Studies Focus On The Cold Facts Of Life
The University of Wisconsin poker experiments definitely rate as a most uncommon way to study the common cold. But British researchers using “scantily clad volunteers in drafty hallways” are nothing to sneeze at, nor is chicken soup analysis at the Mt. Sinai Medical Institute in Miami Beach.
Everything’s fair game when trying to figure out how people catch colds or how to stop the nearly 200 different cold viruses. There were a billion cases of the common cold in the U.S. in 1994 (and plenty more lurk as the peak cold season stretches through April), causing 157 million days of restricted activity and 15 million sick days at the workplace. Colds are the top reason why people, especially kids, go to the doctor. American grade-school students average six to 10 colds a year, with their parents picking up about four. Other adults are likely to experience two colds. It’s all bound to keep scientists busy.
“I’m still going at it because I think we are getting near a way to stop transmission of colds by filtering the air,” said Elliot C. Dick, 68, professor of microbiology and pokermeister at Wisconsin. “We’ve already done it with medicated tissues, but maybe within a year we can figure out how to treat the air.”
Dick has been in Madison since 1961, but his research breakthrough came in the mid-1980s when he developed a “human model of a cold epidemic” by putting together voluntarily infected donors and susceptible recipients at poker tables. He inoculated the donors with rhinovirus 68, which comes from a family of 110 rhinoviruses causing one-third of all colds. The participants played cards from 8 a.m. to 11 p.m. with breaks for three meals and a group jog. Stakes were low (three-raise limit with dime maximum bet) but kept everybody interested.
“Poker is one of the few games, other than bridge or pinochle, you can play for hours at a time,” explained Dick. “It also allows plenty of hand-to-hand contact through the cards and chips while everybody faces one another with all the nose-blowing, coughing and sneezing.”
The university’s microbiology lab has conducted some 50 poker studies since 1983. About half of vulnerable recipients were infected, with most people experiencing symptoms within 36 to 48 hours (a small percentage were infected but never developed symptoms; people who tested for the correct antibody in their blood to fight rhinovirus 68 were not used).
In experiments when subjects were restrained from touching their noses or mouths, they were almost equally infected. When the air was free of the virus but recipients were forced to use gooey cards and chips from an infected room’s game (“some were quite reluctant at first”), no one caught a cold.
“We were surprised and amazed,” Dick said. “This suggests it can be very difficult to catch a rhinovirus by hand-to-hand contact with other people and hard enough to catch it through the air. Statistics show even married partners only give each other a cold 30 percent of the time.”
Dr. Jack Gwaltney, an internal medicine physician at the University of Virginia, is more wary of nose-to-hand-to-hand-to-nose contact. The 63-year-old virologist has been studying the common cold since 1963. He conducted research that shows applying iodine to the fingers of an infected volunteer will reduce the spread of colds by 50 percent.
“The virus is in the nasal secretions and somewhat in the saliva,” he said. “Touch the secretions or saliva while still moist, then touch your own nose or eyes, you can be infected. Another way is coughs or sneezes through the air.”
Gwaltney said there also is scientific disagreement on when a cold can be contagious.
Some studies show it can happen before symptoms are physically evident, others say not until you experience a sore throat or nasal draining. In any case, the contagious period is estimated at about three days.
“If you really don’t want to get a cold, it’s best to stay away from people. Short of that, wash your hands after every exposure to somebody with a cold and don’t let anyone sneeze or cough in your face.
“Use paper tissues; cold viruses can survive on handkerchiefs.”
Part of the problem is the viruses themselves. There are just too many of them to develop one vaccine. While rhinoviruses (from the Greek word rhis for nose) can be stabilized and studied at the molecular level, other identified cold strains cannot be grown in the laboratory.
Rhinoviruses are most active in the fall, spring and summer, when outside temperatures are not too cold. Another family of viruses, coronaviruses, do much of the dirty work in cold-weather states during the winter because they thrive at lower temperatures.
Other viruses are known to cause both colds and the flu (if you have a high fever, persistent chills and/or splitting headache, it’s the flu), and cold viruses that are yet to be identified account for somewhere between one-third and one-half of all colds.
Just as problematic - and more annoying on a conscious level - is your body’s reaction to the virus. Cold symptoms such as a runny nose or scratchy throat have more to do with internal defense mechanisms than any submicroscopic invasion.
The first line of defense is mucus, which is produced by membranes in the nose and throat to trap the virus (it can also capture pollen, dust and bacterias) before carrying it out of the body. But the virus might penetrate through the mucus, enter healthy cells and force replication of new virus-infected cells.
The viral cells make it to the nose, which sends out a distress signal to recruit specialized white blood cells to the site of infection. The blood cells unleash immune-system rescuers such as kinins, prostaglandins and interleukins. These chemical substances lead to common symptoms by causing swelling and inflammation of the nasal membranes, leakage of proteins and fluid from capillaries and lymph vessels, and increased production of mucus. This brings on a stuffed-up feeling and maybe a fever less than 100 degrees. Within a day or so, you are bound to get some general achiness and, especially, a runny nose.
