Diagnosis
Runny nose, scratchy eyes, just watch a Niquil® commercial. Is there anyone who needs a cold described?
Epidemiologic Risks
Being around someone with a cold. Believe it or not, the exact mechanisms for transmission are not known. But we can put a man on the moon. The heck.
Rhinoviral viral load peaks at day 1-2, but can detectable virus can be found up to 2 weeks. And the higher the viral load, the more symptomatic (PubMed)
Microbiology
Many viruses from the rhinovirus, adenovirus, coronavirus, myxovirus, paramyxovirus, picornavirus families.
Empiric Therapy
None. But we can put a man on the moon.
How about Zinc? One study in the Annals suggested efficacy, but a structured review says zinc has yet to be proven effective (PubMed). The increasingly less reliable Cochrane review says zinc reduces the average duration of cold symptoms by almost a day when taken within 24 hours of symptom onset, and also decreases symptom severity with a 50% chance of side effects (PubMed). But there is Newton's law of the medical literature, for every meta-analysis, there is an equal and opposite meta-analysis (PubMed).
However, being fit is protective for developing a cold, or the cold, (PubMed).
Shockingly, a study by Vics showed Vaporub helped with cold symptoms in children.
The issue of vitamin D is interesting. In some studies with vitamin D deficient people, taking vitamin D decreased the odds of a URI. In a study where a general population in New Zealand was given vitamin D or placebo, there was no benefit for preventing URI (PubMed). And high dose vitamin D does not prevent colds in children (Pubmed).
The best you can conclude from the preponderance of data is it is of benefit not to be vitamin D deficient but taking extra does nothing. Adding gas when the tank is full is a waste of time. Vitamin D is not the panacea for the prevention of infections that the SCAM web sites would have you believe.
Pearls
NSAIDs during an acute respiratory infection increase MI risk 3.4x (PubMed).
Did you know that we can put a man on the moon? At least at one time we could. The designs for the Saturn IV rocket were thrown away, so maybe no longer. Bush wants to go to Mars and he is more than welcome to go. I will follow at a later time when my cold has resolved, thank you very much.
A rhinovirus doesn't do much to us, but it will kill Chimpanzees (PubMed). We get Ebola and HIV from them, we give them a fatal cold. It seems a fair trade.
Rants
Maybe we can't put a man on the moon after all, but hey, how about our health care system? Second to none. Because we are a distant 14th.
By the way, Echinacea doesn't do diddley (PubMed)(PubMed), and there are many studies now to demonstrate the fact. Nor does Vitamin C. See my podcast on the topics at quackcast.com. Pardon the French, but there are few things as stupid as 99.9% of "alternative" medicine.
Everyone has seen a picture of the spray associated with a sneeze. But what does the sneeze do? Sneezing increases the airborne dispersal of S. aureus by 4.7, Coagulase-negative Staph by 1.4, and other bacteria by 3.9 fold. "With each sneeze, 2.83 colony forming units (cfu) of S. aureus, 3.24 cfu of CoNS, and 474.61 cfu of other bacteria (are) released per cubic meter of air per minute (PubMed)."
Un-needed radiation. They did CT's on patients with the common cold to see what happened to the sinuses and repeated the CT in some patients. The results were in the (NEJM): "The common cold is associated with frequent and variable anatomical involvement of the upper airways, including occlusion and abnormalities in the sinus cavities." Water is wet, fire his hot, radiation causes cancer (PubMed).
Curious Cases
Relevant links to my Medscape blog
Last Update: 07/15/18.