It starts with sore throat or stuffed nose, sneezes, coughs and sometimes fever - go to the doctor or will you have enough rest? We have gathered all the recommendations of the Israeli Association of Internal Medicine for winter sickness • Everything you need to know to pass the cold season in peace

• Flu vaccine // Photo: GettyImages

Against the backdrop of the flu, and the heavy burdens in the hospital's internal wards, the Israeli Association of Internal Medicine released a winter sickness guide for the first time on Sunday. Winter sickness is a common name for a variety of diseases, the prevalence of which is much higher during the winter than other seasons. These diseases, mostly viral, pass from person to person and infect. Every time a sick person sneezes, or the coughing virus spreads in its immediate vicinity and may infect those around it.

The major diseases under this explosive headline are the familiar coldness for all of us, which includes a large variety of viruses, which cause a bad general feeling, cough and runny nose. Throat inflammation, which is accompanied by fever (often high), sore throat and cough, is also considered a winter disease and can be caused by both bacteria and viruses, and the flu - which has already led to 11 deaths this year, a viral disease accompanied by high fever, muscle pain, throat And head, runny nose, cough and fatigue.

Jacob Litzman vaccines against the flu // Photo: Moshe Ben Simhon

Why in winter?

Influenza viruses and other viruses that cause winter morbidity are present throughout the seasons. The reason for their proliferation precisely in winter is the tendency at this time of year to congregate in confined and non-ventilated rooms, while sneezing, or coughing. In the summer - venting and staying outside greatly reduce the chance of virus spread. It is also possible that the cold itself reduces the body's ability to cope with infections due to decreased blood supply to various organs, such as the nose.

Who is more prone to complications?

Adults over the age of 65, patients with chronic diseases such as kidney failure, chronic liver disease, diabetes and heart disease, pregnant women, patients with chronic lung disease, immune system patients, cancer patients, organ transplant patients, immune system suppressing patients, Like steroids and patients with significant obesity.

How to avoid the disease?

Non-influenza viruses, and which are usually infected with a mild disease, do not have an effective vaccine. It is possible to reduce the chances of infection (both influenza and other viruses) by hygiene rules such as hand washing with water and soap especially after sneezing and coughing, nose and mouth cover during sneezing and coughing - it is better for tissue paper or not, then for elbow and not for palm and stay at home Don't feel well.

Is it too late to get vaccinated against the flu?

The vaccine is recommended for anyone over six months of age. There is much evidence in the medical literature that the vaccine lowers the rate of influenza by about 70 percent on an average season, and also reduces the severity of the disease in those who are infected, especially the appearance of complications such as bacterial pneumonia, hospitalization and mortality. .

The vaccine is recommended and especially important for all the above risk groups, as well as for all employees in the various health professions. However, as mentioned above, anyone over the age of six months is advised to get vaccinated.

When should you be vaccinated?

It is advisable to vaccinate each year in October-November, before the influenza season begins, but it is advisable to vaccinate later as well, if this is not done during the fall season. Vaccination is required every year, as the strains responsible for a particular genetic change are immediately passed through - and the vaccine is tailored to the World Health Association recommendations (in light of the changes that occur from season to season). Also, many anti-flu antibodies start to fade naturally, starting six months after the vaccine is given, so their level is usually not enough one year after the previous vaccine date.

What does the flu vaccine consist of, and does it have any side effects?

The vaccine consists of (usually) dead, sometimes weakened viruses - which do not cause the flu. Heat and respiratory disease, which appears near the vaccine, is usually caused by a non-influenza virus, which almost never causes a disease that causes complications, which require hospitalization.

The side effects are mostly local - redness and pain in the immune area, and last only a few hours or days.

What to do if flu patients?

In most cases, treatment is only symptomatic and is recommended for patients to rest, take heat-reducing drugs and painkillers, and no other treatment is needed. Patients with background illnesses and risk factors, as mentioned above, should be considered for the treatment of a medicine called Tamiflo (osltamibir).

In principle, the drug has been shown to be effective in shortening and relieving the duration of symptoms - if the start of treatment is within the first 48 hours of the onset of the signs of the disease. It is also common to treat patients with severe flu, which requires hospitalization.

It should be noted that this treatment is not effective against other winter viruses. There is no evidence that alternative therapies so prevalent on the market alleviate the signs of illness, certainly do not cause complication rates.

What can be the complications of the disease?

In most cases, the flu is a mild, unpleasant illness, but transient within a few days. However, in a small group of patients the disease can be difficult to bring to hospital, and there is even death from the disease. Most of the severe cases appear in the groups of patients mentioned above.

The main and more common complication of influenza is pneumonia - sometimes due to the influenza virus itself, and sometimes bacterial pneumonia secondary to influenza. This is the main and common complication that leads to severe morbidity, hospitalization and even mortality. In addition, there is a chance of cardiac disorder - both an increased risk of heart attack at the time of the disease and, more rarely, direct involvement of the heart muscle and pericardium in the disease. Also, brain involvement, severe muscle damage can occur when they are severe but very rare complications.

When to contact a doctor?

In general, flu is a disease that can last for a week, and even more, until the signs pass, and no doctor should be called. However, in the following situations, especially in people with the above-mentioned risk factors, consult your doctor: fever that does not decrease after more than three days, worsening cough, especially if you have a pus and pains in your chest, shortness of breath, headaches or difficulty in looking at light and vomiting. Apart from extreme cases, the family doctor or immediate medical center should be referred first and foremost, where it is necessary to refer to the emergency center (emergency rooms) and hospitalization.

Who are you hospitalized for?

The patients who need hospitalization are those who suffer from the complications of the disease. The most common cause is the development of pneumonia. Not every patient with pneumonia needs hospitalization. However, in the following cases, where the risk of complications and mortality has been shown to be high, patients, especially those at risk, should be hospitalized: older age, decreased blood oxygen levels, development of kidney failure or severe dyspnea.

Other patients who will be hospitalized are those who develop signs that indicate cardiac and brain damage as a result of the flu. These cases are quite rare.

What happens in hospitalization?

The vast majority of hospitalizations are due to respiratory system complications, and treatment includes respiratory support - in oxygen, and in stress, in the soul. It is also common to treat Tamiflu (if it is proven that the virus that causes the disease is influenza virus) and also antibiotic therapy for bacterial pneumonia, as a treatment for the main complication of the flu. Sometimes additional treatments are needed for rarer complications - cardiac and brain.

The information was collected by Dr. Eyal Brown, Director of Internal Medicine H at Rambam Medical Center