Winter season brings a plethora of illnesses, with health clinics overwhelmed and hospital internal medicine departments filled to capacity. Among these, a particularly troubling phenomenon stands out: "serial" patients – individuals, especially children, who recover from one illness only to quickly contract a new virus or another infection. What causes this phenomenon? How can it be addressed? And what are the recommendations for breaking the cycle of illness?
Causes: Viruses, bacteria and everything in between
Winter months are characterized by a significant increase in respiratory illnesses caused by a wide range of viruses, such as Influenza A and B, rhinovirus, RSV and coronavirus, sometimes even a combination of them.
"After the body is weakened by a viral illness, bacteria seize the opportunity and cause infections such as pneumonia, throat infections, ear infections, and sinusitis," explains Dr. Ilan Yehoshua, head of the Southern District Family Medicine Department at Maccabi Healthcare Services. "Each virus has small 'arms,' called receptors, that help it penetrate the human body. The ability of these receptors to attach to specific tissues in the body depends on the interaction between the virus and the tissue – sometimes the interaction exists, and sometimes it doesn't."
He explains that the virulence of the virus, meaning its aggressiveness, affects its ability to invade the body. The more aggressive the virus, the higher the likelihood that tissues cannot resist it. "However, it's important to distinguish between virulence and pathogenicity," he notes. "A virus like rhinovirus, for example, can easily infect due to its high virulence, but the illness it causes is usually not severe."
Dr. Hani Abukias, a specialist in family and internal medicine at Clalit in Haifa and the Western Galilee, adds that, in most cases, serial patients are exposed to several different viruses, rather than suffering from one prolonged illness. "Especially in crowded environments like daycare centers, schools, and workplaces, people are exposed to various viruses that lead to recurring waves of illness."
Breaking the cycle of illness
Personal Hygiene: "Handwashing is one of the most important recommendations, as most viruses are transmitted through contact," says Dr. Abukias. "Additionally, avoid touching your face and use masks in crowded places."
Avoid Spreading Illness: Dr. Yehoshua emphasizes the importance of avoiding going to work or sending sick children to school or daycare to prevent chains of infection.
- Exposure to Fresh Air and Ventilation: Contrary to popular belief, staying indoors is not helpful. "It's important to get fresh air and ensure proper ventilation of closed spaces, such as opening windows and doors," recommends Dr. Abukias.
- Nutrition and Physical Resilience: A balanced diet and sufficient hydration strengthen the body. "Chicken soup or clear broth is an excellent 'Jewish antibiotic' that provides fluids, electrolytes, and strengthens the body," says Dr. Yehoshua.
- Supplements: Regarding vitamins, Dr. Yehoshua mentions that the effect of vitamin C is not proven, but vitamin D may contribute to the body's resistance to winter illnesses.
- Vaccinations: Vaccination against influenza and other viruses is an effective means of preventing winter illnesses. "Unfortunately, this year there has been a significant decline in vaccination rates, likely due to public fatigue after COVID-19 and concerns about vaccines," says Dr. Abukias. "This decline in vaccination rates is likely directly related to the increase in illnesses this year."
Increase in illnesses: What do the numbers say?
This year has seen a significant rise in respiratory illnesses, especially influenza. "Influenza cases have increased by 15%-20% compared to previous years," notes Dr. Abukias. "Hospitals report heavy loads in pediatric emergency departments and internal medicine wards."
Clalit reported that so far, about 850,000 people have been vaccinated against influenza. Last week, there was a 10% increase in online consultations with family doctors, along with a 4% rise in requests for sick leave certificates for adults. However, the exact causes for these requests could not be isolated.
Dr. Hani AbukiasPhoto: CourtesyMaccabi Healthcare Services reported that since the start of the current flu vaccination campaign in September, approximately 380,000 members have been vaccinated. The age group with the highest vaccination rate is 65 and older, with about half of this group already vaccinated. Over the past two weeks, there has been a 5% increase in the issuance of digital sick leave certificates compared to the previous three weeks.
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In the Leumit HMO, 66,000 have been vaccinated against influenza so far, with a 15% increase recorded last week compared to the previous week. Additionally, there was a 25% increase in the issuance of sick leave certificates for adults, both independently and through doctors, compared to the prior week.
Amos Maor, Deputy CEO of Customer Division at Meuhedet HMO, said, "Since we launched the option to receive an automatic sick leave certificate on our website and app, we've seen that 60% of people requesting sick leave certificates online now do so automatically, without going through a doctor. It's important to note that we haven't seen an increase in the total number of requests, but rather a reduction in the burden on doctors."