By Dr David Delvin

It’s a fact of life that during the colder part of the year, the more senior members of society are likely to develop various ‘winter ailments’ - mostly caused by germs.

Why does this happen?

Well, it’s partly because exposure to cold weather lowers your defences against viruses. When the temperature goes down towards freezing, your nose starts losing its ability to repel these little ‘bugs.’ So they cheerfully make their way in!

Also, people tend to crowd together more in winter – particularly in buses, trains and shops. Regrettably, a lot of them are likely to cough or sneeze all over you. Result: you pick up an infection.

In this article, I’ll be looking at the common winter illnesses and how to avoid them – and also how to treat them.

I’ll be dealing with:

• Colds
• Sore throats
• Coughs
• Sinusitis
• ’Flu

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COLDS

The average person gets about two colds a year, but in Britain some over-50s may get several of them in the course of one winter.

Unfortunately, a cold does NOT give you immunity against further infections. This is because there are over 100 different ‘common cold viruses’ – and getting one of them doesn’t give you protection against all the rest. So if you’re unlucky, you could catch two colds in quick succession.  

Symptoms Of course, you know the symptoms of a cold very well: runny nose, sneezing, itchy eyes and being bunged up. And very often, you feel miserable!

Treatment There’s an old medical saying: ‘A treated cold lasts a week – but an untreated one lasts seven days.’

In other words, there’s no CURE for the common cold. But you can ease the symptoms a lot by using things like:

• Steam inhalations;
• Aspirin;
• Paracetamol;
• Ibuprofen;

Your local pharmacy will be pleased to sell you proprietary remedies, many of which do in fact contain aspirin, paracetamol or ibuprofen.

Penicillin and other antibiotics have no – repeat NO – effect on colds. This is because antibiotics only kill BACTERIA – not VIRUSES. So there’s no point in going to your doctor for treatment of a cold.

Some people swear by vitamin C, and there’s no harm in trying it, but latest research suggests that it probably doesn’t have any genuine effect, though if it’s taken as soon as symptoms occur, it MAY shorten the duration of the cold.

Zinc was very much in fashion as a cold remedy during the 80’s and 90’s, but there has been no real scientific proof that it works, and so it seems a bit less popular now.

One final tip of my own: I have found that in a lot of people who are badly ‘bunged up,’ the symptoms can be alleviated by washing the nose out with a solution made up of half a teaspoon of bicarbonate of soda to a litre of (comfortably warm) water. Any health professional can show you how to do this.

Prevention The one sure way of avoiding colds is to keep away from other people. You can’t catch a common cold unless there’s somebody to give it to you. That’s why solo Arctic explorers never get colds!

Of course, in everyday life you can’t really keep away from everybody else, can you? But during winter, it’s a good idea to steer clear of crowded trains, tubes and buses – and (most especially) doctor’s waiting rooms! From December to April, these waiting areas are packed full of people with infections, and some of them are hell-bent on coughing and spluttering over YOU …

Will face masks prevent you catching a cold? Possibly. A small number of British people have now adopted the Japanese habit of wearing masks while commuting or sitting in crowded places. Less dramatically, wrapping a scarf round your nose and mouth isn’t a bad idea.

Also, you should avoid touching SURFACES that people with colds may have touched. Research shows that the virus often lies around on banisters, door-knobs or desks, and then gets onto people’s hands. If you then raise the hand to your nose or your eye – bingo! – you’ve caught the germ.

Does vitamin C act as a preventative? Again, the scientific evidence is lacking, but recent research has suggested that people who are undergoing great physical stress – like marathon runners – get fewer colds if they take daily ‘Vit C.’

What about preventative vaccines? If you’re over 50, you may remember that back in the 1960s a lot of doctors were dishing out a so-called ‘cold vaccine’ injection. This proved to be absolutely useless, I’m afraid, so its use has long been abandoned.

