Sick Again? Why Some Colds Won’t Go Away

About a month ago Sharon Gilbert was hit with a runny nose, sore throat and a cough. The whole snotty works.

A few weeks later she thought she had recovered. Then her husband Derek got sick, and bam. “Suddenly I started getting all the symptoms [again] and it was worse,” said Ms. Gilbert, a 61-year-old writer in Charleston, Ill.

In the winter that seems to have no end in many parts of the country, people like Ms. Gilbert have been plagued with the seemingly everlasting cold.

That’s partly because the common cold can last longer than many people think—up to two weeks for the principal symptoms and perhaps weeks more for a cough that lingers even after the virus has been cleared away. There’s also the possibility of secondary infections such as bacterial sinusitis.

And some patients might get back-to-back colds, doctors say. It isn’t likely people will be reinfected with the same virus because the body builds some immunity to it. But people can pick up another of the more than 200 known viruses that can cause the common cold, some of which are worse than others.

“When you hear people who have the cold that ‘won’t go away,’ those are typically back-to-back infections of which we see a lot of in the cold weather when people are cohorting together,” said Darilyn Moyer, a physician at Temple University Hospital and chairwoman-elect of the American College of Physicians Board of Governors.

Influenza may get all the attention, but the common cold is the leading cause of doctor visits, according to the National Institutes of Health. Each year, people in the U.S. get about one billion colds, and 22 million school days are lost to the stubborn viruses.

Experts say adults on average get two to five colds a year; school children can get as many as seven to 10. The elderly tend to get infected less because they’ve built up immunity to many viruses. And adults who live or work with young children come down with more colds.

Don’t I know it. For more than a month now my family seems to be playing a game of pass-the-nasty-cold. My husband had a cold and lingering cough for weeks, which we suspect he gave to our infant. Finally I succumbed.

We blamed the purveyor of all germs, our kindergartner. Just as we were all recovering, the infant started day care and brought home a virus and we’re all on round two of apparently a different cold.

Experts say it’s possible that the carrier of germs—in this case our kindergartner—can infect others without having symptoms himself.

“At any given moment if we were to swab you…we’d probably come up with five different rhinoviruses sitting in your nose but you’re not sick,” said Ann Palmenberg, a researcher at the Institute of Molecular Virology at the University of Wisconsin-Madison. Rhinovirus is the most common viral cause of the common cold, accounting for 30% to 50% of adult colds, and there are more than 150 strains of it.

To get infected, the so-called ICAM receptors, which the rhinovirus attaches to in order to enter the nasal cells, need to be open, Dr. Palmenberg said.

“Rhinos are out there all the time, it’s just a question of when you are susceptible,” she said. Factors such as stress, lack of sleep and people’s overall health can make them more likely to get infected. More than 150 strains or genotypes of the rhinovirus have been identified and researchers believe there are probably many more.

Rhinovirus replicates best in the relatively lower body temperatures of the upper respiratory area, such as the nasal passages, sinuses and throat.

Other viruses, such as the less-common adenovirus, can replicate and attach to receptors in the upper and lower respiratory tracts, causing a more serious illness.

Other viruses—including the coronavirus, respiratory syncytial virus and enterovirus—have also been identified as causing cold symptoms. “The most confounding thing of all is that we still haven’t identified the cause of 20% to 30% of adult common colds,” said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health.

Sometimes a cold that never seems to end could be a sign of something more serious. A cold may result in a sinus infection, bronchitis or pneumonia. And cold symptoms are at times confused with seasonal allergies.

A usually dry cough that lingers after a cold is typically due to bronchial hyperreactivity or tracheal inflammation, doctors say. “After you go through an infection in your respiratory system, you can almost have a transient form of asthma where your bronchial tubes are very highly reactive and very irritated and inflamed,” said Dr. Moyer, of Temple University Hospital.

A review of various studies, published last year in the journal Annals of Family Medicine, found that coughs on average last about 18 days. The report also said a survey of nearly 500 people found that most participants expected a cough should disappear in about a week and believed antibiotics from their doctor would help them. (A big no-no!)

