Selected Podcast

You Can Prevent Many Common Illnesses

Your immune system may be well developed, however, there are some common illnesses that many people will get anyway. Some may actually be prevented.

The caring medical professionals at Meritus Health's Urgent Care treat conditions ranging from earaches, sore throats and rashes to sprains and strains, mild-to-moderate asthma, as well as many other conditions.

In this segment, Dr. Rabail Razi-Akmal, M.D., board certified internal medicine specialist at Meritus Health discusses some of the most common illnesses that people get, the treatments available, and what you can do to prevent them.
You Can Prevent Many Common Illnesses
Featured Speaker:
Rabail Razi-Akmal, MD
Dr. Razi-Akmal earned her medical degree from Stony Brook University School of Medicine in Stony Brook, N.Y., and completed her residency at Rutgers New Jersey Medical School in Newark, N.J. Dr. Razi-Akmal is board certified in internal medicine with the American Board of Internal Medicine.

Learn more about Dr. Razi-Akmal

Melanie Cole (Host): Your immune system may be well-developed. However, there are some common illnesses that many people will get, and some may actually be prevented. My guest today is Dr. Rabail Razi-Akmal. She’s a board certified internal medicine specialist at Meritus Health. Welcome to the show, Dr. Razi-Akmal. Let’s talk about some of those common illnesses certainly that are going around today, colds and flu being some of the most common. How do we know if it’s a cold or if it’s an allergy at this time of the year?

Dr. Rabail Razi-Akmal (Guest): You asked a very good question about allergy versus cold. Sometimes it’s hard to tell, although a lot of people who have a history of allergies, it’s easier for them to pick it out because they’ll notice the stuffy nose, congestion, maybe a little headache that worsened in the morning when the pollen counts are high or after a whole night. Sometimes the therapy is similar because you’re gearing towards symptomatic treatment. An antihistamine will help with allergy symptoms as well as even if you have a cold, so that includes your Claritin, Allegra, Zyrtec, anything that’s over the counter for allergy symptoms.

Melanie: So if somebody does have a cold, there’s so many over-the-counter medications for a cough, and for fever reduction, and for cold symptoms, what do you recommend that people take and what do you recommend that they stay away from?

Dr. Razi-Akmal: In terms of taking over-the-counter stuff, we really like anything for cough suppression because again, we’re gearing towards your symptoms and the cough itself is what’s causing the worst effect on people, so anything with dextromethorphan is usually – that helps the cough suppression. Again, going back to the antihistamine, studies show that if you take an antihistamine and a decongestant combination, that usually tends to help a lot, so any of those multisymptom relief that say it’s got some antihistamine in it, some cough suppressant, some decongestant, things like Allegra-D, or Claritin D, those things would really help.

Melanie: What about a fever? If we are suffering from a fever, or if our children get a fever along with a cough or the cold, do we worry about a fever, when do we worry, and do we give them something to bring it down?

Dr. Razi-Akmal: You should absolutely give something to bring down the fever, whether it's Tylenol or ibuprofen, and even viruses that cause these illnesses will give you a fever the first couple of days, it’s a matter of that fever trend coming down, not continuously going higher, and higher, so we’ll still treat that as something viral unless it keeps going on.

Melanie: And is a certain fever high enough that we call our doctor? When do we worry?

Dr. Razi-Akmal: I would say, well 100.4 is when we say, “Okay, yes it’s a fever,” but after maybe the first 24 hours or 36 hours of having that high fever that every time you take the Tylenol or ibuprofen, it keeps coming back up, along with some other signs that are going throughout your body, maybe a lot of body aches or fatigue, that might make me think of influenza, or an ear infection and I would probably order testing for that sooner rather than waiting a few more days.

Melanie: So now that you’ve mentioned influenza, first of all, how do we know that that is what we’ve got and what are some of the symptoms to watch out for, and what are the treatments?

