By Lindsay Travis
University of Kentucky
This holiday season, Kentuckians of all ages continue to deal with the trifecta of resurgent illness: flu, RSV and COVID-19.
The Commonwealth is on course for its worst flu season in 10 years. As of Monday, Dec. 19, the governor’s office reported six new pediatric flu deaths, and the Department of Public Health said none of those children had received a flu shot. The department also reported that fewer than 40 percent of Kentucky children received a flu shot this season. State leaders are encouraging families to get flu shots.
RSV can affect anyone, but is most serious in infants and the elderly. Cases of COVID-19 also spike in the state after Thanksgiving.
UKNow spoke to Dr Ilhem Messaoudi, Chair of the Department of Microbiology, Immunology and Molecular Genetics at the UK College of Medicine, about ways to stay healthy during the holiday season.
UKNow: With three viruses currently circulating (flu, RSV and COVID-19), what advice do you have for people to stay healthy?
Messaudi: My big tip is to keep up with your vaccinations. We have great COVID and flu vaccines. Influenza cases are reaching much higher levels than we have seen in the last 10 years. All the data seems to indicate that this year’s flu vaccine is pretty good for what’s circulating. So this is a great reason to go get vaccinated. Get your bivalent omicron vaccine because it will protect you against ancestral strains as well as what is currently circulating.
RSV is different. In older children and immunocompetent adults, this is usually just an annoying episode of respiratory illness.
Risk groups from RSV are the very young and the very old. It’s problematic when you have children under one year old who get really sick. There are some therapeutic agents, but they are reserved for premature infants at high risk of cardiovascular complications from RSV.
The virus can be a huge problem in nursing homes. If you are visiting a loved one in a nursing home, just be very aware of it.
In addition to keeping up with your vaccination regimens, I would say if you have a baby at home, an older parent, or an older relative, just be extra careful with them. Maybe avoid large gatherings or wear a mask if you have to go to a crowded place.
UKNow: Are there any steps we can take to keep our immune systems healthy?
Messaudi: I know it sounds cliche, but eating a very balanced diet this time of year is a big help. You also want to be aware of your body mass index and any underlying conditions such as obesity, smoking, or any substance use problems. All of these things are known to weaken the immune system.
Trying to manage these underlying conditions with the help of a primary care physician is always great—not just this time of year, but in general. We’re approaching a new year, which can be a great motivator for healthy resolutions.
I also increase my vitamin C and zinc intake just to cover this period where I know a lot of respiratory pathogens will be circulating because some studies suggest that this improves immunity. The reason these two go together is just like calcium. You should not take a calcium supplement without vitamin D. These two things work together.
There’s nothing specific you can take if you already have a cold, but taking these little supplements, like taking a multivitamin over time, just makes sure you’re not missing any micronutrients you might need. My reason? There is evidence-based data that vitamin C and zinc are beneficial.
UKNow: What can parents do to keep their children’s immune systems healthy?
Messaudi: Same things. Make sure your children eat a balanced diet. I give my kids some vitamin C and compound gum which they love.
I think it’s just important to keep them healthy with good nutrition and exercise and keep them well rounded. Make sure they see their peers and get that interaction they need. We want our children to be mentally and physically healthy because both affect the immune system.
UKNow: What affects our immune system?
Messaudi: There are many things: if you don’t sleep enough, if you don’t eat well or if you drink too much. All substance use disorders affect the immune system.
Obesity is a major cause of immunosuppression and chronic inflammation. So we want to avoid that if we can, or deal with it. I think there’s a big myth that people have to run and lift weights and stuff like that. But there’s great research that getting your 10,000 steps a day, that type of walking, is a great way to just stay healthy and exercise and improve performance from that standpoint.
Taking care of your mental well-being is really important.
We know that stress causes high levels of cortisol, which is a well-known immunosuppressant. So sleep, trying to manage stress or underlying stress conditions, focusing on holistic nutrition, engaging with loved ones, and focusing on positive things are all great ways to keep your body healthy.
UKNow: Why does disease spread more easily during the colder months and holidays?
Messaudi: That’s a good question. If you ask my mom, she’ll tell you it’s because you go outside with wet hair. But there are other reasons.
We know that influenza A follows the migration of birds from the southern hemisphere to the northern hemisphere and back. As the birds interact with other animals, the virus mutates and comes out with its new strains for the year. This is a constantly evolving virus.
Back to the cold – this time of year people are more indoors and there are more gatherings, especially for the holiday. People are traveling more. So we create these events where there will be more transmission of respiratory pathogens.
Finally, there are some studies that show that cold air can damage the lining of our airways, creating conditions for more infections.
UKNow: What steps can people who travel take to avoid contracting or spreading disease?
Messaudi: I would disguise myself on a plane. I still do, even in a huge airport with so many people from everywhere. It’s a great mixing bowl for all those pathogens. So it’s not a bad idea to take extra precautions. If you could drive, I’d say drive and avoid the planes.
We know people haven’t been able to see their families the same way they could before COVID. This goes back to the importance of mental health and well-being. So it’s a cost-benefit analysis as people make plans.
Right now, if I were an immunocompromised person, I would be very careful and thoughtful about where I go. I’d say if you’re coughing or not feeling well, cover up or maybe just don’t go to that one thing you were going to for the sake of everyone else around you.