Some experts believe having one cold virus and a weakened immune system could make catching another virus easier. Because the epithelial linings in the nose are weakened when you have a cold, the broken down mucus-membrane barrier may be more prone to picking up another virus.

But others suggest that proteins such as interferons, which are secreted during a cold to help fight the virus, may also boost resistance to getting infected by a second virus, according to Dr. Fauci, of the NIH.

What can a person do to prevent or shorten a cold? Nearly everyone knows someone who swears by taking echinacea or zinc or downing packs of vitamin C.

But doctors say the evidence isn’t conclusive that any of these remedies helps. Some research indicates that exercise and meditation could help prevent colds.

The good news is spring is here, at least officially, so the worst of the winter cold season should be over. Come summer, however, a new batch of viruses emerge and you might find yourself saying hello to the pesky summer cold.

Source: The Wall Street Journal

Common cold prevention and treatment

People sick with a runny nose, sore throat and cough from the common cold will try myriad remedies, but only a few have proved to get results, a Canadian doctor says.

Colds are common, affecting adults about two to three times a year and children under age two about six times a year.

Dr. Michael Allan, of the department of family medicine at the University of Alberta in Edmonton, reviewed and summarized the sometimes conflicting research on treatment and prevention of colds in Monday’s issue of the Canadian Medical Association Journal.

“For treatment of common cold, what you’d be looking at are things like fever and pain control, so acetaminophen or ibuprofen, again kids are a little bit better with ibuprofen for fever,” Allan said in an interview.

“For adults, you could consider some of the over-the-counter remedies, particularly the antihistamine combinations can make you feel a little bit better if you’re desperate, but remember at best one in five will feel better on those.”

For children, Allan suggests honey at bedtime for those troubled with cough. Honey should not be given to infants because of the risk of botulism.

“If you give the two to five age group a single dose at bedtime of either half a teaspoon or two teaspoons, what’s been shown is reduction or improvement in sleep scores.”

Over-the-counter cough remedies and combination products are clearly associated with bad events in children under the age of six, he cautioned.

For prevention at all ages, the review suggests that frequent washing of hands as well as alcohol disinfectants and gloves for health-care workers can be effective.

Trying chicken soup, non-traditional remedies?

Zinc may work to prevent colds in children and possibly adults, based on the findings of two randomized trials that pointed to lower rates of colds and fewer absences from school. There’s also some evidence that zinc lozenges may shorten the duration of a cold, although Allan noted many people complain about the bad taste and zinc can cause nausea.

Antihistamines combined with decongestants or pain medications like acetaminophen and ibuprofen appear to be somewhat or moderately effective in treating colds in children over the age of five and adults.

For non-traditional treatments, the role of ginseng in preventing colds is questionable, Allan and co-author Dr. Bruce Arroll of the University of Auckland in New Zealand concluded.

Results were so inconsistent or small effects for other non-traditional treatments, such as vitamin C, that Allan says it “just not worth it.” He also recommended against Chinese remedies, which were “batting one out of 17” in the studies on benefits with no information on potential side-effects.

“Desperation will lead to just about anything,” Allan said with a laugh. “When people are sick, they’ll try everything, from a spoonful of cayenne pepper, etcetera. Of course there’s very little research, or no research, on any of those kind of things.”

Warm soup falls into that category. It’s warm and gentle on the throat, but improbable that a can of soup will help you get rid of a cold any sooner, Allan said.

Some commuters in Toronto pointed to herbal teas as a soothing option.

“I swear by ginger. Freshly grated ginger tea in the morning sets me right for the whole day,” said Prati Vaidya. “The other is a warm glass of milk with tumeric and a little bit of jaggery,” [sugar].

Source: cbc news

Best ways to prevent and treat the common cold

Although the world of medicine has made incredible progress when it comes to tackling certain illnesses, scientists still have not been able to find the cure for the common cold. But there are ways to prevent colds as well as treat them. The question is, which are the most effective?

According to a review in the recent edition of the Canadian Medical Association Journal, hand washing and possibly taking zinc seem to be the best ways to avoid getting sick. Investigators reviewed 67 randomized controlled trials that showed hand washing as well as alcohol disinfectants are the best ways to ward off colds.

