Weather's enough to make you sick

For those among us unlucky enough to be vulnerable to such things, the changes of seasons can mean sickness is inevitable. Health experts say that a rise or fall in temperature can distract our immune systems from their task of protecting our well-being. Kirsten Kraemer and her family fear change - at least where the seasons are concerned. Every time the clime changes from summer to winter, or the other way around, the family falls ill. A spreadsheet Mrs Kraemer keeps details how much the family spends on medical bills and treatment for her and her husband Darren, a financier, and their two children, aged six and three. But the former accountant from Germany, who has lived in Dubai since 2006, says the most expensive period has been the past few weeks, when her entire family have fallen sick. "My husband has bronchitis, I have an upper respiratory infection and the children have coughs and colds," says Mrs Kraemer. "From the middle of April until the end of May we spent Dh2,000 and that's on doctor's appointments alone. If you include medication, that figure jumps to almost Dh3,000. "My family always gets ill around November when the weather cools, and this time of year when the temperatures rise." It is no cooked-up theory. Health experts confirm that the Kraemer family is reacting to the sudden jump in temperature in the middle of last month, when the mercury rose by more than 10°C in days, from the early 30s to 45°C. While the heat snap was certainly a talking point among residents, for local medical clinics it signalled a rush of new patients. "For the last two or three weeks there has been a significant increase in the number of patients," says Dr Adham Alameddin, a general practitioner and the medical director of Synergy Integrated Medical Clinic on Al Wasl Road in Dubai. Dr Alameddin says the surgery and its two sister clinics in the emirate have had a 40 per cent rise in the number of appointments. Complaints typically include viral infections, influenza, upper respiratory infections and gastrointestinal complaints such as diarrhoea and stomach flu. Dr Alameddin says the reason for the increase in illness is because our bodies cannot cope with a sudden heatwave. "The difference in temperature between your office and your car park sometimes reaches 25°C and when you are exposed to such a big change in a matter of seconds, some people's bodies cannot tolerate it," he explains. "This causes disturbance in the areas most exposed to this change, such as the respiratory tract." Dr Alameddin stresses that most viruses and bacteria that cause illness already exist in our bodies, but because they are suppressed by our immune systems they do not affect us. However, when they are activated by something such as an acute change in temperature, our immune system can no longer cope and we become ill. "The tract is already trying to deal with the cold, dry air inside your office and then suddenly it's very hot and the surface of this respiratory tract is disturbed," Dr Alameddin says. "You end up with reduced blood circulation, which leads to reduced immunity in this area so these diseases take the opportunity to attack." If this is the case, why is it that only some people fall ill? It's because the community is divided into two groups - those who are vulnerable to illness and those who are healthy. For the healthy sector, as long as they continue to eat a balanced diet, take a lot of exercise and drink plenty of fluids, their body will be able to cope with the dramatic onset of heat. For those who fall into the vulnerable category - young children, pregnant women, the elderly and those suffering from chronic conditions such as asthma, diabetes or cancer - the risk of feeling unwell is much higher. "It's common that people suffer in heatwaves but the people that usually suffer the most are the vulnerable members of society," says Dr John Schneider, a specialist in occupational and environmental medicine at UAE University in Al Ain. Dr Schneider argues that heat does not increase the number of infections in the community, it simply exacerbates the symptoms. "The biggest problem with that is dehydration, so if people are already running a fever they are going to be a lot more vulnerable when it's hot outside because that adds to the heat load that they've got on their body," he says. "For a lot of these people, if the temperature hadn't jumped they'd still have the virus but they'd be able to cope." It is not only the struggle our bodies have in adjusting that puts people at risk, but the fact that as the mercury rises we rush indoors to the malls, cinemas or air-conditioned offices. These confined spaces provide more opportunity for airborne infections and flu to be transmitted from one person to another. Dr Alameddin says it only takes one sick person sneezing to release millions of viruses into the air that simply float around us. Hundreds of new viruses enter our bodies every day and are stopped from causing harm, as long as our immune systems are not compromised. But by rushing indoors to escape the heat that is already weakening our immunity, we are heading into an environment where prolonged exposure to cold, dry air - and unclean air-conditioner ducts that carry a host of bacteria and viruses of their own - further weakens our immune systems. It is not only the vulnerable in Gulf countries who are affected by temperature variations. Sudden heatwaves can have a detrimental effect on people more accustomed to colder climes, such as those from the United Kingdom and northern Europe. "You get reports of increased hospital admissions and increased deaths, particularly in the colder countries where people aren't used to hot weather, but that happens at a lot lower temperatures than people experience here," says Dr Schneider. He refers to a study published last year by the London School of Hygiene and Tropical Medicine that examined different causes of death during a heatwave. The study found people were more susceptible to death when temperatures rose as little as 1°C above the standard average for the region. While the steepest increase in risk was for respiratory conditions, the study concluded heat-related death could be attributed to a range of causes, so introducing preventive measures for specific illnesses would be unnecessary. But while preventive measures may be unnecessary in the northern hemisphere, in the UAE they are crucial because as well as the vulnerable, the group that suffers during sudden heat spurts is those working outside, such as construction workers or farmers. "Although these people are young, fit and healthy, they're doing a lot of strenuous work," says Dr Schneider, who says that workers need to be outdoors for up to 10 hours a day, four days a week to become acclimatised to heat. "When you work hard, a lot of the energy you expend gets wasted and generates increases in body temperature and that can lead to dehydration. "When the temperature gets above 37°C, the only way people can cool down is by sweating. If you're sweating, you're losing fluids and if you don't replace the fluids, then dehydration can set in. "People feel more fatigued, lose their energy and don't function as well, and that's when they start to have accidents because they make mistakes they would not normally make." But it is not just heat rises that can make us ill. When the temperature cools in October and November it creates the optimal conditions - not too hot or too cold - for new viruses to develop. "Transitional seasons such as spring and autumn are the time when we usually have the most new generation of viruses and bacteria because the weather helps," says Dr Alameddin. "All over the world our bodies' immunity is a little bit less during these transitional seasons so it gives more chances for these diseases to flourish." For those trying to preserve their health as the weather heats up, the experts advise staying well hydrated, staying warm in cold, air-conditioned environments and maintaining a balanced diet. But ultimately when you fall ill, you must also think of others and stay at home. "If you are sick, you have a responsibility not to infect other people, so try to limit your presence in public areas or take a day off to look after your sick children at home," adds Dr Alameddin. By The National