DR Sven E Mathura Sven Mathura Mandal, MD

Colds and Flu: Time Only Sure Cure

It's not chicken soup. Believe it or not, a much more unorthodox therapy of warm-and-cold showers has recently been proposed--though not proven--for the prevention of the common cold. Shower therapy joins an ever-growing spectrum of suggested preventers and treatments for the common cold--among them, hand washing, vitamin C, interferon, seclusion, and various over-the-counter cough and cold medications.

"An efficient, practical and inexpensive prophylaxis [preventive measure] against one of the most frequent (and 'expensive') diseases has been identified at last," claims water therapy researcher Edzard Ernst, M.D., in the April 1990 issue of Physiotherapy. Though some may doubt his shower theory, Ernst is right about one thing--the common cold is a frequent and expensive disease, striking some people as many as 12 times a year and leading to some 15 million days lost from work annually in the United States. Influenza, or flu, likewise, is a frequent and expensive disease, reaching epidemic levels in the United States each year.

Identify the Enemy

Flu is like the cold in many ways--most basically, they're both respiratory infections caused by viruses. If a cold is misdiagnosed as flu, there's no problem. At worst, a cold can occasionally lead to secondary bacterial infections of the middle ear or sinuses, which can be treated with antibiotics. But if the flu is misdiagnosed as a bad cold, potentially life-threatening flu complications like pneumonia may be overlooked.

Typically, colds begin slowly, two to three days after infection with the virus. The first symptoms are usually a scratchy, sore throat, followed by sneezing and a runny nose. Temperature is usually normal or only slightly elevated. A mild cough can develop several days later.

Symptoms tend to be worse in infants and young children, who sometimes run temperatures of up to 102 degrees Fahrenheit (39 degrees Celsius). Cold symptoms usually last from two days to a week.

Signs of the flu include sudden onset with a headache, dry cough, and chills. The symptoms quickly become more severe than those of a cold. The flu sufferer often experiences a "knocked-off-your-feet" feeling, with muscle aches in the back and legs. Fever of up to 104 degrees Fahrenheit (40 degrees Celsius) is common. The fever typically begins to subside on the second or third day, and then respiratory symptoms like nasal congestion and sore throat appear. Fatigue and weakness may continue for days or even weeks.

"The lethargy, achiness and fever are side effects of the body doing its job of trying to fight off the infection," according to Dominick Iacuzio, Ph.D., influenza program officer with the National Institutes of Health (NIH).

Influenza rarely causes stomach upset. What is popularly called "stomach flu"--with symptoms like nausea, diarrhea and vomiting--is technically another malady: gastroenteritis.

Cold and flu-like symptoms can sometimes mimic more serious illnesses like strep throat, measles, and chickenpox. Allergies, too, can resemble colds with their runny noses, sneezing, and general miserable feeling.

If symptoms persist, become severe or localized in the throat, stomach or lungs, or if other symptoms such as vomiting and behavioral changes occur, consult your physician. "With the typical symptoms, it's not necessary to contact your physician immediately," Iacuzio says.

The Treatment Arsenal

There is no proven cure for colds or flu but time. However, over-the-counter medications are available to relieve the symptoms.

"OTC cough-cold products can make you more comfortable while you suffer," says Debbie Lumpkins, a scientist with the Food and Drug Administration's division of over-the-counter drug products. "They are intended to treat the symptoms of minor conditions, not to treat the underlying illness."

Don't bother taking antibiotics to treat your flu or cold; antibiotics do not kill viruses, and they should be used only for bacterial complications such as sinus or ear infections. Overuse of antibiotics has become a very serious problem, leading to a resistance in disease-causing bacteria that may render antibiotics ineffective for certain conditions.

Children and teenagers with symptoms of flu or chickenpox should not take aspirin or products containing aspirin or other salicylates. Use of these products in young flu and chickenpox sufferers has been associated with Reye syndrome, a rare condition that can be fatal. Because cold symptoms can be similar to those of the flu, it's best not to give aspirin to people under 20 with these types of symptoms.

The active ingredients FDA considers safe and effective for relieving certain symptoms of colds or flu fall into the following categories:


Nasal decongestantsopen up the nasal passages. They can be applied topically, in the form of sprays or drops, or taken orally. But using sprays or drops longer than three days may cause nasal congestion to worsen.
Antitussives, also known as cough suppressants, can quiet coughs due to minor throat irritations. They include drugs taken orally, as well as topical medications like throat lozenges and ointments to be rubbed on the chest or used in a vaporizer.
Expectorants, taken orally, help loosen mucus and make coughs more productive.
Until recently, another category of over-the-counter drugs called "antihistamines" was approved only for use by sufferers of hay fever and some other allergies. In October, clemastine fumarate, the active ingredient in products such as Tavist-1 and Tavist-D, was approved to treat cold symptoms. The effectiveness of other OTC antihistamines for this use is still being studied.
Most nonprescription cough-cold remedies contain a combination of ingredients to attack multiple symptoms. These combination products often contain antipyretics to reduce fever and analgesics to relieve minor aches, pains and headaches.

Users of OTC medicines should carefully follow the labeling instructions and warnings. Under a new FDA rule, all OTC products will soon have labels with a standardized format and simplified language to help consumers understand the information.



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