It is that time of year: The holidays are over, your house is cleaned up, but the visitors left more than a box o f chocolates. You thought your tiredness was a result of all the festivities, but now your head and throat hurt, your muscles ache and “a bug” has settled into your lungs.

This is the time of year when Montana generally begins to see an uptick in influenza cases. Often the southern and eastern parts of the country have widespread flu by now, but in Montana it’s just picking up. As people travel nationwide for the holidays, they can bring illnesses from their regions.

Jefferson County saw a sharp increase in respiratory illness in the last few weeks of 2019. Respiratory Syncytial Virus (RSV), pertussis and influenza were all reported. The symptoms of these and colds and other respiratory illnesses can range from mild to severe, with complications such as pneumonia and hospitalization possible. Many don’t need medical care, but all should limit contact with the public while ill to reduce the risk of spreading to others. The length of time of illness varies depending on the germ: RSV and influenza last approximately a week; small children and persons who have weakened immune systems may be infectious longer. Untreated pertussis is infectious for 21 days.

RSV’s symptoms include cough, runny nose and fever. Most small children have been infected with RSV by age 2. In infants it may cause inflammation of the small airways (bronchioles), decreased appetite and apnea, or pauses in breathing. Infants and adults with chronic medical conditions such as heart or lung disease or weakened immune systems, and adults over 65 are at higher risk for more severe infection also. An estimated 170,000+ adults are hospitalized each year with RSV.

Pertussis often starts with a runny nose then proceeds to cough which may be uncontrollable (can’t stop) or worse at night. Babies may have apnea. Pertussis is contagious for 3 weeks if untreated, but with appropriate antibiotic treatment is no longer infectious after the 5th day of treatment. The bacteria toxin causes some damage which leads to the extended time of coughing. For this reason, pertussis has the nickname “the 100 day cough.”

Influenza symptoms include fever, sore throat, cough, body aches and fatigue. Vomiting or diarrhea can occur and more frequently in children. It can lead to pneumonia and hospitalization. Antiviral treatment is most effective if started within 48 hours of onset of symptoms. Last year in Montana, 767 people were hospitalized with influenza and 38 deaths were attributed to the flu.

As the schools and daycares reconvene and people return from vacations, please keep these respiratory bugs in mind if you or a family member becomes ill. Here are some recommendations:

  • Get vaccinated. This helps to reduce the number of susceptible people and severity of disease (pertussis and influenza). Most vaccines take about two weeks to work fully.
  • Maintain your health: eat well, get adequate sleep and exercise. These all help your body fight infections.
  • Keep your hands clean. Wash before touching your eyes, before eating and before preparing food. Wash after covering coughs and sneezes or blowing nose.
  • Cover any coughs to contain the respiratory secretions. Then clean your hands again!
  • Clean commonly touched surfaces that may harbor germs: toys, countertops, door knobs, etc.
  • Complete your treatment as prescribed. Unfinished antibiotics or antivirals can lead to resistant organisms and fewer treatment options in the future.
  • Stay home while ill and avoid contact with others unless you need to seek medical care. Don’t return until you are feeling much better and you have either finished your antibiotic (pertussis treatment) or have gone at least 24 hours without any fever.

Search the Centers for Disease Control and Prevention ( for more information on RSV, pertussis and influenza.

Karen Wandel, RN, is supervisor of the Jefferson County Public Health Department.

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