Understanding Seasonal Infections: A Deep Dive into Winter Viruses

Understanding seasonal infections and how to prevent them can help you enjoy the winter without becoming sick. During the colder months, breathing problems can be brought on by RSV, influenza, COVID-19, and common colds. Symptoms of a winter virus may include signs such as a cough, runny or congested nose, fever, aches, changes in taste or smell, wheezing, or shortness of breath. In most cases, the sickness is self-limiting and brief.

However, problems might arise from underlying disorders. Proper hygiene, wearing a facemask when sick, and vaccines can reduce the chance of developing a dreaded respiratory infection.

Winter viruses: infections of concern

Fall and winter bring longer nights, shorter days, and sometimes extremely cold temperatures. Depending on where you live, these seasons can also bring snow, freezing rain, floods, and other inclement weather. During this period, we are more vulnerable to a range of respiratory infections because our immune systems are not functioning at their peak.

Types of seasonal infections and viruses

In cooler climates, people spend more time indoors and interacting with others during the fall and winter months. Children are exposed to a variety of viruses at school, and they frequently bring these infections home with them. Although the common cold can strike at any time of year, during the cooler months, there's an increased chance of getting respiratory illnesses.

Many viruses tend to become active during the winter. Thanksgiving, Christmas, and sugar plum fairies remind us not only of holidays but also of a period when we are more susceptible to respiratory illnesses such as the common cold viruses (including non-COVID-19 coronaviruses). In addition to the common cold, the most prevalent seasonal viruses during this time include respiratory syncytial virus (RSV), influenza (the flu), and COVID-19.

Many respiratory illnesses have similar symptoms, such as:

• Headaches
• Runny noses
• Coughing
• Sneezing

However, depending on the type of virus, additional symptoms may appear.

The common cold typically causes the fewest problems and symptoms. The flu, however, can sometimes cause a high fever, extreme fatigue, and headaches. Compare this to COVID-19, more commonly associated with a sore throat, exhaustion, loss of taste or smell, and breathing difficulties. Finally, RSV is the most likely to cause clinical wheezing. Regardless of the underlying virus, symptoms will vary from individual to individual.

RSV

In most people, RSV, an Orthopneumovirus, causes common cold-like symptoms that last one to two weeks. Signs of RSV are most likely to appear in people under one or over 60 years. Although RSV can happen at any time, it usually manifests in winter.

Influenza, aka the flu

There are multiple types of flu viruses in the Orthomyxoviridae family. These viruses present a spectrum of subtypes based on variations in the surface proteins—hemagglutinin (H) and neuraminidase (N). These alterations dictate the virus's virulence (ability to infect others easily) and its potential to cause widespread outbreaks or pandemics. Still, most commonly, humans are infected by Influenza A and B types.

Influenza A is known for its ability to mutate (change) rapidly and has a high potential of triggering global pandemics.

Influenza B is less likely to mutate than Influenza A, can still trigger seasonal epidemics, contributing to a substantial illness burden among global communities.

COVID-19

COVID-19, caused by a coronavirus, caused the global pandemic that started in 2020, and it is here to stay. While not a seasonal virus, meaning it can strike any time of year, as the weather gets colder and nights get longer, combined with other respiratory illnesses, it complicates matters. The presence of COVID-19 can increase one's risk of developing breathing problems and other complications this winter.

The common cold

The common colds are usually not too bad and last for a few days to a week. They come in different types, but most of them are caused by tiny germs called rhinoviruses.

While winter brings the flu and RSV, COVID-19 and the common colds happen regardless of the time of year. If you feel sick with things like coughing, sneezing, body aches, or a fever, it might not necessarily be one of the big viruses everyone's talking about. It could just be a regular cold or some other virus. If you're healthy and have a good immune system, most of them go away on their own.

If you get sick and after 4-5 days don’t feel better or worsen, have trouble breathing, or if your fever keeps going up and doesn’t get better with over-the-counter medication like acetaminophen or ibuprofen, see a healthcare provider.

General strategies to prevent winter viruses

There are a few steps that you can take to prevent seasonal infections and viruses:

• Practice proper hygiene.
  
• Wear a facemask when sick to protect others.
• If you are sick, try to stay at home as much as possible, especially if you have a fever (higher than 100.4°F [38°C]).
• Get plenty of sleep. Too little sleep weakens the immune system.
• If you cough or sneeze, cover it and avoid sneezing or coughing directly into your hands or the air.
• Keep your distance from those with underlying respiratory illnesses.
  
• Get vaccinated against the flu and other diseases.

