Every year in the winter the so-called "seasonal illnesses" begin to circulate: sometimes in a more aggressive form, sometimes less, they never miss the appointment. The media regularly provide full details on the difference between flu and cold, viruses and bacteria, antibiotics, antipyretics and so on, but these are notions that are almost always perceived as theoretical: at the showdown, when one gets sick and even more when a child becomes ill, it is the concrete aspects that leave doubt about how to move and sometimes create concern.
What are the risks of the flu and what are the symptoms that should not be underestimated? The blow could be a cause?
At the first signs of flu, "do-it-yourself" methods are often used, taking over-the-counter medications such as antipyretics and cough syrups. When is it necessary to go to the doctor for a visit?
What remedies can we use? Antibiotics: yes or no? In which cases is the aerosol effective?
What are the main precautions to be taken to avoid the flu?
Is the flu vaccine a weapon in the prevention of seasonal influenza?
To answer these and many other questions, we have chosen to rely on professionalism and courtesy of the Dr. Ilaria Saredi, specialist in General Medicine in Dubai gathering his explanations and his advice in paragraphs of immediate consultation.
Here's what Dr. Saredi told us:
THE RISKS OF INFLUENCE - Most people affected by the flu heal spontaneously after a couple of days or usually within two weeks.
Influenza complications can be moderate, such as sinusitis, otitis, asthma, or more severe as pneumonia - due to influenza virus or other viruses / bacteria while weakened by influenza. There pneumonia it can be particularly dangerous for groups at risk of complications. The consequences of infection can be severe, and inflammation can affect the heart (myocarditis), the brain (encephalitis) and the muscles. In more severe cases, multi-organ failure may occur, including renal and respiratory failure, leading to sepsis (an infection in the blood).
RED FLAGS - A fever (temperature over 38 ยฐ C) that persists for more than 48-72 hours should always motivate a visit to the doctor. In particular, it is urgent to contact your doctor in the presence of the symptoms listed below.
In children:
- accelerated breathing or breathing difficulties
- blue color of the skin
- Inability to drink enough
- excessive drowsiness or minimal interaction
- irritable children that will not accept to be held
- improvement of the initial flu symptoms followed by a worsening of fever and cough
- fever with rash
- inability to eat
- absence of tears during crying
- less wet diapers than usual
In adults:
- difficulty breathing or feeling short of breath
- chest or abdominal pain
- sudden dizziness
- confusion
- persistent vomiting
- improvement of the initial flu symptoms followed by a worsening of fever and cough
In general, but especially in children (who are not always able to explain how they feel), the sixth sense (or common sense) of parents always prevails over the presence or absence of the symptoms mentioned above.
THE BLOW OF AIR
There is a partial truth in the belief that cold weather makes you sick. Although cold, flu and other seasonal illnesses are undoubtedly due to viruses, along with other bacterial diseases,ย some studies have shown that cold temperatures could lower defensesand therefore make us more susceptible to microbes and falling ill with them. Our body comes into contact with thousands of germs every day, but we do not always get infected by them. The immune system is able to fight these daily attacks. If, for reasons of stress, fatigue, certain deficiencies or other reasons (such as cold weather) the immune system is lowered, we become more susceptible to microbes.ย
Moreover, the cold seems to paralyze those small "brushes" (the mucociliary system) that are in our respiratory system and that help to trap in the mucus and sweep away the germs. Paralyzing this defense, the germs would have the possibility of passing one of our body's defenses.
It must be highlighted however, that respiratory viruses and bacteria are also present in warm environments, is the air conditioning can cause important outbreaks if not cleaned and regular maintenance not undertaken.
OVER THE COUNTER DRUGS
Over-the-counter medication is certainly useful for first self-medication: however, we also risk spending a lot to try "fashionable" and "natural" therapies without having much result.ย
antipyretic: paracetamol and ibuprofen are also analgesic, that is to say they help to reduce pain (muscular, for example, sore throat) and fever. However, it is advisable to always start with paracetamol at the correct dosage (for adults it is 1 gram every 6 hours, regardless of meals). The ibuprofen should be used only if the fever does not go down with paracetamol, also because of the most important side effects compared to paracetamol. A good rule is to consult the doctor after the second day of fever (or earlier in the case of infants or young children).
