The Cold War
Sniffle-beating strategies for the entire family.
by Donna Christiano

We sneeze, cough, and sniffle through an average of two to four colds a year, according to the National Institute of Allergy and Infectious Diseases in Bethesda, Maryland. Our kids fare worse; they catch 6 to 12 colds a year because of poorer hygiene, immune systems that haven't built up resistance to a lot of viruses, and close contact with other children in day-care centers and schools.

Most of these colds occur in fall and winter because we spend more time indoors, swapping germs in closer quarters. You know how it goes: Your child catches a cold from a friend at preschool, you get sick while caring for her, and-boom!-soon the virus spreads to the entire family.

Short of isolating your family, there is no foolproof way to avoid a cold. "The cold is caused by 200-plus viruses, and developing a vaccine that would vanquish all of them would be extraordinarily difficult," explains Michael Macknin, M.D., a cold researcher and chair of the Department of General Pediatrics at the Cleveland Clinic in Ohio.

Instead of a vaccine, researchers are working on treatments that will combat rhinoviruses, which cause nearly half of all colds. One promising treatment is a nasal spray that will prevent rhinoviruses from "docking" on cells lining the nose and throat. But for the spray to work, you would need to know that you had been exposed to a rhinovirus, so it's not entirely practical, notes Dr. Macknin.

Fortunately, there are other ways to reduce your chances of getting sick; you don't have to wait until this cold-stopping spray makes it to the drugstore. But first, you have to understand how a cold is spread.

How We Catch a Cold

Though a cold virus can linger on contaminated surfaces, "you have a greater chance of getting infected through skin-to-skin contact," explains Jack Gwaltney, M.D., professor of internal medicine at the University of Virginia School of Medicine in Charlottesville.

Picture this: Someone with a cold coughs or sneezes virus-laden secretions into his hand, then touches your hand or contaminates a doorknob that you subsequently handle. Then, with germ-laden fingers, you innocently touch your nose or eyes-areas lined with mucous membranes through which viruses infect the body and cause a cold.

Warding Off a Cold

To get fewer colds or, at least, less severe ones, here's what our experts recommend:

Keep your distance.

The most effective way to beat the bug-avoiding close contact with people who have colds-is easier said than done, especially if your child or a coworker is sick. However, a few precautions may minimize the risk of infection, such as canceling a playdate when your child's friend has the sniffles (the virus is most contagious in the first three days after symptoms appear) or sleeping on the sofa so you're not within sneezing distance of a sick spouse.

Make hand washing a habit.

The best defense against colds is to wash your hands, says Don Shifrin, M.D., clinical professor of pediatrics at the University of Washington School of Medicine in Seattle. A study published in the May 1999 issue of Epidemiology showed that a hygiene program that included frequent hand washing and toy cleaning reduced the rate of colds by 25 percent in 24 Canadian day-care centers, compared with the rate at centers that didn't adopt these methods.

Experts recommend washing your hands at least five times a day (before meals and snacks and always after wiping your nose or your child's). Water temperature doesn't matter and antibacterial soaps aren't necessary-it's the action of rubbing your hands together and the lathering effect of the soap that washes germs down the drain, says Dr. Shifrin. What is important: scrubbing for at least ten seconds.

Kid tip:

"To get young children to wash their hands thoroughly, have them sing 'Twinkle, Twinkle, Little Star' or their ABCs while they lather up," suggests Dr. Shifrin.

Practice contagion control.

Teach kids not to share cups, utensils, toothbrushes, and towels-otherwise, they will be sharing germs, says Dr. Shifrin.

Also, get everyone in the habit of tossing used tissues in the garbage right away and then washing up.

Kid tip:

"If they're at school and there are no tissues in sight, tell kids to sneeze into the crook of their elbow," suggests Dr. Shifrin. This keeps cold bugs off their hands and classmates.

Harness people power.

Having a wide circle of friends may also help save you from the sniffles, according to a 1997 study reported in the Journal of the American Medical Association. Researchers found that people with a wide variety of social ties-personal, family, social, community, religious, work related-were least likely to develop colds, even though a larger social network may expose you to more cold viruses. "People with a diverse social network have more motivation to take better care of themselves and experience less stress and depression, which have been shown to lower immunity," speculates Sheldon Cohen, Ph.D., professor of psychology at Carnegie-Mellon University in Pittsburgh.

Kid tip:

"No studies have been done to prove it, but theoretically this should apply to children as well," says Dr. Cohen. For health as well as social reasons, consider getting your children involved in playgroups, after-school programs, religious groups, or community activities.

