Preventing seasonal maladies

A weaker immune system and increased germ exposure make us vulnerable to winter bugs. Here's what you need to know.

Winter is on the way, and along with cold temperatures, the season brings a spectrum of potential health problems for everyone — especially for older adults. That's why it's important to take precautions now, before you get sick.

The cold weather link

Cold weather doesn't cause illness, but it may foster it. "Some studies have found that both cold and flu viruses can multiply and spread more easily in lower temperatures and humidity. Additionally, cold air reduces blood flow to the lining of the nose, throat, and lungs, which may dampen the immune system response," says Dr. Craig Jones, an ear, nose, and throat specialist with Harvard-affiliated Massachusetts Eye and Ear.

But what really triggers so much illness during the winter is increased exposure to germs. "Cold temperatures drive people indoors. If you're in a store with people clustered around and less air circulating, it's easier to catch bugs because everyone's in closer proximity," explains Dr. Suzanne Salamon, a geriatrician with Harvard-affiliated Beth Israel Deaconess Medical Center.

A disadvantage

To make matters worse, older adults are especially susceptible to getting sick. "That's partly because the immune system gets a little weaker as we get older," Dr. Salamon says. "Also, as we get older, we tend to get other conditions, like arthritis, that compete for the attention and energy of the immune system, distracting it from fighting an infection."

What you're up against

There are many kinds of winter illnesses. Here are some of the usual culprits.

The common cold or viral rhinitis can be caused by more than 200 viruses. Symptoms come on gradually and can include a sore throat, nose and sinus congestion, thick and sometimes discolored discharge, a runny nose, sneezing, a cough, or hoarseness.

Sinusitis is an infection that can be caused by cold viruses or bacteria. The sinus lining swells, blocking mucus from draining. Symptoms include pressure, pain (in the cheeks, over the eyes), nasal congestion, thick yellow or green discharge, a diminished sense of smell, fever, headache, and fatigue.

Bronchitis is an inflammation of the lining of the bronchial tubes, the hollow air passages that connect the windpipe to the lungs. Viruses cause most cases of acute (short-term) bronchitis, although bacteria also can cause the condition. Symptoms include tightness in the chest and a cough that produces phlegm.

Pneumonia is inflammation deep in the lungs, affecting the small air sacs and nearby tissue. Both viruses and bacteria can cause the condition. Symptoms include fever, chills, a cough producing phlegm, labored breathing, fatigue, and sometimes pain in the chest when you breathe in deeply. But the symptoms of pneumonia can be more subtle. "Very frequently older people are just confused or very tired, no cough or fever," Dr. Salamon says.

Influenza (flu) is a very contagious and potentially deadly viral illness. Symptoms come on quickly and include fever, cough, sore throat, runny nose, muscle aches, fatigue, and sometimes vomiting and diarrhea.

Stomach bugs are viruses, such as norovirus, which are contagious and cause vomiting and diarrhea for a few days. You can get sick from an infected person or by eating, drinking, or touching something with the virus on it.

COVID is not just a winter virus. COVID is caused by a coronavirus known as SARS CoV-2. It is very contagious and potentially even more deadly than influenza. Symptoms may be mild and similar to symptoms of a common cold. But it can also cause high fever, cough, shortness of breath and loss of smell. 

Prevention

To avoid winter illnesses, you'll have to take extra precautions. Get a flu shot, make sure you've had the pneumococcal vaccine if you're 65 or older, and wash your hands before eating or touching your eyes, nose, or mouth. Consider wearing a mask in crowded places. Carry hand sanitizer when you travel.

Avoid close contact with people who're sick. "For most common illnesses, waiting two weeks after the person became infected is enough time to reduce the risk of catching the infection. For young kids who have the flu, it may be better to wait three weeks after the illness," Dr. Jones says.

On airplanes: "Direct the air vent toward your face, as the air coming from the vent is filtered and will help to deflect any germs away from your nose," Dr. Jones advises.

"And stay away from shared food, like potlucks, during norovirus [winter] season," Dr. Salamon warns.

What if you get sick?

Take symptoms seriously, and report them to your doctor if they're severe or they last a few days. For bacterial illness, such as bacterial pneumonia or sinusitis, you'll need an antibiotic.

For flu, you may be able to shorten its course and avoid serious complications with antiviral medications. But that's only if you begin treatment within two days after symptoms appear.

Otherwise, there's little you can do for the flu or any virus (like a cold) but treat symptoms. How? Take lozenges for a sore throat, over-the-counter painkillers for body aches, and antidiarrheals for diarrhea.

"For nasal congestion, you can use oxymetazoline nose spray [Afrin], but not for longer than three days unless your doctor tells you to, as it can lead to increased nasal congestion beyond that. For excess mucus, use guaifenesin [Mucinex]," Dr. Jones advises.

And for all winter bugs, try to rest and get lots of fluids so you can get better soon.

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