Winter Care

Most of us will probably have a cold this winter and some of us will have flu. Find out how to look after yourself if these viruses affect you.

Colds and flu are caused by viruses. There are more than 200 common cold viruses, and three types of flu virus with many different strains, so they’re hard to avoid. These viruses can be spread through droplets that are coughed and sneezed out by an infected person. The viruses can also be transferred on a person’s fingers. For example, if you have a cold and you touch your nose or eyes and then touch someone else, you may pass the virus on to them.

The main symptoms of winter bugs are coughing, sneezing, blocked nose, sore throat, headache and a slight temperature. If these are the only symptoms you have, it’s unlikely that your GP will be able to do anything.

Children can also be treated using over-the-counter painkillers to ease discomfort and help to bring down a fever. Both paracetamol and ibuprofen are available as a liquid for children and can be given from the age of about three months. Always check with your doctor if you aren’t sure which treatments you can give your child.

In most cases, antibiotics (which are used to treat bacterial infections) aren’t necessary. Colds and flu, and most coughs, are caused by viruses so antibiotics can’t help. Minor bacterial infections will also be fought off by natural immunity,

You may want to visit your local pharmacy, where you can get advice on how to manage the symptoms and buy over-the-counter medicine.

You can help prevent colds by washing your hands regularly. This destroys bugs that you may have picked up from touching surfaces used by other people, such as light switches and door handles. It’s also important to keep the house and any household items, such as cups, glasses and towels, clean, especially if someone in your house is ill.

Top tip: If you get a cold, use disposable tissues instead of cloth handkerchiefs to avoid constantly re-infecting your own hands.

There are some benefits, particularly for children, in catching a few coughs and colds. “Children tend to get a lot of colds because the body takes time to build up immunity. Your body learns to fight off a particular kind of virus every time you get an infection, which is why you get fewer colds as you get older,” says Angela Chalmers.

While most bugs will run their course without doing any real harm, Dr Shah says there are certain cases when you or your child should see a GP. These include:

• if you or your child has a chronic condition such as asthma, diabetes or heart disease
• if you have a very high temperature and feel ill, for example if you also have an unusually severe headache or abdominal pain
• if your child is vomiting but does not have diarrhoea, or has a rash in addition to the fever
• if your child stops drinking and is unusually lethargic
• if your child’s fever doesn’t respond to paracetamol or ibuprofen

Babies, and older and frailer people should get help if they’re unwell. All babies under three months with a temperature of more than 38°C (100.4°F) should be urgently assessed by a doctor, as should babies aged three to six months with a temperature higher than 39°C (102.2°F).

Sore throats are common in winter and are almost always caused by viral infections. There’s some evidence that changes in temperature, such as going from a warm, centrally heated room to the icy outdoors, can also affect the throat.

Top tip: One quick and easy remedy for a sore throat is to gargle with warm salty water. It won’t heal the infection, but it has anti-inflammatory properties and can have a soothing effect. Dissolve one teaspoon of salt in a glass of part-cooled boiled water.

Cold air is a major trigger of asthma symptoms, such as wheezing and shortness of breath. People with asthma should be especially careful in winter.

Top tip: Stay indoors on very cold, windy days. If you do go out, wear a scarf over your nose and mouth. Be extra vigilant about taking your regular medications, and keep rescue inhalers close by and in a warm place.

Also known as the winter vomiting bug, norovirus is an extremely infectious stomach bug. It can strike all year round, but is more common in winter and in places such as hotels and schools. The illness is unpleasant but it’s usually over within a couple of days.

Top tip: When people are ill with vomiting and diarrhoea, it’s important to drink plenty of fluids to prevent dehydration. Young children and the elderly are especially at risk. By drinking oral re-hydration fluids (available from pharmacies), you can reduce the risks of dehydration.

• The symptoms of viral gastroenteritis usually begin 24–48 hours after you are infected. This time is called the incubation period.
• The incubation period for bacterial gastroenteritis can range from 12 hours to 5 days, depending on the bacteria responsible.
• Repeated episodes of diarrhoea are the most common symptom of gastroenteritis. Loose, watery stools are usually passed three or more times within 24 hours. The stools may contain traces of blood and mucus.