Zinc was found to work mostly in children, with two trials showing that little ones who took 10 to 12 milligrams of zinc sulfate every day had fewer colds and fewer absences from school because of colds. Authors of the study suggest that zinc could work for adults. Vitamin C, the “gold standard” of cold fighters, did not seem as effective.

When it came to treating colds, the review stated that acetaminophen, ibuprofen and perhaps a antihistamine/decongestant were the best ways to keep runny noses, sore throats, fevers and coughs under control.

Ibuprofen and acetaminophen, which are both pain relievers, helped with the aches and fever. Ibuprofen worked better in children who had higher temperatures.

Combining antihistamines with decongestants or pain medication was somewhat effective in older children but not in children under the age of 5 or in adults.

Congestion was more difficult to handle. Nasal spray with ipratropium, which is used to treat serious pulmonary disorders, was found to stop drippy noses but did nothing to cut down on the stuffiness both in the nose and the chest.

Even though there were no major surprises in the findings, doctors said the review does stress the need to wash your hands, something a lot of people don’t do enough of.

“This is a thorough meta- analysis,” said Dr. Assil Saleh, an internist with Foxhall Internists in Washington. “It reaffirmed that the fundamental common sense measure of hand washing is the most effective measure to reduce the transmission of respiratory infections caused by viruses or bacteria.”

A point was also made that colds are usually viruses, with only about 5% being caused by bacterial infection. Yet, many patients with colds are prescribed antibiotics, which don’t help.

“Treatment typically aims to relieve symptoms rather than eradicate the infection itself, “noted Saleh. “It’s important to emphasize that bacteria-killing antibiotics are often overused in treating what is almost always a viral illness.”

While doctors shouldn’t be prescribing antibiotics for colds, patients should their part and not insist on antibiotics. If they are used too often for things they can’t treat, they can stop working effectively against bacteria when you or your child really needs them. The CDC has been concerned about antibiotic resistance for years and considers it to be one of the world’s most critical public health threats.

According to the review, the common cold affects adults approximately two to three times a year and children under the age of 2 about six times a year. A strong cold can keep people in bed, knocking many of them out their routines for a week or longer. That’s why doctors say prevention is so important.

“Although self-limiting, the common cold is highly prevalent and may be debilitating, ” says review authors Drs Michael Allan, from the Department of Family Medicine, University of Alberta, in Edmonton, Canada, and Bruce Arroll with the Department of General Practice and Primary Health Care, University of Auckland in New Zealand. “It causes declines in function and productivity at work and may affect other activities such as driving.”

Source: CNN health


5 Common Cold and Flu Facts, Fictions, and Surprising Half-Truths

No matter how many cold and flu seasons you’ve weathered in your years, chances are you’re still buying into some far-too-common illness myths. So before you waste another perfectly good sick day lying around in bed (instead of out playing hooky), we ran some of the most popular pieces of cold and flu wisdom past New York City physician Jennifer Collins, M.D., a diplomat of the American Board of Allergy and Immunology and Internal Medicine. Here’s how they held up.

You Shouldn’t Exercise With a Cold: Myth
Skip the gym and you’ll actually stay sick longer. “Light to moderate exercise when you’re sick can actually boost your immune system’s function,” Collins says. She recommends reducing your workout intensity by 75 to 80 percent to prevent overstressing your body. Also, make sure you wipe down your gym equipment—and your hands—both before and after use. One study in the Clinical Journal of Sports Medicine found the cold virus (a.k.a. rhinovirus) on 63 percent of fitness centers’ machines.

Chicken Soup Fends Off Colds: Fact
No wonder you still want your mom when you’re sick. Her chicken soup really does make you feel better. Research published in Chest found that chicken soup reduces the movement of certain white blood cells in the body to reduce cold symptoms. What’s more, typical chicken-soup ingredients like carrots, parsnips, celery, garlic, and onions are packed with vitamins A and D, calcium, magnesium, phosphorus, and potassium to help your immune system work at its best, Collins says.

