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Dr. Zach’s Guide to Winter Health

BT Montreal | posted Tuesday, Dec 6th, 2016

By Dr. Zach Levine, ER physician, MUHC

Colds and Flu Season

Why are viruses more prevelant in the winter? Beacause we spend more time indoors sharing air and viruses prefer dry air.

Colds are caused by one of several virus’; Symptoms are a runny nose, cough, congestion, low grade fever, sore throat – not caused by being cold.

Flu is caused by the influenza virus.  Every year 10-25% of Canadians get flu and 500-1500 die from it.

Virus shedding begins day before symptoms appear and lasts five-to-seven days.  Most ineffective on the second and third days after infection. Correlated with fever.

Virus lives longer with low humidity and lack of sunlight.  15 minutes on tissues, five minutes on skin, and one-to-two days on plastic or metal. Mucus protects (it remains up to 17 days on banknotes!)

Symptoms can include fever or feeling feverish/chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches and fatigue.

Remember you can infect others, even if you take meds and feel better; see a doctor if sob, chest pain, drowsy, neck stiff, fever in infant less than three months, not urinating.

You can always get the shot! Flu shot (shot is dead virus, nasal is live weakened, only for ages 2-49) is available for everyone six months and older.  It takes two weeks to gain immunity.  If you have a chicken egg allergy you can get it, unless unless it is severe – if worried, 1/10th the dose and observe 30 min before giving the rest. Some people get soreness, or mild flu-like symptoms. Caregivers should get it.

Heart attacks – They increase in winter with 5-30% increase in heart related deaths in winter, up to 50% more MI’s in winter.

Cold causes vasoconstriction so increased bp.  Also blood clots easier in cold.

Caused by cold, shoveling, emotional stress, weight gain, little exercise, more salt, binge drinking and AF. Know the symptoms!

Recommend Vitamin D supplementation, and calcium for:

Bones and teeth

Immune system

DM control

CV health

Prevent cancer


SAD – Seasonal Affective Disorder is caused by a decrease in sunlight

Light therapy (10000 lux, little UV as possible as it is damaging to skin and eyes), 20-30 minutes soon after waking, eyes open but not looking directly; meds & therapy also an option.


Frostbite – An injury to the body caused by freezing.  It most commonly affects areas that are extremities and that are uncovered, such as the nose, ears, cheeks, fingers, and toes, especially in those with reduced blood circulation.  If recognized early, frostbite can be mild, but if left untreated it can lead to severe damage or loss of the frostbitten body part.

Signs of frostbite include a white or gray skin colour, numbness, and firmness or waxiness of the skin.  It is wise to warm or cover any area that begins to feel painful or turn red in the cold because once frostbite sets in the area may be numb and more damage may result without you feeling it.

Frostbite can be associated with hypothermia, another serious condition that is caused by the cold.  If you think you might have frostbite, seek medical care.  Until you can see a health care professional, the following tips might help: get warm, do not walk on frostbitten toes, put the frostbitten part into warm water or warm the area with body heat.  Be careful not to burn the affected area which may well be numb.

As always, prevention is better than treatment.  Dress properly


Hypothermia: Abnormally low body temperature – 35ºC or less.  Very cold temperatures or less cold temperatures if not well dressed or wet.  Very old and very young especially susceptible.

Warning signs of hypothermia include shivering, exhaustion, confusion, problems with coordination, memory loss, and slurred speech.  In infants you might note very low energy and bright red, cold skin.

Get warm, get help if bad. Move to a warm place, remove wet clothing and warm the person (such as in a warm blanket).  Warm beverages can help the person to warm up as well. Dress warm, wear layers. Be careful about falls.

Shovel, salt, stay active for muscles & balance, slow down, shoes with traction, bring a phone & have a plan.