Dr. Razi-Akmal: You know you have influenza because it really drains you out, and it can feel similar to maybe something else like an ear infection or a strep throat, but the tiredness and the muscle aches are usually the bigger part of the picture. People will maybe have high fevers the first couple of days, not wanting to get out of bed, if we’re going to start you on treatment, Tamiflu is the pill that’s used for it. It’s best if it’s started within 48-hours of symptom onset, so that’s why we say flu is one thing that we try to get you in sooner rather than later. And there is a nasal swab that can be done to confirm that it’s influenza. Again, if you are someone outside the 48-hour window, the best thing that you can do is wash your hands -- good hand hygiene, and trying not to breathe close to other people, and avoiding crowds, is the best thing to prevent the transition of influenza.

Melanie: And what about the vaccine? Who should receive the flu vaccine?

Dr. Razi-Akmal: It is now recommended for all adults according to the CDC and especially if you have any chronic illnesses like lung disease, diabetes, liver disease, anything like that, that may suppress your immune system, then we say, “Yes, you should get a flu vaccine every year.”

Melanie: And you mentioned ears before. What about ear infections, especially in children? Parents tend to want the antibiotic right away. Some pediatricians recommend to watch and wait. What do you recommend as far as ear infections in children?

Dr. Razi-Akmal: Well, I mostly see adults. In children, yes, sometimes it can be viral, so it might get better on its own. In adults, however, ear infections usually are bacterial, so we’ll go ahead and treat with an antibiotic if, on an ear exam, it looks like you have an infection, and you’re describing something that sounds like it.

Melanie: So bust up a few myths for us, Doctor, if you would. Respiratory problems – people start with a cough, and right away they say, “I’ve got bronchitis. I need an antibiotic,” or if they cough up something that’s green or yellow, then they say, “I’ve got an infection.” Is that always the case, and do we always need an antibiotic for that?

Dr. Razi-Akmal: No, you barely ever need an antibiotic for a common cough and cold. They’re usually viral. The color of the phlegm, although it’s so convincing, actually means nothing. Even when you have really bad allergies, it can give you a very thin, green mucous, the phlegm, so it’s not very reliable. In terms of developing bronchitis, bronchitis simply means that your cough has been going on for more than one week. Again, it’s almost always viral, so you have to just go through the symptomatic treatment, the cough suppression, some sort of a decongestant to help you if congestion is also going on. Unless you have any chronic lung disease and you have chronic bronchitis as a diagnosis, usually it’s viral.

Melanie: And what about sore throats. People get sore throats all the time maybe because it’s dry outside, or the season, or any number of reasons, but when is a sore throat – when do we do something about it and do you have home remedies that we can use for our sore throats?

Dr. Razi-Akmal: Yeah, sore throat is – it turns out that most people who seek care for sore throats are mostly concerned about the pain because it hurts to swallow, so home remedies help much more -- the Cepacol lozenges, or the benzocaine, lidocaine lozenges that you can get from the over-the-counter pharmacy, those really help because it will help numb everything up and the pain also gets better. You can also try ibuprofen, Tylenol, salt water gargles, anything to soothe the throat. Honey helps, absolutely.

If you’re having high fevers and on exam, the throat looks very red, inflamed, maybe some drainage in the back, then we do check for streptococcal – the strep throat – the bacteria that causes it. If it comes back a positive test, then yes, antibiotics will fix that, but a lot of times you’ll have a lot of pain and swelling, and it will just be viral. You can still have a fever the first couple of days, but it will have to take its course.

Melanie: So wrap it up for us, Doctor, if you would, with your best advice that you give people every day about some of the common illness that go around all over the place and possible ways that we can prevent getting some of these.

Dr. Razi-Akmal: Ultimately, good hand hygiene is the most important thing. Wash your hands if you’re going to touch – if you’re going out into public, come home and wash your hands. If you’re going to eat something, wash your hands prior to that, especially if you’re sick. You have to prevent the transmission to someone else. Also just avoiding crowds, breathing on people, or coughing – when you’re coughing try to cough into your sleeve, not just into your hands because that’s just going to spread the disease even more. Yes, there’s some studies out there that say taking multivitamins or vitamin C and vitamin D may help, but we don’t have very clear, hard data on saying yes, this is a recommendation.

Melanie: Thank you, so much, that’s really great information. It’s so important for people to hear. You’re listening to Your Health Matters with Meritus Health, and for more information, you can go to, that’s This is Melanie Cole. Thanks, so much, for listening.