The cold and flu season can wreak havoc on those of us who are immunocompromised and are taking immunosuppressants. It seems like everywhere you go there are people hacking and coughing, sneezing and blowing their nose. And of course they are NEVER doing so in a way that could protect others from getting their germs. So here are a few questions to think about. Why do immunocompromised patients get more infections than others?  Why are infections often times more serious in an immunocompromised patient? And what can we do to avoid picking up every cold, flu and infection? Lets do some investigation and find out.
A body’s immune system uses a variety of defenses to prevent or get rid of infection. An infection can be caused by numerous organisms such as bacteria, viruses or fungi. That being said the immune system can be weakened by a number of disease and/or treatment. Thus making it easier for those with a weakened immune system to become ill.                       Below are some examples of what can weaken a person immune defense:

• A breakdown of skin, lining of the mouth or any part of the GI tract. This could be cause by side effects of medications, radiation, or other reasons.
• A person having lower numbers of the infection-fighting cells,  most commonly know as the white blood cells. This can happen as a result of certain cancers, or side effects of medications used to treat cancer.
• The presence any foreign object. This can be an IV or an urinary catheter. Patients who have these devices have to be vigilant so infections can be avoided.

So now we know why immunocompromised patients get more infections. Now lets look into how these infections often end up being much more serious and even dangerous. 

• For indivuals with poor immune systems many times the usual symptoms may not be present. They may not show the classic symptoms of an illness, like swelling or redness at an infection site. The only symptom they might have might be a fever. 
• The infection can move in quickly. As we learned above that the immunosuppresed patient may be low on the infection fight blood cells, the infection can go from zero to 100 in no time flat.  For this reason alone most Doctor require their patients to report any fever as it may be the only symptom. 
• Lastly, Their systems may not respond quickly to infection. Those with weak immune systems may have trouble getting the infection to clear their bodies. Like the “flu” it may take longer to from someone with a weak immune system compared to a person with a healthy immune system. 

So now we know how and why…. Lets see what we can do to prevent infection.

The KEY to prevention this time of year:

• Make sure you get a yearly flu shot!! As well as the pneumococcal vaccine when you are eligible. Please make sure you get the proper pneumococcal vaccine that provides long term immunity to one type of pneumonia. 
• In contrast to the flu shot that is given yearly. The pneumococcal vaccine is only to be given every 5 years.
• Make sure to get enough sleep. Lack of sleep will actually lead to a weaker immune system.
• If you are traveling on public transportation you might want to consider purchasing an N95 face mask in case you are seated next to the cougher. 
•  WASH YOUR HANDS, WASH YOUR HANDS, WASH YOUR HANDS!!! This is essential, especially if you are wiping your nose as many infections will gain entry to the body through this route.
• Try to avoid contact with anyone who might be sick. Even the common cold has the potential to make a patient with a weakened immune system very sick. 
• Many suggest immune stimulants, this time of year, such as echinacea. However, before starting these stimulants you really should consult your doctor. This is said because conditions such as RA, and Lupus are associated with an overactive immune system. Taking an immune stimulant could potentially aggravate these conditions.

Hope this information helps you during this cold and flu season

~Amber

Resources:

• Https://www.verywell.com/immunosuppressive-meds-prevent-illness-189184
• Https://www.stjude.org/treatment/patient-resources/caregiver-resources/infection-tips/infections-immunocompromsed-patients.html