coughs and colds

eason of coughs and colds
YOUR HEALTH
DR GITA MATHAI

Self medication can be harmful, consult a doctor when your child is sick
In India, we enjoy four seasons — winter (January and February), summer (March to May), monsoon (June to September) and a post-monsoon period (October to December) with unseasonal rains causing an overlap amongst them. Each season has its own set of illnesses.

During winter and the rains, we often suffer from colds and coughs. People blame it on the weather — getting caught in an unexpected shower or going about on a grey, chilly day. These are unproven theories and fall in the category of urban legends.

Colds are infections caused by 200 types of viruses. With so many subtypes around, immunity is poor and infections are common.

Infection occurs when the cold virus reaches the nose. It is transported to the back of the throat in 10-15 minutes. The nasal mucous membrane attempts to wash out the virus by swelling up and increasing its secretions. This causes sneezing and a characteristic drippy nose.

Sneezing and coughing expel the viruses into the environment to infect others. The viruses can temporarily survive on furniture, walls and clothing. Hands placed on contaminated walls or furniture and then on the nose can cause infection.

During the monsoon and winter, people tend to keep windows and doors shut. As they sit close together with inadequate ventilation, colds spread rapidly.

Children under the age of one year are most susceptible. They have a little immunity passed on by their mothers while in the uterus and also through breast milk. This wanes in about six months. Later, as they come in contact with many others, especially in a closed environment like a poorly ventilated classroom, the number of initial infections proportionately increases. This causes a dramatic increase in the number of fevers, colds and “lost school days”.

Children may develop eight to 10 infections a year. Each cold lasts seven to 10 days. This means around 60 days of ill health due to colds alone, leading parents to feel the child is always sick. They begin to fear the child is suffering not from recurrent illnesses due to different viruses but something more sinister like primary complex or tuberculosis. (These illnesses do not have a symptom free interval — the child is continuously sick.)

The classic symptoms of a cold are mild fever, watery or slightly yellow nasal discharge, a scratchy feeling in the throat, cough and body ache. It is best tackled with rest. If the temperature rises above 100.5° F, or if the body ache is severe, paracetamol may be taken. Adults do not require more than 500mg and children 10-15mg/kg body weight per dose. The medicine can be repeated every four to six hours. Sore throat can be tackled with 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 frequently for prolonged periods, atrophy of the nasal mucosa.

Anti histamines can cause drowsiness. Both anti histamines and cough suppressants can cause side effects. The prescribed dose should not be exceeded. Nor should they be used 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.

Consult a doctor if:

■ The fever lasts more than five days

■ There are chills

■ The headache is continuous

■ There is abdominal pain or vomiting

■ There is earache

■ Breathing becomes difficult

■ There is a persistent cough

■ There is drowsiness.

In children, continuous crying or grunting must be taken seriously. Antibiotics will not shorten the course of a cold or prevent one from appearing. They need to be used if there are complications like an ear infection, sinusitis, bronchitis or pneumonia. They need to be taken in the prescribed dose. The medication should not repeated every time there is a cold without a medical opinion.

The ability to cope with a cold is better in people who keep themselves fit with regular physical aerobic exercise and breathing asanas.

Not all colds are infective. Some may be allergic rhinitis, a watery discharge from the nasal mucosa as a response to allergens like pollen, crackers, mosquito repellents, room fresheners, incense and chalk dust. Allergies are difficult to treat if the cause is not determined. The newer anti allergic nasal sprays if used regularly as directed cause the hypertrophied mucosa to shrink and the allergy to subside.

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