Cough syrups: it is important to characterize the cough, whether it is a fat cough (with mucus present) or a dry cough, and to adjust the choice on a mucolytic or a cough sedative later. I would always recommend contacting a doctor in case of fever and cough together because more targeted therapies may be needed.
Multi-medicated patients (with various medicines amongst the daily treatments of chronic diseases), children and pregnant women should always ask their doctor for advice before self-medication. A visit to the doctor allows you to diagnose and treat the disease effectively and precisely instead of wasting time and money in self-care, which can also be harmful to the fetus if taken in pregnancy, or be too high a dosage for the pediatric population.
Pregnant patients and cardiac patients should be careful with the various "flu and cold" preparations available in pharmacies, as these often contain decongestant vasoconstrictors that should not be used. It is better to ask your doctor for advice and to have medicines that are safe for your health, and in the meantime use simple remedies. Pregnant women should not take ibuprofen or other non-steroidal anti-inflammatory drugs. In case of pregnancy and presence of fever or pain, it is possible to take Paracetamol at the appropriate dosage (adult: 1 gram every 6 hours). It is important to note that a fever in pregnancy must motivate an immediate consultation with your doctor.
THE MEDICAL EXAMINATION
During the course of the visit, the doctor will gather information on the current disease episode and may ask questions about the therapies used so far. It always continues with an accurate clinical examination, using the otoscope to examine the ears, lowers tongue (or cold spoon!) To check the oral cavity and pharyngeal, palpation of cervical lymph nodes, paranasal sinus examination, in addition to an examination of heart and lungs. If the initial clinical examination shows doubtful or troubling signs, other tests such as the pharyngeal swab, the Rapid Streptococcal Test (a bacterium frequently called into the tonsillitis), the nasopharyngeal swab for the flu, may be used. up to blood tests or chest x-ray if deemed necessary to define the diagnosis and modify the therapy.ย
ANTIBIOTICS - Antibiotics should only be prescribed if there is a bacterial infection. By definition, antibiotics are useful only against bacteria, and not against viruses. Seasonal illnesses are often due to viruses, it is better not to start antibiotic therapy at home without first consulting your doctor. Antibiotic therapy must be targeted against the suspected bacterium, which may vary depending on the location of the infection. Antibiotic therapy must always be followed until the end to avoid creating strains of resistant bacteria that are difficult to treat in the future.
For viral infections there are anti-viral drugs (eg Oseltamivir), but they are to be used only under the indication of the doctor in case of overt flu, and only useful if taken within 48 hours from the onset of symptoms.
AEROSOL - In the medical terminology the English term of compliance is common to define the act of following the medical advice in a diligent manner by the patient. Although the aerosol is loved by many, compliance for this type of therapy (for reasons of time and preparation required, sometimes the smell and the difficulty in keeping the little ones still) is not always optimal. The best therapy is always to choose based on the pathology, age and clinical examination of the patient, without forgetting the probability of adherence to therapy.
The nebulizer is useless, for example, in the case of:
- rhinopharyngitis (cold)
- pharyngitis
- tonsillitis
- acute otitis media.
Aerosol is effective in case of:
- asthmatic bronchitis
- laryngitis
- bronchiolitis (especially in children)
because they can transport the drug in the lower airways such as lungs, bronchi and trachea.
Patients should be aware of the (undoubtedly faster) possibility of using valved holding chambers for inhalers. After an initial explanation by the doctor, these are a useful weapon for those who cannot sit still 10 minutes in front of the nebulizer. In this case it is essential to consult a doctor to understand what the disease is and consequently which therapy is the most suitable before taking DIY medication. When the upper airways are full of phlegm, the nebulizer is only useful to hydrate the airways. We generally recommend nasal washes with physiological solution (5ml-10ml in each nostril) to reduce the accumulation of mucus and avoid its colonization by bacteria. Viral infections often cause an overgrowth of mucus that can stagnate in the upper airways, paranasal sinuses and the Eustachian tubes and then be colonized by bacteria that cause other infections such as sinusitis and otitis.
