10 embarrassing questions about influenza and ARVI:

In this series of articles, well-known experts answer questions that are usually awkward to ask: it seems that everyone already knows about it, and the questioner will look stupid.

During the flu season, we talked with virologist Daria Danilenko about how to avoid getting infected, whether folk remedies help, why to get vaccinated every year and what will happen if you don’t get treatment.

Daria Danilenko

Virologist, Candidate of Biological Sciences, Deputy Director for Research, Head of the Department of Etiology and Epidemiology of the Research Institute of Influenza named after. A. A. Smorodintseva, Ministry of Health of Russia, Deputy Director of the WHO National Influenza Center.

1. What is the difference between influenza and ARVI? What about different types of flu: regular, swine, avian? What’s the most dangerous?

Influenza is a disease caused by influenza viruses A, B, C and D. Only the first three cause illness in humans. Influenza C is a mild infection. Influenza B mainly affects people and rarely some marine mammals.

Influenza A is very diverse. Influenza A viruses are scientifically referred to by complex names that include the species of animal or bird from which it was isolated and the place where it first appeared. But all this is difficult for the general public to perceive. Therefore, new influenza viruses often receive “popular” names. For example, swine and bird flu .

Pigs and birds do get the flu, and occasionally humans can get it.

Regarding the danger. We have seasonal influenza viruses, they cause the seasonal epidemics that we expect. As a rule, we become infected with the known strains of groups A and B. It is impossible to say which of them is more dangerous, since the severity of the infection depends on the individual characteristics of the body, and complications may also arise.

There is a pandemic flu. This is the name given to a new strain of influenza A virus, the danger of which is higher than that of the seasonal one, because, as a rule, no one has immunity to it. For example, the Spanish flu (1918 strain), the Asian flu (1957–1958), and the Hong Kong flu (1968–1969) were pandemics.

There are also zoonotic influenza viruses that sometimes people contract from animals. Such infections can be severe if we are talking about avian influenza viruses of the H5 subtype. But in ordinary life it is not so easy to get infected with such a flu. Because animal influenza viruses are adapted to infect animals and birds. And in order to infect a person, special conditions are required. This can happen, for example, if on some farm there are a lot of birds that are sick and have died from the flu, and people start gutting them. In such a situation, an aerosol (“cloud”) is formed, in which there are many virus particles. A person inhales this aerosol and becomes infected.

But other viruses are responsible for ARVI. They cause diseases of the upper and lower respiratory tract, which initially have the same symptoms. Therefore, diseases are grouped. It is very difficult to distinguish them without laboratory diagnostics.

In terms of symptoms, influenza and acute respiratory viral infections may or may not differ: each one develops individually.

Someone may have ARVI with conjunctivitis, or a severe cough, or a high fever. Some people may not have these symptoms.

It’s the same with the flu: for some people the temperature rises very high , but for others it may not change. For example, in older people, the flu often occurs without fever.

2. Why do people get sick with influenza and acute respiratory viral infections more often in autumn and winter?

There are questions to which we do not fully know the answer. One of them is why do influenza viruses circulate seasonally in some countries, but not in others? It is known that in countries where the climate is seasonal, the circulation of influenza viruses is tied to the autumn-winter-spring season, as, for example, in our country. The incidence increases in autumn, reaches its peak in winter, and decreases in spring. In summer it is very low.

But there are areas where there is no seasonal change of seasons and, surprisingly, influenza viruses circulate year-round. For example, in Hong Kong, the incidence is always approximately the same level, with slight increases twice a year.

Perhaps this is due to the weather, humidity, wind speed – there are many hypotheses. But it is impossible to say for sure that the infection occurs at such and such an average low temperature.

3. Will I get sick if I wear warm clothes? What if I eat garlic and apply ointment?

To protect yourself from a viral infection, no miracles are needed. Our immunity takes care of us. To get sick less, we need to train him to recognize pathogens. To do this, you must first be vaccinated against diseases for which there are vaccines.

We have a flu vaccine , and we need to get it every year. The fact is that influenza viruses change very quickly, and after them the vaccine has to be changed. That’s why it’s different every season.

So far, the scientific community has not been able to create a universal vaccine that would protect us for life or at least for 10 years.

In addition to the flu shot, we now have a vaccine for COVID-19 and will soon have a vaccine for respiratory syncytial virus infection, which is very dangerous for newborns and young children, as well as for people over 65 years of age. There are no vaccines yet for other pathogens of ARVI.

In addition to vaccinations, our immunity will be helped by a healthy lifestyle and compliance with reasonable safety measures . For example, you should not visit crowded places during an epidemic.

Yes, you need to dress according to the weather so as not to get hypothermic. But even if you put on three fur coats and still enter a vehicle full of sneezing people, clothes are unlikely to save you if your immune system is not ready for it.

As for garlic , citrus fruits, berries, which are rich in active substances and vitamins: they can have a beneficial effect on the immune system. But you should approach everything soberly. If you only smear yourself with garlic and don’t get vaccinated, it’s unlikely to help you. As an additional measure – perhaps.

