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Healthier in winter. What to do to defend yourself against factors that increase the risk of disease


Cough, sore throat, runny nose, fever… It’s no coincidence that these complaints usually take us back to the coldest season of the year. The risk of respiratory infections, which manifest themselves through these and other symptoms, increases considerably at this time of year. Just as pollens are responsible for a peak incidence of allergic illnesses in the spring months, winter respiratory illnesses at this time of year are mostly infectious.

Many are caused by viruses and bacteria, microorganisms whose development is favored by the cold and humidity. The good news is that both their transmission and our susceptibility to resist them depend, to a large extent, on a healthy lifestyle and the adoption of protective behaviors. Jaime Alvarez de Pina, pulmonologist, explains how to prevent, identify and act against the most common problems at this time of year.

The importance of prevention:
The factors that increase the risk of respiratory infections act in synergy. Besides viruses and bacteria developing more in winter, “it is accepted that cold and damp environments make the respiratory mucosa more susceptible to penetration,” says Jaime Alvarez de Pina, vice president of the Portuguese Lung Foundation. However, as the specialist adds, “it is admitted that the main reason is in the models of life related to the seasons.
“We confine ourselves to the interior of our houses when the winter weather arrives. Now, these spaces provide optimal conditions for the transmission of respiratory infections, which is done by inhalation, from person to person, or through droplets transmitted through the hands”, informs the pulmonologist. “This explains the importance of hygienic measures that hinder the transmission of the virus, but not only”, also adds the renowned specialist.

Preventing the infection also means strengthening the body’s defense system. For that, besides vaccines, considered fundamental weapons, healthy habits are important. “A good immunity requires an adequate diet, with few fats and salt, in addition to regular physical activity and respect for rest periods,” he says. “It is during the night rest that the immune cells recover”, explains the pulmonologist. On the other hand, one must know how to protect the respiratory system, a behavior that is often undervalued by the Portuguese in their daily lives.
“Each day we breathe 6,000 to 10,000 liters of air with particles of pollution, bacteria and viruses capable of causing inflammation and infection. The health of the respiratory system depends on breathing unpolluted air, both indoors and outdoors. Similarly, more aggressive and persistent weather conditions, such as cold, rain, humidity, and wind, can lead to conditions that facilitate infections, which must be avoided,” warns Jaime Alvarez de Pina.

What to do to stop rhinositis:
It is one of the problems that annually affects thousands of people around the world in the coldest times and Portugal is no exception. The word, unknown to many Portuguese, results from the association between the terms rhinitis (an acute or chronic inflammation of the membrane lining the nasal cavities and nasal mucosa) and sinusitis (an inflammation of the sinuses, usually associated with an infectious process caused by viruses, bacteria or fungi).
“While in spring, a patient with pollen allergy may have only an inflammation of the nose [in the case of rhinitis], in winter, the vast majority of the time, the infection of the nose is associated with infection of the sinuses [in the case of sinusitis], which are cavities in the bones of the face that communicate with the nose,” he says. The most common symptoms are a stuffy nose and thick nasal secretions with pus, which is usually yellow, green or even brown.

The list of manifestations also includes headaches and/or pain in the bones of the face, which, like fever, are the most frequent. Also common are a reduction or loss of smell, bad breath, coughing reflex to the nasal secretions running down the pharynx, pain in the ears and in the teeth of the upper jaw, malaise, and fatigue. To defend yourself, you must reduce inflammation, promote proper drainage of nasal secretions, and treat the infection are the goals. To do this:
– Drink fluids, to keep secretions as fluid as possible.
– Flush the nasal passages with saline solutions such as sterile saline and seawater.
– See a doctor if these measures are not enough. You may need to take a nasal mucus thinner, a decongestant, or an antibiotic. This drug can be used to treat the infection for 7 to 14 days in acute sinusitis or up to four weeks in chronic sinusitis.

How to combat pharyngitis, laryngitis, tonsillitis, and otitis:
They affect different anatomical structures, but all belong to the so-called upper airway. “As they are in contact with the outside, they are the first to suffer the impacts of aggression by microorganisms, hence their inflammation or infection is so frequent, especially in children,” explains Jaime Alvarez de Pina. Although the viral origin is the most frequent, often through rhinoviruses, they can also be caused by bacteria, particularly streptococci.

