Sometimes it seems like winter is just one long case of the sneezes; we all know what it's like to go around for weeks with a cold we just can't shake. Yet some lucky folks seem to get through the cold and flu season with nary a sniffle. How do they do it?
As it turns out, it's not really luck. Although it's true that some immune systems are more robust than others, just about anyone attacked by a cold virus is going to get a cold. The secret: Prevent the cold virus from breaching your defenses. And at the first sign of exposure or symptoms, mount a full-bore offense to stop it in its tracks.
How to stop a cold before it starts
The germs that cause colds have a preferred route of travel. Unlike various strains of influenza virus, which tend to travel in airborne droplets, cold viruses prefer a physical transmission route: from your hands to your nose or eyes, and then to the nasopharynx -- where the nose meets the mouth at the back of the throat (and where most colds begin). Studies have shown that most cold viruses can survive for up to three hours on nonporous surfaces such as doorknobs, countertops, and coffee cups. They can also survive on people's hands for several hours if they don't wash them.
That's why hand washing -- after you shake hands, after you open a door, after you push a shopping cart -- is item number one in your anticold defense manual. If you kill cold germs on your hands before you transfer them to your nose or eyes, you stop a cold before it can start.
Few of us can wash our hands as often as needed, though, so be sure to follow these other strategies as well:
Avoid touching your face, especially your eyes and nose. There are hundreds of viruses that cause the common cold, and most of them are rhinoviruses, which need to get into the mucous membranes lining the nose or into the tear ducts in order to cause infection. That means touching your face -- specifically your nose and eyes -- is the primary way people give themselves cold germs. The nasopharynx, where the nose meets the mouth, is the "sweet spot" for cold viruses. If they can reach this spot, it's very likely you'll get sick; if you prevent them from getting there, you won't. And a virus deposited at the base of the nose can easily be inhaled higher up into the nose.
So your mother was right: Don't pick or touch your nose. The tear ducts provide another pathway; rub your eyes and the cold virus can easily drain through the tear ducts into the nasopharynx. Don't rub them, and you avoid another possible cold.
Try not to touch public surfaces. Studies show that teaching children to sneeze into their elbow, rather than cover their mouths with their hands, has been very effective at reducing the incidence of colds in schools. Why? Because then the virus isn't on their hands, where it can be passed to others via shared surfaces such as doorknobs, chair backs, books, and toys.
Here's the surprising-but-true example doctors use: Did you know you're far more likely to catch a cold from touching an infected person's water glass and then wiping your eye or picking your nose than you are from drinking a sip of the sick person's water?
Knowing this, medical personnel recommend being as ingenious as possible in your efforts not to touch surfaces that many other people have also touched. One internist reported that she trained himself to push elevator buttons with her knuckles; a nurse mentioned he's learned to open doors by pushing them with his elbow or forearm.
Be finicky about sanitation. Dispose of dirty tissues promptly; the cold virus can live on them for several hours. Use hand sanitizer when you can't wash your hands right away; a recent study found there was less spread of colds in families using alcohol-based hand gels frequently.
Don't skimp on sleep. The studies are clear: Those who sleep less are much more susceptible to the cold virus once they're exposed. In one study published in the January 2009 Archives of Internal Medicine, people who slept fewer than seven hours a night were three times more likely to develop a cold when exposed to a rhinovirus compared to those who slept eight or more hours a night.
How to get over a cold fast
Even when you try your hardest, you might still get an occasional cold. Fortunately, most colds begin to fade on their own after about a week, but sometimes it takes two weeks before you feel better. If more than two weeks has passed and you're still coughing, it may be that tissues in the lungs have become irritated. These "rhinovirus-induced changes" can last up to four weeks.
Is there anything you can do to shorten the downtime? In a word, yes. Here's what helps:
Go to bed. Rather than getting in the car and heading to the drugstore, get into bed and go to sleep. While you sleep, your body recharges your immune system, which is what fights off a cold. Studies show that people who get eight or more hours of sleep increase their resistance to cold viruses -- and get better faster if they do catch a cold.
Drink a lot of water. And tea, and juice, and clear broth. Fluids help your body heal from a cold by loosening congestion and preventing dehydration. Water, juice, clear broth, or warm lemon water with honey are the best fluids to rely on; alcohol, coffee, and caffeinated sodas only make dehydration worse.
Cheer up with chicken soup. Recent studies that tested the effectiveness of chicken soup discovered that it does seem to relieve cold and flu symptoms. Scientists believe chicken soup acts as an anti-inflammatory by inhibiting the movement of neutrophils, the cells of the immune system that mount the body's inflammatory response. Hot chicken soup also temporarily speeds up the movement of mucus through the nose, helping relieve congestion and limiting the amount of time viruses are in contact with the lining of the nasal passages.
And no, it doesn't need to be homemade. Researchers at the University of Nebraska compared homemade chicken soup with canned versions and found that many, though not all, canned chicken soups worked just as well as soups made from scratch.
Gargle a sore throat. Dissolve a half teaspoon of salt in an 8-ounce glass of warm water and gargle with it to temporarily relieve a sore or scratchy throat. The reason this time-honored home remedy works is that a sore throat occurs when the throat tissues become inflamed by bacteria and germs. This inflammation takes the form of tiny fluid-filled bumps called edemas. The dehydrating action of salt draws out the edema fluid, killing the bacteria, which require a warm, moist environment to survive.
"Irrigate" your nose with saline. Studies show that over-the-counter saline nasal sprays work to combat stuffiness and congestion and also reduce the amount of time that virus particles are in the nasal passages. And unlike nasal decongestants, saline sprays don't lead to a rebound effect -- a worsening of symptoms when the medication is used for too long. A neti pot, an alternative therapy gaining in popularity, is basically another nasal irrigation technique that puts the saline solution directly into the nasal passages.
