A surge in throat infections, headaches, cough, malaise, body aches along with fever aptly named ‘common cold’, occurs around the winter months in our country. The term ‘flu’ is also used to describe such a set of symptoms but generally is used for more severe varieties.

Although almost everyone suffers from these infections over a period of a few years, most cases are considered mild but many have still required hospitalizations due to progression to respiratory distress and also pneumonia. Many are requiring intensive care and sadly there have been cases of patients having difficult recoveries.

Although these are the most common illnesses to infect humans, many of their aspects still remain in confusion. This is owing to the fact that the causative agents are a wide variety of viruses like rhino, adeno, entero, corona, influenza etc. Periodically other viruses are also found to be causing flu-like symptoms such as nipah, zika, RSV etc.

In each culture there are various beliefs associated with the medical conditions arising from these infections. Thus we would like to address some and provide practical clarity on the matter.

The cold weather / seasonal variation
Colder months from October are generally associated with an increase in occurrence and transmission of these infections. Generally these months provide ideal conditions for viruses to survive like lower temperatures & dry conditions. Increase in air pollution and poor air quality also aids in the spread of infections. The mucosal membranes that provide an effective barrier against viruses become dry and their effectiveness is reduced. Also as the weather is cold people tend to gather indoors increasing chances to catch the viruses.

Respiratory viruses also tend to have a higher rate of mutation and new seasons bring new variants that may be resistant to immunity in the given population. Therefore, gatherings especially in confined spaces must be avoided whenever possible. Immunization may be considered wherever possible eg. flu vaccines against influenza virus.

Travel and infection
Increased viral transmissions are seen in confined spaces in planes, trains and buses. In addition, the viral genome of different places may differ and so will the immunity of the local populations. Many viruses are spread by contact with surfaces and daily use articles. In recent times traveling has been associated with increased viral infections both respiratory and also gastric. Therefore masks must be used whenever in crowded places. Hand and personal hygiene is also very important.

Vulnerable populations
Extreme age groups of children and senior citizens are vulnerable to viral infections. Diabetics & those with respiratory illnesses like COPD, severe asthma etc. also are prone. Persons with Immuno-compromised states also have increased chances of infections. Therefore caution must be taken in such cases. Infants, especially under 6 months of age are specifically vulnerable to viral infections and have a rapid progression to pneumonia. In case of repeated throat infections an ENT evaluation regarding tonsils and adenoids must be sought.

Severe infections / when should I consult ?
In general the symptoms are mild and self resolving in about a week to 10 days. Antibiotics should not be taken as these are ineffective against viral infections. Although most cases are self limiting, many have progressed to pneumonia and later get infected with bacteria also requiring hospitalization. Such incidents have increased in the colder months starting from october due to factors discussed above. Exacerbations in already existing respiratory illnesses like COPD, asthma, bronchitis etc. also occur, worsening the outcomes.

A medical evaluation must be done if the symptoms last for more than 10 days to 2 weeks and / or are severe enough to cause breathing difficulties, cyanosis (bluish lips and fingers), high grade fever and inability to maintain oxygen saturation above 92%.

General considerations
To prevent against viral infections, we should keep some points in mind

● Maintain good hydration – minimum of 1.5 to 2 liters per day
● Take vitamin B and C rich vegetables and fruits or supplements
● Avoid travel and polluted places whenever possible.
● Avoid gatherings wherever possible. Infants under 6 months must not be exposed. Good ventilation is necessary in gatherings.
● Wash hands and use sanitizers as much as possible. Reduce the habit of touching your face.
● Use ginger, lozenges, gargles, mouthwash, steam inhalation for mild infections
● Manage other issues like diabetes, thyroid imbalances, cholesterol levels, asthma, COPD.
● Reduce or quit substance use like tobacco (including smoking), alcohol and opioids or seek help for the same
● An active lifestyle reduces frequent infection. Exercise regularly.
● Do consider vaccination if you have frequent seasonal infections.