This situation occurs “autonomously or secondarily to the viral infection,” he explains. Inflammation is denoted by a pain that is predominant in otitis, tonsillitis, and pharyngitis. In this case, it occurs mainly when swallowing. Redness, swelling, and changes in function are other signs. In laryngitis, the most typical symptom is hoarseness. In tonsillitis, the infection is visible through the dots or whitish plaques that line the tonsils.

In the face of fever and the severe local symptoms that often arise, namely intense pain, difficulty swallowing and/or hoarseness, you should seek medical attention. “Not least because these situations are sometimes associated with complications that can be life-threatening for patients”, Jaime Alvarez de Pina emphasizes. If it is a bacterial infection, an antibiotic will be prescribed. If it is viral, in most cases the treatment will only be symptomatic.

Steps to take in case of a cold:
A stuffy nose, sneezing, damp eyes, throat irritation and headache are the most common symptoms of the flu. They usually come on gradually. High fever or body aches may rarely occur. “It is an uncomfortable but not very serious condition, and in most cases it resolves spontaneously,” the doctor assures. “Most of the time it’s caused by a virus of low virulence, in which rhinoviruses predominate”, Jaime Alvarez de Pina himself refers.

The cold, a very common health problem at this time of year, affects exclusively the upper respiratory tract, namely the nose, sinuses, pharynx and larynx. To get rid of it, rest and drink plenty of liquids. Besides water and natural juices without sugar, use and abuse of teas and infusions. And avoid smoking and cold. Symptoms tend to disappear spontaneously, but you may have to resort to symptomatic medication.

What to do to stop the flu:
Caused by the influenza virus, this systemic infectious disease is highly contagious and can be fatal. “Every year an average of 1,200 to 1,800 people die in Portugal due to influenza,” recalls Jaime Alvarez de Pina. This pathology is contracted by inhaling particles containing the virus, eliminated through coughing, sneezing, breathing and speaking by sick people. These particles can remain in the air, with infective capacity, for about 34 hours.

Direct hand contact with droplets of infected material also transmits the virus. After an incubation period of one to five days, the signs and symptoms appear abruptly. One of them is a high fever, which can range from 38º C to 40º C. The list also includes chills, chills, sore nose and throat, headaches, muscle and joint pain, general malaise, prostration, and cough, which can be dry or with sputum.
“In addition to general measures such as resting, drinking plenty of fluids, not drinking alcohol, and not smoking, fever should be treated when it is high,” he advises. “Paracetamol should be preferred, because cases of Reye’s syndrome [inflammation in the brain] have been described in children who have used acetylsalicylic acid derivatives. We can also use effective antivirals [ozeltamivir and zanamivir] from the first hours of the infection,” he explains.
If the symptoms traditionally associated with the flu persist, if you have a pre-existing disease, such as diabetes or chronic obstructive pulmonary disease, also known by the acronym COPD, which has decompensated, or if a complication arises, namely pneumonia, one of the most dreaded and which may require hospitalization, you should seek urgent specialized help by going to a hospital, to avoid worsening your health condition.

The symptoms that indicate pneumonia:
It is an infection of the lung that can be caused by bacteria, viruses or fungi, which determines its severity. The most common ones are community-acquired and caused by a bacterium called pneumococcus. The risk is greater for people with diminished defenses. This is the case of the elderly, especially the institutionalized. Smokers, malnourished people, and immunocompromised patients, especially those with HIV/AIDS, should also be vigilant.
People without a spleen, with chronic illnesses, or with other respiratory diseases, require the same care. The classic symptoms are “high fever [39º C to 40º C] that rises abruptly, throbbing [chest pain that worsens with breathing movements], and cough and yellow, green, brown, or rusty-colored sputum,” explains Jaime Alvarez de Pina. “Pneumonias have a very multifaceted clinical expression”, warns the doctor, however.

Its action “depends on its extension and the type of agent” and, “in the elderly, they can manifest themselves in a less typical way, for example, only by behavioral changes or by a fever”, he adds. To combat it, consult a doctor, who should order a chest X-ray to confirm the disease, prescribe antibiotics, and decide, after knowing all the results, whether the treatment should be inpatient or outpatient.


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