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SORE THROATS

Sore throats are spread around in much the same way as colds – in other words, by people coughing, sneezing and spluttering, especially when they don’t use a hanky!

Various germs can be responsible, some of them fairly trivial viruses, but some of them rather more serious, like the streptococcus which causes the famous ‘strep throat’ – which American patients often claim that they have.

Smoking is frequently a major factor in causing sore throats, since the delicate membranes of the back of the throat weren’t built to have cigarette smoke drawn across them.

Symptoms You can get varying degrees of soreness, ranging from an uncomfortable tickle to a really bad pain. You can also have difficulty in swallowing, and if this occurs you should always get a health professional to look at your throat – in case you have developed a quinsy (a type of throat abscess) or tonsillitis.

Treatment If you’re a smoker, stop. Buy yourself some soothing preparation from your pharmacy. Useful ones include:

• Beechams Throat-Plus;
• Bradosol;
• Dequadin;
• Lemsip Sore Throat Lozenges;
• Meggezones;
• Mentholatum;
• Strepsils;
• Tyrosets.

I advise you NOT to buy sore throat remedies containing local anaesthetic, which are widely employed in France, though rather less commonly used in Britain. They numb the throat, but can sometimes cause a nasty sensitivity reaction.

Do you need antibiotics?  Well, most sore throats do not respond to penicillin or other ‘ABs’. But if your symptoms go on for more than a week, see your doc and she will tell you whether any antibiotic medication is needed.

Prevention To avoid sore throats, the principles are the same as we’ve mentioned for colds. Avoid crowded, enclosed places, and do not smoke.

Also, if your job involves using your VOICE a lot, give it adequate periods of rest!

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COUGHS

Unlike colds and sore throats, coughs can be due to all sorts of different causes. For example, you can get a cough because of problems in:

• The upper respiratory passages;
• The lower respiratory passages;
• The lungs;
• Very occasionally, the heart.

Also, some coughs are caused by medication – particularly certain pills for high blood pressure.

In winter, many coughs are due to infections in the UPPER part of the respiratory tract – that is, behind the nose. Mucky stuff drips down the back of the throat and irritates the larynx (voice box). Result: a troublesome, irritant hacking cough.

A lot of winter coughs are due to infections in the LOWER respiratory tract – like bronchitis or even sometimes pneumonia.

A few are due to heart problems. And in smokers, there is always the worry that a cough that just won’t go away could be due to lung cancer (see below).

Symptoms   Coughs are either non-productive (that is, dry) or productive (i.e. making you bring up sputum). Chemists will generally ask you WHICH of these two types of cough you have before recommending a medication.

Some coughs cause a lot of pain in the chest, and where this happens you should consult a doctor. If you cough up any BLOOD, you definitely must see your GP within a few days – just in case there is anything serious wrong.

Treatment   Most coughs get better on their own, within a week or so. Medication from the chemist will make the cough more bearable.  They tend to offer either soothing cough linctuses or cough suppressants.

Some of their products are described as ‘expectorants,’ but in reality it is very doubtful whether any medicine can make you ‘expectorate’ (that is spit stuff up!).

When should you go to the doctor for treatment?  I feel you should consult your GP if a cough drags on for 10 days, or if it is causing you pain or distress, or if you are bringing up a lot of green or yellow phlegm – this usually indicates bacterial infection.

Depending on what she finds when she examines you, your doc may prescribe antibiotics. But if she thinks that it’s just a viral infection (which wouldn’t respond to ‘ABs’) then she won’t.

Prevention Don’t smoke. And stay away from people who are coughing or sneezing!

IMPORTANT NOTE: IF YOU’RE A SMOKER AND YOU HAVE A COUGH WHICH GOES ON FOR WEEKS AND WEEKS, YOU REALLY MUST GO TO YOUR DOCTOR FOR EXAMINATION, TREATMENT AND INVESTIGATION (SUCH AS AN X-RAY).

To be utterly frank, this is because of the risk that the cough is caused by lung cancer.