There is also research that applying auxiliary substances, such as oxolinic ointment, to the sites where the virus enters can slow it down. But it is worth remembering that the virus enters the body not only through the nose, but also through other mucous membranes, such as the eyes.

Therefore, all these funds can serve as a supplement. They won’t make things worse, but they won’t protect you 100%.

4. How long is the patient contagious? Is it even possible to understand that a person is spreading the virus?

With influenza, the patient is contagious mainly for 3–5 days after the onset of the disease, sometimes up to 7 days. In the case of COVID-19 and a number of other acute respiratory viral infections, this period is slightly longer. Research on COVID-19  has shown that after an average of 10–12 days, no matter how the patient feels, they are no longer contagious.

You can only tell for sure whether a person is contagious if they have symptoms . If there are no symptoms, laboratory testing can tell you that he has the virus.

5. Will vaccination be 100% safe?

Flu vaccines are on average 50–70% effective. But they are still necessary. Firstly, they protect us from several strains of influenza at once. Secondly, unvaccinated people can become very seriously ill, requiring hospitalization. Against the background of a severe course of the disease, other infections, both viral and bacterial, may occur . And then complications associated with the cardiovascular, respiratory and other systems develop.

Unfortunately, a number of severe infections can be fatal. According to world statistics , 250–650 thousand people die from influenza and its consequences every year. There is also the concept of delayed mortality, when a person suffered an infection and against this background there was an exacerbation of a chronic pathology that existed earlier. And in the weeks to months after illness, the risk of death, for example from cardiovascular disease, increases, especially in older patients.

The risks of complications depend on what chronic diseases you have, how severe the course of the disease was, and how timely and effective the treatment is.

Thirdly, by getting vaccinated, we protect risk groups for whom vaccination is contraindicated or unavailable, including members of our families. For example, children under 6 months of age should not be vaccinated against the flu, but the more people around them who are vaccinated, the less likely they are to get sick.

6. Do I need to take antiviral medications for prevention or during treatment?

Today there are broad-spectrum antiviral drugs against influenza and ARVI. But since there are many viruses , there are also antiviral drugs. And under no circumstances should you prescribe them for prevention. After all, if you don’t have a virus in your body, what will they do?

These medications must be prescribed by a doctor. You cannot know what is wrong with you.

If the doctor prescribed you medications, it means that he has reasons to believe that your body will not cope with the virus without medication. As a rule, drugs are not prescribed for mild forms of the disease.

For preventive purposes, antiviral drugs may be prescribed in rare situations. For example, when the patient is in constant contact with vulnerable groups of the population – with the elderly, people with chronic diseases, with infants , as well as patients themselves from risk groups. Sometimes prophylactic administration is prescribed in areas where the virus is spreading. But even in these cases, drugs are always prescribed only by a doctor.

And these drugs have nothing to do with dietary supplements or homeopathic powders , which you see in abundance on pharmacy shelves and whose effectiveness has not been proven.

If you have an irresistible urge to take medication, you should consult a doctor before doing so.

7. Is it possible to be treated with some folk remedies? For example, does garlic, tea with lemon, milk with honey help?

The most important thing for influenza and ARVI is rest, sleep, self-isolation . Tea and milk are simply sources of fluid, which is important for us to replenish, because we lose it at high temperatures.

Everything should be taken in moderation, and if you want tea or garlic, drink and eat. But they are not magic remedies that will instantly get you back on your feet. In the normal course of the disease, the body should cope with it within a few days.

8. What happens if you don’t get treatment? What if you endure illness on your feet and don’t rest? Will it go away on its own or are there possible complications?

Carrying an illness on your feet is the worst decision. Often this is what leads to the fact that a person becomes worse, he gets sick longer and more severely, and at the same time also infects the people around him.

Influenza and ARVI are acute diseases that can cause severe discomfort, but occur quite quickly and normally go away on their own with proper adherence to the regimen.

The body itself fights the infection – we can only alleviate our condition symptomatically: take antipyretics, medications for a sore throat or headache. These conditions are not life-threatening.

If after a few days you do not feel better , you notice that it is harder for you to breathe, your temperature does not decrease, a severe cough develops, or symptoms that are unusual for you, then you should definitely call a doctor and not let everything take its course. Because influenza or ARVI viruses may be joined by some other viruses and bacteria that will aggravate your condition and can lead to complications. And here you can’t do without a specialist.

9. They say that high temperature helps the body destroy viruses. This is true? Does this mean that the temperature does not need to be lowered?

It’s not like we need high temperatures. It’s simply the body’s response to an infection that it is trying to cope with.

We bring down the temperature to alleviate our condition. If it is very bad, you can take an antipyretic.

10. Is it possible to get sick several times in a row? Or does immunity still develop?

Here we return to the first question. If we have different groups of influenza viruses and different pathogens of acute respiratory viral infections, then, of course, you can get sick with different strains in a row. This risk can be reduced by getting vaccinated.

It is unlikely that you will be infected with the same virus again.

If you get sick very often, several times a season, then you need to figure out with your doctor why your immune system is weakened. Healthy adults don’t get sick as often.