THE COMMON COLD

February 9, 1999
		Common myths and common sense about the common cold, from Susan Dentzer of our health unit, a partnership with the Henry J. Kaiser Family Foundation.

Jan. 4, 1999: Long-term care. Dec. 24, 1998: More American's are uninsured. Nov. 11, 1998: News about heart disease. July 2, 1998: Generic V. Brand-Name Drugs. June 23, 1998: The FDA approval process. Browse the NewsHour's Health coverage.     National Institute of Allergy and Infectious Disease The Sacramento Bee on Cold and Flu Season Cold -Eeze claims to reduce the severity of common cold Kaiser Permanente's Cold and Flu Webzine Better Homes and Gardens Guide to the Cold and Flu	(Sneezing and coughing) SUSAN DENTZER: It's that time of the year again -- when you or people around you have a cold. PHYSICIAN: Give me an, "ahh." PATIENT: Ahh. PHYSICIAN: Okay. Well, I think you have a cold. CASEY BYRD: (in store) I feel like there's an elephant sitting on my face. There's a lot of pressure and stuffiness and feeling very boxed in and not very social. (laughing) SUSAN DENTZER: And millions of Americans are likely to feel that way at least sometime this year. Collectively, we'll experience a projected one billion colds in 1999, yet for all the familiarity we have with colds, strangely enough we seem to know very little about them. WOMAN: Thank you. Bye. SUSAN DENTZER: For example, we spend more than $3 billion a year to relieve cold symptoms, despite scant evidence that many of these remedies actually work. SAMUEL WILLIAMS: (in store) I always take garlic during the winter months, and it seems to keep me away from a cold. CASEY BYRD: The zinc lozenges and stuff I've had very good luck with. Those seemed to help a lot. If I'm feeling a little bit poorly, sometimes I'll get some as a preventive thing.
	Treating a cold.
	SUSAN DENTZER: We gripe that scientists can send people to the Moon but can't seem to cure the common cold. Meanwhile, we often rely on non-scientific cold treatment, says family physician Kevin Ferentz of the University of Maryland Medical School. SUSAN DENTZER: "Starve a cold, feed a fever"? Or is it the other way around - feed a fever, starve a cold? DR. KEVIN FERENTZ, University of Maryland Medical School: It depends on who your mother was. It could be either way, but either way, scientifically it doesn't make a whole lot of sense. SUSAN DENTZER: Many of us even have our own elaborate mythology about what causes colds in the first place. TROY NICHOLSON: (in store) If you have something wet on your head for a period of 30 to 45 minutes, your chances of getting sick increase maybe 100 percent. SUSAN DENTZER: Figuring that we all might be in need of a refresher course on colds, we consulted with Dr. Ferentz and other leading experts. We asked about the causes, effective treatments, and even potential cures for colds. As for causes, they told us forget wet hair or going out in bad weather without your galoshes. Colds begin when we first come into contact with cold viruses, microscopic organisms that consist of genetic material wrapped up in a protein coat. Dr. Anthony Fauci heads the National Institute of Allergic and Infectious diseases, the federal institute responsible for common cold research. DR. ANTHONY FAUCI, National Institutes of Health: You'll shake hands with someone who has blown their nose and has some of the virus that gets onto their hands. They don't know it. Their hands are not wet, they seem fine. DR. KEVIN FERENTZ: And then you happen to rub your eye or you rub your nose. That's how the cold virus actually gets into your system. SUSAN DENTZER: And as for that cold virus, well, unfortunately, it turns out that there isn't just one virus or even one family of cold viruses. To date, scientists have identified more than 220 different cold viruses; they range from rhinoviruses, which cause colds in the fall and spring, to coronaviruses that cause the traditional winter cold. Worse, it appears that there may be hundreds more cold viruses lurking out there that have yet to be identified. DR. ANTONY FAUCI: About 50 percent of all common colds that people have, you never find out-- even if you look-- what the virus is, so you're talking about a great mystery. SUSAN DENTZER: But it isn't a mystery what happens when any of these viruses lands in your nose or eyes. They all follow a common line of attack, moving into your respiratory tract, then latching onto special receptors in the body's cells. Next, the virus elbows its way into the cells, commandeering their genetic material and churning out thousands of copies of itself. When the body's immune system detects the invaders, it launches a counterattack. That includes unleashing certain chemicals called mediators to vanquish the virus. Unfortunately, those mediators have a nasty side effect. It is they, rather than the cold viruses directly, that cause those familiar cold symptoms like runny noses and coughing.
	The ruckus.