Other symptoms of gastroenteritis include:

• vomiting, nausea, stomach cramps, headaches, a high temperature (fever) of 38–39C (100.4–102.2F)

Dehydration is where your body loses more fluid than you can take in. It is a very serious complication that can occur if fluid lost through vomiting and diarrhoea is not replaced.

Elderly people are particularly at risk from the effects of dehydration which, if not treated, can be fatal.

Therefore, you should be aware of symptoms that may suggest you or someone in your care is becoming dehydrated.

The symptoms of dehydration include:

• tiredness,  apathy (a lack of emotion or enthusiasm), dizziness, nausea, headaches, muscle cramps , dry mouth, pinched face, sunken eyes, passing little or no urine, rapid heartbeat.

When to seek medical advice

In most cases, medical treatment is not needed for gastroenteritis because the symptoms usually pass after a number of days (typically two to three days for viral gastroenteritis and four to seven days for bacterial gastroenteritis).

However, medical treatment may be required in some circumstances. Contact your GP if you have any of the following symptoms:

• vomiting that lasts for more than two days
• an inability to keep liquid down for more than a day
• diarrhoea that lasts for more than three days
• blood in your vomit or in your stools
• seizures (fits)
• changes in mental state, such as confusion
• double vision
• slurred speech
• signs of dehydration, such as a dry mouth, sunken eyes and an inability to pass urine

Also seek medical advice if your symptoms do not begin to improve after three days, or if you think you got the infection while in a part of the world with a poor standard of water hygiene.

Also contact your GP if you have any risk factors that increase your risk of developing a serious complication from infections, such as:

• being over 65 years of age
• being pregnant
• having Crohn’s disease or ulcerative colitis
• having a weakened immune system due to another condition, such as HIV, or receiving treatment, such as chemotherapy

Many people with arthritis say their joints become more painful in winter, though it’s not clear why this is so. Only joint symptoms, such as pain and stiffness, are affected by the weather. There’s no evidence that changes in the weather cause joint damage.

Top tip: Many people get a little depressed during the winter months and this can make them perceive pain more acutely. Everything feels worse, including medical conditions. Daily exercise can boost a person’s mental and physical state. Swimming is ideal as it’s easy on the joints.

Most of us recognise that cold sores are a sign that we’re run down or under stress. While there’s no cure for cold sores, you can reduce the chances of getting one by looking after yourself through winter.

Top tip: Every day, do things that make you feel less stressed, such as having a hot bath, going for a walk in the park or watching one of your favourite films.

Heart attacks are more common in winter. This may be because cold snaps increase blood pressure and put more strain on the heart. Your heart also has to work harder to maintain body heat when it’s cold.

Top tip: Stay warm in your home. Keep the main rooms you use at 21C (70F) and use a hot water bottle or electric blanket to keep warm in bed. Wrap up warm when you go out and wear a hat, scarf and gloves.

Raynaud’s phenomenon is a common condition that makes your fingers and toes change colour and become very painful in cold weather. Fingers can go white, then blue, then red and throb and tingle. It’s a sign of poor circulation in the small blood vessels of the hands and feet. In severe cases, medication can help, but most people live with their symptoms.

Top tip: Don’t smoke or drink caffeine (they can both worsen symptoms) and always wear warm gloves, socks and shoes when going out in cold weather.

Dry skin is a common condition and is often worse during the winter when environmental humidity is low. Moisturising is essential during winter. Contrary to popular belief, moisturising lotions and creams aren’t absorbed by the skin. Instead, they act as a sealant to stop the skin’s natural moisture from evaporating away. The best time to apply moisturiser is after a bath or shower while your skin is still moist, and again at bedtime.

Top tip: Have warm rather than hot showers. Water that is too hot makes skin feel more dry and itchy. Hot water will also make your hair look dull and dry.

Flu is a major killer of vulnerable people. People aged 65 and over and people with long-term health conditions including diabetes, pregnant ladies, COPD, asthmatics heart problems and kidney disease are particularly at risk. The best way to prevent getting flu is to have the flu jab. It gives good protection against flu and lasts for one year.

Top tip: Find out if you’re at risk of getting flu by asking your Doctor who should have the flu jab. If you’re in a high-risk group, see your Doctor to get the vaccination.