If you were lucky enough to avoid an episode of the common cold this winter, the odds are that you will “catch one” soon. In the course of a year, people in the United States suffer one billion colds. Adults average 2 to 4 colds; however, if over the age of 60, the frequency drops to less than once per year. Women, especially those between the ages of 20 to 30 years old, have more colds then men, probably because of their closer contact with children. (NIH/NIAID, December 2004).[i] Children have 6 to 12 colds a year, with school attendance associated with higher frequency. According to the Centers for Disease Control and Prevention, 22 million school days are lost annually in the United States due to the common cold.
The common cold, in reality, is a mild viral infection of the upper respiratory tract, and is the most common acute infectious illnesses in humans. Symptoms include sneezing, sniffling, runny nose, scratchy, sore throat, coughing, headache, and tiredness. Fever is usually slight, but can climb to 102ºF in infants and young children. Ninety-five percent of people exposed to one of the responsible viruses will become infected.
More than 200 different viruses can cause symptoms we associate with the common cold. Rhinoviruses (from the Greek rhin, meaning “nose”), the most common viral infective agents in humans, cause an estimated 30 to 35 percent of all colds, and are most active from spring through early fall. Rhinoviruses can live up to three hours on the skin, as well as inanimate objects such as telephones and stair railings.
Following an episode of the common cold, an individual develops immunity to the particular offending virus. However, because of the large number of different cold-causing viruses, this immunity is of limited protection, as an individual can easily be infected by another cold virus, which will start the process all over again.
Currently, there is no cure for the common cold. The great diversity of the causative viruses and their ability to mutate to survive make the development of a vaccine or any antiviral medications all but impossible. Antibiotics are not useful for managing a cold, and should only be taken if bacterial complications occur.
Treatment is mainly focused on the relief of symptoms and includes a wide range of options, from over-the-counter (OTC) drugs (i.e., decongestants and cough suppressants) to herbal therapies (i.e., Echinacea and garlic). In the recently published Diagnosis and Management of Cough: ACCP Guidelines (Chest, January, 2006), the American College of Chest Physicians concludes that OTC cough suppressants show limited efficacy in patients with a cough from an upper respiratory tract infection. This controversial statement precipitated an immediate Press Release by the Consumer Healthcare Products Association (CHPA) on January 11, 2006 stating: “The U.S. Food and Drug Administration and other regulatory agencies world-wide support the use of over-the-counter (OTC) cough/cold products for providing relief of coughs and other symptoms associated with the common cold, and studies demonstrate symptom relief among consumers using these products.”[ii]
Herbal therapies are always of interest to consumers in the United States, but do they work? The National Institutes of Health (NIH) is in the process of conducting two Phase III clinical trials. One clinical study is evaluating the effects of Echinacea, Propolis and Vitamin C on Upper Respiratory Tract Infections in Preschoolers. The study design is a prospective, randomized, double-blind, placebo control with 104 children between the ages of 3 and 6, to be concluded in March 2006. The second clinical trial is assessing the effects of Echinacea vs. Placebo Effect in Common Cold. The study design is randomized, double-blind, placebo control with 800 participants; it will be completed in December 2006.
So, until the results of the studies are available, the doctor recommends plenty of sleep and extra helpings of chicken soup!
Ioana Carabin, M.D.
[i] [i] NIAID – National Institute of Allergy and Infectious Diseases at http://www.niaid.nih.gov/factsheets/cold.htm
[ii] CHPA Statement on ACCP’s Cough Guidelines: