Temperatures are dropping, days are getting shorter, and with it have started the first signs of sore throats and sniffles, characteristic of this season. Along with these ailments, however, there are a handful of other health afflictions to look out for, say doctors – ones that are particularly likely to take hold in low temperatures and already dry and polluted air. Doctors say that in the winter months, viral infections become more common, as do respiratory illnesses, so much so that even people with no prior history of these issues can develop them, as well as other lung, heart and bone related complications.
Lesser known winter risks
Dr Devashish Desai, consultant, infectious diseases, Ruby Hall Clinic, Pune, in speaking of winter-specific illnesses, says “The majority of the population does not bother to consider the fact that the illnesses in relation to winter are much more diverse than the flu-like symptoms.” For starters, asthmatic bronchitis is a common illness that gets triggered in winter, shares Dr Desai.
Respiratory syncytial virus or RSV is also a common condition that flares up in winter, apart from weakening the immunities of people already coping with respiratory issues, heart issues and other viral infections. Patients with other diseases like tuberculosis, interstitial lung disease and AIDS are also at higher risk of health issues. Further, “Frequent winter infections may lead to inflammation indirectly reducing heart health, which is why it is important to treat even the routine winter infections carefully,” advises Dr Desai. On how the cold weather can impact health, he explains in some detail, “Cold and pollution may constrict the airways and aggravate breathing. People with uncontrolled diabetics, heart diseases, kidney diseases and liver disorders are also more vulnerable, because the infection can deteriorate the existing condition or cause complications such as pneumonia or heart attack.” Dr Desai also mentions mental health issues like SAD or seasonal affective disorder. “Another risk factor is obesity — it causes poor lungs functioning and it becomes difficult to overcome the infections. Immunosuppressive drugs and old age also predispose people to severe infections and delayed recovery,” Dr Desai points out.
Dr Pujan Parikh, consultant, pulmonary and sleep medicine at Sir HN Reliance Foundation Hospital, Mumbai, says, “Individuals with respiratory illnesses such as asthma, COPD (chronic obstructive pulmonary disease), lung fibrosis, or a history of smoking are more likely to develop severe respiratory complications,” adding, “Besides these, those with diabetes, cardiac diseases, or cancer are also more susceptible to winter-related respiratory infections.” He adds, “In recent years, there’s been a notable rise in cases of persistent post-infectious cough, even among younger individuals who were otherwise healthy.” He adds that infants, young children, and the elderly are particularly vulnerable to respiratory issues during winter due to weaker or compromised immunity.
Dr Parikh warns that health issues contracted in winter could also have long term impacts long after winter has passed. “Severe respiratory infections, especially viral pneumonia or influenza, can cause prolonged cough, fatigue, or post-infectious bronchial hyperreactivity lasting weeks or months. In individuals with pre-existing respiratory conditions, these infections may accelerate lung function decline,” he says, adding that by and large, immune systems in general are more at risk during winter. “The incidence of viral infections spikes in winter too as viruses thrive in colder, drier air. Poor air quality also weaken respiratory defences, making it easier for infections to spread and harder for the body to fight them off,” observes Dr Parikh.
At-risk population
“The two ends of the age supply are the most susceptible in other words young children below five years and older adults above sixty,” says Dr Desai. He explains that the immune systems of children are vulnerable because they are still developing, and as for the elderly, people aged 60 years or above are more susceptible because their immunities are already slightly compromised with health vulnerabilities. “Pneumonia and heart attacks are other complications associated with the elderly that put them at high risk,” he said. “Extreme viral infections can cause post-infectious fatigue, which is a condition that makes them feel weak and breathless in weeks,” he warns.
