Fighting fit

Give flu the cold shoulder with Dr Lynda Morton’s advice for keeping those pesky germs at bay this winter.

As we head towards Halloween, there is another spectre on the horizon – the onset of seasonal coughs, colds and flu. Generally, there is little to be done apart from keeping yourself hydrated, well rested and taking paracetamol to ease the symptoms. This year, the government is spending even more vaccinating the population against influenza. All primary school children and children between the ages of six months and five years (in Scotland) and all over-65s, along with the most vulnerable groups, will be offered a jab against it. Why are we spending so much on a disease which, at face value, is selflimiting and whose symptoms are readily eased by simple over-the-counter medicines? As soon as the temperature drops and the leaves start falling, the influenza virus rears its head. Although the flu virus can be around all year, it usually starts to increase in number in October and peaks in February and early March. In the UK, somewhere between 600 and 10,000 people die because of the virus every year, despite the vaccination programme. Symptoms appear suddenly and usually start with a high temperature, tiredness and weakness, headache, general aches and pains and a hard, dry cough. Cold symptoms like a sore throat and runny nose or diarrhoea can be mistaken for the flu but are usually not as severe and settle quickly, unlike the flu which can last for up to 14 days and can leave you feeling tired and washed out for weeks after. The complication of secondary infections like pneumonia and cardiac problems are the things that lead to severe illness and even death in those susceptible because of immunosuppression due to illness or disease, or those who have illnesses which make them more vulnerable. Part of the problem is the virus is very crafty and changes so quickly that the body’s immune system is rarely prepared for the next strain that comes along, so each year a new vaccine needs to be created. Why does flu spread so quickly? Perhaps it’s because we spend more time indoors huddled together in our air-conditioned buildings rather than being out in the fresh air, and are in closer contact with people who may be carrying viruses. There’s also a theory that, with less sunlight, we are more likely to be low in vitamin D which our immune system needs to work properly, making us more vulnerable to infection. But it still doesn’t completely explain the predictable annual appearance of the flu. The virus likes cold, dry weather and seems to slow down in warmer, wetter conditions. The mixture of mucous, bugs and cells you sneeze and cough out stay in larger, heavier particles in moist air, falling quickly to the ground rather than floating around and staying active in drier air. Some studies have shown that adding a humidifier to a school or waiting room can reduce an outbreak by up to 30%. And, of course, there is “man flu”. There are many behavioural and physiological differences between men and women which result in differences in how they contract and combat viral illnesses in general. Some studies show that men suffer more than women when it comes to flu and common viral respiratory illnesses, being more likely to contract them and they last longer. Hormonal differences offer women more protection from the brunt of the illness and oestrogen seems to trigger a stronger immune response both to the vaccine and to the actual virus itself as higher testosterone inhibits the overall immune system. So perhaps men are not quite the whining wimps we once thought!

So what can you do to arm yourself for the winter months? The usual general health nags apply. Don’t smoke, keep your weight in check and get a little exercise. Get outside and get a little vitamin D – and wet weather helps to keep the virus in check. Vitamin D is also found in oily fish, mushrooms and eggs, so perhaps there is some value in the cooked Scottish breakfast in winter! If you are eligible for the flu jab, get it. Those with immune-suppressing illnesses or drugs are most at risk, so those with rheumatoid arthritis, diabetes and asthma, for example, are more susceptible to the complications of flu and much more likely to have a bad time with it – so take the vaccine. Good hygiene is important too. If you are around people with coughs, sniffles and flu then keep your distance and wash your hands. The virus can live on surfaces for up to two days, so things like phones, keyboards and door handles need a wipe. Use disposable tissues to cover your mouth and nose when you sneeze and cough. Face masks are a curious thing. In theory, as you are continually breathing a fine mist of other people’s coughs and sneezes, you would think they would help and indeed one study showed that by getting visitors to a hospital to wear them they were 80% less likely to develop flu – but only if they followed good general hygiene rules as well. So maybe those walking around with disposable face masks aren’t so daft after all.

Keep hydrated and take paracetamol for a cold – but take the flu vaccine if it’s offered to you.