How to Beat Winter Bugs
Posted on October 31
The War on Germs
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Tis the Season—According to Jerry Huang, D.O., an osteopathic family practitioner for Kaiser Permanente, the reasons that we get sick more often in winter are multiple. “When the temperature drops, people are cooped up in the house, breathing the same germ-filled air because the window is closed, the room has no ventilation, and the room is also very dry because of the heater. So we have a more concentrated germ population attacking the dry and weakened mucous membranes in our noses and mouths.” In addition, our immune systems are at their lowest in cold temperatures, says Huang, making it more difficult for us to fight off germs. Lastly, some viruses thrive in the cold, but not in the heat.
Staying Healthy, Flu Shot or No
What’s the best way to stay healthy during cold and flu season? Doctors ordinarily would tell you that the influenza (flu) vaccine is a smart place to start—and it’s still considered a priority for those in high-risk groups, including children between 6 and 23 months, adults 65 and older, anyone with a chronic health condition and others. (For complete list, see “Flu Shot Guidelines” on page 137.) But with this year’s flu vaccine supplies cut in half due to a contamination problem, limiting its availability to those who need it most, many of us no longer have the option of a shot, shifting the focus to other forms of prevention.
From frequent hand-washing to getting enough rest, there’s plenty we can do to decrease the odds of catching colds and flus. But first things first: Do you know which is which? “Many people don’t know the difference between colds and flus,” says David Herbert, M.D., an assistant physician-in-chief and infectious disease specialist for Kaiser Permanente. “There is enormous confusion.” Influenza and the common cold are both upper respiratory infections, but the similarity ends there.
When people say they have the “flu,” Herbert says, they’re often referring to any number of viral syndromes, but not influenza. “It could be a cough, it could be a cold, it could be diarrhea, or fever with aches—all of those things are what people commonly refer to as the ‘flu.’ But influenza is a fairly characteristic clinical syndrome.” The flu starts abruptly and hits hard, and typical symptoms include high fever, significant muscle aches, a sore throat and usually a cough. In brief, it feels like you got hit by a truck, “and not just a little motor scooter,” says Herbert. “And if you have only nausea and vomiting, that’s certainly not the flu. That’s another range of viruses.” This confusion, he says, is a major reason why the myth persists that the flu shot causes the flu. “If you don’t understand what the flu is and you get the flu shot, and later get sick, you might think you’ve got the flu when in fact you don’t.”
The classic common cold, on the other hand, begins with a sore throat and progresses to nasal congestion, runny nose, and sometimes a cough. And though some of the symptoms are similar to that of the flu, the most fundamental difference is that colds are not debilitating—flus are. The flu will put you flat on your back, while colds are just flat-out annoying.
And while we certainly wouldn’t want to blame the kiddies, they are, in fact, the major carriers of colds.
“The reservoir for most cold viruses is the upper respiratory tract of young children,” notes Stuart Linné, M.D., an infectious disease specialist and director of infection control at Catholic Healthcare West’s Woodland clinic. Whereas most children have six to eight colds a year, the average adult gets two to three, partly because we become immune to the viruses we’ve already had—meaning the older we get, the fewer colds we can expect. But since we would all rather be entirely cold-free, here are some tips for staying healthy and keeping germs at bay:
• Wash your hands frequently. Boring as it may be, it’s still one of the best ways to stay germ-free. Hand-washing with soap and water removes any virus particles you pick up.
• Use alcohol-based hand sanitizers. “The alcohol-based ones are actually more effective than soap and water, because they kill off more than 99 percent of the germs,” according to Huang. Another plus: They’re convenient, especially those itty-bitty bottles you can easily carry on your person. Alcohol-based sanitizers are preferred to nonalcohol-based antibacterial products, some of which can leave residues that may lead to the development of stronger strains of bacteria.
• Don’t touch your eyes, nose or mouth. This prevents self-infection.
