Common cold - why home remedies are preferable

 The common cold, as it’s known for short or acute upper respiratory tract infection in medical terms, is the most frequent illness affecting humans with 1 to 3 annual episodes among adults and up to 8 among younger children. In the vast majority of cases, it is a benign disease and the rare complications are mainly found in infants or among people with immune deficiency. 

However, the treatment of common cold leads to frequent iatrogenic issues (problems induced by medical treatment) due to the inappropriate and excessive use of antibiotics and over-the-counter cough and cold products.

The common pathogen is a highly contagious rhinovirus and as more than 200 different viruses can trigger a cold, there is an important variability in the symptoms. 

The common cold is contracted during the rainy season in tropical countries and during autumn and winter in western countries. In Thailand, outbreaks of colds start in June and July partly due to rapid fluctuations in temperature following rainfalls. 

People catch a cold when they are in close contact with infected individuals through droplets released during sneezing, coughing or when sharing objects, which have been contaminated with saliva or nasal secretions. 

After 2 to 3 days incubation period, symptoms start with a progressive general ill feeling and include sore throat, cough, nasal congestion, runny nose, sneezing, moderate fever around 38-38.5 degrees Celsius and mild weakness. Contrary to more serious viral infections such as the flu, the uncomplicated cold does not compel bed rest and sick leave. 

Complications arise mainly in infants due to their immature immune system and are linked to secondary bacterial infection of the ear (otitis), sinusitis and possibly pneumonia. More worrisome symptoms with high fever, breathing difficulties, persistent cough and pain in the ear or sinus suggest the development of acute secondary bacterial infection that requires medical consultation.

As most episodes go away without medication within 3 to 7 days, an uncomplicated cold does not justify visiting a doctor. Old and simple home remedies are effective enough to alleviate most symptoms. You must maintain proper hydration with plenty of fluids – ideally lukewarm water with fresh lemon juice and honey – eat the ubiquitous chicken soup or rice chicken soup and get more rest. Children need to be taught how to blow their nose, and for the really little ones, the use of saline solution with a nasal aspirator is effective in relieving the discomfort. 

A few dietary supplements such as vitamin C, Echinacea preparations and zinc lozenges may be beneficial but only if given within the first 24 hours from onset. However, these agents are not effective in preventing cold and daily use during the cold season for this purpose is ineffective. Even mild painkillers like paracetamol are often not necessary. 

Contrary to popular belief, over-the-counter cold preparations have not been found any more effective than a placebo in reducing the symptoms or duration of cold and are not endorsed by medical societies. For instance, cough suppressant such as dextromethorphan has many side effects and is strictly contraindicated in infants younger than 4 years old and should be used with caution with older children. A nasal decongestant may be used in adults only to improve the symptoms but for a short period of time because these medicines may prolong the inflammation.

Most importantly, antibiotics have no effect on any viral infection and are not only useless for the common cold among healthy subjects but also deleterious for two reasons: first, antibiotic may induce undesirable and potentially serious side effects, including diarrhoea, allergic reactions and nerve damages. Antibiotics are indicated only if patent bacterial infection occurs or in susceptible individuals. Second, unnecessary use of antibiotics has contributed to widespread antimicrobial resistance that is recognised today as an emerging public health issue. This problem is serious in Thailand because antimicrobial resistance varies from 20 to up to 80 per cent depending on the antibiotic type and bacterium strain. 

Prevention of cold relies on common sense hygienic precautions, frequent hand washing, relevant disinfection and keeping distance from infected people. 

 

 

Dr Gerard Lalande is managing director of CEO-Health, which provides medical referrals for expatriates and customised executive medical check-ups in Thailand. He can be contacted at [email protected].