COLD AND FLU SEASON IS HERE AGAIN: WHAT CAREGIVERS NEED TO KNOW
The September Edition of the Institute of Child Health Monthly Seminar was delivered by Prof Osawaru Oviawe; a Professor of Child Health & Consultant Paediatrician (Pulmonologist),Paediatric Respiratory Medicine, University of Benin Teaching Hospital on Thursday 8th October 2015.
The lecturer of the day started the seminar by describing the different types of weather in Nigeria. He said that Nigeria lies within the tropical zone and has wide climatic variations. Distinctively, these are the Wet Season (April to October) and the Dry Season (November to March). He also stated the difference in season in different geographic location in Nigeria. For instance, in the southern Nigeria: There are the Rainy Season (sub-divided into the Long Rainy, Short Dry, and Short Rainy Seasons) and the Long Dry Season. In northern Nigeria there is mainly one rainy season (short, wet season) and prolonged dry season (July and September).
The lecturer then went on to state that there have reports of association between seasons and pattern of infectious diseases. However, that the mechanisms underlying this association remain poorly understood. Factors implicated include (A). Human factors – Human activity, Season variability in human immune system function, Seasonal variations in Vitamins D levels, Seasonality of melatonin, Pathogen infectivity and (B). Microbiologic factors which include factors that influence agents to flourish (such as when the weather is cold, people living in closed houses and crowding together of people in-door during cold season) and the factors encouraging decrease in infectious diseases (such as warmer weather, people’s activity of getting outdoors, ventilation of homes – doors and windows opened and in some communities’ mechanical ventilation of homes are practiced).
Prof Oviawe then went on to define Cold and Flu diseases. He said that these are infectious illnesses that are frequently associated with weather seasons; example seasonal flu and commonly affect the breathing apparatus up to the level of the bronchi of the lungs.
The Common Cold also known as nasopharyngitis, rhinopharyngitis, acute coryza or simply a Cold is an infectious process that involves the lining of the nose, throat, and sinuses. The infectious agent is mostly virus and symptoms sually abates within 7 or 14 days. He said that a child may experience about 8 – 12 episodes of Common Cold in a year; an assertion that was scientifically proven by the speaker and Oviawe N and published in 1993. Causes include common viruses such as rhinovirus, parainfluenza virus, coronavirus, bocavirus, enterovirus, adenovirus, metapneumovirus, respiratory syncytial virus (RSV), etc. The rhinoviruses (have more than 100 subtypes) are implicated more often than the others.
Flu is a more serious disease than Common Cold and is usually caused by the Flu viruses namely Influenza A, B, and C viruses. Flu involves the respiratory tract goes beyond that seen in the Common Cold, often extending to the bronchi. He also said that the dreaded Avian flu (H5N1) is also known as Avian influenza or Bird Flu and is a subtype of the Influenza Type A virus (highly contagious in birds but does not usually infect humans). Transmission to humans is mainly by direct contact with infected live, sick, or dead poultry and when this occurs may be devastating and may be of public health importance.
Cold and flu viruses are spread by droplets from infected humans. These droplets are coughed or sneezed out by an infected person and generally, humans are at risk of getting and spreading these viruses when these droplets are breathe in by other people. In some instances, the droplets are transferred to the eyes or nose via the hand (fingers). The peaker stated that the role of kissing in transmission of Cold and Fle is still debatable.
Those who are at higher risk of acquiring Cold and Flu and developing Flu complications include adults over the age of 65 years and infants, those with poor nutritional status, lowered immunity status due to disease or medical treatment, concomitant disease (e.g. asthma, diabetes, serious kidney disease, congenital heart diseases, e.t.c). Others include attendance at nursery/pre-primary school, for the child or sibling in school; one or both parents with Cold/ Flu; presence of individuals/parents/sibling in assembly of infected subjects.
Prof Oviawe stated that Flu and Cold share similar symptoms although flu symptoms tend to last longer and are usually more severe, weakness and fatigue from flu can last for up to two or three weeks. Furthermore, symptoms attributable to lower respiratory tract disease may be associated with flu. He said that symptoms usually start 1 – 3 days after infection and the first symptom is usually a scratchy or sore throat or discomfort in the nose. This is followed later by sneezing, running nose and feeling mildly ill. Fever is not common except in the case of flu in which there is sudden onset of high fever. Similarly, cough occurs at the late stage of cold as compared to early onset of dry cough in Flu. Flu symptoms in school-age children and adolescents are similar to those in adults. However, children tend to have higher temperatures than adults. The lecturer stated that it is difficult to pin-point symptoms of flu in pre-school children and infants and the care provider will have to perform laboratory test to confirm the diagnosis of flu in these age groups. Ideally stomach symptoms such as nausea, vomiting or diarrhoea may occur in Flu but not in Cold.
Cold are usually diagnosed based on the typical symptoms. Similarly, laboratory tests are not usually needed to diagnose a Cold. However, in the presence of complications, X-ray of the sinuses and blood tests may be requested. As for flu, there are rapid diagnostic tests that can diagnose flu provided the test is carried out within 2 or 3 days of illness.
Effective vaccines for Cold prevention are not available because of multiplicity of cold viruses and their subtype. Consequently, the main treatment for Cold and Flu is to practice Good Healthy Habits such as regular hand washing practices with water and soap, use of tissues/ elbow to trap droplets (hands not allowed) during sneezing/ coughing. Such tissues should be discarded appropriately in a bin. Infected and non-infected individuals should keep a distance during sleeping, perhaps should sleep in separate where possible. The Speaker advocated for absence duty or school for infected individuals so that they keep the viruses to themselves and limit spread to the community members. As much as possible the objects and surfaces such as door handles should be disinfected and cleaned. Influenza vaccine such as the Flu shot (inactivated vaccine?? FluMist) is given in some countries usually before the beginning of the Flu season. The speaker stated categorically that the common practice of giving high dose of vitamin C (up to 2000 mg per day) does not prevent Cold nor does eating citrus fruits. Use of antibiotics is also not necessary.
Prof Oviawe concluded the seminar by giving the following highlights to caregivers. He said that Common Cold can be caused by more than 200 viruses, while the Flu is caused by one of the three flu viruses namely influenza A, B and C. He said that everyone should know that there is no specific treatment for the Common Cold, while Flu jabs (vaccine) are available for those at risk of complications of Flu. Antiviral medication may be provided for those with complicated Flu illness and chronic medical conditions. Hand washing health strategy is helpful in prevention of transmission of Cold and Flu to friends, school and work mates. The main treatment for Cold and Flu is purely home remedies which include oral fluid, “bed rest”, and nasal toileting. The main preventive measures include adequate housing, proper nutrition, immunization (vaccination), and appropriate management of chronic medical diseases. The Professor then concluded by urging everyone to practice and maintain Good Health Habits and STOP THE SPREAD OF COLD AND FLU NOW!!
Written and edited by Dr Damian, U Nwaneri – Research Fellow-1, Institute of Child Health, College of Medical Sciences, University of Benin And Honourary Consultant Paediatrician, Paediatric Infectious Disease Unit, University of Benin Teaching Hospital, Benin City Nigeria.