How to find cold comfort this winter

Got a runny nose? Then a brisk walk and a curry might do you more good than most over-the-counter remedies

Those suffering from a cold would do well to stop and think before heading for the medicine cabinet. The Government has launched an urgent investigation into the safety of a drug found in cold remedies, after American authorities found it was linked to strokes in young women.

Those suffering from a cold would do well to stop and think before heading for the medicine cabinet. The Government has launched an urgent investigation into the safety of a drug found in cold remedies, after American authorities found it was linked to strokes in young women.

America's Food and Drug Administration has started the formal process of banning phenylpropanolamine (PPA) - found in over-the-counter medicines such as Benylin Day & Night, Contac 400, Vicks Coldcure, Day Nurse and Sinutab - after it was said to have been responsible for 200 to 500 strokes in people under 50. Ninety-eight per cent of PPA doses sold in America last year were in cough and cold products, with the remainder being in diet drugs.

The drug will remain on sale in Britain while the Medicines Control Agency carries out its enquiry. However, the Department of Health said the amount of PPA used in cold remedies in Britain was lower than in the US.

Professor Ron Eccles, director of the Common Cold Centre at Cardiff University, which runs clinical trials on new medication for the pharmaceutical industry, and carries out research into the symptoms of the common cold, says those looking for an alternative oral decongestant could try the drugs pseudoephedrine or phenylephrine, which have exactly the same effect on colds as PPA. They can be found in a number of over-the-counter remedies, including Sudafed and Lemsip. "There is no evidence at the moment that they are causing any problems," says Professor Eccles, who advises patients to consult their pharmacist if concerned.

Another alternative to PPA is topical decongestants, such as nasal sprays, which are more effective than oral decongestants as they are applied directly to the nose. The best time to apply them is early evening so their effects last all night, promoting better sleep.

The best medication to take at the beginning of a cold is an analgesic such as paracetamol, aspirin or ibuprofen, according to Professor Eccles, who is also chairman of the Cold & Flu Council, an independent advisory body. Analgesics reduce headaches, fevers and chilliness, muscle aches and pains, and sore throats. Sufferers should carefully monitor the number they swallow if they are also taking multi-symptom medication containing an analgesic, as there is a risk of overdose.

For those who do not wish to take drugs, there are some very effective natural ways of helping to reduce the severity of a cold. And sadly, staying under your duvet watching Richard and Judy isn't one of them. The best decongestant is mild exercise, such as a walk round the park or a swim. "It opens up all of the nose," explains Professor Eccles. "Exercise activates nerves in the nose that cause the blood vessels to constrict [a blocked nose is caused by swollen blood vessels]. The medicinal decongestants mimic the effects of these natural chemicals that decongest your nose during exercise.

"Mild exercise is also beneficial because a lot of our immune system - the white cells - tend to stick in the lungs and don't circulate around to the nose so easily. Exercise moves the blood around the body, and that promotes recovery." But those who feel too ill to exercise should refrain.

A runny nose, often the hallmark of a cold, should not be regarded as a curse. "Snot is beneficial. It traps viruses and bacteria," says the professor. But those who reach for a hanky should not overdo it. "Some people blow so hard that they tend to push secretions up into their sinuses and into their ear, which can create further infection. So do it very gently - the way some people do it, it's like blowing a trumpet."

Hot drinks - the tastier the better - will stimulate mucus production in the nose. Honey and lemon is a good choice as it combines sweet and sour. Hot soups also work, as long as they are tasty. A couple of hot toddies are acceptable, but any more and the alcohol is likely to cause congestion. Spicy foods - such as curry - will also increase mucus levels. Inhaling steam from a bowl of hot water containing menthol or vapour rubs is also beneficial. "It provides symptomatic relief for coughs, sore throats and nasal congestion," says Professor Eccles. "You will also get a sensation of nasal clearness, even though it's not actually opening up." Menthol has a mild local anaesthetic and anti-bacterial action.

Contrary to popular belief, common colds are not very contagious. Most are caught at home, as you need to be snuggled up to someone for many hours to catch one. While scientists have never proved that you can catch a cold by sitting in a draft, or by getting caught in the rain, Professor Eccles believes it is possible, as it puts an additional stress on the body.

"We do know that the common cold and flu are seasonal, occurring most commonly in cold weather. Perhaps our immune system changes with the seasons. We have a saying in Britain, "feeling under the weather", so maybe our mood changes and influences our immune system.

"It has been said in the past that it's because we're all shut indoors coughing and sneezing on one another in crowded offices, but offices are just as crowded in summer as they are in winter. It is a factor, but I think there are probably other factors that are within our own body."

Colds may also occur more frequently in the winter because the cold virus grows better below body temperature. Covering the nose with a scarf may help. You should also wash your hands after being in public places to prevent catching the virus. "You tend to poke your finger into your eye or your nose, and the eye is just as good an entrance to the nose as the nostril, because the tear duct drains into the eye."

Many people mistakenly believe - or tell their bosses - that they have flu when in fact they have a severe cold. "A lot of the so-called influenza that we had last year was severe common cold. And if you look at the way it's reported by Flu Watch, run by the Royal College of General Practitioners, they don't refer to it as influenza, they refer it to as 'incidents of flu-like symptoms'. Even we cannot tell the difference between common cold and influenza just from symptoms, we need to isolate the virus." Flu tends to be more severe, strikes suddenly and the patient has a temperature.

Those wishing to take proactive measures to avoid catching a cold could try the herb echinacea. "There is evidence that it can influence the immune system, and can be taken to help prevent colds and infections," says Professor Eccles. Zinc has also been shown to be beneficial to the immune system. Onions and garlic have antibacterial and antiviral properties. Large doses, such as a couple of grams or more, of vitamin C has a mild effect in reducing the severity of symptoms. There is not much evidence, however, that vitamin C can prevent colds.

Another factor that may contribute to catching a cold is stress, by depressing the immune response. So, remember to smile through the long winter months.

Advice from the Cold and Flu Council can be found at www.coldandflucouncil.org