Prolonged cough and complaints of fatigue on the rise

Mumbai: City doctors are seeing an unusual surge in viral infections with prolonged cough and complaints of fatigue. Though synonymous with the monsoon season, doctors said viral infections have resurfaced after a hiatus of two years, and the frequency of repeated viral infections is more, especially in children.

Dr Hemlata Arora, internal medicine and infectious diseases expert, Nanavati Max Super Speciality Hospital, Vile Parle said in the last three months, patients are returning with two to three viral infections. “There is an unusual surge in viral infections this season. Covid-19 infection was followed by swine flu and other viral flu. Which are still on. Persistent fatigue and cough are seen in most cases,” said Dr Arora. “Prolonged rains this year, resumption of normal life with no social distancing and masking are likely reasons for the present surge in viral cases.”

Dr Radhika Banka, pulmonologist, PD Hinduja Hospital said, on average nearly 20-30% patients at their outdoor patient department (OPD) have symptoms suggestive of a viral respiratory tract infection. “Hospital admissions are more among the elderly and immunocompromised presenting symptoms of pneumonia due to non-Covid viral infections such as common flu. Hence, it is extremely important for this cohort to get vaccinated with the flu vaccine,” said Banka.

She added that there are trends of increasing infections post Covid possibly due to alterations in the immune system. “However, reassuringly most of these infections seem to be self-limiting. Most of these patients tend to resolve within a few days with symptomatic treatment including antipyretics to reduce fever, antihistamine for allergy, and cough syrups. While fatigue and lethargy was a more conspicuous symptom of long Covid, it is seen in much lesser proportions post non-Covid viral infection,” she said.

While the viral infections are reported across age groups, doctors say children are the worst affected. Dr Bakul Parekh, senior paediatrician practising in Ghatkopar said 99% of the cases he sees in the outdoor patient department (OPD) are of viral fever and viral infection.

“The major difference that we are seeing in viral cases is that they are lasting longer. Instead of 4-5 days, it is taking 10-12 days for the child to recover. We are also seeing that as soon as they recover from one infection, within a week or two, they are falling prey to another viral infection,” he said. Dr Parekh said cough, cold, fever with bodyache are the common symptoms seen in OPD.

“We are hospitalising the children who are having loose motions, high fever that is refusing to subside, breathlessness. Children in the 0-5 age are more affected,” said Dr Parekh.

Dr Vijay Yewale, paediatrician and senior member of the Indian Academy of Paediatrics (IAP) said the community is presently having immunity debt because of which the frequency of repeated viral infections is very high.

“Repeated viral infections are known in children but not at such high frequency. The change has been noticed after we have opened up post the Covid-19 pandemic. Scientists are referring to the term immunity debt or lack of immunity in people that has resulted as during the two years of lockdown, people followed social distancing, hand hygiene. As a result, the viruses disappeared from circulation. Now that we have opened up and returned to normal life, we haven’t been exposed to these endemic viruses and developed immunity in the last two years and are falling prey to the infections,” he said.

Dr Yewale said good hygiene, nutritious food is needed to combat the present phase of viral infections. “Do not take antibiotics as these are viral infections. Consult a doctor instead of self-medication. Avoid overcrowded and badly ventilated places,” he said.

Dr Lancelot Pinto, consultant pulmonologist and epidemiologist at PD Hinduja Hospital, Mahim said while you are recovering from a virus, and exposed to another virus, your period of recovery extends. “You tend to be fatigued, there is a loss of energy,” he said.

While doctors advised taking flu vaccines as a precautionary measure, Dr Pinto added that people should not forget the learnings of Covid-19 and implement it in controlling other viral transmissions. “People who have symptoms should stay home. We saw how learning and working can happen from home during the pandemic. Also, if there is a trend of rise in viral infections in a particular season, offices and schools on an individual level can switch to work from home mode to break the transmission chain,” he said.