R5 The Uncommon Truth About the Common Cold

You may know that not all colds are caused by the same virus. But did you know that there are more than 200 different varieties of cold viruses? If that’s not enough to make you reach for the vitamin C, then consider this: many strains of viruses cause nothing worse than a bad case of the sniffles. But one of these, Adenovirus 14, has proven deadly to previously healthy adults.

Here are some more facts to consider: cold viruses can be spread by droplets produced during a sneeze or a cough, but most often they are spread by touching the eyes, nose, or mouth after contact with a person who already has the virus or a contaminated surface, on which cold viruses can live from a couple of hours to a couple of days. The illness is most prevalent from early fall until spring for several reasons. Among them: this is the time when kids, who are more prone to pick up illnesses because of less attention to personal hygiene, go back to school where they can share their colds; and when it’s cold outside, we tend to stay indoors, concentrating our exposure to viruses. And you can, in fact, be contagious before experiencing any symptoms, although you’re most contagious on the day or two when symptoms are at their peak.

Anyone with a preschooler knows that children are more likely than adults to suffer from colds. “We tend to get fewer viruses as we age,” says Kira Geraci-Ciardullo, MD, of White Plains Hospital Center. “As we get older, we get better at caring for ourselves. We’re more hygienic.” Thus, although those under six years of age get six to 10 colds a year, the incidence drops to about two to four times a year for adolescents and adults.

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Contrary to what many believe, you do not develop significant immunity as you recover from each cold virus. “There are so many different strains of viruses that, due to mutation, the strains that are out there change every year,” says Arthur Forni, MD, an infectious-disease specialist with Westchester Medical Group in White Plains. So even if you did get some limited immunity from a given strain, it probably wouldn’t be helpful the next time around. In other words, since there are various strains of one type of virus, you could contract the virus again, but not the same strain of it.

When your body recognizes the onset of a contagion, often first perceived in the nasal passages, it does its best to avert the attack. Mucus membranes have special cells lining your airways, and their purpose is to produce lots of mucus in the hope of trapping the virus and getting rid of it. When irritated, these same mucus membranes swell as well as put mucus production into overdrive, making the airways smaller. This irritation also triggers sneezes. Coughing is caused by mucus that drips down the back of the throat or is produced in the lungs. Coughing and sneezing are simply side effects of having the cold and serve no useful purpose in getting rid of the virus, according to Dr. Forni.

Not so with a fever. “A fever is the body’s way of getting rid of a virus,” Dr. Forni says. “The virus’s enzymes work at a certain optimal temperature, and when the body raises the temperature, the virus can no longer produce those enzymes.”

It’s easy to recognize the symptoms, yet, without tests, you’ll have no idea which of the 200 viruses is responsible for your cold. The sheer numbers of viruses also hamper researchers trying to develop vaccines. But the difficulties don’t stop there. “The flu and cold viruses aren’t like mumps, measles, and chickenpox,” Dr. Geraci-Ciardullo says. “Those viruses don’t change over time. Cold or influenza viruses can change frequently.”

Chicken Soup, Anyone?

Methods for treating most colds have changed little since your great-grandmother was getting the sniffles. Increasing hydration will help keep mucus membranes moist while they try to heal. Secondhand smoke will further irritate these already inflamed membranes, so avoiding it is crucial.

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Over-the-counter (OTC) cold medications for adults abound. Although in adults, OTC medications help alleviate symptoms, they can’t do anything to get rid of the virus itself. Doctors also now recommend against the use of OTCs that have traditionally been used for children, especially infants and preschoolers. Their bodies are not just smaller versions of adults’ and the effects and metabolization of medications can be radically different in babies and preschoolers than even in older, school-aged children. Common cold medications, in particular, recently have been determined not only to be clinically ineffective in very young children, but to be responsible for several deaths. Instead, saline nose drops and a cool-mist (a warm mist can serve as a breeding ground for bacteria) humidifier may help alleviate some symptoms. Tylenol (acetaminophen) may help relieve mild cold discomfort. However, any product containing aspirin should be avoided, as the use of aspirin-containing medications to treat colds, flu, and chickenpox in children has been linked with a serious illness called Reyes Syndrome, a potentially fatal disease that causes damage to organs such as the brain and liver.

