Even though it is March, the cold season is still with us. And despite all of the publicity (and media-induced panic) generated by the fear of influenza, the common cold is, well, more common, hence a more practical topic for this column. How are colds spread, how to prevent a cold, and how to minimize downtime if you get one, is all information that you should have, and put to use.
The common cold is caused by the rhinovirus. Its name tells us how it is most commonly spread: through the nose. Less commonly, it can enter the body through the mouth. It is transmitted either by direct contact with an infected person, or through the aerosol droplets of a well-aimed sneeze. You can also infect yourself by touching your unwashed and contaminated hand to your nose. Once the virus lands in the nasal mucus membranes, it attaches itself to mucous membrane cells, and begins to replicate. As new virus particles are formed, they are shed into the nasal passages, and are soon ready to fly through the air, sneeze-powered, to the next victim. Colds are highly contagious, but you can do a great deal to prevent them and minimize their effect.
The main clinical symptoms of a cold are in the upper respiratory tract. Nasal congestion, nasal discharge, and sinus pressure start the process which then may progress downward: postnasal drip to a sore throat. Cough, hoarseness and occasionally chest symptoms follow. The clinical picture of a cold is different from a flu. It is more severe, and systemic symptoms dominate: chills, fever, muscle and joint aches, rarely progressing to pneumonia. The flu is more taxing, and potentially more dangerous, especially for “at risk” patients.
Once the immune system is stressed by the viral infection, it is not uncommon to develop a secondary bacterial infection. This is when your mucus turns from clear or white to yellow or green. At this point, antibiotics may be helpful.
How to avoid colds? Short of totally renouncing contact with mankind, you need to minimize physical contact, even proximity, with anyone who may be infected. When traveling on buses or subways, try not to sit next to anyone who appears ill, even if means strap-hanging for a 10-minute ride. At the risk of appearing mysterious or remote, cover your face with a scarf. It forms a good filter for trapping droplets from an unexpected cough or sneeze. (On an interesting side note, in the deferential and socially more interconnected culture of Japan, it is quite common to see pedestrians walking on the street, wearing surgical masks. These are people who have colds, and are trying to avoid infecting their fellow citizens. Consideration for strangers – what a bizarrely refreshing concept!)
Wash your hands frequently – not just after going to the bathroom, but also before eating and putting on your make-up. Do this especially if your work requires social contact with people, such as frequent hand shaking or sharing implements (pens, telephones, exercise equipment) with potential cold carriers. Some of us have a tendency to touch our faces out of habit, in furtive attempts at self-grooming, at moments of indecision, embarrassment or stress. Monitor and control this tendency. By touching your nose, you may be self-inoculating the cold virus sitting on your hands.
Other forms of prevention involve keeping yourself generally healthy. The usual measures (plenty of sleep, exercise, good nutrition) should be supplemented by vitamins, particularly Vitamin C. Stress, both physical and emotional, weakens the immune system. If you get sick, don’t try to “work through it” with your usual exercise routine. Modify or avoid exercise until your body has recovered from the infection.
If you do get a cold, Vitamin C in larger amounts (2000 mg a day in divided doses) is helpful. Vitamin C is water-soluble; hence excess unused amounts are excreted in the urine. Another reason to keep well hydrated is that this not only helps the body to function, but excess Vitamin C can act as a diuretic.
What about Echinacea and Zinc? I have no advice on Echinacea, although anecdotes of success abound. Zinc on the other hand has been shown to shorten a cold, reduce its symptoms, and also reduce its transmission. Two final points about Zinc: It works on existing colds, but is not a preventive, so take it early, but only after a cold begins. Second, it works almost as well by mouth (pills) as in a nasal spray form; the use of pills avoids the nasal burning and irritation, which can be unpleasant to some.
Disclaimer: The suggestions given by Dr. Jahn in these columns are for general information only, and are not to be construed as specific medical advice or advocating specific treatment which should be obtained only following a visit and consultation with your own physician.