Dr Niranjan Singh, senior consultant, internal medicine, CK Birla Hospitals, Jaipur, elaborates, “Cold weather causes the blood vessels to constrict, or vaso-constriction, which can elevate blood pressure. Physical exertion or sudden heavy activity places intense strain on the heart. Moreover, respiratory infections common in winter can increase inflammation in the body, potentially destabilising arterial plaques and leading to cardiac or neurological events.” He adds that unfortunately, public awareness on these risks continues to be low. He says that people with diseases or conditions including cancer, tuberculosis, AIDS, interstitial lung disease (ILD), and rheumatoid arthritis are also at a heightened risk of their symptoms getting exacerbated during winter. “Their weakened immune response makes it harder to fight infections or cope with temperature fluctuations,” he says. He clarifies that our immune systems are more vulnerable “Not because the cold itself directly weakens immunity. It’s more accurate to say we are more exposed to threats, and our immune system’s environment becomes less favourable,” says Dr Singh. In winters, the OPD (outpatient department) is full of patients with a vast variety of illnesses that get aggravated due to the cold and dry climate, Dr Singh shares from his experience. “There’s a noticeable rise in heart attacks and strokes, flare-ups of chronic illnesses like diabetes, tuberculosis, interstitial lung disease (ILD), and rheumatoid arthritis. Skin-related issues such as dryness, eczema, and cracked skin are also frequent due to reduced humidity,” he shares.
Dr Desai’s experience with treating patients also reflects the same — “Cases of respiratory tract infection, asthma exacerbation, bronchitis, sinusitis, and pneumonia dramatically increase during winter season in OPDs. The symptoms that patients frequently complain about are persistent cough, shortness of breath, wheezing and fatigue,” he says.
Bracing for the season
Doctors suggest timely vaccinations and conscientious diets to attempt to brace for all the winter vulnerabilities coming our way. Speaking of an ideal winter diet, Dr Singh advises, “Certain dietary habits can weaken immunity during winter, such as consuming high-sugar foods, refined carbohydrates, excessive alcohol, and highly processed foods.” He says to strengthen immunity, every meal should include colourful fruits and vegetables for vitamins A, C and antioxidants; quality proteins like beans, lentils, chicken, fish and eggs; healthy fats and fibre from nuts and seeds, and to “include fermented foods like yogurt with live cultures, kefir, kimchi, sauerkraut, and kombucha for probiotics.” Stressing these tips, Dr Parikh adds for his part, “Fried and oily foods can cause acid reflux, irritating the airways and leading to chronic cough. Maintaining a balanced diet rich in fruits, vegetables, proteins, and adequate hydration helps support overall immunity.”
Dr Singh also advises that people work against their instinct to stay warm and cozy indoors during the winter as, “Reduced sunlight leads to lower vitamin D levels, which is vital for immune function.” For those risking respiratory issues, he says specifically, “When outdoors, breathing through your nose is better than mouth breathing. Covering your nose and mouth loosely with a scarf creates a pocket of warmer, more humid air. Those with asthma should always keep a rescue inhaler handy.”
Dr Desai holds that the health burdens associated with the winter can be reduced to a large extent by “timely intervention and prevention measures such as vaccination, proper nutrition, and control of underlying diseases.” He adds that individuals over 50 years should take the yearly flu shot as it helps to lower the chances of infection by a large margin. “Preventive measures like flu vaccination annually, keeping indoors warm, and not being exposed to contaminated air are very essential to both vulnerable groups — infants as well as senior citizens.”
Lesser known winter maladies
- Chronic Obstructive Pulmonary Disease
- Seasonal affective disorder or SAD (seasonal depression)
- Respiratory Syncitial Virus
- Heart attacks/strokes
- Worsened diabetes symptoms
- Worsened interstitial lung disease symptoms
- Worsened rheumatoid arthritis symptoms
- Worsened AIDS symptoms
- Pneumonia
- Skin irritations
Preventive measures
- Regular vaccinations
- Regulate breathing and lung function
- Include fermented foods in diet
- Adequate sunlight and vitamin D
- Include vitamins A, C and antioxidants in the diet
- Emollient moisturisers for skin eczemas