What about antibiotics? Not only are antibiotics useless against viral illnesses, but, according to the American Academy of Pediatrics, the over-prescription of antibiotics is responsible for worldwide outbreaks of antibiotic-resistant germs such as Methicillin-resistant Staphylococcus aureus or MRSA.

This is not to say that colds can’t be responsible for medical conditions requiring antibiotics. After the virus has finished its dirty work, typically in a week or two, it can leave behind just the right conditions for “opportunistic” infections: irritated membranes filling swollen airways with bacteria-loving mucus. Ear, sinus, and throat infections and pneumonia—especially in those who already are suffering from illnesses such as asthma, emphysema, and allergies—are not uncommon.

It’s always best, of course, to avoid the viruses in the first place. But how can we do that? “Hand washing, hand washing, hand washing,” Dr. Erdman says.

Cold or Flu?

ARE YOU CONFUSED ABOUT WHETHER YOU HAVE A COLD OR the flu? You’re not alone. Instead of thinking of them as two different illnesses, let’s consider the idea that the cold and the flu are on a single spectrum. At the bad end of the spectrum is influenza or, as it’s more commonly known, the flu.

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“Influenza is the name of a syndrome or collection of clinical signs and symptoms, sometimes called ‘influenza-like illness,’” says Dean Erdman, MD, a virus researcher at the Centers for Disease Control and Prevention in Atlanta, Georgia. Called ILI for short, influenza-like illness can be difficult to differentiate from the common cold in its early stages. According to Dr. Erdman, ILI continues on to more severe symptoms that can include fever, chills and sweats, fatigue, dry cough, loss of appetite, and muscular aches and pains. Diarrhea and vomiting may also occur, especially in children.

In the middle of the infection spectrum is a cold. On the opposite end, we find the sniffles, or an infection that was defeated by the body’s immune system before you’ve experienced any symptom at all.
Although a particular type of influenza virus is usually associated with ILI, influenza viruses are not necessarily the culprits. “It is important to note that any of the respiratory viruses under the right conditions can cause colds or they can continue to produce influenza-like illnesses,” says Dr. Erdman. “It is also important to note that infections with any of these viruses may lead to no symptoms at all.”

True or False?

We hold many beliefs about the common cold. Which are true and which are false? We asked Dr. Arthur Forni, an infectious-disease specialist with the Westchester Medical Group, White Plains, to separate fact from fiction.

Getting chilled will make you catch a cold. In a cold environment, our nasal passages are exposed to the cold air, and there might be minor damage and drying out of membranes, which are our first defense. But even if you’re chilled, if you’re not exposed to the virus, you can’t “catch” one.

Drinking milk thickens mucus. No, there’s no correlation.

Feed a cold; starve a fever. Huh? Dr. Forni wonders. Does it mean you feed the cold by eating a lot? Other than staying hydrated, there’s no correlation between what you eat and how well you recover.

Chicken soup is good for cold sufferers. Salt, water, and steam can’t hurt, but there’s no particular substance in chicken soup that will help you get better, or someone would be marketing it by now.

Hot buttered rum alleviates colds. Dr. Forni tells people to drink hot tea with honey or lemon. If you add Scotch, it might make you feel better, but it won’t do much to help your cold.

Vitamin C helps fight colds. There have been studies done on vitamin C and zinc, but the evidence that it counters colds is spotty. Zinc did a little better, but it had no major treatment effect.

Echinacea helps prevent and treat a cold. There’s no hard evidence that Echinacea helps prevent or treat a cold.

Over-the-counter medications help. Decon-gestants can make you less congested, but they just treat symptoms and don’t do anything to accelerate recovery. The exception would be cough suppressants before bed if you’re coughing a lot, because they let you sleep at night and that’s important because coughing can irritate the mucus membranes. If you can sleep, the membranes have a chance to heal.

Exercise is good to fight a cold. Most experts say not to exercise when you’re sick, because you’re robbing your immune system of energy it needs to heal. Save the exercise until you feel better.

Mary McIver Puthawala, an RN with a BS in nursing, believes she could have done this article equally well without the terrible cold that she came down with while writing it. She wishes all the readers of Westchester Magazine a healthy holiday season.

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