Autumn brings pleasant weather, weddings and a slew of festivals—reasons enough to meet and greet friends and family. It is also the time for the seasonal flu to do the rounds. You could suffer the sniffles and visit doctors, or starting this year, work on building your immunity.
“It is the strength of our immune system which decides who gets sick and who doesn’t,” says Nalin Nag, consultant, internal medicine, Apollo Indraprastha Hospital, New Delhi.
However, many factors challenge immunity. “We are living longer than ever before, and with age, the defence mechanism of the body becomes less effective,” says Randeep Guleria, professor, department of medicine, All India Institute of Medical Sciences (AIIMS), New Delhi. “Overcrowding in urban areas, low hygiene and faster intercontinental travel all lead to the incidence and rapid spread of pandemic flus.” Some drugs, such as steroids, also suppress immunity.
Stress plays a key role in underminning immunity too. “Even routine daily stresses—deadlines and traffic jams—can downplay immunity,” says Ashima Puri, consultant psychologist, Aashlok Hospital, New Delhi. Other factors include lack of exercise, improper food and working in closed environments, according to S. Chatterjee, senior consultant, internal medicine, Apollo Hospital, New Delhi.
Should you get a shot?
Getting vaccinated to prevent the flu seems like a good short cut since vaccines add acquired immunity to your natural shield. However, many doctors remain concerned about a swine flu vaccine developed on the fast track. S.P. Byotra, senior consultant and co-chairman, department of medicine, Sir Ganga Ram Hospital, New Delhi, is one of the sceptics, and finds it “unbelievable” that companies are claiming a safe vaccine for a disease that is just a few months old. Should this concern extend to regular flu shots?
Doctors point out that the country’s immunization schedule contains only shots deemed both safe and essential by the Indian Academy of Pediatrics. Though recommended by the World Health Organization (WHO), flu shots are not on that list. Whether you or your child should take a flu shot at the onset of the flu season is something Indian doctors are still debating.
Nitin Verma, senior consultant, Max Super Speciality Hospital, Saket, New Delhi, says, “Every year, end of August or beginning of September, a new vaccine—depending on WHO recommendations about the flus to be covered—is released.” He recommends that all children aged 6 months or above get the shot at the beginning of the flu season, only around September.
Dr Byotra, however, feels that adults should take only very essential vaccines. “For example, if you are travelling to a particular country that has an endemic disease pocket”. For children, he believes the childhood immunization schedule should suffice.
How to stay healthy
Raising your immunity is like reinforcing your shield. The other half of your defence is avoiding the attackers. Some pointers:
Hand hygiene: New research suggests a flu mask is not that effective against viruses. The effective alternative: washing your hands. “The way (flu) germs are spread is not by inhaling them, but by picking them up on our hands and spreading them to our face, where they can gain entry to our body through the membranes of the eyes, mouth and nose,” says Dr Nag. Seemingly innocent surfaces such as door knobs, light switches, telephones and keyboards are loaded with germs and every time you touch any of these surfaces and then your face, you are transferring the germs into your system. A study published last month in the journal Risk Analysis found that US college students working on their laptops touched their eyes, noses and lips once every 4 minutes.
Wash repeatedly even when at home or at work, not just before eating, but also every time you sneeze or cough. Keep hand sanitizers and tissues with you. Dr Nag suggests washing hands after touching any potentially contaminated surfaces, and immediately after coming in from outside. Touch as few surfaces as you can when using public transport, elevators and in shared spaces (such as at work or restaurants). Avoid touching your face, especially when in public. Dr Shehla Agarwal, consultant dermatologist, Mehak Skin Clinic, New Delhi, adds, “Although antibacterial soaps are popular, regular soaps are good enough.” Dr Agarwal also suggests a moisturizer to prevent dry skin, which can provide an entry point for germs.
Don’t spread your germs. Instead of a handkerchief, use a tissue when coughing or sneezing and discard it immediately. If you don’t have a tissue, cough or sneeze into the crook of your elbow rather than your hands.
As far as possible, avoid direct contact with the ill. Try to stay at least 3ft away from someone who is coughing or sneezing and 6ft from someone known to have influenza. In the festive season, be careful when you meet and greet people. Avoid too many handshakes, kissing and hugging. A namaste is the elegant, hygienic alternative.
Rest and relaxation: “If practised regularly, any of the well-known relaxation techniques—from aerobic exercise and meditation, reading a book, taking a walk, meeting friends (see Friends as protectors) to doing something you enjoy for just 30 minutes a day—help block the release of stress hormones and increase the immune function,” says Dr Puri.
You also need seven-eight hours of sleep. “Sleeping is our body’s way of repairing your defences,” says Dr Chatterjee. You should go to bed and wake up at the same time each day, not relax your schedule on weekends, he says. If you have trouble falling asleep, step up your exercise routine earlier in the day (however, evening exercise can leave you too alert). A warm bath before bed can also help. In bed, learn to consciously relax your muscles from head to toe, while breathing deeply.
