How to stay healthy during the indoor time of year

Every parent knows what comes after school starts in September: runny noses, sore throats, coughs, fevers, achy muscles, rashes and, of course, stomach bugs.

And we aren’t just talking about the kids.

Children seem to bring home every germ, spreading infection to siblings, parents and even grandparents. A 2009 University of Utah study found that families with up to four kids had a viral infection in the house about 50 percent of the year. That’s compared to childless households that only had a viral infection 7 percent of the year, according to a report by NPR.

Some winters, it seems like a never-ending cycle of colds, flu, COVID, strep, stomach bugs and Respiratory Syncytial Virus or RSV. While most infections will be more annoying than anything else, there are some, such as RSV, that can be risky for older adults or young babies.

“Flu and RSV seasons are coming around the corner,” said Lori Zito, MD, of Bass River Pediatrics in South Yarmouth. “Strep just goes pretty much the entire school year. It's not super contagious, but (kids) can get it if they're sharing crayons and pencils and things that the other kids had in their mouths.”

So, how can you keep your household healthier this school year? We talked strategy with Dr. Zito and pediatrician, Leif Norenberg, MD, of Briarpatch Pediatrics in Sandwich. They had two important recommendations:

Get Back to Basics on Hygiene.

After almost four years of COVID, we all know the drill: proper handwashing, hand sanitizer, social distancing, masking.

“Handwashing, first and foremost, and covering your mouth when you cough and sneeze – not with your hand, but with your elbow,” Dr. Norenberg said. “Social distancing does work. If you have a cold, a cough, a fever, you might have COVID, you might have the flu. Distance yourself. Don’t go to work when you’re feeling really horribly sick and don’t go to school. Get tested.”

Ask children to wash their hands and their faces when they come home from school, Dr. Zito suggested.

And masks can help stop the spread when someone is sick at home, she said. “People didn't like masks, but it did teach us that if you put masks on, it helps,” she said. “If you don't want to get [sick], it can't hurt to put on a mask.”

Get Adults and Kids Up-to-Date on Vaccinations.

The pediatricians endorse the routine vaccines as recommended by the American Academy of Pediatrics, such as measles, mumps and rubella (MMR), HiB and pneumococcal meningitis vaccines, pertussis (whooping cough), and polio. They also recommend the seasonal vaccines, including COVID-19, flu and RSV.

Because of these vaccines, pediatricians no longer see as many illnesses, like pneumonia, meningitis and ear infections, Dr. Norenberg said.

Adults, particularly those over 60, should also be up-to-date on immunizations. That includes flu and COVID, as well as shingles and Strep pneumoniae, depending on your age, according to the U.S. Centers for Disease Control.

And there are new immunizations for RSV, now more likely to be diagnosed due to the rapid tests developed in the last few years.

While there is no treatment for RSV, a new monoclonal antibody called Beyfortus can be given to children up to 8 months old during their first RSV season, to give them passive immunity, lessening the severity of the disease and the need for hospital admission. High-risk children can receive a second season’s dose, up to the age of 19 months, Dr. Norenberg said.

The vaccine doesn’t prevent RSV but can keep it from becoming severe, Dr. Zito said.

“It’s actually a monoclonal antibody,” she said. “So it doesn't prevent RSV, but if the baby gets RSV, it contains it and keeps it from becoming a severe respiratory infection in the chest.”

A maternal RSV vaccine, Abrysvo, can be given to mothers at 32 through 36 gestational weeks of pregnancy and helps to protect babies in their first six months. “That will cause no side effects for the baby. It's just mom taking the sore arm and maybe a low-grade fever,” Dr. Norenberg said. “For the full-term kids that get that at 32 to 36 weeks through mom, it's going to be a game changer.”

Meanwhile, an adult RSV vaccine, Arexvy, has been approved for people over 60. RSV leads to 60,000 to 120,000 hospitalizations and 6,000 to 10,000 deaths among adults 65 years of age and older in the United States annually, according to CDC. The vaccine significantly reduced the risk of developing RSV-associated lower respiratory disease by 82.6 percent and reduced the risk of developing severe RSV-associated disease by 94.1 percent, according to the U.S. Food and Drug Administration.

The CDC recommends it particularly for older adults with weakened immune systems or chronic illnesses.

“I'd absolutely recommend that 60-year-olds and above ask their providers about it,” Dr. Norenberg said.