The use of cortisones by inhalation (aerosol) in children in upper respiratory tract infections has not shown benefit compared to the use of the physiological solution alone in the case of diseases of the upper respiratory tract (different is the case in bronchospasm for example); therefore it is advised not to use it except under medical advice. In addition, cortisones may give rise to oral candidiasis problems that are not always indicated.
PREVENTION
In case of prolonged contact with a person affected by the flu, and particularly if you belong to a category at risk of complications from influenza, you should discuss an anti-influenza prophylaxis with anti-viral drugs with your doctor.ย The best prevention, however, remains the flu vaccineย done in advance of the winter season.ย
THE INFLUENZA VACCINE - Influenza vaccination is a very important weapon in the prevention of seasonal influenza. A new vaccine is developed each year on the basis of the viruses most involved in the previous year. With vaccination, we protect against the most probable influenza virus strains each year, limiting the appearance of complications of influenza.
Some studies have shown a potential reduction of 60% of visits to the doctor in vaccinated patients, as well as a reduction in hospital admissions of about 74% in children.
Vaccination is strongly recommended for:
- People over the age of 65
- People with cardiovascular, pulmonary, renal, neurological, haematological or chronic diseases such as diabetes or in treatment for cancer
- Immuno-compromised people (from drugs, HIV)
- Children under 5 years
- Women who are pregnant or will be pregnant during flu season
- Workers in the health sector, schools, and kindergartens
- Residents in nursing homes
- Obese patients
These recommendations are based on the principle of protecting people with a weaker immune system, as they are at a greater risk of complications from influenza (such as pneumonia, febrile convulsions, premature birth to name a few). Children under the age of one are more at risk of hospitalization if affected by the flu.
When to get vaccinated? Vaccination is possible from 6 months of age, and is usually given in two doses (after 4 weeks) up to 8 years if this is the first time the flu vaccine is taken. Otherwise, only one annual dose will be made.
The vaccineโs effect starts approximately 2-3 weeks after inoculation, therefore it is advisable to get vaccinated by the end of October to allow a good protection in the months between November and February. If you are late it is still worth vaccinating to protect yourself from any late outbreaks in the season.
THE PRECAUTIONS
As with many other diseases, seasonal illnesses (due to respiratory viruses or bacteria) are transmitted by tiny dropletsย Flugge, or tiny droplets emitted at every sneeze or cough. The "hand in front of the mouth" is therefore always valid as it is now modified in "elbow in front of the mouth", to avoid spreading the microbes with the hands if it is not immediately possible to wash them. The use ofย alcoholic hand solutions or frequent hand washingย remains the first useful advice to follow in the winter months (and not only) in order to avoid the spreading of infections transmitted by contact.ย
Ventilation of any closed environment should be performed daily in case of sick people at home, and care should be taken to not share glasses, bottles or other personal objects to prevent the transmission of microbes.
Finally, sick people should rest at home and avoid attending nurseries, schools, workplaces where they risk contaminating other people.
PRACTICAL REMEDIES
During colds, coughs and diseases of the respiratory tract it is always a good idea to use a few simple remedies, for example:
- increase hydration
- use the sterile saline solution for nasal hygiene and eliminate excess mucus
- humidify the environment (and consequently the airways)
- maintain a correct temperature at home (about 20 *C without exaggerating with heating)
- use only disposable tissues to avoid spreading the infection.
We thank Dr. Saredi for the valuable advice and clarity of her explanations. Let's keep away from the do-it-yourself and in case of doubt always resort to the opinion of your doctor without hesitating: better safe than sorry!
Article by Marilena Falcone published on Health online.ย
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