Eating immunity: “30-40% of your immune system is in your gastrointestinal system,” says Jyothi Prasad, chief dietician, Manipal Hospital, Bangalore. “Daily probiotics will restore the natural state of health that a diet of excess sugar, meat, processed foods and prescription drugs have destroyed. Have ‘five a day’ of fruits and veggies. Make your plate colourful: The more colourful they are, the more the phytonutrients.” Nuts and oilseeds (flaxseeds, pumpkin, sunflower) are excellent for immunity. Green tea, studies have shown, can also help fight flus and colds.
“Diet therapy is the most effective way to boost immunity. Take a glass of hot milk with a teaspoon of turmeric powder every morning; chew five-six ‘tulsi’ leaves every day; increase the usage of black pepper in your diet. Increase the consumption of milk and milk products, eggs, spinach, beans, carrot, soybean, banana, almonds and dry dates. Take a glass of juice prepared from bitter gourd (30g), ‘tulsi’ leaves (30g) and Gilo Sabz (Tinospora cordifolia) (30g)—(this) acts as a protective shield against flu; having 10g of ‘tulsi’ plant juice with 5g of black pepper powder is a good preventive measure too. Unani formulations that help to boost the immune system are Khamira Gaozaban Ambari Jawahar Wala, Dawaul Misk Motadil Jawahar Wali and Khamira Marwareed.”
— Mohammad Tariq
Unani physician and in-charge, board of physicians Hamdard Wakf Laboratories, Delhi
“If there are toxins present in the body, immunity will take a beating. (For detoxification), have lots of salads, sprouts, vitamin C-rich fruits like sweet lime, oranges, lemon and gooseberry. Have two cups (sip it through the day) of a decoction made of ginger, pepper and garlic. To make it, crush all three and boil in two glasses of water till it becomes about a glass.”
Joint chief medical officer
Jindal Naturecure Institute, Bangalore
“(One) should always have easily digestible food and the temperature of the food should be around 5 degrees below the normal body temperature. This would help in proper digestion. One should have lukewarm water, liquid foods (such as ‘dal’, ‘khichdi’, vegetable soup, among others) and avoid fermented food (such as curd, pickles, sour products, among others). It is essential that one doesn’t allow the body temperature to go below the normal body temperature as viruses grow the most when the temperature is low.”
— S.V. Tripathi
Moolchand Ayurveda Hospital, New Delhi
“In homeopathy, the process of boosting immunity is usually twofold. To improve general immunity, homeopathy medicines are prescribed by a qualified practitioner after a deep study of the patient. This works best when the person is not afflicted with any disease. For immunity for specific ailments, specialized medicines are suggested. Gelsimium and Influenzinum 200 help treat and prevent all flus, sneezes and sniffles.”
— Akshay Batra
Deputy management director
Dr Batra’s Clinic, Bangalore
A polio-free pilgrimage
Saudi Arabia has announced that everyone arriving for the annual pilgrimage to Mecca in November would have to swallow a dose of oral polio vaccine in the presence of health officials. Polio has hovered on the brink of eradication for years in the kingdom. Earlier, Saudi authorities asked for proof of vaccination when pilgrims applied for visas and forcibly vaccinated only those arriving from countries where polio was endemic. It is endemic in only four countries: Pakistan, Afghanistan, parts of Nigeria and India. Each year, travellers from endemic countries seed outbreaks in poor countries, where vaccination drives had been dropped when the disease was thought to have been eliminated. © 2009/THE NEW YORK TIMES
Help poor countries fight H1N1 virus
Rich countries should make more vaccine available to poorer nations where the H1N1 virus is starting to hit, UN health officials said on Sunday. They said increased readiness for swine flu was needed in developing countries with weaker medical systems and with large, young populations who are most vulnerable to the disease. Some countries, such as the US, Brazil and France, have agreed to make 10% of their national vaccine stockpile available to developing countries. Manufacturers have also donated about 150 million doses of the vaccine. More is needed, said David Nabarro, UN coordinator for fighting emerging flus. September and October are usually the start of flu season in the northern hemisphere, but there are signs of a second H1N1 wave this year, said Julie Hall, an infections disease expert at the World Health Organization. Reuters
Friends as protectors
You should certainly avoid spreading germs, but do keep your friends close. Studies show that the value of nurturing, social support and camaraderie is phenomenal. So friends can also be good preventive medicine. In a 1997 study published in ‘The Journal of the American Medical Association’, researchers exposed people to a cold virus and then monitored how many contacts they had with friends, family, co-workers or members of community groups. The more social contacts they had and the more diverse the contacts, the less likely they were to catch the cold. Kavita Devgan
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