Let’s talk about the common Cold (upper respiratory infection), today – Written by Dr Harold Gunatillake-Health writer


A cold (coryza) is considered the commonest malady that affects almost everyone, including children worldwide. It is always a virus infection and never bacterial, unless you get affected secondarily whilst suffering from a common cold.

There are many viruses that can cause a cold and the most common one is the rhinovirus. Other less common ones are- adenovirus, coronavirus, enterovirus, and so on. Rhinovirus is more potent than the others as it can cause other infections like pneumonia, otitis (ear infections), sinus and throat infections, and can trigger an asthma attack.

You could always diagnose a cold without seeing your doctor: runny nose, (sniffles), sore throat, ear ache and fever. Unlike bacterial infections, viral infections have a life span- may be a week or two and you getting better. Unfortunately, you do not acquire immunity from further future infections- meaning the same virus can inflict a recurrent infection.

The common cold can spread in a household to every member and is contagious. The incubation period is about 24 hours

Remember, there are no antibiotics that will kill any viral disease. You can only temporise to feel better by drinking plenty of fluids, home remedies, and taking over the counter cough mixtures, throat lozenges, and inhalations. You still need to go through the life cycle of the virus.
If the sinus infection and sore throat lasts longer than 10 days, you should see your doctor, and he is bound to give you antibiotics to end the secondary infection. Your doctor will invariably order x-rays to check your sinuses.
When your nose is blocked, inhale steam to soothe the nasal congestion. You may use a nasal spray, instead. Saline nasal solutions help break up nasal congestion and remove virus particles. A good at- home solution would be to mix 3 teaspoons of iodine-free salt and 1 teaspoon of baking soda, and place the mixture in an airtight container. Use 1 teaspoon of this mixture with 8 ounces of warm distilled water. Fill a plastic syringe and squirt the solution into the nose while holding the head over the sink. The other nostril should be closed.

Post-nasal drip
In most situations when your nose is congested with nasal discharges, there is a tendency for this secretion to dribble down into your throat and most coughing in the nights is due to this dribble.

Antihistamines and decongestants may help to dry your throat and get rid of the excessive mucus. Cortisone based nasal decongestants do help to dry your nostril mucosa to prevent further post nasal drips (PND)

Viral infections are referred to as upper respiratory infection because it is limited to the nasal passages, sinuses and may be your throat.
Wash your hands as a habit daily to prevent a cold. Use an alcohol-based sanitizer product, or soap and water. Avoid going into crowded areas, and keep away from the cold weather, especially the winter season, if you can.

Zinc tablets for cold
Zinc tablets are supposed to prevent people getting colds, but studies has shown mixed results about zinc and colds. Zinc may prevent the rhinovirus from multiplying in your nasal passages and throat. It may be effective when taken in lozenges or syrup form, which allows the substance to stay in your throat and attack the virus. Zinc in lozenge form may have side effects, including nausea or bad taste in your mouth. You may lose your smell permanently when you use a zinc nasal spray.

Vitamin C
While earlier studies reported that taking vitamin C reduced how long a cold would stick around, the current consensus is that for the general population, it is ineffective.

However, there are certain groups of individuals who may benefit from vitamin C when a cold is looming. These include people who undertake severe physical exercise, those exposed to cold environments, and those with vitamin C levels below the recommended levels.
Drinking milk whilst having a cold

Drinking mild may increase the amount of phlegm, and make it thicker and irritate your throat. Milk does not cause your body to make phlegm.

Chicken soup
Warm chicken soup is soothing when you have a cold. Chicken soup thins the mucus and also supposed to be ‘anti-inflammatory’.

You need to rest when you have a cold. Stay hydrated. Drink plenty of water, juices like lemon containing high concentrations of vitamin C, Tea, warm apple juice, might be soothing and help ease congestion by increasing mucus flow. Sip hot lemon with honey for an irritable cough. Avoid alcohol, coffee and caffeinated sodas, which can make your dehydration worse.

Drinking tea with honey and lemon: This can ease a sore throat and researchers have found honey to be an effective cough suppressant.
Drinking hot water with fresh ginger: This can reduce feelings of nausea associated with the flu.
The onion in sock home remedy has origins in western folklore and is hundreds of years old. It also has links to the Chinese practice of reflexology.
Many people claim that the onion in sock remedy is an effective treatment for a cold or the flu. Despite these claims, there is no scientific evidence to support this. There are no proven health benefits to this remedy, but it is not known to be harmful.

What’s the difference between cold and Flu?
At the onset, both colds and Flu have similar symptoms… Both are caused by viruses, and not bacteria, and you feel miserable.

In a cold you get a runny, stuffy blocked nose and in flu only mildly occasionally. You sneeze more with colds and less with Flu. Coughing is more common with a cold with a mucus discharge, whilst in Flu you get a dry cough.

A sore throat is more common with a cold and occasionally with Flu.

Body aches and pains are mild with a cold and more severe with Flu.

It is rare to get fever, chills and sweats with a cold but always present in Flu Symptoms come about slowly in a cold and may take days while it comes fast within hours with Flu. A cold you could get any time of the year, more during winter months, but flu is more seasonal. Only influenza viruses cause the flu, while many different viruses can cause colds.

There is a vaccine to prevent the flu, while there is no vaccine to prevent the common cold.
Adults have an average of two to three colds a year, but only get the flu about twice a decade. Kids get colds and the flu more frequently.
Flu tends to give worse problems, especially among the children and the old people, and may lead to pneumonia needing hospitalization.
Men have a weaker immune response. Research has shown that men have a weaker immune response to viruses that cause flu, or the common cold, and as a result, men may have a greater risk of serious symptoms than women.

Is ‘Man Flu’ a Real Thing?
A Canadian researcher says there is some evidence that hormones and other factors may make men more susceptible to serious cases of the flu.
In a 2008 study it was found that women had a stronger immune response to the flu vaccine, meaning they produce greater levels of antibodies against the virus strains in the vaccine, compared with men.
The flu viruses in circulation change each season, and the predominant strain this year is H3N2, according to the new CDC report. Flu seasons in which H3N2 predominates tend to have higher overall flu hospitalization and death rates, according to the CDC.
However, in order to make the flu vaccine, manufacturers typically use chicken eggs to “grow” the flu virus strains. During this process, the flu strains may acquire genetic changes that make the strains slightly different from those in circulation. This appears to have happened with the H3N2 component of this year’s flu vaccine, the report said, and the changes may lower the effectiveness of the vaccine. (However, there is a “cell-based” vaccine available this year in which the H3N2 component was grown in cell culture.)
Health officials still recommend a yearly flu vaccine for everyone ages 6 months and older, because it’s still the best way to prevent flu.

When would you rush to the hospital when you have Flu?
Whether you rush to see your doctor or the hospital the main symptom that people should watch for is shortness of breath, When you get to the stage of breathlessness means that you are about to progress into pneumonia.

How do you differentiate a Streptococcal sore throat from common cold and Flu?
In the common cold, there’s coughing, sneezing, or a runny nose, indicating that it is not a streptococcal sore throat. Throat infection with strep bacteria can cause a variety of symptoms associated with inflammation of the throat.
Strep sore throat starts with fever, sudden sore throat, and swollen tender lymph nodes in the neck which you can feel. Swallowing becomes painful. There may be white or yellow patches seen in the throat and tonsils. These symptoms are accompanied with headache, and even stomach ache, with nausea and vomiting.

Look at your throat in the mirror with the help of a torch; you’ll notice how the throat lining looks red and angry.
It is contagious and airborne droplets on sneezing can spread the infection.
Some people carry these bacteria without causing any symptoms and referred to as carriers.
Streptococcal sore throat will respond to antibiotics. Your doctor will prescribe penicillin or cephalosporin antibiotics to get rid of the infection. Other popular antibiotics prescribed are amoxicillin, cloxacillin and dicloxacillin, among others.

Should you take antibiotics for a streptococcal throat infection?
When you go to your doctor with a sore throat, he may write a quick prescription for penicillin or amoxicillin, and with the stroke of the pen, helps diminish public health and your own future health by helping bacteria evolve resistance to antibiotics. It is better to develop a spray-on treatment with bacteriophages, or take home remedies rather than taking antibiotics on the first occurrence, Ultimately, your immune system will
subside the strepto’ throat infection. Antibiotic therapy for such conditions given may also destroy your gut microbes that helps creat immune system.
Streptococcal sore throats can lead to rheumatic heart disease, a deadly condition that is very rare in the industrial world, but it still takes a toll in other parts of the world.

What is sinus infection?
Sinuses are empty spaces with mucus lining on either side of the nostrils in relation to the cheek bones called maxillary sinuses, and also there are similar spaces above your eye brows called frontal sinuses, and behind the nose called ethmoid and sphenoid sinuses. These chambers communicate with the nasal passages and drain the mucus discharges. These sinuses could get infected with viruses or bacteria, or allergies causes are the most common.
These sinuses could get inflamed from a virus such as the common cold, and invariably lead to bacterial colonization and cause a bacterial sinus infection- we call it sinusitis.

You could get a yellowish or greenish discharge from your nostrils, sore throat, headache, fever, pain in the forehead, or between the eyes, toothache, and feeling of fullness in the mid-face, stuffy nose and congestion.

You need to consult your doctor before using any drugs to treat your sinusitis.

New findings- Gut microbial interaction
Picture three people seated side by side on an airplane. The person in the middle gets flu and starts coughing. The person on the left gets the flu whilst the person seated on the right escapes. How can you explain this?

The gut microbiota produce a molecule called “desaminotyrosine” (DAT). This molecule is formed in the microbiota from dietary polyphenols called flavonoids which has anti-oxidant properties. These flavonoids compounds are found in chocolate, tea and red wine.
DAT seems to work on the immune system, formed by microbiota. This boost prevents the flu virus affecting the lungs reducing the lung damage. The researchers found that a microbe called Clostridium orbiscindens produced DAT.

So the person on the right did not contract the flu mainly because he had this microbe in his gut to produce the flavonoid DAT, and escapes malady.
So, next time you are on the plane and your next seat passenger starts coughing, drink Tea and eat chocolate and you’ll not go wrong.
Conclusions: Stay at home and rest, hydrate yourself, enjoy chicken soup and other juices to hydrate you. Paracetamol should be okay for aches and pains. There is no cure unlike for bacterial infections, and time is the healer.

This article also helps you to differentiate between many infections having similar symptoms.
Some reference to MedicineNet.com and WebMD

About the author: Dr Gunatillake-Health editor is a member of the Academy of Medicine, Singapore. Member of the Australian Association of Cosmetic Surgery. Fellow of the Royal College of Surgeons (UK), Corresponding Fellow of the American Academy of Cosmetic Surgery, Member of the International Societies of Cosmetic surgery, Fellow of the International College of Surgery (US), Australian diplomat for the International Society of Plastic, Aesthetic & Reconstructive Surgery, Board member of the International Society of Aesthetic Surgery, Member of the American Academy of Aesthetic & Restorative Surgery, Life Member of the College of Surgeons, Sri Lanka, Batchelor of Medicine & Surgery (Cey). Government scholar to UK for higher studies and training.

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