Walk away from colds.

A recent study found that women who took a daily 40-minute walk reported taking half the number of sick days because of cold symptoms as did couch potatoes. Exercise temporarily stimulates the immune system to produce natural killer cells, which battle infections, says David Nieman, Dr.Ph., director of the Human Performance Lab at Appalachian State University in Boone, North Carolina. "Over time, these favorable changes in immunity may have a cumulative effect," he adds.

Battling the Bug You Can't Avoid

Despite your best efforts to avoid a cold, sometimes you still come down with one. Though no medication can cure a cold-antibiotics kill bacteria, not viruses-some home and over-the-counter (OTC) remedies can ease the misery. The key is to act early: Don't let cold symptoms crank up, advises Dr. Gwaltney. Duplication of a cold virus peaks on the day that symptoms first appear, so you'll get the most relief if you don't delay and start treatment right away.

Depending on the symptoms, here are the OTC medicines that may spell relief. Never exceed recommended dosages, and make an appointment with your (or your child's) doctor if a cold seems to get worse (see "When to See the Doctor" below).

Decongestants.

If a stuffed-up nose makes breathing difficult, a decongestant can open airways by shrinking swollen nasal passages. But the drug should not be used for more than three to four days. (By that time, chemicals in the product can irritate the nose, causing even more congestion.)

Kid tip:

"There's no proof that decongestants work in kids under 5," says Dr. Macknin. And because decongestants make some children hyper, don't give them to older kids unless the benefit outweighs this risk, he cautions.

Antihistamines.

If a runny nose and sneezing are causing misery, an antihistamine can dry nasal secretions. But check the label: While some antihistamines can cause drowsiness-a plus if a cold has been keeping you up at night-the newer, nonsedating formulas may not dry mucus as well.

Kid tip:

Like decongestants, antihistamines haven't been proven effective in preschoolers, says Dr. Macknin. And while they may be helpful for older kids, you run the risk of side effects. He adds, "Antihistamines may make kids tired or, paradoxically, hyper."

Cough medicine.

Coughing helps to clear mucus that clogs the airways, so suppressants are best reserved for those who have a dry, hacking cough or a cough that keeps them up at night.

Painkillers.

Either acetaminophen or ibuprofen can ease a headache or muscle pain and bring down a fever. Ibuprofen, though, may cause stomach upset.

Kid tip:

Doctors recommend acetaminophen for children. Never give them aspirin, which has been linked to Reye's syndrome, a serious and potentially deadly liver disorder.

More Ways to Ease the Pain

Aside from the use of assorted medicines, here are other ways to reduce the discomfort of a cold.

Pamper a stuffed nose. Rub petroleum jelly around nostrils chapped by repeated blowing. To help soothe dry, irritated nasal passages if the air in your home is very dry, run a humidifier (but make sure to clean it regularly).

Kid tips:

Use a cool-mist humidifier to prevent steam from burning kids' delicate skin. For babies who are too young to blow their nose, you can use saline nose drops to loosen congestion (but not for more than four days) and a bulb syringe to suction out mucus immediately after using the drops.

Heads up to ease congestion. Sleeping propped up on pillows can help keep mucus from clogging nasal passages, notes Dr. Shifrin.

Kid tip:

Never place a pillow under a baby, however: It could be a suffocation hazard. Instead, if congestion is bad, try putting her to sleep in her car seat.

Fill up on fluids. A cold can sometimes lead to dehydration. Dr. Macknin suggests that adults aim for about five to six 8-ounce glasses of fluid a day; children need four to five.

Kid tip:

To get fluids into sick kids and cheer them up as well, give them ice pops made of frozen juice.

There's no surefire way to beat a cold bug-yet. But as we age and develop immunity to various viruses, we get sick less often. In fact, after age 6, kids catch fewer colds, and teens have the sniffles about as often as adults do. And that's nothing to sneeze at.


When to See the Doctor


Sometimes a bad cold can lead to a secondary bacterial infection, or a medication can cause harmful side effects. Call the doctor if you or your child experience

a.. Symptoms that last longer than a week or so.

b.. A persistent cough or a hacking cough that disrupts sleep.

c.. Consistently greenish or dark yellow phlegm.

d.. Ear pain (pulling on the ear by a small child) or a discharge.

e.. A fever that causes your child discomfort (if you're unsure, check with your child's doctor).

f.. Vomiting or diarrhea.

g.. Any change in symptoms (such as a fever that goes away, then comes back) or symptoms that are sudden and unexpected.



*Submitted by Sherry

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