Dr Kevin McCarrollAs the winter sets in, we brace ourselves not just for the long dark days and cold weather but the seasonal spike in winter-related illness – the surge in colds and flu as well as several health conditions triggered or worsened by cold weather such asthma, cold sores and circulatory problems.
So what if anything can we do to try and stave off these ailments? Simple as it may seem, washing your hands regularly and making sure to keep items clean that have been in contact with those with respiratory illness will reduce your chance of contracting the common cold.
Vitamin C at doses of up to 1g daily may marginally reduce the duration of colds as well as symptom severity but study results are conflicting.
The herbal remedy Echinacea may reduce the risk of developing colds by about 10-20% but study trials are small, include different species of extract and have given inconsistent results.
Flu vaccine
The flu which can develop into severe pneumonia in older adults is best avoided by getting the flu vaccine. It should be considered in anyone with an underlying chest problem such as chronic bronchitis or who is at increased risk due to conditions like diabetes or heart disease. In addition, it is recommended for all adults aged 65 or older as well as pregnant women, carers and healthcare workers.
In those aged 65 or older as well as other at risk groups, the pneumonia vaccine is also advised. It need only be given once every five years and protects against the most pathogenic strains of pneumococcal pneumonia.
Sore throats are nearly always viral in origin but gargling salty water or aspirin which has anti-inflammatory properties can be soothing. For productive cough, mucolytics can help to break up sputum and clear your upper airway. Regular paracetamol and/or over-the-counter anti-inflammatories (like ibuprofen) are good for fever and pain.
If you have very congested sinuses or a bad runny nose, decongestants can help, but beware as they can cause drowsiness and you can get rebound symptoms when stopped.
The ‘winter vomiting bug’ caused by the Norovirus can strike all year around but is most infectious at this time of year. While we tend to hear about it in the hospital setting, most cases are contracted in the community. Unfortunately, it is highly contagious and gives rise to severe vomiting and diarrhoea though this usually lasts for no more than about two to three days.
It can be transmitted via aerosol but washing hands and avoiding contact where possible with anyone with suspicious symptoms is your best chance of avoiding!
Cold air can exacerbate asthma by causing bronchospasm and wheeze while rain and wind and can blow up allergens. Staying indoor on very cold, windy days or wearing a scarf to cover your nose and mouth when outside may help.
Make sure to carry your inhaler too when out.
In those with poor circulation, cold can cause blood vessels to constrict (to conserve heat) which can lead to painful hands and feet. In addition, in those who have Raynaud’s phenomenon, spasm of small blood vessels in the hands can reduce circulation in the skin and cause a severe throbbing and tingling pain.
Hands typically change colour from white to blue in the cold and then to red on rewarming. Raynaud’s is usually diagnosed by the age of 30 and affects up to 10% of adults. The most practical approach to avoiding symptoms is to wear warm gloves (including those that are battery-heated) and avoid exacerbating factors like smoking and caffeine.
For persistent symptoms, medications can be used.
While rheumatological complaints are more prevalent in the Winter, the cause remains unclear and may relate to alterations in joint fluid viscosity and reduced physical activity increasing stiffness, as well as increased pain perception. Keeping physically active with daily exercise, keeping warm and using heat packs may help.
We might all suffer with ‘winter blues’ at some stage though Seasonal Affective disorder (SAD) is a well-described syndrome characterised by low mood occurring consistently during the autumn/winter period. In particular, unlike a normal depression it is often associated with increased appetite and craving for high carbohydrate foods as well as oversleeping. It appears to be due to changes in light exposure and altered brain levels of melatonin. While only occurring in about 5-10% of the population, symptoms can be severe though it usually responds to light therapy.
In summary, make sure to get your vaccinations, keep warm, try and avoid stress (which is bad for the immune system), eat well and where possible avoid coming into contact with those with viral illness! There may be some merit too in a winter ‘sun holiday’ – at the very least it should boost your vitamin D levels which typically drop by about 30% at this time of year!