Invasion by a gang of respiratory viruses

We certainly have no shortage of flu-like illnesses, and, for most people, unless you become very ill, you rarely seek medical attention, and you rarely think that it makes a difference whether it is a “bad cold”, the common cold – caused by one of a variety of viruses but often a rhinovirus or one of the more aggressive respiratory viruses like the coronavirus, the respiratory syncytial virus (RSV) or even the influenza virus. In this part of the world, flu is rarely listed as a cause of hospitalisation or even death.

These viruses are all highly contagious, and a majority of persons who come in contact with them seem to develop symptoms. The results are seen when homes, schools and workplaces are disrupted by affected individuals. Except in special instances, we cannot identify the specific viruses, and antiviral medication is rarely available, so treating the symptoms is the order of the day.

Common symptoms include a runny nose, sneezing and congestion, but individuals may also have muscle pains, a cough that produces phlegm, sneezing, watery or itchy eyes, or even a headache, a post-nasal drip, and generalised malaise. Depending on the particular set of symptoms and an individual’s past medical experiences, these may even be diagnosed as sinusitis, allergies, or blamed on the Sahara dust that adds to the normal dust that settles down around our homes or workplaces.

The challenge posed by viral illnesses, whether aggressive or not, is that they can (and do) cause varying damage by causing inflammation within individuals. In persons with healthy immune systems, when challenged by these viruses, a mild 24-72 hour illness results, and folklore remedies include a variety of rub-downs, a variety of teas or hot chicken soup, or, at least for men of a certain age, a good “stiff-one” will help.

If you have a simple head cold or 24-hour bug, there is not too much to be concerned about. But COVID-19, RSV and influenza, which our Ministry of Health and Wellness tells us are circulating here, are more serious maladies that require a careful approach. That’s because these viral infections tend to cause whole-body inflammation, and hence are more likely to cause long-lasting symptoms: “Doc, I have had the cold for over a month now, [like an old boyfriend] it refuses to leave me.”

This inflammation can irritate your heart and lungs, which ultimately can affect your breathing and the way your heart beats. It takes some time for your body to completely recover from these viral infections, sometimes weeks or months. It can take even longer than average to recover if you’re an older adult or have underlying health concerns, such as diabetes or high blood pressure.

Vaccination, when available (e.g. the flu vaccine and the COVID-19 vaccine are available locally, even though the RSV vaccine is not currently available), is an important preventative tool in helping fight off these viral illnesses, and preventing serious illness, long term complications, and even death. Being well-hydrated, especially in our super-hot climate, and consuming nutritious foods are also crucial, both while you’re ill and when you’re returning to activity. That’s because your body needs energy to fight off the infection while you’re sick and later to fuel your recovery.

Other important measures include close attention to hygiene: remember social distancing? Frequent hand washing should become a ritual. If someone has a cough they must stay away from everyone else, and it’s not a bad idea for everyone around to resume wearing masks.

No matter which virus you had, wait at least five to seven days after recovering before resuming normal activities, or even strenuous exercise. You also should be able to do all of your normal daily activities without excessive fatigue. Your body, heart and lungs need time to recover. Trying to do too much too quickly runs the risk of prolonging your full recovery, or even triggering a relapse. Remember, viruses can kill, especially if you have an underlying illness.

If you have a serious COVID-19 infection accompanied by heart or lung-related symptoms such as chest pain or difficulty breathing, then it is recommended that you see your physician before resuming exercise. If you develop myocarditis, an inflammation of the heart muscle, then the American College of Cardiology (ACC) guidelines suggest you abstain from strenuous exercising for three to six months.

As you’re slowly working back to your normal fitness routine, pay attention to how you’re feeling. If you feel like your heart is racing or beating irregularly, or if you have any chest pain, stop immediately and see your physician. The biggest things to be concerned about are heart attacks and developing irregular heart rhythms (arrhythmias).

Should you become frustrated about how long it’s taking to get back to normal health, remember this: those who are normally physically active are less likely to become very ill, and if they do catch an infection, it’s typically less severe than for someone who is a couch potato. At the end of the day, the healthier we are, the better outcomes we have if we do get sick.

Dr Colin V Alert is a family physician and former researcher with the Chronic Disease Research Centre.