colds and flu

Season of colds and coughs
YOUR HEALTH
DR GITA MATHAI

The monsoon has set in, bringing much relief from the scorching sun and prickly heat. The cool showers and damp surroundings have also ushered in an epidemic of sniffles and sneezes. This effects the young and old alike. There is a constant fear — is this just a cold, or something more sinister? Could it be avian or swine flu?

Both cold and flu start with similar symptoms of headache, body ache, fever, runny nose and cough. Only the severity varies. In flu, the person is unable to move out of bed, whereas one suffering from a cold is not completely incapacitated.

Colds are caused by around 200 types of viruses, the commonest of which are the rhinoviruses (rhino means nose). They spread through droplets sneezed or coughed into the air by an infected person. The virus can also survive on clothing and articles like tables and books. The infection sets in around three days after exposure.

Children have not yet developed immunity against the cold viruses. Also, they are more likely to come in contact with infected children in schools and parks. Many parents, unfortunately, do not let ill children stay at home. In many schools, children with coughs and colds are advised to “take the test and then go home”. By this time they may have infected the entire class.

Children may develop eight to 10 colds a year. Each can last up to two weeks. This makes parents feel the child is always ill. They do not document the number of illness-free days in between one infection and the next. Many of these children are erroneously diagnosed as “primary complex” and started on rifampicin, isoniazide and other anti-tuberculosis medication. As children grow, their immunity builds up. The number of infections decreases to two to three a year.

A perpetually runny nose and cough without fever may not be due to a bacterial or viral infection. It may be due to an allergy to pollen, paint, incense or mosquito mats, coils and repellents. Smoking predispose one to colds. In children, toxic allergenic smoke may be inhaled passively from a smoking adult.

The classic symptoms of a cold are mild fever (it is best to buy a digital thermometer and check the temperature instead of relying on touch), less than 102° F, watery or slightly yellow nasal discharge, a scratchy irritated feeling in the throat, cough and body ache.

The condition is best tackled with rest. If the temperature goes above 100.5° F, or if the body ache is severe, paracetemol can be taken. Adults do not require more than 500mg. In children the dose is 10-15mg per kg of body weight. It can be repeated after four to six hours. Aspirin is contraindicated in children. A sore throat can be tackled with frequent salt water gargles. Saline nose drops can be administered in each nostril every three hours. It is better to avoid decongestant chemical nose drops as they can cause rebound nasal congestion, habituation and, if used for prolonged periods, atrophy of the nasal mucosa.

Anti-histamines can cause drowsiness. Both anti histamines and cough suppressants can cause side effects. They shouldn’t be taken without medical supervision. Traditional remedies like ginger tea, rasam, rice gruel and chicken soup help soothe the throat, relieve congestion and maintain hydration and nutrition.

A doctor should be consulted if —

• The fever has lasted more than three days
• There are chills
• The headache is continuous
• There is abdominal pain or vomiting
• There is ear ache
• Breathing becomes difficult
• A cough persists
• There is drowsiness.

In children, continuous crying or grunting needs to be taken seriously.

Antibiotics will not shorten the course of a cold or prevent one from appearing. But they need to be taken in case of complications like ear infection, sinusitis, bronchitis or pneumonia. The medication needs to be taken in the prescribed dose for the correct duration under medical supervision.

The likelihood of catching a cold can be reduced by washing hands regularly, cleaning toys and table surfaces, using disposable tissues to blow the nose, covering the nose and mouth while coughing and sneezing, and not attending school or work while infected.

Influenza vaccine is available and can be given to reduce the likelihood of catching seasonal flu but not the common cold. Immunisation is advisable for children under two, those over 65, asthmatics and those with compromised immunity.

Supplements of vitamin C, zinc, iron, B complex and some herbs like Echinacea are anecdotally said to reduce the number of colds. These claims have not been substantiated by double blind controlled studies.

The number of colds can be reduced by maintaining a hygienic and healthy lifestyle with at least 40 minutes of aerobic activity a day.

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in