What's Up Doc: Sound advice about the common cold

Q: I hate it when I get a cold, but I get them anyway. Any advice?

A: The common cold is a benign viral infection. There are hundreds of strains of virus that can cause it, the most common being strains of the rhinovirus. There can be up to millions of viral particles in each drop of mucus.

Cold symptoms can include a runny nose (often with colored mucus after the first couple of days), congestion, sneezing, cough, sore throat, low-grade temperature, headache and malaise.

Colds are very common; there are literally hundreds of millions of them in the United States per year, averaging two to three per year for adults and six to eight per year for kids.

They are even more common in the winter. Symptoms typically last five to seven days for adults (but can be longer), and up to 2 weeks for kids. If a kid gets eight colds lasting two weeks each in a year, you can do the math and see why it seems like some kids always have a cold.

The common cold is the No. 1 reason for missed days of school or work, responsible for over $20 billion dollars of direct and indirect costs. In fact, over 40 percent of missed workdays are due to colds.

Sneezes and coughs can transmit the virus through small particles that become airborne, or directly if you get sneezed/coughed on (gross). However, the most common mode of transmission is hand to hand (or hand to surface to hand). That is, someone with a cold gets mucus on their hand (maybe they just blew their nose) then either touches your hand (no wonder TV's Monk won't shake hands) or touches some object (a doorknob, for example) and then you touch the object, get virus on your hands and self-inoculate.

Risk factors for getting a cold include smoking, certain chronic diseases, poor nutrition and certain congenital immune deficiencies. However, having a compromised immune system is not necessary to get a cold. In fact, most colds occur in otherwise healthy people.

Colds usually go away on their own, although they occasionally cause complications such as lower respiratory infections, sinusitis or ear infections (especially in kids).

There are many myths about the common cold, so let me dispel some of these now:

UAlthough cold viruses multiply like crazy in mucus, they don't really like saliva that much, so colds are not usually transmitted just from saliva (although avoiding double dipping is still a good idea at any time and especially when you are sick).

UThe recirculated air in airplanes probably does not increase cold transmissions.

UBeing out in the cold does not increase the risk that you will get a cold, although coming inside and huddling close together, coughing and sneezing on each other certainly does.

UDry air from central heating does not make you more susceptible to a cold.

UTreating symptoms does not prolong how long you will have the cold.

UFeed a cold and starve a fever (did I get that backwards?) is not true. I do not know where this came from.

So, how can you avoid a cold? Stop smoking, get regular exercise and be sure you take your medications to keep any chronic illnesses well controlled (three of my healthy New Year's resolutions). Wash your hands often - those cold germs are everywhere. There is some research that supports Vitamin C and E supplements (not mega-doses) in helping prevent colds, although they do not seem beneficial as treatments.

Treatments are usually aimed at relieving the symptoms with over-the-counter medications. Antibiotics are no help, and may actually cause more harm than good.

Drink lots of fluids and get plenty of rest is not only what Grandma would say, it is also the advice of the National Institute of Allergy and Infectious Disease.

Chicken soup is good for you, really. In 2006 Dr. Stephen Rennard tested chicken soup's effect on the immune system, and, at least in the lab, it showed benefit. Although I would personally credit my grandmother with this advice, the 12th century Jewish physician Moshe ben Maimonides recommended chicken soup centuries ago. However, there is literature from Greek physicians even earlier than this noting that chicken soup is good for colds. For vegetarians, vegetable soup also seems to offer some benefit.

With the height of the cold season upon us, I would recommend washing your hands often and covering your mouth when you sneeze or cough. If you do get sick, drink lots of fluids - with special consideration to chicken soup - and get plenty of rest. Over-the-counter remedies can help with the symptoms. In other words, listen to your grandmother!

Jeff Hersh, Ph.D., M.D., F.A.A.P., F.A.C.P., F.A.A.E.P., can be reached at DrHersh@juno.com.