Cold Weather Can Make You Catch a Cold: Myth
Record lows don’t cause colds—viruses do. Rhinovirus just happens to be more prevalent in the U.S. during the winter, largely due to migration patterns from other countries. In fact, the biggest contributor to cold-weather colds is found in the warm indoors where people (and their germs) are confined together, she says. You could make like a bear and hibernate—or you can just be extra-generous with the Windex this season.

Dairy Can Worsen Your Symptoms: Half-Truth
A stuffy nose can turn you into a veritable mouth-breather. The result: a dry, itchy throat. While fluids are key to quelling the irritation, and milk is thick enough to coat your throat, that’ll only make it feel even more constrained, Collins says. That doesn’t mean you have to avoid it, though. Contrary to popular opinion, dairy is not a phlegm factory. Just take your milk, cheese, or yogurt with water or juice, she says.

Flu Shots Can Give You the Flu: Myth
You finally gave in and got a flu shot, and the next day you’re in bed with a fever. Coincidence? Actually, yes. “The influenza virus infects you 48 hours before you have any symptoms, so if you get the vaccine during this time period, it will appear that the vaccine caused the flu, but you would’ve gotten sick anyway,” Collins says. Looks like you’re getting a flu shot this year

Source: Details

Colds and sore throats not helped by ibuprofen

If you have a cold or sore throat, you might want to opt for the acetaminophen over the ibuprofen for symptom relief, a new study suggests.

Research published in the British Medical Journal shows that taking ibuprofen (commonly known by the brand name Advil) doesn’t seem to relieve symptoms of upper respiratory tract infections as well as acetaminophen (commonly known by the brand name Tylenol).

Taking ibuprofen along with acetaminophen also didn’t provide as many symptomatic benefits as taking acetaminophen alone, the University of Southampton researchers found.

Interestingly, people who took ibuprofen or ibuprofen with acetaminophen were more likely to come back to the doctor with new or worse symptoms, than those who took acetaminophen alone.

“This may have something to do with the fact the ibuprofen is an anti-inflammatory. It is possible that the drug is interfering with an important part of the immune response and leads to prolonged symptoms or the progression of symptoms in some individuals,” study researcher Paul Little, a professor at the University of Southampton, said in a statement. “Although we have to be a bit cautious since these were surprise findings, for the moment I would personally not advise most patients to use ibuprofen for symptom control for coughs colds and sore throat.”

The findings are based on data from 899 patients who had symptoms of a respiratory tract infection. They were prescribed either acetaminophen, ibuprofen, or both ibuprofen and acetaminophen, and were instructed to take it either as needed, or four times a day. Some patients were also told to try steam inhalation to relieve symptoms.

Researchers also found that steam inhalation didn’t seem to provide any symptomatic benefits — and in fact led to mild scalding among 2 percent of people observed in the study who used this method.

Source: Huffington post


Soon, single universal jab to give lifelong protection against all flu strains

A single flu vaccine that would protect against all strains of the virus for life may be coming soon, which could make annual flu jabs that cost the NHS around 100m pound per year a history.

Scientists working on the universal flu jab, known as Flu-v, are in the early stages of development but hope to offer a product to the NHS within three to five years.

The company behind the drug, SEEK, will present the results of a small-scale clinical trial at the Influenza Congress in Washington DC on Tuesday.

Results so far have shown that it can significantly reduce infection rates and also cut the severity of symptoms.

Because flu is so changeable, pregnant women, the elderly and other ‘at risk’ groups are given a new injection every year.

The flu virus regularly mutates its `outer coat`, which is what a vaccine usually targets.

But the team behind Flu-v has managed to isolate a thread common to all strains of flu and by targeting that element, rather than the changing `outer coat`, the vaccine can cater for all requirements.

That means it would protect against strains of bird flu and swine flu, as well as seasonal variants.

`The trial suggest was only need one shot of vaccine,` the Daily Mail quoted Gregory Stoloff, the chief executive of SEEK as telling The Telegraph.Our aim is for the flu vaccine to become more like the mumps and measles – where you only need it once and you get protection for a long time,` he stated.