The Uncommon Cold

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Pathogens & People: Do these 4 things and you might avoid the common cold EDWARD McSWEEGAN, For The Capital Published December 07, 2008 The cold and flu season is almost upon us. We worry about the flu and many of us will take the annual vaccine and try to avoid people who may have the flu. Colds, on the other hand, are viewed as mild irritants. Colds are just a few days of scratchy throats, running noses, coughs and maybe some mild fever. There's not much to do about a cold and not much to wor
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  Pathogens & People: Do these 4things and you might avoid thecommon cold EDWARD McSWEEGAN, For The Capital Published December 07, 2008 The cold and flu season is almost upon us. We worry about the flu and many of us will take the annual vaccine and try toavoid people who may have the flu. Colds, on the other hand, are viewed as mildirritants. Colds are just a few days of scratchy throats, running noses, coughs andmaybe some mild fever. There's not much to do about a cold and not much to worry about either.Or is there?Last year, the Centers for Disease Control and Prevention reported 140 cases of an unusually severe type of cold. Five percent of the patients died.The common cold is caused by hundreds of common viruses. Most colds arecaused by a group of viruses called rhinoviruses. Coronaviruses, parainfluenza viruses, adenoviruses, enteroviruses and some influenza viruses also can causecolds.There are about 50 types of adenoviruses that infect people. The adenoviruses are very hardy and can survive outside a human host long enough to be picked up by another unlucky victim. Some of these adenoviruses are able to cause persistent, but asymptomatic, infections of the tonsils and intestines. Still others are able tocause bronchitis, pneumonia and a sometimes fatal respiratory illness.One of these 50 adenovirus types is called Ad14 or serotype 14. This is the killercold virus that was identified by CDC as the cause of outbreaks in four states in2007. Ad14 was first seen among military recruits in 1955, but since then hasrarely been seen in the U.S. So the 2007 outbreaks may represent the emergence  of a new and virulent strain of Ad14.Newborns, the elderly and people with compromised immune systems would bethe most susceptible to a new and virulent cold virus. The cells of the nose andthroat seem to be the primary targets of viral invasion. The virus triggers localinflammation and the production of immune regulators such as interferon. Theseimmune response molecules in turn trigger most of the unpleasant symptoms of a cold: headache, malaise, fatigue, nausea, congestion and painful sinuses. Over-the-counter medications don't seem to help much, and antiviral drugs such asribavirin and cidofovir don't seem to be very effective against adenoviruses.The emergence of a new and more virulent Ad14 virus could be especially badnews for the military. New recruits - crowded together in barracks and under the24 / 7 stress of boot camp - are ideal candidates for acquiring and spreadingadenovirus infections. The lost training time and medical costs from adenovirusinfections encouraged the Defense Department to fund work on vaccines againsttwo of the more common culprits, Ad7 and Ad4. An effective combination vaccine was produced and given to millions of new recruits, but disputes with themanufacturer led to the end of the military vaccination program in 1999. Thefollowing year, the Institute of Medicine recommended the immediate re-establishment of an adenovirus vaccine supply. Now, eight years later, Barr Labsin Virginia soon may be in a position to begin offering a new oral vaccine against Ad4 and Ad7 adenoviruses.There is no vaccine for Ad14.The common cold, and some of the uncommon causes of those colds, presentunique challenges to both patients and physicians. There are too many viruses,too little understanding of how they spread and cause disease, too few effectivemedicines and even fewer available vaccines. Worse yet, your mother may have been right all along. Remember her telling youto put on a sweater or jacket so you don't catch a cold''? In response, you may have wisely insisted that you couldn't get a cold from being cold. Well, maybe you  do. According to an article in New Scientist  , researchers in the United Kingdomfound more people developed colds after they became chilled. Cool temperaturesprompt the body to redirect blood flow inward, including away from the nasalpassages. The change in blood flow and nasal temperature may make it easier for viruses to enter via the nose. So mom may have been right again. I can already hear the I told you so's. In the end, the best way to avoid a cold - and Ad14 - may be to keep your nose warm, wash your hands regularly, avoid small children and … listen to yourmother.---Dr. Edward McSweegan has a Ph.D. in microbiology and lives in Crofton. He works on and writes about infectious disease issues. He may be contacted atmcsweegan@nasw.org.
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