It is that time of the year again when we look forward to holidays, meeting friends and family, cooking and eating our favorite food. The list of doing fun things can be as long as you want it to be. However, the season also brings something pesky with it: The ever looming threat of seasonal cold and flu. While it is almost impossible to guard against it completely, there are a few things you can do to either prevent it or ride out the dark days of sickness somewhat smoothly.

Why do we get cold and flu in the first place?

Flu, short for influenza, is caused by viruses differentiated by nomenclature A, B, C, and D. The seasonal epidemic of flu is attributed primarily to  Type A and Type B viruses [2]. Similarly, common cold is caused by viruses, however, unlike flu the number of viruses that can give you cold is much higher. There are about 200 cold viruses; but  rhinoviruses are considered to be responsible for 50% of all incidences of colds. The important take away from these pieces of information is that flu and colds are caused by viruses that are NOT treatable with antibiotics.

Cold or flu viruses are highly contagious--meaning you can get it easily from a  family member, co-worker, or even a stranger. Flu viruses  are most commonly spread by droplets, made when somebody with flu talks, sneezes, or coughs around you. These droplets either enter your nasal passage through nose or land in the mouth setting the stage for the onset of a cold/flu  infection. Experts believe that somebody with flu can spread it to others up to at a six feet distance [1].

To a lesser extent, flu can also be spread through touching surfaces or objects that somebody infected with germs has touched it. For example, if you use a phone that somebody with flu has used, you may have a good chance of catching it. Experts believe that flu viruses can survive for up to 24 hours on hard surfaces while most cold viruses can last up to seven days. However, virusus are most potent in the first 24 hours of their arrival on the surface. The period of survival of both cold and flu viruses is shorter on hands compared to hard surfaces. For example, rhinovirus can survive the longest on hands--more than an hour. Most flu viruses on hand lose their potency substantially after 5 minutes [3]. 

The worst thing about flu prevention through contact with others is that flu symptoms show up at least one day later (sometimes 2 days) when somebody has contracted flu. Therefore, you could you get flu from somebody who doesn't think he/she has flu. While most of us tend to take seasonal flu in our stride, it can be dangerous for some. The centre for disease control and prevention (CDC) attributed estimated close to one million cases of hospitalization and 79,000 deaths to influenza (flu) during 2017-18 [1].

Here are five tips that can help prevent or fight flu/cold more smoothly.

Tip #1: Practice healthy hygiene habits

The first line of defense against cold and flu viruses is prevention. The best practices involve healthy hygiene habits. It's amazing that how much these simple habits can help prevent the spread of colds or flu.

• Wash hands with soap and water for 20 seconds

Your hands are highly instrumental in passing on the flu/cold viruses--either to you when you touch your nose or mouth with the flu/cold virus-laced hands or others when you are sick and touch a surface and leave it contaminated with germs. Simply washing hands can prevent passing the germs onto your nose and mouth, food, or any hard surfaces you come in contact with. However, you need to wash your hand thoroughly. The CDC recommends the following 20-second hand washing process:

1. Wet your hands under clean running water. The temperature of water is not important, but in winter months warm water can bring extra comfort. 
2. After wetting hands thoroughly, apply soap. Please don't use "ANTIBACTERIAL SOAPS," as they can do more harm than good. Regular soaps work fine. 
3. Lather your hands--front, back, around, under finger nails, and between fingers. 
4. Rub vigorously for 20 seconds, then rinse. 
5. Dry hands with a single-use towel. 

If hand washing is not an option, then it is best to carry hand wipes or sanitizers. According to the CDC, only alcohol-containing sanitizers, cleaners, and wipes ensure the removal of bacteria/viruses from your hands. While alcohol is not the healthiest option, in an emergency it can prevent a cold or flu. Do make sure to wash your hand thoroughly with soap and water before eating.

If you are wondering when should you wash hands, then it is best to do so frequently after exposure to but not limited to the following:

1. Public places: door handles are a great conduit to pass on any germs. Similarly, sharing phones, pens, or computers (workplace, banks etc.) can become a medium to transfer cold/flu bugs. Airports and the other modes of public transports  are an excellent hub to catch flu/cold viruses. It is best to avoid touching your face or nose before you have washed hands after using public places or transport.
2. Before eating and preparing food: it is of the utmost importance to wash hands before eating as your hands are going to be close to your mouth and nose. This will also prevent infecting your food. In Indian kitchens moms and grandmothers still require whoever enters the kitchen to wash their hands thoroughly before touching any food so as to prevent the spread of any germs from hand to food. This ancient wisdom is totally worth practicing in every day life, flu season or not.
3. After using the bathroom: it's amazing that how many of us don't wash our hands after using a bathroom. According to a recent study by Michigan State University, only 5.3% of all bathroom users wash hands properly enough to ward off any germs in public places [4]. While this accounts for the hand-washing practice in public places, it's best to practice hand-washing every time after using bathroom at home.

• Wipe/clean infected surfaces

If you are going to touch a surface that may have come in contact with a cold/flu-infected person, it's best to wipe those with cleaning wipes/cleaners that claim to kill 99.9% bacteria/viruses.

Similarly, if somebody has been sick at home, don't use the same bedding--bedsheets, comforter, pillow cases, etc.--before washing it.

It is best to use tissue papers or single-use towels to sneeze or wipe mouth/nose as viruses can survive for sometime on a surface.

Tip #2: Stay Warm

Why do cold/flu viruses proliferate during the winter months? According to Ayurveda, the 5,000-year-old health care tradition practiced in India, we tend to get sick when the basic elements that form our body go out of balance. During the cold months, when repeatedly exposed to the cold weather, one of the most important element digestive Agni (fire) goes out of balance, leaving the body more susceptible to catching diseases such as cold [5].