• Stay away from sickies. Quarantine may not be an option, but you can certainly limit your exposure to others who are sick. Huang offers this simple equation: “Think of it as three and three. Typically, the transfer rate is in the first three days. And you want to stay three feet away from that person, because the respiratory droplets they shoot out at you usually won’t go farther than three feet. So stay three feet away from that person for three days.” Hey—it’s worth a try.
• Teach your children well. Children’s hygiene may leave a lot to be desired, but we can at least try to instill healthy habits. “Setting a good example can go a long way,” notes Mark Glatt, D.O., who practices at Kaiser Permanente in Roseville and also serves as the outpatient chief of pharmacy and therapeutics for the North Capital area. “Just remind them to wash their hands, and wash your hands with them.” Reminding kids to cover their mouths when they cough or sneeze is helpful, too—as long as they remember to wash afterward.
• Recruit the coach’s help. “If you go to a soccer game, what do they do at the end of the game?” asks Herbert. “They go down the line and slap hands. So any kid on the team that’s got anything has spread the germ to every other kid. And then what do they do? They go have their snack. Did they wash their hands? Of course not.” Point taken. Coaches can help by directing the team to raise hands and salute “Go, team!” instead of slapping hands together, suggests Herbert. And the “snack parents” can help by bringing along a couple of bottles of hand sanitizers, too.
• Don’t forget the basics. It may seem obvious, but it bears repeating: Eat healthfully, exercise regularly, get enough rest, and drink plenty of fluids (healthful fluids, that is). And don’t smoke. “When it comes down to it, the most basic things are really the most important,” says Huang. Following these principles is especially important at holiday time, when people tend to run themselves ragged, compromising their immune systems and making it extra easy for those germs to drop by and make themselves at home.
Holistic medical practitioners agree with most of the above—except, perhaps, the U.S. Centers for Disease Control and Prevention’s insistence that everyone in high-risk health categories needs a flu shot. “I don’t want to throw the baby out with the bath water where Western medicine is concerned,” says Jeffrey Kauffman, M.D., M.Ac. (U.K.), who uses acupuncture, herbs, vitamins and other holistic applications in his Sacramento and Grass Valley practices. “But I think vaccinations and immunizations cause more problems than they solve.” Children need to experience childhood diseases such as measles, chicken pox and flu, he says, because their immune systems are strengthened with each go-round. In addition to short-circuiting the immune system, he says, many vaccines contain mercury and aluminum, which some researchers have linked to autism.
If you stay healthy, Kauffman argues, you won’t need the flu vaccine. “It’s better to support your immune system—to do whatever you can to make your immune system strong.” By eating healthful (preferably organic) foods, taking appropriate vitamins, supplements and herbs, exercising regularly, and getting enough rest, Kauffman says, you will empower yourself to stay healthy, holiday season or no.
Reducing stress is especially important, he adds, recommending 20 minutes or more of daily meditation.
“Meditation is one of the best ways to neutralize stress,” he says. “You want to keep your stress minimal to zero.”
Believing you’ll stay healthy also is a powerful tool for staying healthy, says Kauffman, who says he rarely gets colds. “Your thoughts create your reality,” he says—a principle he applies to life in general, not just colds and flus. “If you believe that germs are around, and you believe you can catch them, you will—or at least you’ll be much more likely to catch them. But if you believe you’re impenetrable, if you believe that your immune system is strong and that it will take care of you, you won’t get sick.”
Sherman Luo, a Bejing-trained physician and acupuncturist in Citrus Heights, sums it up in just a few words.
“The Chinese medical view is very simple. If the healing energy is sufficient enough, germs won’t cause disease.”
When We Get Sick
OK, so you’ve tried all of the above and you’ve still come down with a nasty winter bug. Is there anything to do but stay home, rest up and let it run its course?
Sorry to say, not much.
“Other than doing the basic things—resting, drinking plenty of fluids—there’s not a whole lot to do except to treat the symptoms,” says Huang. Mostly, that means taking ibuprofen for body aches and fever, sucking on throat lozenges and gargling with warm salt water.
