Down With a Cold ?

At some time or another, everyone — even a robust fitness freak — gets felled by the common cold, developing sniffles, sneezing, puffy eyes, fever, body ache and malaise. Children start to develop colds during their first year, the frequency of which may increase to up to six times a year. This leaves the mothers with the feeling that the child is “always ill”. The average adult gets three to four colds a year.

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Almost 40 per cent of outpatient medical consultations in a general practice deals with colds and their complications. This is not surprising, as colds are unavoidable infections. They are caused by viruses, 80 per cent of which belong to the rhinovirus family. Not only are there more than a hundred members in this group alone, but the types also mutate at a rapid rate. This makes immunity practically non-existent, or at best short lived. To make matters worse, there is no vaccine available, except for flu or influenza.

Colds are highly contagious. The spread is rapid as the virus, contained in nasal secretions, can be propelled forcefully into the environment by coughing and sneezing. It can also be transferred from the nose to the hands of infected people. Patients can then transfer the virus to door knobs, telephones, banisters, switches and other such objects. The virus can remain dormant but viable for 18 hours or more until it finds a susceptible host. Any person touching the contaminated surface has a 50 per cent chance of picking up the infection.

Infection increases during the rainy season and winter months. People tend to huddle together under umbrellas or shelters. Windows may be kept closed. The close contact and lack of ventilation provide ideal conditions for the spread of the cold virus. Contrary to popular myths, colds are not aggravated by washing the hair at night, eating ice cream or using air-conditioning.

The infection incubates for a day or two before symptoms appear. It may then last a variable period of time, usually 5-14 days. If there is no recovery within two weeks, there may be secondary bacterial infection and complications like sinusitis, ear infection, bronchitis and pneumonia may have set in.

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Smokers develop colds more frequently than non-smokers do. Their colds are more severe, take longer to subside and are more likely to be complicated by secondary infection. This is because the cilia — fine protective hairs that line the respiratory passages — are paralysed by nicotine. They, therefore, clear accumulated mucous sluggishly and inefficiently. Also, smokers’ lungs are likely to be scarred, distorted, have a reduced blood supply and function sub-optimally, making elimination of the infection difficult.

Man has reached the moon but a cure for the common cold remains elusive. We still rely on “grandma’s recommendations” of hot drinks like ginger tea, lime juice with honey, rice gruel and chicken soup. These do soothe the irritated throat. Also, resting helps. It reduces the pain in the muscles and bones. Steam inhalations liquefy the secretions and help them to drain, providing relief.

Stuffed and blocked nasal passages can be cleared with saline (not chemical) nose drops. Aspirin and paracetamol reduce fever and pain. Anti histamines reduce itching in the nose and throat and dry up dripping nasal secretions. The older first-generation anti histamines (Avil, Benadryl) are very effective but they cause sedation. The second-generation non-sedating products (loratidine, cetrizine) are less effective.

Many health supplements are advocated to boost immunity and reduce the frequency and severity of attacks. Many are of doubtful efficacy and have not been studied scientifically. Zinc supplements, however, have been proven to be useful. They can be used as lozenges, syrups or tablets. Not more than 10-15 mg a day of elemental zinc should be taken.

Antibiotics do not work and administering them is futile and inappropriate. They do not shorten the course of the infection. Nor do they prevent complications. Antiviral medications used against the influenza and herpes viruses are ineffective against the rhinovirus. If the cold just refuses to go away and there are no bacterial complications, it may not be a cold at all. It may be an idiosyncratic allergic reaction to something inhaled or ingested from the environment. Mosquito coils, liquid repellents, room fresheners and incense sticks are particularly notorious.

The best advice for someone with a cold — “wait it out”.

Sources: The Telegraph (Kolkata, India)

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