Colds – 'tis the season

Feed a cold and starve a fever...or is the other way around? Theories on treatments for colds and other respiratory infections have been offered since Hippocrates noted that colds were more frequent in the winter. Everyone has his own favorite remedy and stores abound in medications for every symptom. It helps to understand what causes colds to fully appreciate how to deal with them.

Colds and flu are not the same. The flu or influenza causes higher fever, severe aches and fatigue, often severe sore throat and hacking cough. The flu hits quickly but colds are more gradual. The average adult gets two to four colds a year; children get six to eight.

Two hundred strains of cold viruses can infect the nose and throat. Although bacteria can infect the respiratory tract they are very different. Bacteria carry on living functions constantly. Viruses are inert until they get inside one of our cells. There a virus takes over the cell and use it to make millions of copies of itself until the cell bursts open releasing all the virus copies to infect other cells. When our immune systems realize we are infected, a battle takes place in our noses and throats. The collateral damage from that battle causes congestion, runny nose, sore throat, fever, sneezing and cough. Most of the time our immune systems kill all the viruses in about a week but it takes another week to heal the battlefield.

During the battle, we seek relief of symptoms since cure is not possible. Antibiotics have no effect because they interfere with chemical reactions that do not take place in viruses, only in bacteria. Using an antibiotic for a virus just kills the normal and beneficial bacteria in our bodies and puts us at risk for a worse infection with bacteria that are resistant to the antibiotic.

There's an old adage that says, "A cold will last two weeks with treatment and 14 days without." Nonetheless, symptom relievers may help us feel better. Pseudoephedrine is a decongestant which can relieve nasal congestion and runny nose. Some people are bothered by palpitations or difficulty urinating when they take decongestants. Guiaifenesin keeps secretions thin so they can be cleared out more easily, but it can cause nausea. Dextromethorphan helps reduce coughing but can cause drowsiness in the dosage needed to work. Antihistamines such as Benadryl can help with sneezing but may thicken mucus. Analgesics such as Tylenol, Advil or Aleve can help the achiness, sore throat and fever.

There is evidence chicken soup helps symptoms. Warm drinks in general help keep mucus thin enough to clear. Nasal saline sprays are also helpful. Nasal decongestant sprays, such as, Afrin or Neosynephrine, are very effective for nasal congestion but tend to cause rebound congestion after 3-5 days of continuous use.

Echinacea might have some benefit in treating colds but it has been difficult to prove through research. If it works at all, it must be taken within hours of realizing that a cold is starting. Zinc nasal gel has been shown to shorten the course of a cold but zinc lozenges may not. Garlic is touted to kill viruses, but once infection is underway, this seems less likely.

As with many other medical conditions, prevention is best. Although we can be infected from the air, this usually requires a closed, dry environment, such as, an airplane where the air is recirculated. Typically we pick up the viruses on our hands and infect our own noses and eyes by touching them. Frequent hand washing or use of alcohol based sanitizers and avoidance of touching our noses or eyes can reduce our risk. Proper nutrition and rest with maintenance of adequate fluid intake makes us less susceptible.

If you get a cold, the first few days are the worst. Over the counter remedies in addition to extra sleep can help the symptoms. Increasing symptoms could signal a secondary infection with bacteria. People with heart or lung diseases, emphysema or suppressed immune systems should work out a plan with their physicians for when to seek treatment before becoming ill. Consider seeing a doctor for increasing facial pain, fever over 102, worsening aches or severe fatigue, an increasingly productive cough or if it lasts more than two weeks. Children with colds who develop throat or ear pain that is not relieved by Tylenol or Advil or who become listless should see a doctor.

Feed a cold? Starve a fever? It doesn't matter; you'll feel better next week anyway.

For more information, go to: http://www.niaid.nih.gov/factsheets/cold.htm