“People recover from colds even if they don’t take anything,” adds Glatt, “so my role is usually to advise them what things are beneficial and what may be harmful.” Nasal decongestants, for example, should only be used for three days at a time, he says. But he does recommend saline nasal spray if there’s a lot of mucus.
Over-the-counter cough syrups draw a negative response from both traditional and holistic doctors. “Studies show they offer no additional benefit,” says Glatt. Naturopathic physician Nick Dordevic, who practices in Carmichael, had more to say. “The worst thing patients can do is use those cough syrups,” he says. By suppressing symptoms, cough syrups can prolong the illness, he explains, which gets in the way of the body’s natural healing process. “It’s very important to just let it go and drink a lot of liquids,” advises Dordevic.â¨Although antiviral medications for influenza are available, they don’t make practical sense for most patients, says Herbert. “These drugs don’t work at all unless you take them within the first day and a half of getting sick,” he explains, “and during the first day or two, most people think they’re just coming down with a cold, so they’re not likely to seek treatment.” Even when the medications are properly used, he says, they only serve to reduce illness by a day or two, at best.
On the other hand, as Huang points out, “If it cuts back your symptoms from 10 days to nine days, that one day can be huge.”
While antivirals may work for some, antibiotics are another matter. “There’s really no point in taking antibiotics for most colds and flus,” says Glatt. “Ninety-nine percent of infections are viral, and antibiotics don’t treat viral infections.” Nor do antibiotics prevent bacterial infections, he notes. In addition, taking antibiotics when they are not needed may lead to the larger problem of creating stronger germs. But if a patient’s symptoms worsen significantly—especially if they’re localized, such as severe ear or sinus pain—it’s a good idea to see a doctor to rule out infection.
While this is a good rule of thumb, such guidelines have limited use, says Stuart Cohen, M.D., professor of medicine in the division of infectious diseases at UC Davis Medical Center. “I believe greatly in common sense,” he says. “If somebody says, ‘I just don’t feel right,’ then I think that’s a legitimate reason to see a physician,” he says. “If you think you need to see a doctor, you’re probably right.”
Flu Shot: Who Should Get One?
There are more than 36,000 influenza-related deaths in the United States every year, according to the Centers for Disease Control and Prevention, and some 200,000 people are hospitalized with complications. This year, with the nation’s flu vaccine supply cut in half, the CDC asked all health care providers to limit giving the shot to those in the following high-risk categories:
• Adults, 65 and older
• Children, 6 to 23 months
• Anyone 2 to 64 years old with a chronic health condition, such as asthma or heart disease
• Pregnant women
• Nursing home and long-term care facility residents
• Children on chronic aspirin therapy
• Health care workers with direct patient contact
• Out-of-home caregivers
• People who live with children younger than 6 months old
Note: Those who are allergic to eggs should not have the flu shot.
For information on getting a flu shot, contact your health care provider or call Sacramento County’s Immunization Assistance Program at (916) 875-SHOT (7468). If you’re a veteran enrolled in the Northern California Health Care System, call (800) 382-8387 or (866) 600-8279. For a list of public clinics, call Sutter VNA at (800) 500-2400.
Alternative Approaches: Advice From Holistic Experts
Linus Pauling tirelessly touted vitamin C. Others swear by echinacea. Can we believe the hype? In the world of alternative medicine, where data is often mixed or insubstantial, it’s hard to say. But we can say this: Used properly, holistic remedies are generally safe—and there’s a lot to be said for doing things the natural way.
Here are some recommendations from local medical practitioners, with an important caveat: For best results, start treatment at the earliest onset of cold or flu symptoms. And, of course, check with your health care provider.