Moisten the air with a humidifier. Cold viruses are happiest in dry conditions, which is one reason colds are more common in winter. Dry air also dries out the mucous membranes, which can both contribute to a stuffy nose and scratchy throat and lessen the body's ability's to fend off cold viruses in the first place. Run a humidifier to add moisture to indoor air. It doesn't matter if it's cool or warm mist; both are effective. But be careful: Running a humidifier can also add mold, fungi, and bacteria to your environment, especially if the humidifier hasn't been cleaned properly. Change the water in your humidifier daily, clean the humidifier with soap and water once every three days, and air out the rooms in which you've been running the humidifier once you're over your cold.
Don't overuse over-the-counter cold remedies. Nonprescription decongestants and pain relievers are useful for relieving symptoms when you just can't stand them anymore, but they won't make your cold go away any faster. And they can have side effects. Decongestants, for example, can have a "rebound effect" -- they can actually make a runny nose come back worse than ever if you use them for more than a few days.
The most effective decongestants are the ones that contain pseudoephedrine (brand name: Sudafed), but nowadays they're kept behind the counter and you have to ask for them. That's because pharmacies are restricting the availability of pseudoephedrine, which can be used to manufacture methamphetamine. But do take the trouble to ask, because the decongestants that contain phenylephrine instead don't work nearly as well. And antihistamines, such as Benadryl, not only don't work as well but can be dangerous because they cause drowsiness. In fact, older adults shouldn't take Benadryl at all, since it can cause dizziness and falls.
Be sure, too, not to double-dose on acetaminophen (Tylenol). Most combination cold remedies contain acetaminophen, so if you take a combination remedy when you've already taken acetaminophen for fever or pain, you'll inadvertently take too much. Read the labels of any cold medication carefully to make sure you're not overdosing.
Use alternative remedies cautiously. At the first sneeze, cough, or sniffle, many of us reach for the vitamin bottle or rush to the drug store for an herbal remedy. Unfortunately, there's little evidence to show that these work. Although some studies of vitamin C, garlic, echinacea, zinc, and the herbal combination in Airborne have suggested promising results, most have shown little or no effect. In most cases they can't hurt, either.
However, sometimes a natural remedy that's powerful enough to affect your health can have serious side effects. Recently, for example, a zinc nasal solution (brand name Zicam), which is sold at health food stores and some pharmacies, has been reported to cause permanent changes to some people's sense of smell. Some researchers think that zinc lozenges could have the same effect. In June 2009, the FDA issued an advisory regarding some zinc products, so be careful about using them.
What to do when a cold won't go away
Most cases of the common cold will go away on their own in one to two weeks, though sometimes symptoms such as a cough can linger longer. But if you've been sick for ten days or more and aren't getting better, or are feeling worse, it's time to rethink your approach.
Go over the checklist -- have you really been following doctor's orders? Typically, when people complain that a cold won't go away, it turns out they've been trying to "power through" it and haven't given their bodies a chance to heal, experts say. Go over the list of treatment options listed above and ask yourself if you've been doing all you can. Rest and fluids are the most important -- have you been getting at least eight hours of sleep a night and drinking plenty of water, juice, or tea with honey?
Take steps to relieve a cough. The symptom most likely to persist for weeks is a cough. And any time the lungs are involved, it's important to take steps to avoid bronchitis or pneumonia.
The best way to get a cough to clear up: Take care of it. Gargle with salt water and drink lots of herb tea or hot water with honey, which has an antibacterial and soothing effect. (One study found honey to be more effective than cough syrup.) If a cough is preventing you from sleeping, try using over-the-counter cough syrup, though experts are divided over whether they work. Read labels and choose one with dextromethorphan, which at least some studies have found effective. Dextromethorphan actually works in the brain, rather than having a physical effect on the lungs or throat. It raises the threshold at which you feel like coughing, breaking the cycle of repeated coughing fits to give your lungs and throat a break. And that gives you a chance to sleep, so your body can heal itself.
Watch for a sinus infection. If a stuffy nose and congestion persists, you could be getting a sinus infection. That happens when mucus gets trapped in your nasal passages and is unable to drain for a period of time, becoming a safe harbor for bacteria. Sinus infections can be difficult to diagnose, particularly in the early stages before a full-blown infection develops. Be sure, then, to keep your nasal passages well irrigated with saline spray to help avoid an infection in the first place. And keep a lookout for these telltale signs of infection:
Facial pain, particularly behind the forehead, cheeks, nose, or between the eyes
Nasal discharge that's green or dark yellow in color
If you suspect a sinus infection, call your doctor. This is one of the rare instances in which you'll probably need antibiotics.
Be on alert for breathing problems. In a small minority of cases, a cold or flu may lead to pneumonia. And if you suffer from asthma, a cold can trigger an asthma attack when the air passages in your lungs overreact to infection by the cold virus. Asthma can be treated with an inhaler or other medication. Pneumonia can be viral or bacterial, so antibiotics may or may not be the treatment of choice.
But if you suspect pneumonia, be sure to see a doctor to get it checked out. Symptoms to watch for include:
Fast, shallow breathing -- the feeling of not being able to draw a deep breath
Difficulty breathing, as though you can't get enough air
Coughing or wheezing that won't stop
Signs of dehydration, such as dizziness when standing or decreased urination (or decreased tears, in an infant)
Blue or purple discoloration around the mouth
Mental confusion that wasn't present before the illness
Convulsions or seizures
In these days of H1N1 influenza, also known as swine flu, it's best to take seriously any illness that won't go away. If you're getting worse instead of better, or are still concerned about symptoms after two weeks, call your doctor.