Saturday, November 3, 2007

Cold and Flu Myths

Reality Check

Colds are not caused by going outside without a coat.

Sorry, Mom. You meant well, but the only way to catch a cold or flu is by picking up a virus. Going out into the cold without a jacket or a hat, or with wet hair, does nothing to facilitate transmission. It's true, though, that we are more prone in the winter. Viruses are more easily shared when people are clustered together indoors.

Reality Check

Flu vaccines do not cause flu.

The Centers For Disease Control and Prevention are emphatic that you cannot get the flu from a flu shot. The vaccine is made from killed or "inactivated" viruses, which can't be transmitted. However, you may experience a few side effects which mimic the disease such as aches and a low-grade fever.

Reality Check

Feed a cold, starve a fever? Nah. Feed 'em both.

This bit of armchair advice is probably repeated as often as it is jumbled. But you wouldn't want to starve either virus: At higher temperatures the body produces more interferon, a protein that helps prevent virus reproduction. "The body is like a furnace, and to create heat you need calories," says Dr. George Wootan, a family physician and author of Take Care of Your Child's Health. "When people have chills it is because they don't have enough calories to bring up the heat normally …by feeding them, they will have enough calories to raise the temperature, increase the interferon, and kill the bugs." Wootan will sometimes recommend to patients without a temperature that they promote their own fever by getting into a hot tub or putting on warm clothes and getting under the covers (drink lots of water, too, if you're going to try this method).

"[Some] might say that you should starve a fever because you don't want the fever to go higher," he concludes, "but the body isn't dumb and won't do damage that it can't control."

Reality Check

Viruses survive on surfaces.

You don't have to wait to be sneezed on to catch a cold or flu-you can pick the virus up right from a counter top, keyboard, telephone or other surface. Rhinoviruses, the family of germs responsible for most colds, have been shown to survive on a surface (or "fomite," in medical terms) for several hours or even days. "The concentration of virus attenuates; that is, the potency is less and less as time goes on. But you need very few viral particles to trigger an infection," explains Dr. Richard Rosenfeld, professor and chairman of otolaryngology at Long Island College Hospital in Brooklyn, N.Y. "Even if there's just a little left and you happen to touch that doorknob or coffee cup, the virus can then survive on your hands for quite a long time. Then all it takes is a little wipe or your nose or eyes and whatever little bit of virus on there will go to town very quickly. It's a very efficient multiplying process."

Reality Check

Colds that linger or worsen may indicate sinusitis.

Barring an underlying condition or immune deficiency, most people can fight off a cold inside of 10 days. When symptoms such as congestion, headache and runny nose drag on, it may indicate a bacterial infection of the sinuses, or sinusitis. "Duration of a cold beyond 10 days is highly suggestive of bacterial infection," says Rosenfeld, who was the lead author of a new guideline for treating adult sinusitis, which addresses the importance of distinguishing a cold from sinusitis. "The other feature suggesting sinusitis is the pattern of 'double worsening.' That's when someone starts to feel better and then all of a sudden they get hit again, and they're getting worse. Now bacterial infection has superimposed itself on the viral illness. When you have prolonged illness or the double-worsening pattern, it's reasonable to consider antibiotics."

Reality Check

Vitamin C is ineffective for preventing or treating cold or flu.

A review of 30 studies on vitamin C that was updated in May 2007 put to rest a few dozen years' of overconfidence in orange juice. "Vitamin C cannot effectively prevent or cure common colds or flu in the majority of people," says Sari Greaves, registered dietician with New York-Presbyterian Hospital. Greaves allows that some benefit has been shown for extreme athletes exercising in extreme cold, but "since vitamin C is only known to offer a biological benefit in certain cases and in a restricted number of people, for the average adult, it's not worth it to supplement."

Reality Check

It's true: we can put a man on the moon but we can't cure the common cold.

The problem is that there are hundreds of varieties, or serotypes, of rhinovirus in addition to other viruses that cause the common cold. Of those hundreds, just a few are causing widespread infection at any point in time. The serotypes change so rapidly that they're impossible to keep up with. A vaccine would have to be specific to the current serotype, and by the time the virus was identified and an antidote developed, the active serotype would have changed. On the plus side, we've been to the moon six times.

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