Vitamin C: While it may not prevent or cure the common cold, studies have shown that vitamin C may decrease the severity or duration of colds by increasing the body’s resistance to infection. “It’s an antioxidant,” explains Donna Schwontkowski, D.C., a nutritionist and retired chiropractic physician in Sacramento. “Antioxidants work in the body against germs, because they’re able to quench the free radicals that are produced from the microbes.” Be careful not to overdo it, though: In high doses, vitamin C can lead to gastrointestinal distress.
Vitamins A and E: These also are antioxidants, explains Schwontkowski, adding that anyone who substantially increases vitamin C intake also should increase intake of vitamins A and E. “Balancing the vitamins gives it a synergistic effect, which helps you to wipe out sickness quicker,” she explains.
Selenium: Taken along with vitamins C and E, the antioxidant selenium is said to enhance the effects of vitamin C.
Echinacea: “Echinacea is one of the strongest herbs for boosting the immune system,” says Jeffrey Kauffman, M.D., M.Ac. (U.K.), an acupuncturist and doctor of holistic medicine. Indeed, echinacea’s popularity has boomed in recent years, and not just in the alternative world: Even American Family Physician reported in 2003 “a modest positive effect” when echinacea was used to treat upper respiratory infections. But don’t get carried away: Regular use of echinacea can reduce its effectiveness. Most health care professionals suggest using it at the earliest sign of cold or infection, and continuing usage only as long as symptoms persist.
Goldenseal: Some herbalists, including naturopathic physician Nick Dordevic of Carmichael, use goldenseal in conjunction with echinacea. “Both of these herbs can be useful for reducing mucus,” he says, recommending the tincture (liquid) form instead of tablets. “It gets into the bloodstream faster,” he explains.
Zinc lozenges: Some studies show that the mineral zinc, dissolved slowly in the mouth, may decrease the duration of the common cold as much as 50 percent. Dordevic is a particular fan of zinc lozenges, especially used alongside vitamins A, C, E and selenium. “This combination works well in reducing inflammation and other cold symptoms,” he says.
Cat’s claw: Also known as una de gato or Uncaria tomentosa, the Peruvian herb cat’s claw helps to put germ-fighting white blood cells into action, says Schwontkowski. “Research shows that it increases white blood cell count and their activity by 33 and 34 percent within two hours,” she says.
Garlic: Good ol’ garlic has been shown to kill several types of bacteria and viruses and to boost immunity. “Garlic makes a lot of difference to one’s health,” says Dordevic. “I’ve been using it for 20 or 25 years.” Schwontkowski uses garlic, radishes, celery, onions and a hot chile pepper in what she calls her “anti-plague” juice—something she concocts as part of her health and wellness classes at the Learning Exchange. Some students who showed up with colds, flus or sinus problems found their symptoms had cleared up after drinking the juice, she says.
A modified fast: Many alternative doctors suggest a high-liquid diet at the first sign of a cold or flu. The reasoning is that a body busy with digestion might have less energy for fighting off germs. “Lots of water, juices and herbal teas can help to keep the body temperature down and to flush out the system,” notes Dordevic.
Meditation: The basics of meditation can be learned in five minutes, say most experts, and as Kauffman says, it’s one of the best ways to reduce stress and keep the immune system strong. Local classes are available at the Siddha Yoga Meditation Center, 1250 Sutterville Road (916-452-6708), where Kauffman himself will teach a class beginning in February, “Meditation for an Awakened Life.” Beginners may also want to check out Meditation for Dummies, written by Stephan Bodian, the former editor-in-chief of Yoga Journal.
Positive thinking: As Kauffman points out, the mind-body connection cannot be overemphasized. “Your thoughts create your reality,” he says, recommending Wayne Dyer’s latest book, The Power of Intention, for those who want to read more on the subject. “Even the term ‘catching a cold’ implies you’re standing there with a baseball mitt, doing your best to catch the cold as it whizzes by.” If you want to avoid colds, flus and other diseases, he says, you have to believe that your immune system is strong—and don’t even think about catching them: Let them sail on by.