Prevention against Acute Respiratory Infections

This winter is not only accompanied by an upsurge in new coronavirus infections, but also by the traditional acute respiratory infections and influenza, which are very difficult to distinguish from covid-19. Personal physician and internist MUDr. Hana Sýkorová explained what the best prevention is and why these diseases should not be underestimated...

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Winter is the season of frequent occurrences of acute respiratory infections (ARI). What causes them?
Most often, they are viral diseases. The causative agents can be, for example, rhinoviruses, adenoviruses, RS viruses, parainfluenza virus, influenza virus and now covid-19. Less often, it is bacterial or other agents. Symptoms of upper respiratory tract disease (e.g. rhinitis, sinusitis, otitis media, nasopharyngitis, tonsillitis and laryngitis) or lower respiratory tract disease (tracheitis, bronchitis, pneumonia or pleurisy) make themselves manifest. The most common symptoms are a runny nose, cough, sore throat or “bronchial” pain, increased temperature, headache, joint or muscle pain, general fatigue, and may include lack of appetite or digestive problems.

Are any groups of people particularly at risk of these infections?
In general, children are significantly more likely to be ill. However, they usually have an uncomplicated, mild course. People aged 60 to 65 and those with chronic diseases, such as diabetics, cardiac patients, people with chronic lung disease or immune disorders, cancer patients, obese people, etc., are particularly at risk of health complications.

What advice would you recommend for prevention?
Let me remind you of the well-known facts – a diet rich in vitamins with a sufficient intake of fruit and vegetables, exposure to fresh air, building your constitution and regular physical activity. Especially for children, it is important to adapt clothing to the weather. And because infections are not only transmitted through the “air” but more often through contact with contaminated objects, it is important to wash or disinfect hands frequently and not to touch your face, nose or eyes. It is advisable to avoid areas with large concentrations of people, especially poorly ventilated areas. The idea of wearing respirators and respirators is well known. Sick people should maintain personal isolation, i.e. not going to work, etc. Of course, this also applies to children. Vaccination against selected diseases – influenza, pneumococcus, whooping cough and, of course, against covid-19 – is recommended, especially for people at risk.

What vitamin preparations or food supplements are useful in prevention?
Generally vitamins C and D. Of the minerals, selenium and zinc have a positive effect on immunity. I would also recommend, for example, preparations containing so-called beta-glucans.

And what medicines for the treatment of winter respiratory diseases are useful to add to the medicine cabinet?
It is good to have medicines at home to reduce the symptoms of a cold, i.e. drops or nasal sprays to reduce nasal secretions, sea water or Vincentka are also suitable. Of course, sore throat preparations that are both topical disinfectants and pain relievers are useful, whether in the form of lozenges, sprays or preparations for gargling. It is also important to have medicines to relieve a dry irritating cough as well as medicines to facilitate expectorating. Paralen and Ibuprofen are useful for reducing temperature and controlling pain. Herbal preparations such as linden tea or plantain syrup can be helpful.

If an ARI has already taken hold, is it enough to rest and take medicines from the medicine cabinet, or is it better to seek medical care? What symptoms should I pay special attention to?
Most acute respiratory infections tend to be viral in origin, so antibiotic treatment is not usually necessary. In most cases, it is sufficient to treat them with rest and symptomatic treatment without the need to see a doctor. Medical attention is needed in case of persistent, non-improving symptoms or when the condition suddenly worsens. Among the warning signs, I would mention in particular breathing difficulties, intense persistent cough, chest pain, runny nose and sinus pressure lasting for more than a week. If tonsillitis is suspected (i.e. severe sore throat, fever without a cold or cough, whitish spots on the tonsils), antibiotic treatment is usually necessary and it is essential to see a doctor. People with chronic pulmonary or cardiac disabilities, immune disorders, etc., are a separate group. In their case, the medical examination should take place in a more timely manner.

How difficult is it to distinguish the symptoms of ARI from those of covid-19?
In general, it is very difficult to impossible. In covid-19 disease, the range of symptoms is very wide and overlapping with other respiratory diseases. Perhaps only loss of taste and smell is typical of covid-19, although it can also occur in other respiratory diseases.

How are acute respiratory diseases treated and which are among the most serious?
Treatment is usually symptomatic and generally familiar (rest, plenty of fluids and sleep, vitamins, medications to relieve symptoms of a cold or cough, sore throat, analgesics, antipyretics). If bacterial disease is suspected, antibiotics are given. Further specific treatment depends on possible complications. Most viral respiratory diseases follow a "mild" course. Influenza in particular can have a complicated course, especially in high-risk groups. Either because of serious complications of influenza itself, such as pneumonia or inflammation of the heart muscle, or because of decompensation of a chronic internal disease, especially in cardiac patients, patients with chronic lung disease, etc. This may result in the need for hospitalization and the risk of death. The issue of covid-19 disease is now well known. Among bacterial diseases, again especially in older age and risk groups, pneumonia caused by pneumococcal disease can also have a complicated course with a life-threatening risk. In infants, pneumococcal disease can cause otitis media or even meningitis.

Can neglecting treatment cause any serious complications?
It is definitely not recommended to "ignore" the disease. Firstly, it leads to a prolonged course, more frequent recurrences of respiratory infections, but above all to the risk of complications. These include pneumonia, inflammation of the heart muscle, sinusitis, otitis media, etc. Thus, there is an emphasis on rest and symptomatic treatment.

Is it possible to protect against at least some respiratory diseases through vaccination?
Annual influenza vaccination is definitely recommended, especially for high-risk groups (age 65+, chronic internal diseases, and pregnant women), where vaccination is covered by health insurance. Although vaccination against pneumococcal infections is possible at the age of over 50 years, it is not covered by public health insurance until the age of over 65 years or for people with chronic internal diseases, as is the case with influenza. Furthermore, vaccination against pneumococcal infections is recommended for infants to prevent otitis media and meningitis. In adults, I would remind readers of the importance of pertussis vaccination. This vaccination is even recommended for pregnant women in the third trimester of pregnancy. Finally, I would stress the importance of universal vaccination against covid-19, including the importance of administering the third dose, not only in populations at risk.


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