The Common Cold

A quick quizregarding the common cold can enlighten us about the nature and treatment of the common cold

Nov. 11, 2012, 5:45 p.m. Published in Magazine Issue: Vol. : 06 No.-10 Nov. 09-2012 (Kartik 24, 2069)

When doctors contemplate writing a health column, amazingly the first thing that comes to mind is the potentially monotonous topic of the common cold( “rugakhoki”) . Now that winter is here it may be time to talk about the common cold and to find out ways in which we can deal with this problem.Of course the common cold in some health person may have a different, and more benign effect than in those who have other illnesses at the same time, for example, lung disease, heart disease and so forth. People who have these underlying illnesses may fare less well than those who are healthy to start with. In many instances, a full-blown, debilitating bacterial illness is preceded by a mild viral illness.

A quick quizregarding the common cold can enlighten us about the nature and treatment of the common cold.  Here is the question: Which of the following has been shown to decrease the duration of the common cold (or nonspecific upper respiratory tract infection, as it is known in medical parlance)? The choices are : a) azithromycin ( an antibiotic), b) vitamin C,  c)zinc, d)Echinacea herb e) all of the above f) none of the above.

Upper respiratory tract infections are the leading cause of ambulatory visits to the doctor’s office. These infectionsare characterized by a general feeling of being unwell, stuffy nose with some discharge ( rhinorrhea), sore throat, and cough.These illnesses are caused by viruses which sometimes prepare the ground for  bacteria to cause “super added” infection. Some doctors say that when the nasal discharge and the phlegm become colourful ( green or yellow), bacteria have settled in. The most commonly implicated virus is the rhinovirus, followed by the influenza virus, and adenoviruses. In general, unless ‘super added infection” has taken place, bacteria are not the initial culprits.

So, the answer to the above question is not an antibiotic because virusesunlike bacteria, do not respond to antibiotics. Many people  swear by vitamin C, but  randomized controlled trials ( RCTs, the gold standard in western medicine for judging the efficacy of any drug or device) have shown that vitamin C don’t work for “colds”. Zinc and herbs are also ineffective. So, the correct answer is, none of the above.

When you suffer from a cold, the drug treatment is basically nothing except if you wish, some paracetamol, a nasal decongestant, and  cough medicine. But many of these medicines have side effects like sedation and drowsiness that may be unacceptable.

Proper hand washing and covering your mouth while coughing will inhibit the transmission of the illness to others. Where available, annual vaccination against influenza A and B viruses have been found to be the most effective method of preventing influenza. The US Advisory Committee for Immunization Practices ( ACIP) now recommends influenza vaccination for everyone> 6 months of age, including pregnant women. Some influenza vaccine  incorporates the H1N1 ( swine flu) vaccine too. H1N1 caused a scare some years ago and continues to be problematic at times. A point about hand washing.
Many people think that the common cold can only be transmitted by aerosolized droplet infections that lodge in our nose or mouth and then travel into the respiratory system. What many people may not be aware of ( and which needs to be emphasized) is that as noted above proper hand washing with soap and water also helps eliminate the spread of common cold.   

Buddha Basnyat.jpg

Buddha Basnyat MD

Buddha Basnyat, MD, MSc, FACP, FRCP, Director of the Oxford University Clinical Research Unit-Patan Academy of Health Sciences, Kathmandu.

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