KATHMANDU, JANUARY 5
As winter deepens across Nepal, doctors are reporting an increase in respiratory illnesses ranging from common colds and flu-like infections to more serious conditions such as pneumonia and acute respiratory infections. The seasonal spike is being seen across age groups, with people suffering from chronic lung diseases facing the highest risk of complications during the colder months.
Respiratory infections remain among the most common illnesses during winter. These include acute viral respiratory infections, influenza, bacterial infections and pneumonia, which often present with cough, fever and breathing discomfort. Recent data from the National Public Health Laboratory shows the severity of the winter surge. In 2024, a total of 1,313 people tested positive for influenza viruses. Of these positive cases, 952 were infected with influenza A(H1N1), 253 with influenza B, and 108 with influenza A(H3). The overall positivity rate for influenza was 16.1 percent.
Many of these infections affect otherwise healthy individuals and tend to settle within a few days with treatment. However, a significant number of patients already living with chronic lung conditions experience a worsening of symptoms during this period.
Dr. Ramesh Chokhani, a senior consultant in pulmonary, critical care and sleep medicine with over 30 years of experience said winter illnesses generally fall into two categories. "In winter months there can be two types of problems. One is acute problems: flu-like symptoms, common colds, simple pneumonia, acute viral respiratory infections, and sometimes bacterial infections also. These are pretty common in winter months," he said, adding that such cases are usually seen in patients without any underlying health conditions and resolve with treatment.
The more serious concern, doctors say, lies with patients who have pre-existing lung diseases. "We have another large chunk of people who already have underlying lung diseases," Dr. Chokhani said, referring to conditions such as chronic obstructive pulmonary disease (COPD), bronchial asthma, bronchiectasis and interstitial lung diseases. These patients are prone to flare-ups during winter, often triggered by infections.
"People who already have underlying lung diseases are most vulnerable to flare-ups during winter months," he said. These flare-ups, commonly caused by viral infections, can be dangerous. A recent study conducted in 2025 at Dhulikhel Hospital in Kavre district found that the overall prevalence of COPD among people aged 50 and above was 19.36 percent. The research, which examined 470 patients, revealed that increasing age is strongly associated with COPD risk, with those over 80 years old showing significantly higher prevalence. Educational status and family history also emerged as important factors influencing COPD development.
Environmental factors such as air pollution further aggravate respiratory problems during winter. While pollution levels vary by region, doctors note that poor air quality in certain areas contributes to worsening symptoms. "Even in Kathmandu, sometimes the air quality index is very high, and during winter months in particular, patients may have flare-ups of their underlying problems," Dr. Chokhani said.
Health experts stress that prevention plays a crucial role in reducing winter-related respiratory illnesses. Avoiding exposure to extreme cold, limiting contact with infected individuals and following vaccination schedules are key protective measures. "One of the precautions that has scientific evidence to say it helps is vaccination," Dr. Chokhani said.
In Nepal, two vaccines are commonly available for respiratory protection: pneumococcal and influenza vaccines. "The pneumococcal vaccine is given once in a lifetime, while the influenza vaccine is given yearly. The influenza virus strains keep changing worldwide, so based on WHO recommendations, the vaccine is prepared fresh every year," he explained. Influenza infections are known to be more prevalent during winter and the monsoon season in Nepal.
Doctors are also urging people not to ignore early warning signs. "If patients notice any change in their symptoms, need more medicines than usual, develop fever or feel more unwell over a few days, it is best to report to a doctor," Dr. Chokhani said, emphasizing that timely treatment can prevent serious complications.
With respiratory infections expected to remain prevalent through the winter months, health professionals continue to advise vigilance, early medical consultation and preventive care, particularly for children, older adults and those living with chronic lung diseases.