This is the season for viral fevers. Cynics may say : “Which season is NOT ? ” Yes, it is true that viral fevers have become more common now a days. Viruses attack us more easily when our immunity is lowered due to faulty eating habits, overwork, over crowding and stress.

Viral respiratory infections are the commonest cause of viral fever. They cause the typical ” flu like ” symptoms like fever, body and head ache, throat pain, runny nose and cough. In a usual case, the fever gets ok in 3-5 days, weakness in a week and cough in 2 weeks. Antibiotics are usually not required. The old adage that a flu will get ok in a week if you take antibiotics and in 7 days if you don’t, is very true.

But things get more troublesome and complicated for an asthmatic. When an asthmatic gets a viral respiratory infection, the fever usually is not higher nor remains longer. Nor are viral infections more common in an asthmatic. But there is much more cough and wheeze and shortness of breath. An asthmatic has hypersensitive air tubes. Just as they over react to allergens ( pollens, dust and molds ), they also are oversensitive to viruses. The cough and wheeze produced by the virus in an asthmatic can last upto 4-8 weeks. This tires him out and really tests his, and the doctor’s patience.

If the asthmatic is regularly taking the preventer inhalers, the wheeze and cough will be less. Montelukast started as soon as the viral fever starts reduces the intensity of symptoms, at least in children. Increasing the dose of inhalers is the usual policy. Cough suppressants are required for the first week or so. Oral steroids are sometimes required. I may add here that, unlike allergen induced wheeze, viral induced wheeze is not very responsive to medication. Oral steroids are also not that effective.

Also remember that antibiotics are not required for viral fevers. They cannot kill the virus. But they do kill the bodies’ good bacteria. Overuse of antibiotics also caused drug resistance. Overuse of antibiotics in children is one of the reasons for increasing asthma in children. High fever or severity of symptoms alone is no reason to start antibiotics.

The doctor must be consulted in the following situations:

• Very young children or elderly patients.
• Existing diseases like diabetes or severe heart or lung disease.
• Shortness of breath or chest pain.
• Mental confusion.
• Very high fever.
• Fever not settling in 5 days.

Drinking plenty of warm fluids like warm water, tea and coffee is helpful. Chicken clear soup is particularly useful. Ginger water and honey helps.

So it is clear that viral respiratory infections are quite troublesome for asthma patients. Also, their treatment is not highly effective. Therefore an asthmatic should try everything possible to prevent getting such infections.

This is what can be done to minimize the chances of getting a viral respiratory infection:

• During the viral season, frequently wash your hands.
• Use separate hand towels.
• If someone at home or office has a viral fever, then take special care to protect yourself.
• Avoid going to crowded places.
• Flu vaccine helps, but only somewhat. More on that in another newsletter.