Health: Still fighting the cold war

Half the people who read this article will probably be suffering from a cold. Yet last month, the Common Cold Centre admitted there is still a long battle ahead to find a cure for the world's most common illness
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Fifty years from now, no doubt, cancer will be controllable, heart disease a distant memory and we'll all have clones for organ transplants. But you can bank on it that even in 2050 we'll still be sniffing, coughing and sneezing our way through the rest of the century.

It is almost as if the doctors have given up trying to find a cure. Ten years ago, the famous Cold Cure Unit in Salisbury closed its doors, partly because their extended trials just didn't find anything conclusive.

Now is when we need it most - the cold is the most prevalent disease among humans. Every day, about 50 million people worldwide wake up with one. Around 400,000 people will have a cold today, and this week probably half your office will have one. During an average lifespan (75 years), we'll catch around 210 colds - each lasting five or six days. On average, we each spend three years of our lives coughing and sneezing.

So why do these generally harmless infections cause so much discomfort? The virus itself causes only tiny pinpricks of damage to the lining of the nose. The symptoms of a cold are caused by our immune system which triggers the disinfecting process - coughing, runny nose - to wash away the virus.

These days, most research is carried out in other countries, even though the common cold feels like a British institution in itself. If the symptoms are, the cure certainly won't be; last month we heard that after 10 years and pounds 5m of research, including the painstaking construction of a 2ft high model of a cold virus, the head of the Common Cold Centre had finally admitted defeat. "I don't foresee a cure in which we eradicate all the viruses," said Professor Ronald Eccles, the director of the centre at University of Wales, Cardiff. "I think the best we can hope for is to live at peace with it."

The centre has tested a large number of potential cold cures, including high-tech anti-viral agents, and so far none of them look set to eradicate the cold for ever. Instead, doctors are starting to agree that maybe lifestyle and diet could hold the key. Certainly, stress plays a part. Research has shown that worrying about an infection can make the symptoms more severe, weakening the immune system because the brain thinks the bug is actually worse than it really is.

As we approach the end of the century, viruses are really coming into their own; mutating, dividing and growing more resistant by the decade. As Eccles says: "The trouble is that there are more than 200 different viruses which cause colds. Finding a single cure is like trying to cure measles, chickenpox, mumps and rubella all at once."

The other obstacle is that most colds don't last long enough for doctors to prove whether the drugs have really attacked the virus that caused them. Dr Karl Nicholson, senior lecturer at the Leicester Royal Infirmary, says: "By and large, they're short lived infections, so you've got to have a drug that gets to the virus very quickly. It's very difficult to show that you've cut an infection from two days to one day, and much easier to prove if the symptoms last for, say, six weeks and your drugs cut it to three."

Nicholson specialises in flu viruses rather than common colds - the two might seem similar but there are important differences. Whereas the cold is a minor form of upper respiratory illness, flu tends to affect the lower respiratory area, the chest, and is generally a more serious virus. It also seems more likely that they'll find a cure for it. According to Dr Nicholson, there are several on their way. "There have been some important developments in the last five years."

In particular, a new flu cure that stops the virus spreading in the body by blocking the action of neuraminidase, an enzyme the virus relies on to infect new cells. Glaxo has applied for a licence following trials of more than 2,000 patients in Britain and worldwide.

But the cure doesn't help cold sufferers, who will just have to wait for their miracle cure. Wrapping up warm, drinking plenty of fluids, and staying in bed still seems to be the safest and most beneficial remedy. Or you can choose from one of the "symptom relievers" below, and kid yourself that they really work. As Professor Eccles says: "Never underestimate the power of a placebo."

Comfort but no cure from pills and potions

Antibiotics

Far too many antibiotics are prescribed unnecessarily for colds and flu viruses. In a recent US survey, 60 per cent of patients seen by GPs for a common cold were given some sort of antibiotic. Another study, in Switzerland, found that antibiotics were effective only in the 20 per cent of patients who had bacterial complications, which is the only reason any antibiotics should be prescribed.

Aspirin

Another symptom-reliever, which reduces fever. "Gargling soluble aspirin can also help sore throats, acting like an anaesthetic," says Roger Odd, who does warn against giving aspirin to children under 12 years old. In rare cases, it can cause Reye's syndrome in younger people, causing brain and liver damage. Many GPs prefer paracetamol, which also reduces feverish symptoms.

Steam Inhalation

The oldest remedy around. It's widely believed that breathing in steam from a bowl or jug can ease the soreness and discomfort of a cold. It is cheap and safe and some people find it helpful, though there's no solid evidence to back up the belief.

Echinacea

This herbal treatment based on root extracts is an increasingly popular remedy, and supposedly boosts the immune system. In a recent German trial, though, there were no significant differences between those who took it and those who were given a placebo. Professor Eccles is still keen to see more research carried out. "The widespread usage of echinacea preparations for many different infections supports the case for further analysis," he says.

Vitamin C

Over the last 30 years, there has been a glut of studies examining the effectiveness of vitamin C. A recent overview of the research suggests that this vitamin does appear to decrease the symptoms of the common cold by an average of 23 per cent. Roger Odd says: "There is some proof it fights against the initial infection, but there's no real evidence that it can make you better once you've caught a cold."

Zinc

This is another remedy that doesn't really target the virus itself. Like vitamin C, it should be taken regularly to protect from an infection - by the time a cold starts it's probably too late. In eight recent trials, four showed a benefit and the other four didn't. Some people swear by its properties, although the exact mechanism through which zinc affects the common cold remains unclear.

Antihistamines

Available in tablets, capsules or spray. Speak to a pharmacist about which one to use - there are ones designed specifically for certain symptoms, such as a blocked nose. According to a recent US study, these are one of the most effective symptom relievers - "significantly" reducing sneezing and runny nose - rhinorrhoea. Roger Odd, head of professional and scientific services at the Royal Pharmacy Society, says, "These can ease but not cure your symptoms. Don't overuse them - your body can build up resistance to them."

Camphor Rubs

There are various decongestant vapours that stimulate the nasal passages, such as the menthol-and-eucalyptus-based Vicks Vaporub, and olbas oil. Old-fashioned but soothes symptoms.

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