Ensuring you practice proper hygiene goes a long way. You should wash your hands thoroughly or use alcohol hand sanitizer with 60% or greater strength if you have handled anything someone else touched with unclean hands.

Facemask etiquette

If you have to spend time with someone who has respiratory symptoms, wear a facemask. Research shows that wearing a cloth, surgical device, or a KN95 or N95 mask lessens the risk of respiratory infection transmission (to others and the wearer). However, the degree of protection varies with the type of mask used. Generally, cloth masks are the least protective to the wearer, while KN95/N95s are the most protective.

Since we cannot always isolate ourselves, even when sick, we can take steps to protect others. For example, when sick, you should wear a mask in public to help protect others and minimize disease spread.

Consider wearing a facemask to protect yourself if you are well but worried about getting sick, particularly if you have high-risk factors like underlying conditions like diabetes, heart disease, or asthma. If you plan to travel by plane, train, or even the subway, as well as attend events in large spaces like movie theaters or gatherings, you should also think about wearing a facemask.

RSV, COVID-19, and FLU Vaccinations

There are various ways that vaccines work to protect our immune system. Regardless of how the vaccine works, immunizations boost your immune system to make antibodies that fight the disease. These antibodies recognize when you're sick and help your body fight the virus, hopefully keeping you from getting ill but, at a minimum, minimizing your risk of hospitalization or death.

Every year, influenza vaccinations are updated; therefore, the vaccine’s effectiveness varies each year. This is due to the organism's quick adaptability and mutation rate. Still, getting the vaccine increases your chances of fully recovering if you get sick or stops signs from happening in the first place, especially if you already have risk factors.

Long-standing research supports the use of the flu vaccine and its effectiveness in reducing disease in various populations and age groups. From a technological point of view, the efficacy of reducing the flu-related disease burden is well established and demonstrated.

Although the efficacy of the flu vaccine varies from year to year depending on the degree of mutation, extensive and well-established research has demonstrated the vaccine's advantages, and healthcare professionals advise getting it every year.

COVID-19 boosters

The COVID-19 strains differ depending on the region. This affects vaccine effectiveness. Additionally, fewer documented vaccination studies exist because the disease is relatively new, and several vaccines use more recent technology. As we have more scientific data to back up the vaccines, updated boosters have been developed and might be a possibility for you. Talk to your healthcare provider to determine if you are at risk, if they recommend the booster, and how often.

RSV vaccination and antibodies

Currently, we have a vaccine available that can help protect some populations against RSV. There is a new vaccine available for people 60 years and older. Early effectiveness studies suggest that vaccinating older adults is effective at disease prevention or symptom reduction. However, since this vaccine is still relatively new, more research is required to determine its long-term efficacy. To find out if this is appropriate for you, consult with your healthcare professional.

In addition, pregnant women now have the option of receiving a vaccine to protect the unborn child since newborns and infants are particularly vulnerable to RSV. This vaccine is given between the 32nd and 36th weeks of pregnancy. If a pregnant woman isn't vaccinated, an alternative is to give infants the RSV antibody. Research suggests that using this monoclonal antibody in infants can shorten the duration of symptoms or reduce the risk of developing RSV disease, even though it is not a vaccine.

Who’s at risk?

Most people are going out into the world now that they are not in quarantine due to COVID-19. This puts us at risk of exposure to respiratory disease; therefore, everyone should take precautions to protect themselves. Still, a few groups are at higher risk of more serious conditions or complications from respiratory illness.

Those at higher risk include:

• Kids under five. Smaller lungs, airways, and a developing immune system increase their risk.
• The elderly. As we age, the immune system weakens, thus increasing the risk of airway infections.
  
• People with underlying conditions. Those with asthma, COPD (chronic obstructive pulmonary disease), heart disease, diabetes, cancer, and other diseases that weaken the immune system are at higher risk of respiratory conditions. People who take immunosuppressive drugs may also be at higher risk.

Prevent those pesky seasonal bugs

Traveling to large gatherings, flying, and the winter season expose people to respiratory infections, whether you are heading to your family's enormous Thanksgiving meal or taking a winter vacation to the Caribbean.

Protect those you love and yourself by:

• Washing your hands often.
• Avoiding touching your face, eyes, nose, and mouth.
• Talking with your healthcare provider to see if vaccines may be right for you.

Taking precautions to avoid seasonal infections goes a long way, so winter does not have to be a season of aches, pains, and coughing. But be aware that anyone at any age can contract COVID-19, RSV, influenza, and other cold viruses at any time of year.