In  the modern scientific world, some studies have proven that the cold temperatures and low humidity, typical of winter months, offer ideal breeding conditions for cold viruses [6]. Similarly, according to a study published in the Journal of Virology, cold temperatures combined with low humidity exhibit higher incidence of spreading flu viruses in guinea pigs [7].

The clear path of action is to stay warm when outdoors and turn on that dust-gathering humidifier when indoors. Remember to practice layering, i.e. don't just throw your jacket over a t-shirt but wear 2-3 different garments to protect you from getting cold. Here is a great article on LAYERING from Cool Wilderness. If you need another in-depth look on layering, here is another article from Untamed Space. 

1. Base Layer: this is the underwear layer and helps absorb and evaporate sweat. So choose a t-shirt or shirt that can help wick sweat.
2. Middle Layer: this layer insulates by keeping the body heat. Choose a warm sweater to go over your shirt or t-shirt.
3. Outer Layer: This is your outer jacket that you can take off when indoors.

Don't forget to carry your gloves, hat, and scarf (around your neck) to prevent escaping heat from hands, head, and throat respectively.

Using spices and herbs that have warming effect on body also help combat the cold weather. You can have these herbs in the form of tea or add to your everyday food. Here are some herbs and spices that promote heating:

• Black pepper--use in tea, soups, and lattes
• Cinnamon--use in porridge, tea, soups, and curries
• Clove--chew on a clove if you have an itchy throat, use in tea, bread, and curries
• Ginger--use in teas, curries, breads, and lattes
• Nutmeg--sprinkle on porridge and use in curries
• Tulsi (Indian basil)--make a tea
• Turmeric--make latte, hot milk (non-dairy), and curries, salad dressings

When thinking of staying warm, it is best to avoid cold-temperature foods such as ice-cream and cold beverages as they tend to weaken the digestive fire [5].

Try this immunity-boosting herb and spice tea from my mom's (and grand mom) kitchen. Some variation of the spices used in this tea are used everyday in making tea in Indian households, especially during the winter months.

Immunity-boosting Herb and Spice Tea

Or try this Golden Turmeric Milk

Tip #3: Shore up your immune system

What is your immune system?  While it can take a lot to explain the whole thing, in short your immune system is your body's defence mechanism against outside agents such as bacteria, viruses, toxins, etc. Eating healthy and real food daily is one way to keep your immune system in good condition. During the cold/flu season you can give it an extra boost by eating foods that our body likes. Here are some helpful tips:

• Amp up fruits and vegetable intake. Soups are a great way to keep warm as well as eat your veggies. Find lots of soup recipes from TLC HERE.
• Reduce/eliminate processed food from diet, especially those high in artificial ingredients and sugar. For example, soda, sugary yogurts and treats, boxed cereals, canned soups, and salad dressings. Your body has to fight the load of toxins or sugar, leaving you more vulnerable to catch colds/flu.

Tip #4: Quarantine--take time off to get better

The word Quarantine is derived from the Latin word quadraginta, which translates to "forty." The word means isolating somebody who is sick to prevent the spread of infectious diseases. Historically, the isolation period lasted for 40 days, but now it has come to mean a period of isolation of any length. According to the CDC, those with flu-like symptoms should stay home until at least 24 hours after being free of fever without any fever-reducing medication [1]. This means that you can go back to work or send your kids to school when they are fever free for at least one day[100° F (37.8°C)]. However, the risk of giving flu to another person still persists for ten or more days, albeit the risk spirals downward considerably.

Even at home, it's best to stay in one place--possibly your bed-- so as not to spread germs to other family members. If it becomes super hard to stay in one place, and it definitely can, assign yourself a place, where you can sit and do whatever you want to do before getting better.

Tip#5: Stay Hydrated

Water is a wonderful beverage that costs you nothing, except maybe a good filteration system. But drinking enough water has the miraculous effect on every function of your body. During cold and flu, it becomes of utmost importance to keep your water intake up to the mark. In fact, a new study suggests that drinking less water than your body needs is associated with increased risk of getting flu, cold, and other respiratory conditions [8].

What counts as water? The short answer is plain water (preferably filtered water)  and true herbal teas. The caffeine-laced drinks--coffee/tea- actually work more to dehydrate us rather than vice-versa. Soda and fruit juice contain loads of sugar; and it's best to avoid.

How much water should you drink? Experts believe that you should drink 8 glasses of water a day, but that can vary from person to person. A good measure is trusting your thirst and the color of urine. If you are feeling thirsty, you are already dehydrated; similarly, if the color of your urine is dark yellow or bordering onto become deep amber or light brown then your body is in need of more water. Drinking herbal teas is a good way to not only get water but also feel better as they warm up the body.

So this holiday (winter) season, combine these tips with a bit of luck to not get sick!

Remember: this post is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here.

Resources

1. Center for Disease Control and Prevention (CDC): www.cdc.gov
2. World Health Organization--www.who.com
3. How long do bacteria and viruses live outside the body?
4. Hand Washing Practices in a College Town Environment 
5. A Practical Approach to The Science of Ayurveda--Acharya Balkrishna
6.  Ikäheimo, T. M., Jaakkola, K., Jokelainen, J., Saukkoriipi, A.,  Roivainen, M.   Juvonen, R., Vainio, O.  and Jaakkola, J.J.K., A Decrease in Temperature and Humidity Precedes Human Rhinovirus Infections in a Cold Climate, Viruses,  8(9), 244.
7. Lowen, A.C., Steel, J. Schultz-Cherry, S. (editor), Roles of Humidity and Temperature in Shaping Influenza Seasonality, Journal of Virology, DOI: 10.1128/JVI.03544-1
8. Why Water can Ward-off Flu