The Basics

The common cold (“Ganmao”感冒) is an infection of the head and upper lungs. It is caused by one of a couple hundred viruses—and it is very, very common worldwide. Adults get 2-4 infections a year; children get 6-8 a year, and daycare children get about 10!

Why So Common?

It is extremely infectious, carried in the air in water droplets and also lasting on surfaces for a while. Plus, persons can transmit the virus even before they start having symptoms. This helps explain why a cold usually goes from person to person in a family – and sometimes starts all over again, especially with infants and toddlers.

Symptoms

The most common symptoms are known to all: usually you first feel fatigue, sore throat, and low fever. Later, you develop a runny nose, headache, and cough. Sometimes a cold can become a more serious pneumonia, sinusitis, or bronchitis. But usually the symptoms are very mild and resolve within a week. The cough, however, could linger for much longer as your airways are still irritated.

It’s important to realize the difference between a cold and the flu. The flu, caused by different viruses, usually is much more dramatic and rapid, with especially high fever, muscle aches and headaches. It’s important sometimes to know, because the flu does have a vaccine and an antiviral for it. Your doctor can help decide – but it’s also important to realize that the flu, just like the common cold, usually isn’t serious and can be dealt with at home without a doctor visit or antibiotics. Note: this advice is for the annual flu, not the epidemic flu such as the current H1N1 swine flu.

Prevention

A drug company would make a fortune creating a vaccine, but unfortunately there are too many different viruses to contend with. So, prevention is key! Unfortunately, as I just mentioned, healthy people can be infectious even before having symptoms, so there’s only so much we can do. But there are some basics:

• Wash your hands! This is crucial; hand washing definitely kills or washes off the virus and decreases infections. Soap and water are good, but those alcohol-based gels that evaporate are even better, and very convenient to carry along.
• Get enough sleep. This has actually been proven in a recent fascinating experiment, where those who slept 6-7 hours were 300% more likely to get the common cold than those who got 8 hours. It was a very cool study; the researchers dropped the live virus directly into people’s noses and monitored their infection rate.
• Stay fit and eat well. Again, this may seem obvious but many people still don’t eat well or exercise enough – and your immune system definitely gets a boost from exercise and healthy foods (leafy greens, fruits, grains, minimal processing, etc).
• During the super-dry Beijing winters, humidifiers greatly help keep your lungs and throat moist enough, to prevent infections and also cut down on that all-too-common Beijing cough. By the way, the Yadu brand of humidifiers are decent and available everywhere — I prefer their high-end ultrasonic models.

Self Treatment

As a doctor, I always find it very humbling that the most common illness worldwide has the least effective medicines! There is no vaccine; no good antiviral pill; and many symptom relief medicines work mildly at best or dangerously at work. Fortunately, the disease itself is almost never severe. And there are a host of cheap OTC (over the counter) medicines you can find in any pharmacy, including most Chinese ones. The bottom line: the common cold is a mild illness, so take minimal amounts of medicine only as needed for comfort; eat well and sleep well, and you’ll be fine in a couple days.

• Congestion: Most people just want the constant runny nose to go away. Fortunately, a few medicines help well. The best medicine, by far, to stop a runny nose for up to 6 hours, is the readily available pill pseudoephedrine (“sudafed”, 伪麻黄碱). If you have multiple cold symptoms, my favorite are the combination pills like Contact Cold, Bufferin Cold日夜百服咛 or Tylenol Cold 泰诺感冒片. All of these include pseudoephedrine, so don’t double dose! Also, a couple nasal sprays work well: nasal saline sprays are natural and especially safe for children, or you can use the stronger medicine Oxymetazoline (“Afrin” 羟甲唑啉), which helps for up to 10 hours.
• Cough: it’s important to realize that most cough medicines only help a little, if at all. In the US, the government recently banned most cough syrups for children under 2 years, and may extend that ban to children under 6. Why? Because at best they help about 15-20%, and at worst children have died from overdoses. And a recent study suggested that honey works just as well as cough syrup! But if you must use something, dextromethorphan右美沙芬syrup is best, and the “Delsym” brand in the US is most effective of all. Try to avoid the combination syrups for children as there are many ingredients for symptoms they may not have, and you may be overlapping medicines with other OTC meds like Tylenol Cold or Bufferin Cold pills. As for cough drops, none seem to work better than the others, but I prefer sugar-free Ricola as well as Strepsils (all available in Beijing)

Self Treatment: Herbals

Many people, especially Europeans, swear by natural and herbal medicines for the common cold; Chinese also swear by certain TCM herbals. There is a great free article on http://www.naturaldatabase.com that details the latest evidence regarding this – what works and what doesn’t.

Seeing The Doctor

They can do exams and tests to see whether it’s viral or bacterial. Otherwise, for the common cold, no antibiotics are needed.

Why No Antibiotics?

Overprescription of antibiotics for the common cold is a big issue worldwide; prescribing or self-medicating with antibiotics does absolutely nothing for the common cold. Antibiotics only fight bacterial infections; the common cold is not a bacteria, but a virus. So your expensive Augmentin or Levofloxacin not only is not helping, it’s probably giving you side effects – and even worse, contributing to the rapid resistance of antibiotics all over the world. Many, many people automatically reach for amoxicillin-type medicines because “they’ve always done it”, or “it always helps” or “my doctor gave it to me”. Yes, many doctors do incorrectly give antibiotics “just to be safe”, or often because the patient demands it. Hopefully, as people get more information about this problem, the overuse of antibiotics will ease.