We are fast approaching the time of year when such respiratory viruses as influenza, respiratory syncytial virus (RSV), and 100 varieties of cold-causing rhinovirus come out to party — just as we do.
If it seems everybody is coughing and sneezing or moaning about flu aches after Thanksgiving and Christmas, you’re not imagining it, infectious disease experts said.
Some of this has nothing to do with the holidays. These bugs thrive in cooler, drier winter air.
So a lot of us would get sick in December or January even if our friends and family weren’t giving viruses a free ride from, say, Dallas or Chicago or Paris to Philadelphia International Airport and then into our dining rooms.
But there’s little doubt that our holiday desire to reconnect helps germs more easily spread from one regional hot spot to another. Are we doomed or can we protect ourselves from that sick guy on the plane or that runny-nosed nephew?
PROTECT YOURSELF AND OTHERS
The single best thing you can do to protect yourself from flu is to get a flu shot, experts agree. The shot is only about 60% effective against getting sick, but it reduces symptoms if you do catch something, meaning it is better at preventing hospitalizations and deaths. Even if you’re healthy and the flu is more a nuisance than a serious threat, getting a shot can protect babies too young for inoculation and other people whose weakened immune systems prevent a strong response to the shot. That includes people with cancer and the elderly.
Yet lots of people don’t get the flu shot, and there are no shots against RSV and cold viruses. RSV is underappreciated as a danger for children and older adults. All these germs are spread through droplets in the air that sick people expel with coughs and sneezes. We get sick by breathing them in or, more often, touching something contaminated, then touching one of the viral portals on our face: eyes, nose and mouth.
Anne Norris, an infectious-disease specialist at Penn Medicine, said that colds tend to be the leadoff hitter in the fall-winter viral onslaught. You can thank the return of young children to school for that. Kids, she said, spread the highly contagious virus through “direct contact with basically snot on the fingers.” When it comes to rhinovirus, which causes more than half of common colds, “children are clearly the vectors,” she said.
Flu tends to start later, with the average season lasting 13 weeks between December and March. RSV and flu often coexist. (You’ll probably know you have flu because it hits fast and hard with aches and fever. The respiratory symptoms tend to be less pronounced than in a cold or RSV.)
Norris said planes are not as bad for spreading germs as many fear. Ventilation systems have improved, and studies have shown you’re most at risk if you are sitting directly beside or in front of someone who’s sick.
Kevin Morgan, a nurse practitioner with MinuteClinic in Center City, said germs can live for hours on surfaces that might not be thoroughly disinfected between flights. He recommends travel packs of disinfecting wipes to clean the tray table, arm and headrests, and seat belt buckles. At your hotel, wipe down the TV remote and light switches. Travel-size hand sanitizer is also a good idea, he said.
Many holiday travelers take long trips on buses and trains. Transmission is not as well-studied on those forms of mass transit, but you’re clearly at higher risk when packed in with lots of people.
As for the sick travelers who show up at your home, well, science mostly fails. As Daniel Mueller, an infectious-disease doctor at Temple University Hospital, puts it: “You’re not going to tell grandma or grandpa to go back home.”
Norris also sees little way out. “You’re socially constrained here,” she said, “but I would avoid prolonged face-to-face contact with someone who was expelling infectious particles.”
If you’re pretty sure you’ve been exposed to flu, Norris and Mueller said, your doctor might be willing to prescribe a prophylactic dose of an antiviral medicine such as Tamiflu.
If you manage to avoid germs from fellow travelers and guests, the pathogens are everywhere. The grocery store. The day care center. The mall. And the office.
A new economic paper from researchers at Emory and Ball State Universities and the University of Alabama-Birmingham found that higher employment and flu transmission rates go together. A 1% increase in the employment rate correlated with a 16% increase in influenza-related doctor visits. The trend was strongest in the retail and health care sectors, where there is a lot of interpersonal contact.
‘RHINOVIRUS ALL OVER THE PLACE’
This brings us to what sick people can do for the rest of us. First of all, stay home if you’re sick, particularly if you’ve got a fever over 100 degrees or so. Wait till the fever has been gone a day to interact with healthy people. People are less likely to stay home with colds, which typically don’t cause fevers, but Norris wishes they would. “They’re leaving rhinovirus all over the place for the rest of us,” she said.
If your job has skimpy sick days or a culture of show-up-no-matter-how-bad-you-feel, try to protect the common air and surfaces by coughing into your arm or shoulder. Throw tissues away after one use. Use hand sanitizer after you blow your nose. Take cough suppressant. You could even wear a surgical mask.
We can all try not to touch our faces. Norris said there’s no good evidence that extra vitamins will help most of us ward off infection.
The best protection is easy and cheap: Wash your hands. A lot. Wash them after using the bathroom. After flying. After riding a train or bus. After shopping. Especially before you eat.
“In every study of every kind,” Norris said, “hand-washing makes a difference.”