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SINUSITIS

Sinusitis is really common, especially between December and April. It’s an inflammation of the sinuses – which are the little air cavities located inside the bones of the face. All of these air spaces are connected with your nose – which is why germs can easily get into them and cause inflammation.

Symptoms Sinusitis causes pain in the face or forehead, a badly blocked-up feeling, and often fever and sensations of giddiness. Sufferers frequently complain that they feel absolutely awful.  

Treatment  If you think you’ve got sinusitis, begin by dosing yourself with aspirin or paracetamol, plus a ‘decongestant’ (i.e. de-bunger upper) from your chemist, such as Contac 400. Inhaling steam or Karvol Drops may be helpful.

But if the symptoms persist for a few days, you will need to go to your general practitioner.

These days, many GPs are quite rightly trying to cut down on antibiotic prescribing – so your doc may well be reluctant to start you on ‘ABs,’ and might want you to continue on pain-killers and decongestants. However, I personally treat sinusitis with antibiotics and decongestant nose drops.

Prevention This is difficult. If you’re prone to sinusitis, try to avoid crowded, germ-ridden places! At the first hint of an attack, use a good decongestant. If you know how to wash your nasal passages out with saline or a bicarb solution (see above), then do it.

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INFLUENZA

’Flu comes around every winter – but it’s far worse in some years than in others. It usually causes somewhere around 12,000 deaths per winter – and it’s important to realize that the majority of these fatalities are in the over-50s. So you need to take care and protect yourself!

What about influenza pandemics (that is, really widespread epidemics), like the notorious Spanish ’flu of 1919 which devastated Europe and America? Well, we haven’t had a really bad pandemic for several decades now, so one may be due fairly soon!

And it could possibly be the avian (bird  ’flu) type – though this depends entirely on whether the virus that kills birds manages to change its nature, so that it can spread like wildfire among humans.

That could happen, though we must hope it doesn’t. The UK Government’s Chief Medical Officer has recently said that a bad outbreak of influenza could kill 750,000 people. Clearly, we have to be prepared.

Symptoms The symptoms of ‘’flu are generally like those of a cold – only much, much worse.

Features usually include:

• Headache
• Sneezing
• Runny nose
• Aching all over
• High temperature
• Cough
• Feeling absolutely terrible – usually so bad that you can scarcely get out of bed.

In some types of influenza, you also get ‘tummy symptoms’ – like abdominal pain, diarrhoea and vomiting.  This is often referred to as ‘gastric   ’flu.’

Treatment If you get ’flu, stay at home and GO TO BED. Do not even think of trying to travel to work, because you will only spread the germ around. Drink plenty of fluids, and use paracetamol, aspirin or ibuprofen.

If you’re feeling really rough, ring your doctor’s surgery for advice, and tell them your symptoms. Because influenza is caused by a virus (and is therefore unaffected by antibiotics), GPs do not routinely give penicillin or other ‘ABs.’

However, if the doctor thinks you have developed a ‘secondary’ bacterial infection as a result of the ’flu – and that is common – she WILL give you an antibiotic.

There are also several uncommonly-used anti-viral drugs, including Tamiflu and Relenza. It is reported that the British Government has stockpiled enough doses of anti-virals to treat half the population in the event of a pandemic.

Prevention  Everybody over 65 (and a lot of people with chronic health problems) should make sure that they have the ’flu jab each year.

Recently, some researchers have cast doubt on the value of this vaccine – but the overwhelming majority of doctors believe in it. I’ve had one myself!

If the AVIAN (bird) ’flu ever arrives in Britain and starts killing human beings on a massive scale, then:

• Stay indoors;
• If you really have to meet other people, wear a mask;
• Take an anti-viral medication, if and when your doctor advises it.

You should also lay in supplies of food – since the economy of the country would probably be disrupted for several weeks, and shortages would be bound to occur!

Let’s hope it doesn’t happen!

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