La Gripa

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By Russ Ham

Maybe it was the big lunch.  Sitting with friends that afternoon, breathing was a conscious exertion; it was a chore to lift my arms or to stand, and there was a warm ache behind my eyes.  I hoped that I just needed to sleep off that extra-large fettuccine alfredo.  But as our gathering ended, a paceño friend noticed that I seemed tired.  I described how I felt, and he had an immediate answer, “¡La gripa!

La gripa?”  My friend had no medical training, but plenty of middle-aged wisdom and a lifetime of local experience.  I went home and tried to decode his diagnosis.

According to the Spanish-English dictionaries, the more common word is gripe (“GREE-pay”), which can mean a cold or the flu.  But the word used in La Paz — and throughout Mexico — is la gripa.  One authority says that “gripa” is a mispronunciation of gripe that has become so common that the Real Academia Española (the authority on matters of Spanish language) has acknowledged it as a legitimate variation.

But which malady is being described?  It turns out that the imprecise language mirrors a medical analysis where distinctions are matters of degree.  So for further understanding, TBC asked some experts — an epidemiologist from IMSS and the practicing MD who is responsible for the annual flu vaccinations for the marina community.

DISCLAIMER: TBC has consulted knowledgeable doctors for general advice which is shared here with information from other sources.  But this article is not a substitute for medical advice.  If you are suffering from an illness that concerns you, please see a doctor right away!

Generally, “la gripa” is the common cold.  “La gripa mala,” or “gripa del perro” (invoking dogs to convey intensity) is an influenza.  Both maladies are viruses and do not respond to antibiotics.  Both are carried by respiratory vectors, traveling in droplets expelled into the air by an infected patient.  Symptoms and epidemiology overlap, and to diagnose one or the other requires judgments regarding the degrees of a patient’s suffering.

If a patient has a mild fever — no more than 100 degrees F — and the patient is sneezing, with a “frequent and abundant” runny nose, and other possible symptoms including a sore throat, minor dry coughing, eye irritation, mild headaches, or general bodily discomfort, then one has the common cold gripa.

But if a patient has a higher fever (38-40 C, 100-104 F), a significant dry cough, body aches in the longer muscles of the arms or legs and the back or pain in the joints, and strong headaches, one might have influenza — “la gripa mala.”

Either condition should run its course in three to five days.  Treatments are similar.  Dr. Ramón Gaxiola Robles, an epidemiologist with IMSS, says, “If someone calls me or comes in and they have la gripa, I suggest they take a couple of aspirins and call it a day.”  Nasal congestion can be worse at night, so patients are advised to sleep with their heads elevated; a neti pot can also help with nasal congestion, as will over-the-counter antihistamines.  Sore throats can be treated by gargling salt water.  Immune systems can be fortified by vitamin supplements such as ADerogyl (an over-the-counter supplement of Vitamins A, D, and C).

Folk remedies abound, although their usefulness is debatable.  Some will stir minced garlic and hot peppers into a small jar of honey and recommend a teaspoon every hour.  Dr. Enrique Tuchmann — who performs the annual vaccinations for the flu and other illnesses at the marinas — lists honey as well as lemon tea and propolium drops as home remedies, but cautions, “It is important not to self-medicate, to avoid complicating the disease.”  It is easy to develop secondary nasal or bronchial infections, for which antibiotics can be helpful in avoiding bronchitis or pneumonia, but one should never use antibiotics without a prescription.

In our day-to-day lives, the doctors agree that it is almost impossible to avoid exposure to these viruses.  Even with scrupulous hygiene, it is hard to avoid touching people.  Simply shaking hands or a Mexican-style saludo (the air-kiss on the cheek) can expose you to these diseases.  Dr. Gaxiola puts it plainly: “If you want to avoid getting the cold, don’t touch people.  And if someone is under the weather, tell them to stay home!”

One significant distinction helps the authorities control the flu: colds are caused by many different viruses, but the flu comes from a smaller batch of viruses. They change from year to year, but they can be identified and vaccines can be prepared that are usually quite effective.  There are years when an unforeseen virus emerges that isn’t covered by that year’s vaccine, but by and large, people can be vaccinated against the flu. 

As with most health problems, the very young, the very old, and people with decreased immune systems are more at risk.  If you have either type of la gripa, the doctors ask that you shut yourself in and especially avoid people who may have a harder time fighting off the infection.  Dr. Gaxiola says, “If the symptoms last more than three days and they don’t disappear or actually worsen, then it is time to consult a doctor.  If you have contracted a nasal or bronchial infection, antibiotics may be prescribed. If you need them, you have to take them. There is no other option.”

Russ Ham is a musician, photographer, and writer who loves the people and culture of the peninsula.  He hosts an Open Mic night every other Wednesday at La Morante Art Bar.