‘Tis The Season

Jun 13, 2011Medical Blog Posts

You can’t hear the wheezes emanating from my chest right now, but I’m in the grips of a nasty cold. Whole family is under the weather, actually — and we’re short a humidifier. I always thought we were a two-humidifier family, but this week has proven me wrong.

The common cold is usually caused by one of the many rhinoviruses — a family of 110 distinct strains, though additional virus families, such as coronoviruses, bring the total to over 200 strains. Understanding this disease process is complicated by the fact that there is no good animal model for experiments. In other words, not many critters catch colds.

This has not stopped researchers from attempting to infect the usual suspects: mice, rats, hamsters, rabbits and the like. Further efforts with hedgehogs, voles, ferrets, and a variety of primates from the red patas monkey to the sooty mangabey failed as well, leaving researchers with no other option than to work with the often reluctant and unreliable homo sapiens sapiens. Trust me, they drive a much harder bargain than those capuchin monkeys who work for grapes.

Despite these setbacks, we do know a few secrets of the common cold:

  • Colds are not caused by exposure to cold or wet weather.
  • Children are a prime vector for cold transmission, probably because of their close contact in schools (and often suspect hand hygiene).
  • Colds transmit better in close quarters, which may explain the seasonal spikes at the start of school and the onset of cold weather (both drive people inside).
  • Cold viruses can live up to 3 hours on your skin. They can also survive up to 3 hours on objects such as telephones, stair railings, Legos, Thomas trains, and anything manufactured by Mattel. (I’m just kidding about those last three, but it’s probably true anyway.)

Let’s move on to treatment. The rows and rows of cold medications on display at any drugstore have such potential for toxicity (combined with limited clinical value) that the medical community increasingly recommends against their use in the most frequent group of cold sufferers — children. I would echo that recommendation for their parents, too. The stuff just doesn’t work.

Other generally ineffective “natural” remedies include vitamin C, echinaceagarlic, and a variety of Chinese herbs.  Three others deserve special mention:

  • Airborne, that ubiquitous combination vitamin preparation, was sued by 32 attorneys general in 2008 (for comparison, 41 states sued the tobacco companies in the late 1990s) for false advertising.
  • The makers of Emergen-C, wary of Airborne’s experience, have resorted to the highly unscientific gimmick of customer testimonials. You can read Meghann’s achingly vague claims of benefit here.
  • zinc nasal preparations have been associated with permanent loss of smell, prompting the FDA to issue a warning against their use. Oral forms of zinc have also been researched and results are contradictory in the two most recent studies.

But I shouldn’t throw stones, since my own routine (chicken soup, ibuprofen, sinus rinsing, and a nighttime humidifier) is also largely unproven, with exception of the ibuprofen.

If you absolutely need medication for cough, only one thing works: hydrocodone. Unfortunately, hydrocodone has high abuse potential and has gained quite a following in certain circles (Purple Drank, anyone?). Side effects can also limit its effectiveness.

As for prevention, our weapons are few. Good handwashing is a must, but for heaven’s sake avoid those antibacterial soaps. Alcohol-based gels are effective when a sink is not available. There’s also evidence that insufficient sleep leads to more colds, so try and get at least 7.5 hours of sleep nightly. Which is why I am going to end this posting here, since it’s past midnight and I have to get up early tomorrow.

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