Surviving the Cold Season and Influenza: What’s Useful! What’s Not!

How much do you know about the common cold? (CDC quiz)

• Question 1: Antibiotics will help you recover from common cold? True or False
• Question 2: Rhinoviruses are the most common causes of colds. True or False
• Question 3: Colds are never serious for anyone. True or False
• Question 4: Colds are most common winter and spring. True or False
• Question 5: You can get a cold from someone by shaking their hand. True or False

Answers:

1: False: Antibiotics do not work against viruses; may make it harder for body to fight future bacterial infections if taken unnecessarily. To feel better with a cold, get lots of rest and drink plenty of water.

2: True: Many different viruses can cause the common cold; rhinoviruses are the most common. Other viruses include respiratory syncytial virus, human parainfluenza viruses, and human metapneumovirus.

3: False: Young children with symptoms such as temperature higher than 100.4F, symptoms lasting more than 10 days, or symptoms that are severe or unusual. Most people recover from colds within about 7-10 days. People with weakened immune systems, asthma, or conditions that affect the lungs and breathing passages may develop serious illness, such as pneumonia.

4: True: Most people get colds in the winter and spring, but it’s possible to get a cold any time of the year.

5: True: Viruses that cause colds can spread from infected people to others through the air and close personal contact such as shaking hands with someone who has a cold after they have sneezed or coughed into their hands, or touching a doorknob or phone that has viruses on it, then touching eyes, mouth, or nose.

Note about Rhinoviruses: derived from the Greek for “nose”, are the most common infective virus to cause the common cold in humans. There are about 100 identified rhinoviruses that cause the common cold. Sore throat and runny nose are usually the first signs of a cold, followed by coughing and sneezing. Other symptoms include runny nose, sore throat, and congestion. These symptoms may be accompanied by headache, muscle ache, muscle weakness, malaise and loss of appetite. Most people recover in about 7-10 days. Adults have an average of 2-3 colds per year, and children have even more. Older adults usually have fewer colds since they have already been infected and built some immunity to the 100 or so rhinoviruses.

The Good and the highly questionable remedies for the common cold:

Good home remedies (what your granny used): For aches and fever: cool compress or sponge bath. For congestion: chicken soup, nasal irrigation with saltwater rinse, cool mist humidifiers, and steam inhalation (do not put anything such as Vick’s in water as it contains oily molecules). For cough: honey (works as a demulcent) but avoid giving honey to infants and young children because of botulinum spores. Sore throat: gargling with warm salt water.

OTC drugs: For aches and fever: acetaminophen, ibuprofen, and naproxen (read directions for use and interactions and note contraindications such as the risk of bleeding with NSAIDS if one is prescribed a blood thinner. For congestion: Oxymetazoline nasal spray, phenylephrine, pseudoephedrine, camphor or eucalyptus/menthol rubs. Each carry risks such as skin irritation with rubs or worsening stuffiness if sprays used more than 3 days or if drugs raise blood pressure or worsen glaucoma. For cough: dextromethorphan (cough reflex), guaifenesin (expectorant), topical rubs, and lozenges. Risks include rash with topicals, nausea and sleepiness and rapid heartbeat with drug. Lozenges act as demulcents and increase salivation. Lozenges with zinc are not recommended. For runny nose and sneezing: Several antihistamines are available and promoted but they target allergies not rhinoviruses and are not recommended for common cold symptoms. For sore throat: benzocaine, dyclonine, menthol and chloraseptic sore throat spray. Medicated lozenges provide cooling sensation and may work longer than sprays; menthol drops may affect bleeding if one is on warfarin.

Not so good/highly questionable remedies: As for supplements (e.g., echinacea, vitamin C, probiotics, zinc, garlic, homeopathic remedies) the best advice from National Institutes of Health (particularly the CDC), CRConsumer Reports, and the FDA is to save your money. Recall that supplements are not required to be proven safe and effective.

Advertising claims such as maximum strength, non-drowsy, nighttime, extra strength, and fast are not defined in the Federal Register of FDA. In consumer health, we often call these terms weasel words!

Influenza: Updated synopsis of information from CDC on influenza vaccinations this season: This season, only injectable flu vaccines (flu shots) are recommended. Some flu shots protect against three flu viruses and some protect against four flu viruses.

Options this season include:

• Standard dose flu shots. Most are given into the muscle (usually with a needle, but one can be given to some people with a jet injector). One is given into the skin.
• High-dose shots for older people.
• Shots made with adjuvant for older people.
• Shots made with virus grown in cell culture.
• Shots made using a vaccine production technology (recombinant vaccine) that does not require the use of flu virus.

Live attenuated influenza vaccine (LAIV) – or the nasal spray vaccine – is not recommended for use during the 2017-2018 season because of concerns about its effectiveness. Getting vaccinated later than October however, can still be beneficial and vaccination should continue to be offered throughout the flu season, even into January or later.

Couple of other points: Staying home when having a cold is a good idea but not as important as compared to the flu. Flu is a much more serious illness, especially for the young and older population groups. There is no evidence that antibiotic soaps work better than regular washing hands with soap and water. FDA ordered companies to stop using triclosan in all soaps back in 2017 but read label and look for another compound, chloroxylenol, that should be avoided.

Prevention Tips: Wash hands often with soap and water. Wash them for 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer, although not as effective as handwashing. Cold viruses do stay on hands; regular handwashing can help protect people from getting sick.

• https://www.cdc.gov/flu/about/season/flu-season-2017-2018.htm#effectiveness
• https://www.cdc.gov/flu/index.htm