Common infections that we see are primarily related to the weather. We are seeing a lot of viral infections going around, especially respiratory viral infections such as influenza and other related viruses, including H1N1 and COVID-19. There is also a rise in dengue because of increased mosquito breeding following the rains. We are also seeing a rise in other bacterial infections, with cases of gastroenteritis as well as a significant number of typhoid cases.

The increase is attributable to the change in season. Respiratory viral infections are extremely seasonal and are related to rainfall. The monsoon can have a significant effect on the transmission of respiratory viruses. Across India, there has been significant rainfall and a huge increase in respiratory viral infections such as influenza. Chennai usually does not see this to the same extent during this season, but this year, since we have had more rain than usual in August and September, we are seeing a significant increase in respiratory viral infections.

How can you tell whether a fever is likely to be viral or bacterial?

Dengue and influenza are also viral infections. Generally, most viral infections are short-lasting. Bacterial infections such as typhoid can last for more than a week.

If you have a non-specific fever where you feel tired and feverish but do not have any major organ-system involvement, or if there is clear respiratory involvement such as a runny nose and sneezing, a viral illness may be more likely.

However, these are only pointers. It is not a good idea to self-diagnose. We can talk about which symptoms may make a bacterial or viral infection more likely, but these are only likelihoods. It is always best to seek a physician's advice to determine whether the infection is bacterial or viral.

When should you see a doctor?

A physician should be consulted if the fever continues for five days or longer and is not getting better. Medical attention is also important if there is other organ-system involvement, such as:

  • Shortness of breath
  • Burning or severe pain while passing urine
  • Persistent diarrhoea
  • Jaundice
  • Other symptoms involving a specific organ system
  • High-grade fever with shivering or shaking chills

High-grade fever with shivering or shaking chills requires medical attention as soon as possible. These symptoms can sometimes indicate a more serious infection and need prompt evaluation.

Also Read: Chennai Hospitals Struggle With Surge In Flu, Respiratory Infections And Dengue

What precautions should people take?

The precautions that we learned during COVID-19 remain very important when dealing with respiratory viral infections.

  • Wearing a mask, especially for vulnerable people, is important.
  • If somebody is unwell, the best thing to do is stay home and take a few days off.
  • Hand hygiene is very important.
  • Do not allow water to collect, as this can contribute to mosquito breeding.
  • Ensure safe drinking water and safe food.
  • Maintain good respiratory etiquette.
  • Workplaces should pay attention to ventilation, regular cleaning and hand hygiene.

Workplaces can be a little challenging because most are centrally air-conditioned and may have limited fresh-air circulation. Good ventilation is important in reducing the spread of respiratory infections. Regular cleaning and hand hygiene are therefore particularly important in such settings.

Why should you avoid self-medication?

Self-medication beyond paracetamol is not advisable. It is best to seek a doctor's advice.

Just because a fever looks the same does not mean it is the same disease. Fever is a symptom, not a disease, and fever can happen with many different infections. Certain non-infectious conditions can also cause a rise in temperature.

Just because you have a fever does not mean you need an antibiotic or a specific antibiotic.

It is particularly important not to take additional painkillers on your own if dengue is a possibility, because some medicines can increase the risk of bleeding. The best way to know what treatment is appropriate is to seek a physician's advice.

What symptoms may suggest something more than a simple viral fever?

A fever may be less likely to be just a viral fever if it lasts for more than five days or if there is high-grade fever with shivering.

Another important factor is the presence of clear localising symptoms. If you are coughing up a significant amount of thick or discoloured sputum, have shortness of breath, or have severe pain or burning while passing urine, these may suggest an infection involving a specific organ system.

Such cases may require further evaluation and, depending on the diagnosis, antibiotics.

Are infection numbers reliable?

Across India, hospitals are busy because of a lot of these infections, mostly viral, but some bacterial as well. Both outpatient and inpatient services are fairly busy because of this. These numbers may settle as the rains also settle down.

There may not be reliable numbers that can be quoted simply because a lot of patients do not get tested. We know there is likely to be significant underdiagnosis because many patients do not get tested, so I would not worry too much about the numbers alone.

The general public also knows people who are falling sick, and many of them have fallen sick, so it is not a very rare or unusual situation that we are talking about. At this point, taking sensible and common-sense steps will help keep all of us quite safe and healthy.

Also Read: Dengue Cases Spike In Chennai: When Should You See A Doctor?

What about people with existing health conditions?

Always pay attention to chronic underlying medical conditions. If you are diabetic, please make sure your blood sugar is under control. These things also make a difference in terms of long-term outcomes and the risk of becoming severely ill.

The important message is that people should not panic, but they should also not ignore persistent or worsening fever. Fever is a symptom, not a disease. When in doubt, it is always better to seek a physician's advice rather than self-diagnose or start medication on your own.

(By Dr. Subramanian Swaminathan, Director of Infectious Diseases and Senior Consultant, Gleneagles Hospital, Chennai)



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