By Rod Moser, PA, PhD
I think I could have an entire practice just devoted to colds. Some days, I think it has happened already. Colds are among the most common human afflictions – well over 60 MILLION cases each year in the United States according to someone in our government who is apparently being paid to count them. I suspect the number may be higher, since many colds are cared for at home and go unreported.
Children, with their weaker immune systems and considerably less-honed hygiene practices, account for twice as many colds than adults. Adults with children obviously have more colds than adults without children simply due to exposure. There are over 20 million missed days of school attributed to colds, and probably an equal number of days of missed work for the parents who stay home with them. The cost of colds to our economy is astronomical, especially if you factor in the billions spent on cold medicines to alleviate the symptoms.
Colds are caused by 200 or so different respiratory viruses that keep changing and mutating. Our only defense against the common cold is our own immune systems. If you have a good one, you may only get one or two colds a year. The average adult gets three to four, although some can be so mild they’re ignored. Children average 6-9 per year, with children in school or daycare achieving those higher numbers. Kids under six are usually card-holding members of the Cold of the Month Club in the fall and winter months. Cold temperatures, cold drafts, drinking cold water, or taking cold showers do not cause colds (Sorry, Grandma), but colds are certainly more prevalent in the colder months.
Colds are mostly transmitted by hands contaminated by mucous. I know that is snot what you wanted to hear, but it’s the truth. From contaminated hands, they will typically enter the body of the victim through the nose or eyes. As little as 12 hours later, someone will share the joy of your cold for the next 7-10 days. In children, colds can last up to 14 days. When you have one cold, you can still catch another, or have a series of back-to-back colds that can last months.
A slight sore throat is often the first symptom, quickly followed by a watery, runny nose; sneezing; and coughing. Fever is common for the first three or four days when the cold is at its worst, especially in children.
Colds can set the stage for secondary bacterial infections, like sinusitis or pneumonia, but taking antibiotics will not prevent them. Colds are viral and should never be treated with antibiotics unless there is a confirmed bacterial component. However, this does not keep people from soliciting unnecessary antibiotics from their medical providers, or providers from just shelling them out like candy.
Colds can be miserable so treatment is usually directed at reducing symptoms. In children, the treatment has become a bit more complicated because of the current recommendation not to use cold medications at all in children under two (and with caution in children age 2-4). Studies have shown that they are not very effective anyway and can cause some very serious adverse events.
Decongestants will drain a stuffy nose, but if taken at night, can pour a river of mucous down the back of your throat. They also tend to be as stimulating as a cup of coffee. Antihistamines will dry up a watery nose, but can thicken mucous. Cough suppressants may reduce the number of times that you cough, but coughing helps clear the airway. Cough expectorants make you cough, as if you needed the extra help. To complicate matters, many combination cold medicines have ALL of these things: a medicine to make you cough combined with one to stop coughing; and a drug to thin and drain your mucous combined with a drug to thicken it. It is kind of silly when you think about it; sort of like taking a laxative with Kaopectate.
What about the natural remedies like zinc, Echinacea, or vitamin C? Do they work? Studies are few and most do not really prove efficacy much beyond a placebo effect. Vitamin C is not effective at all, but that does not stop people from ingesting thousands of milligrams thinking that it does. Zinc may have a mild antiviral effect, but for some reason, not so much in children. If it has any protective effects, it is minimal at best. Honey has been recently touted as a natural cough suppressant, and one study showed it to be superior to pharmaceutical cough suppressants. Whatever you do, remember that colds will last about a week if you aggressively treat them, and about seven days if you don’t. The best way to treat them is with contempt.
Each time that you get a cold, your immune system is challenged and responds. This will make you stronger and more resistant (eventually) to future colds. Medical science has promised a cold vaccine for generations, and maybe someday we will have one, but until then, think of colds as Nature’s Vaccinations.