The spread of seasonal flu and other respiratory viral pathogens peaks from November to January, and is the main cause for exacerbation of respiratory issues such as wheezing, asthma, and COPD (chronic obstructive pulmonary disease). Winter and cold weather trigger spasms in airways that make breathing difficult for people with known respiratory conditions, especially the elderly and children.
As per the Central Pollution Control Board, the Air Quality Index of India is very poor in the months of November to January. This makes breathing more difficult, not only for respiratory patients but also for those with no health issues.
Additionally, December and January are also months of festivals and holidays when places get crowded. Children pick up infections first and may spread them easily to family members and the community. Even though flu presentations may vary from a mild cough and runny nose to severe pneumonia leading to ICU admission, the nuisance of symptoms and healthcare expenditure is heavier for those infected. Timely precautions and preventive measures, however, can help curtail infections.
Curtailing spread
Wherever possible, maintain a social distance of at least six feet: coughs and sneezes spread infected droplets up to six feet. Use a hand sanitiser whenever coming into direct contact with people. Wash hands with water and soap before touching household items.
Wearing a mask is essential, especially for those with viral symptoms. Daily washed, clean cloth masks are as effective and safe as surgical masks. If surgical masks are used, they should ideally be changed every hour or if that is difficult, at least every four hours, as they are effective only for four hours. N95 masks are encouraged but are expensive, and should be replaced every 24 hours.
Avoid mingling with people, especially the elderly and children, when you have symptoms of a cough and cold. Avoid unnecessary travel and local outings. Avoid closely spaced workouts, gyms, or sports; instead opt for sports in open areas.
Also Read: Study highlights gaps in cough management, calls for scientific approach to its categorisation
Home remedies
Carry warm water in a flask with you. Cold water from new places may have new viral pathogens that could cause cold-related symptoms. Practice steam inhalation, which can help clear a stuffy nose and sore throat. Deep inhalation of steam through the nose and mouth for two to three minutes is adequate. Do not add salt, turmeric powder, or eucalyptus oil to the water. Even if there is no nasal block, steam inhalation twice or three times a week is advised for everyone to maintain good nasal hygiene.
Vegetarian or non-vegetarian soups, with little spice but adequate pepper, can be consumed frequently to soothe the throat, which reduces cough and phlegm.
Peppermint or eucalyptus herbs soothe the upper airway by reducing inflammation and breaking up the mucus, which reduces pain and cough. Fenugreek tea reduces mucus and helps clear it from the throat and lungs. Saltwater gargling helps in expelling mucus in the throat and reducing coughs. If you use excess salt while gargling, it may produce more mucus and cough, and so, caution is needed. Saline nasal drops reduce inflammation of nasal and throat passages, and the cough subsides.
Safeguarding environments
Ensure you follow cough etiquette at all times. At home, cleaning of contaminated air coolers and cleaning of AC filters will reduce dust and that may reduce viral exacerbation.
Vaccination against influenza (flu) and pneumonia for the elderly, children, immunocompromised individuals, and healthy people who care for immunocompromised individuals reduces the burden of disease spread.
When to see a doctor
Cough is triggered by excess mucus secretion in the lungs. It becomes a nuisance if more mucus is secreted, and at this stage, it is likely to get a secondary infection. The condition can be noticed by a change in the colour of the sputum from white to yellow, green, or black.
Breathlessness is an alarming symptom of a viral infection that warrants immediate medical attention. However, if symptoms are mild and vitals are stable, home remedies can be tried. Having sips of warm water will give some relief. Drinking a small amount of coffee or green tea may help in opening up the airway and easing breathing. Inhaling warm air dilates the airway and reduces difficulty in breathing. Rest is vital for cellular repair in the body, but it may be especially beneficial for shortness of breath, if physical exertion is kept to a minimum.
Chest pain may result from a persistent cough. Turmeric/ginger tea reduces the inflammation and mucus secretion and opens up the airways. Patients can then expel the secretion and breathe easily, which eventually reduces the pain. Hot soup helps reduce the phlegm in the chest and the pain too.
For mild fever, or for one episode of fever, home remedies can be tried. If fever is high or persists, it is important to seek medical help. Consuming liquids and electrolytes during a fever can help prevent dehydration. Bathing in lukewarm water can help the body cool down. If bathing is not possible, sponge the body with towels dunked in lukewarm water. The moisture may cool the body surface and reduce fever.
Seek proper healthcare attention if symptoms do not improve within 48 hours or if they worsen.
Post-viral pain and sleep issues
Post-viral pain that follows a viral infection is not attributed to other causes. Many patients complain of body ache even after proper treatment for recent viral prodromes. Residual inflammation post-infection causes muscle pain and persists even weeks to months after an infection. Mild pain can be managed with doctor-prescribed painkillers, proper rest to restore energy, energy preservation techniques by avoiding hard workouts, mild massage or passive flexion and extension of limbs, hot baths to reduce inflammation of muscles, maintaining adequate hydration, meditation or yoga, adequate sleep at night and during the day, an intake of a diet rich in vitamins, specifically vitamin D and vitamin C, as well as breathing exercises to alleviate stress and pain. If the pain lingers, reach out to your doctor for help.
Post-viral fatigue is a common symptom that occurs at work or rest. It can be muscle fatigue due to physical work or brain fatigue due to cognitive work.
Post-viral sleep disorder is a common presentation during or immediately post a viral infection. Insomnia and inadequate or unrefreshed sleep are frequently documented. Sleep initiation, maintenance, or fragmented sleep is due to ongoing viral inflammation. To overcome post-viral sleep disorder, avoid heavy food at night, have dinner early at night, sleep in a dark room, sleep on a comfortable bed, spray a mild fragrance in the bedroom to lift the mood, listen to light music before sleeping to relax the mind, drink hot water or milk before going to bed, refrain from electronic usage one hour before bed, and take a hot bath at night to induce sleep.
Precaution before an infection and early intervention if an infection occurs are crucial to avoiding infections and reducing the spread of infections in the community.
(Dr. N. Sankararaman is clinical lead & consultant interventional pulmonologist, Kauvery Hospital, Chennai. ama.krr@kauveryhospital.com)
