
- Over-the-counter cold medications should not be used in children younger than four years 3
Considerations for Infection Control if Symptoms Develop
Droplet Precautions
- If influenza is later suspected or diagnosed, place the patient in a private room or with other patients with confirmed influenza 1
- Wear a surgical mask when working within 3 feet of a patient with suspected or confirmed influenza 1
- Limit patient movement and transport to essential purposes only 1
Personnel Considerations
- Healthcare personnel with influenza-like illness should be evaluated to determine whether they should be removed from duties involving direct patient contact 1
- More stringent criteria should be applied for personnel working in high-risk areas (e.g., intensive care units, nurseries, organ transplant units) 1