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Going viral: tips for getting the upper hand.

The docs tackle your questions about viruses.

Q I TAKE A TROPICAL VACATION EACH WINTER AND ALWAYS SEEM TO GET A COLD SORE WHILE I'M AWAY. WHAT GIVES?

A: Folks who have the cold sore virus, herpes simplex, can go a long time without an outbreak because the immune system is constantly at work to keep the virus under control. But when the immune system isn't at its best--like when you're traveling and facing immunity interlopers such as stress and sleep deprivation--the virus can reactivate and cause a cold sore. Surprisingly, sun exposure, particularly UVB radiation, also has been found to inhibit the immune system and allow cold sores to crop up. Injuring your lips (for example, by letting them crack after exposure to dry, windy air) can trigger recurrences, too.

Do your best to prevent them by getting ample sleep, planning ahead to avoid travel stressors, wearing plenty of broad-spectrum sunscreen--including on your lips--and keeping lips moisturized and protected from the wind. You might also consider talking to your doctor about antiviral medications that will prevent outbreaks.

Q MY WIFE WANTS TO GO ON a CRUISE, BUT I'M FREAKED OUT BY THE STORIES OF NOROVIRUS MAKING PASSENGERS SICK. WHAT'S THE REAL RISK?

A: Believe it or not, norovirus is far more common on land, where about 20 million people in the U.S. are hit annually, according to the Centers for Disease Control and Prevention. At sea, there have been roughly 150 confirmed outbreaks in the past 10 years, the CDC reports, which is less than 1 percent of annual cases of norovirus.

Still, if an outbreak does occur onboard, it can be bad news, because it's extremely contagious and spreads like a brushfire in the close quarters of a ship. And the illness itself is no fun: Acute gastric distress, meaning vomiting and diarrhea, will last one to three days.

Here's how to reduce your chances of becoming infected on a cruise or anywhere else:

* If you or a travel companion is feeling ill, postpone your trip until you feel better.

* Wash your hands frequently. And if someone becomes infected, wash every surface near the person with plain soap and water. Carry hand sanitizer to the dining room and let the liquid dry on your hands before you touch anything.

* Opt for plastic utensils sealed in plastic wrap, because under-washed utensils seem to be a source for spreading this virus.

* If an outbreak occurs onboard, don't touch your face with your hands unless they are freshly washed.

Norovirus is no joke, but don't let it stop you from having a wonderful vacation. Your chances of becoming ill are slim.

Q I'VE HEARD THERE'S A NEW TYPE OF ENTEROVIRUS GOING AROUND. WHAT SHOULD I KNOW?

A: Enterovirus D68, also known as EV-D68, was identified by scientists in 1962 and is one of more than a hundred non-polio enteroviruses. (Yes, the virus that causes polio is from the same family.) Non-polio enteroviruses cause between 10 million and 15 million respiratory infections in the United States each year, and most of them strike in the summer and fall. Their symptoms can be as innocuous as the common cold, and some people who get infected have no symptoms at all.

But last year, there was an outbreak of a relatively new strain of EV-D68 called B1. Most cases were mild, but others caused severe upper respiratory infections requiring hospitalization, especially in children under 16 who had asthma or a history of wheezing. B1 EV-D68 also made headlines last year when a potential link between it and acute flaccid myelitis (AFM)--which is a sudden onset of muscle weakness and paralysis--in children was suggested. Although scientists are still exploring this link, it's important to take the following steps in order to keep you and your little ones healthy:

1. Know how to prevent it. Wash your hands regularly for 20 seconds at a time with soap and warm water. Cover your coughs. Avoid touching your mouth, nose or eyes without washing your hands before and after. And never share food with those who are sick.

2. Know what to look for. Mild symptoms are the usual suspects: fever, runny nose, sneezing, coughing and body aches. More severe symptoms can include sudden coughing, wheezing and difficulty breathing. Your doctor might prescribe an inhaler to help you breathe more easily, but so far no antiviral agent targets D68.

Q HOW CAN YOU TELL WHETHER A SINUS INFECTION IS BACTERIAL OR VIRAL? SHOULD YOU ASK A DOCTOR TO DO A CULTURE? AND WHAT'S YOUR STANCE ON ANTIBIOTICS FOR SINUS INFECTIONS?

A: Based on symptoms alone, it is next to impossible to diagnose a sinus infection as definitely bacterial or viral. You'll almost always have congestion, postnasal drip, sinus pressure, and possibly a fever, whether the cause is a virus, bacteria or allergies.

If we had to take a wild guess, though, chances are your sinus infection is viral--the vast majority of sinus infections come from viruses (mostly these are the same ones that cause the common cold). Your misery can last quite a while, up to several weeks, although the longer the symptoms last, the more likely it is to be a bacterial infection.

Even doing a culture may not make a difference to your outcome, because 60 to 70 percent of people with sinus infections recover without antibiotics. A study in The Journal of the American Medical Association found that patients with sinus infections who took no treatment healed just as fast as--and sometimes faster than--those who took antibiotics, even if the cause was found to be bacterial.

Doctors are increasingly reluctant to prescribe antibiotics, thanks to justified fears about resistance. So they're more likely to suggest drinking water, using a neti pot and (do we sound like a broken record?) hand-washing. But if you have diabetes, heart or lung disease, or a compromised ability to fight infection, your doctor may prefer to put you on antibiotics, so ask about the best course of action for you.

MEHMET OZ, M.D.

MICHAEL ROIZEN, M.D.

OZ IS THE DIRECTOR OF THE CARDIOVASCULAR INSTITUTE AND INTEGRATIVE MEDICINE CENTER AT NEW YORK'S PRESBYTERIAN/ COLUMBIA UNIVERSITY. HE HOSTS THE DR. OZ SHOW.

ROIZEN IS THE CHIEF WELLNESS OFFICER AND CHAIR OF THE WELLNESS INSTITUTE ATTHE CLEVELAND CLINIC.
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Title Annotation:HEALTHY YOU
Author:Oz, Mehmet; Roizen, Michael
Publication:Success
Date:Dec 1, 2015
Words:1049
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