“We need to find a treatment to tame the body and not just the virus,” said Gwaltney.
Of course, our susceptibility to the viruses is an issue. According to the National Institute of Allergy and Infectious Diseases, research shows little relationship between picking up a virus and being too cold or overheated in frigid weather. (One prominent study at Britain’s Common Cold Institute showed no effect on underdressed subjects who were submitted to drafty hallways; a control group caught just as many colds during a transmission process.)
But there are limited findings that cold air makes the nasal passages drier, which makes you more prone to viral infection.
There is no proven positive relationship between preventing colds and a healthy diet or exercise program, but federally funded research does show possible negative effects of psychological stress. Exercising regularly or avoiding certain foods can help you manage the stress. Allergic disorders and menstrual cycles are also possible triggers for colds.
While there is no conclusive evidence that vitamin C prevents colds, government officials say that preliminary studies show it may reduce severity or duration of symptoms. Since 1971, more than 20 placebo-controlled studies have showed that more than 1 gram of vitamin C per day (1,000 milligrams, or 940 milligrams more than the U.S. Recommended Daily Allowance) reduced the severity of symptoms by an average of 23 percent. Vitamin C improves the way white blood cells move around in defending the body, and it has antihistamine properties that can be helpful.
The late Linus Pauling, who won the Nobel Prize in chemistry in 1954 and the Nobel Peace Prize in 1962, was renowned for his zealous attitude about vitamin C. Pauling, who died in August at the age of 93, retired from Stanford University in 1973 to start a private research institute. He recommended taking 2,000 milligrams on first sign of a cold, then 2,000 more every hour until symptoms are gone.
His rationale was simple: Our prehistoric ancestors could produce vitamin C in their bodies, but we have lost the ability. Animals still have it.
Goats make 13 grams a day, while the family dog or cat produces a daily supply equivalent to 10 to 12 grams.
One caution about vitamin C: Our bodies can absorb only so much at one time. Some studies show as little as 250 to 500 mg every few hours, while others say our bodies will use whatever it needs - 1,000 mg or more during especially stressful times. Still, taking too much will cause diarrhea and might distort results of tests commonly used to measure the amount of glucose in urine and blood.
But vitamin C may be more effective than more expensive products at the drugstore. The National Institute of Allergy and Infectious Diseases downplays the efficacy of over-the-counter cold remedies for preventing, curing or shortening the duration of a cold but says such products might relieve some cold symptoms.
For example, antihistamines can subdue histamines but don’t work against other chemical substances that also inflame the nasal passages; you feel a bit less congested, but there is no research to show the cold is shortened.
Similarly, cough medicine is recommended if you have a dry cough or it is disrupting work or sleep, but it hasn’t been found to rush a cold to its conclusion.
Aspirin is an option for adults who have general achiness, but it only lessens the pain; your muscles are still under siege. Interestingly, research shows aspirin increases the amount of viruses shed in nasal secretions, possibly making a person more hazardous to others.
One caution: Aspirin is not appropriate for children with colds or flu (also chicken pox) due to its adverse effects on the blood and nervous system.
“Most colds last seven to 10 days,” said Dr. Steven Hagedorn, a physician in the family medicine department at the Mayo Clinic in Rochester, Minn. “It will get progressively worse the first four days, then better from days five to seven. If your symptoms last longer than two weeks, you probably have something more than a cold.”
That something could be an allergy or secondary bacterial infection, such as strep throat, laryngitis, sinusitis, bronchitis or an ear infection known as otitis media.
Hagedorn said he doesn’t think a doctor can recommend anything more for patients with a common cold than to follow your grandmother’s advice: Get extra rest, drink lots of fluids (to flush the system and accommodate the loss of moisture from breathing through the mouth), use petroleum jelly on a raw nose and generally give the body time to heal (“taking one day off work can really help, or at least don’t do anything that will wear you out”).
“We see so many patients with common colds, it makes us inaccessible to people with more serious problems,” said Hagedorn.
“It is appropriate for someone with a cold to see a physician when there are complications: a plus-100-degree fever for two or three days; severe pain behind the ears or eyes or pain in the jaw or sinuses; an extremely sore throat or swollen glands in the neck; if you can’t shake the cough or cold after about 10 days.”
Otherwise, Hagedorn is a big fan of rest and a homemade saltwater spray to shrink the mucus membranes and thin the secretions. He also likes regular doses of chicken soup to be part of fluid replacement.
Which brings us to Mount Sinai Medical Institute in Miami Beach. The center tested cold water, hot water and chicken soup on subjects to see how effectively each worked in helping expel virus-laden mucus from their systems. A traditional version of the soup scored considerably better than cold water and about the same as hot water.
“If you find anything that makes you feel better, given the current body of knowledge, go ahead and use it,” said Dr. Michael Macknin, a physician at the Cleveland Clinic who has been unable to clinically prove the value of hot-steam treatments, even though half his research subjects said they felt better after undergoing such therapy.
“Just make sure it doesn’t hurt you or have side effects.”