Dr Udaya Sureshkumar
Ringing in the New Year and the festivities, means gatherings, new experiences, socializing and of course, parties. And in sneaks a familiar foe - the un-friendly neighbourhood flu! And with it brings the annual rise of what is labelled "the common cold".
80% of the OPD is a trail of patients coughing vigorously, all with a common complaint of unremitting cough, troubling at night and disturbing sleep, and also loss of character of voice. Another phenomenon is vomiting (post cough bouts) and in some cases, even black-outs. So let's understand what goes behind these symptoms.
The usual and main culprit seen in these severe exaggerated symptoms is a virus called Influenza, snd the supporting villains adding to mischief is the weather change. As we all know, there is a drastic change in the temperature and season cycles now, and this unpredictable nature and the sudden switch from hot to cold or vice versa, not only increases these infections (as they survive longer in cold dry air), they also thrive in such conditions. The dry air also leads to lot of microcracks in the nose and airways which acts as a portal of entry for these viruses and impacts the mucous clearance. The weather changes also affects AQI , that is, increased pollution causing smog which traps the so-called causative triggers and prolongs the exposure. Additionally spending more time indoors, in crowded areas having poor ventilation helps it spread easily. In India, spikes are seen in monsoon due to similar reasons.
We need to understand two more points - does this affect everyone similarly and how to differentiate it from common cold. Usually common cold has milder symptoms, develops gradually and has less severity. People with allergies and asthma are more predisposed to these because it acts as trigger to an already hyperreactive breathing tubes. So then why does everyone have a different presentation?
Influenza categorically is of two types - Influenza A and B (C & D are not significant in humans).
Influenza-A is further sub-typed based on the proteins on the surface of virus as:
- H1N1 (famous for being the cause of pandemics like the Spanish flu, swine flu), known to affect young patients more with severe life threatening disease.
- H3N2 seen more in elderly and mutates faster.
- H5N2 also known as avian flu.
Influenza-B rarely causes pandemics, it's seasonal and milder. The newest variant H3N2 subtype K has been reported in a lot of countries currently. There is nothing to be alarmed, as this is a common feature of the viruses, where in, they have the inherent power to change/mutate and mix certain parts to form a different version, when this happens in a small amount, seasonally it results in yearly flu.
In cases where a bigger change/mutation occurs - especially when there are intermediate hosts like animals such as pigs, birds etc. - it causes a bigger & more rapidly spreading infection like a pandemic. So does that mean vaccines are not effective? NO. Vaccines usually contain components of multiple strains and have a protective effect, where in the severity of illness is reduced.
So this flu season - be aware, be protected.
- Take the flu shot before every flu season, that is, before June or before December.
- Always wear a mask in crowded places, also while visiting people who are sick
- Proper handwashing practices and social distance techniques.
- Take good rest.
To conclude, antibiotics are not indicated in a viral infection unless prescribed by a professional. Hence, DO NOT self-medicate and instead visit your doctor. They will prescribe antivirals when indicated in acute febrile phase, inhalers are known to help with the dry hacking cough and neuromodulators to reduce cough hypersensitivity.
(Dr Udaya Sureshkumar is a Consultant Pulmonologist in KMC Hospital, Mangaluru.)