	DR. ANTONY FAUCI: The ultimate goal of the body's immune and inflammatory system is to get rid of the virus, completely out of the body, and in doing that it creates a lot of ruckus. And it's the ruckus that makes you feel badly. SPOKESPERSON: So what brings you in today? SUSAN DENTZER: To cope with that ruckus, tens of thousands of cold victims each year go to the doctor to seek treatment, but that's usually a mistake. Unless you're feverish or your symptoms include wheezing or pain around your nose, ears or chest, all of which could indicate a more severe infection, you should probably just stay home. DR. KEVIN FERENTZ: Of course, the old adage is that if you treat a cold, it lasts for about seven days, and if you don't treat it, it will last about a week. SUSAN DENTZER: So you'd rather they took two aspirin and didn't call you in the morning. DR. KEVIN FERENTZ: That's right -- only if they didn't get better. SUSAN DENTZER: Still seeking that magic bullet, many cold victims also press their doctors to prescribe antibiotics inappropriately. We caught up with Virginia resident Ed Talfair as he was picking up a prescription for his cold-stricken wife. ED TALFAIR: First symptom of anything, she takes an antibiotic if she can get her hands on one, just to play it safe, which she's been told that's not the smartest thing to do, but she does it anyway. (Laughs) SUSAN DENTZER: His wife isn't alone. Recent studies suggest that nearly seven out of ten patients with colds or other respiratory infections expect antibiotics. And according to a new article in the journal "Pediatrics," some of the chief culprits are parents of sick children who pressure doctors to prescribe them. DR. KEVIN FERENTZ: I don't think you have any kind of a secondary infection. I think you pretty much have a cold. SUSAN DENTZER: But Ferentz and others say you should only be given an antibiotic if you have a so- called secondary infection, such as an ear infection or some forms of pneumonia; these are caused not by viruses but by bacteria that can take root and flourish when you have a cold. DR. KEVIN FERENTZ: Antibiotics do not kill viruses. An easy rule of thumb, a really good rule of thumb is if you don't have a fever, chances are you don't have a secondary bacterial infection that would warrant an antibiotic. SUSAN DENTZER: Besides the confusion over antibiotics, there are plenty of misconceptions over which remedies are really effective at treating colds. Many people put stock in the curative powers of substances like Vitamin "C" or zinc lozenges. Casey Byrd is a true believer in the herbal remedy Echinacea, derived from the purple cone flower. CASEY BYRD: You just have to put your faith in it. I just noticed that over several times of doing it, that when I'm starting to get sniffly or start to cough a bit and you start doing all of these things ahead of time, then it alleviates it sooner and makes it not last as long. SUSAN DENTZER: In fact, studies of Echinacea have been inconclusive at best, and at worst have shown it to be ineffective in preventing colds. And Dr. Ferentz says that a small number of people have extreme allergic reactions to the herb that can prove fatal. MAN: Orange juice. WOMAN: What did you say? MAN: Orange juice. SUSAN DENTZER: On the other hand, there is some evidence that taking vitamin "C" may somewhat shorten the duration of a cold, perhaps by a day. TROY NICHOLSON: Most of the time when I feel a cold coming on, I load up with vitamin "C." I take about 1,000 to 1,500 milligrams of vitamin "C" every four hours.
	Hope for a cure.
	SUSAN DENTZER: But Dr. Ferentz says that's more than four times the amount that has been shown to cut the duration of a cold. Taking so much vitamin "C" is simply unnecessary, and may even be harmful. For now, the best thing you can do is to take conventional aspirin, acetaminophen, or ibuprofen to fight fever or achiness. Ferentz also says that nasal sprays are okay for a few days, and a cough suppressant may also help. And believe it or not, in the long run, there actually is hope for a cold cure. In recent years, science has scored major breakthroughs in viral research that could pave the way for cold vaccines and other treatments. This good news has come from a surprising place: Research on AIDS, which is caused by the virus known as HIV. DR. ANTHONY FAUCI: There have been so many spin-offs. I think the whole area of anti- viral drugs has had a major, major boost that totally transcends HIV by the enormous amount of resources that have been poured into developing drugs that are specific for HIV that now spills over into other areas. SUSAN DENTZER: One approach now being studied is a class of anti-viral drugs; known as protease inhibitors, these are already being used for aids. The drugs block an enzyme that helps open the door to cold viruses. Researchers are also working on creating dummy receptors. These would trick viruses into binding with a decoy chemical instead of with the body's cells. The hope with these and other strategies is that when you feel a cold coming on -- DR. ANTHONY FAUCI: You can go to a doctor's office, go to a nurse's station, quickly get it diagnosed, say, "ah, this is a rhinovirus," and then go in with the specific drugs against a rhinovirus. What you will probably do is instead of having a five-day illness or discomfort, it might be truncated down to one, one and a half days. SUSAN DENTZER: Until such cures make it from the laboratory to the pharmacy shelf, the best thing to do is to avoid catching a cold in the first place. And prevention has nothing to do with taking garlic. If you think you've come in contact with somebody who has a cold - DR. KEVIN FERENTZ: Wash your hands. That's the best advice I can give anybody. SUSAN DENTZER: Oh, and one other thing - DR. KEVIN FERENTZ: Clearly high on my recommendation list is chicken soup, only because it tastes good and it will make you feel good. SUSAN DENTZER: And after about a week, your cold will probably be gone.