Thursday, February 19, 2009

Natural History Notes: the Common Cold

Having been plagued with what feels like more than my fair share of colds this winter, I decided to do a little research into this pesky human ailment. In so doing, I found some excellent information online, which helps dispel some of the myths and misinformation that is associated with this malady. When dealing with these sorts of troubles, I think it pays to be rational and clear in one's approach. I'd like to share the fruits of my labors with you here.

Most of my information comes from an excellent website, www.commoncold.org. This website is sensible, scientific, unbiased and blessedly non-commercial. One thing I'm learning about treating the common cold is that everyone wants to sell you a remedy! I also reviewed some other sources, including the wikipedia.

So, some facts:

The common cold is a viral infection originating in the back of the nose. There are in the neighborhood of 100 different viruses that can cause this infection, but half of them are caused by various kinds of 'rhinovirus.' Rhinoviruses mutate readily, and it is therefore virtually impossible for the body to develop an immunity to them.

A cold is "caught" when virus particles are introduced to the nose. This may happen when one comes into close contact with someone who has the infection, or it can be transported to the nose by your fingers, if you touch a surface onto which a sick person has unknowingly deposited the virus particles. (Perhaps they sneezed, or rubbed their nose and then touched something, etc.)

About 95% of people whose noses are exposed to the cold virus will become infected, but only 75% of those infected will develop symptoms! So, yes, you could be an unwitting carrier!

It only takes about 10 to 12 hours to develop cold symptoms after being exposed to the virus. It grows fast. Symptoms usually peak in 36 to 72 hours. Colds generally last no more than 7 to 10 days and are self-limiting. The infection is not fatal. However, secondary infections can occur (sinus infections, bronchitis, etc.)

Being the most common of human ailments, we all have a pretty good idea of what the symptoms are: runny nose, sneezing, scratchy throat, cough, chilliness, mild fever and a general feeling of 'yuckiness.'

Unfortunately, there is no cure for the common cold. Researchers have been investigating the use of anti-viral drugs, but other than that, the remedies available only treat symptoms.

There is no evidence that vitamins and what not do anything to cure or prevent colds. Sometimes products are sold that are supposed to boost immunity and thus prevent or shorten colds. There's no evidence that boosting immune system functioning (assuming these products even do that) would prevent cold symptoms. It may even be the case that the stronger your symptoms are, the stronger your immune system is! Remember, not everyone who gets the infection has symptoms. The symptoms are caused by your body's immune response to the invaders.

Still, it's worthwhile to treat symptoms. After all, who wants to feel miserable? Treating symptoms can also reduce the chances of secondary infections. It's been in the news lately that blowing one's nose could be a bad thing. Apparently the tremendous air pressures involved can force mucus back into the sinuses. This might lead to such things as bacterial sinus infections. So, if there is a treatment that reduces the running nose, that in itself could be a good thing.

The doctors at commoncold.org recommend the following as basic treatment:

A 'first-generation' antihistamine to reduce the mucus production and inflammation, and a 'non-steroidal anti-inflammatory' drug to treat the general feelings of yuckiness (headache, aches, mild fever, etc.). One might then further add: decongestants and cough suppressants.

Now to personal experience:

I wish I had read the commoncold.org website when I first got the latest cold -- I could have saved myself some unnecessary suffering. The commoncold.org folks don't mention or recommend any commercial products. This is good in terms of showing their lack of bias, but bad in helping the consumer find things at the drug store. They recommended first generation antihistamines (the kind that make you sleepy!) such as Chlorpheniramine. I had to read a lot of labels to find a product that fit the bill. And it was virtually impossible to find a medicine that contained only an antihistamine. The kitchen sink philosophy reigns supreme in over-the-counter cold medicines.

I finally found 'Coricidin HBP Cough and Cold' which contans only Chlorpheniramine and the cough suppressant Dextromethorphan. That, and Advil were my front line.

Well, Chlorpheniramine certainly works! The commoncold.org authors make no mention of expectorants, such as guaifenesin, but since I had a cough and some upper bronchial phlegm and irritation, I thought it might be a good idea.

This combination of treatments, plus rest and plenty of fluids, seems all one can do. I guess hosting a rhinovirus from time to time is just one of those things that comes as a part of the deal of being human.

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