THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Saturday, December 30, 1995 TAG: 9512290080
SECTION: DAILY BREAK PAGE: E1 EDITION: FINAL
SOURCE: By DEBRA GORDON, STAFF WRITER
LENGTH: Long : 196 lines
What can a sick man say, but that he is sick?
- Samuel Johnson
CONSIDER COLD-AND-FLU Land.
Mountains of mucous. A chapping wind constantly blowing. Chilling tremors. Sudden spouts of fever. And a thick fog of misery and malaise that never seems to lift.
At some point this season you're probably going to be paying a visit to the Land of the Virus, if you haven't already. Almost no one escapes.
You'll spend about a week there, gradually clawing your way to its outer edges, then breaking free into sunshine, clear air and clean, flowing streams.
We're here to tell you how to survive that week.
Family practitioners and pediatricians each have their own favorite words for that stuff dripping out noses and down throats.
``Phlegm.''
``Snot.''
``Stuff.''
``Gunk.''
And ``schmutz'' - Yiddish for dirt, filth or muck.
Whatever they call it, the docs see plenty. This time of year, colds and flu-like illnesses are the most common ailments they treat.
The average adult has two colds per year; the average child six or more.
Over and over, doctors tell their patients the same thing: There is no cure for the common cold or the flu.
You've heard it before - we can put a man on the moon, but we can't cure the common cold. And you still don't understand why.
Neither did we. So we went to one of the foremost cold-ologists in the country: Dr. Jack M. Gwaltney Jr., chief of epidemiology and virology at the University of Virginia medical school.
Gwaltney was bitten by the cold bug while stationed at the Army's Fort Dix in the late 1950s. While there, he was responsible for treating soldiers with respiratory illnesses and became obsessed with colds.
Back then, scientists thought one virus caused colds. Find the virus, develop a vaccine, and voila! they thought. No more colds.
Then they discovered there was not just one, but were more than 100 viruses that caused colds. And the effort shifted from cure to prevention.
Gwaltney was intrigued by how the viruses made people sick. What he learned was interesting. It's not actually a virus that makes you uncomfortable, but the body's response to the virus. Cold viruses trigger chemicals in your body, which cause a runny nose, cough and sneezing.
He compares a cold to a leaking rowboat. To get the water out of the boat, you've got to first plug the hole. With colds, the first step is to stop the virus from growing - plug the hole - while also blocking the symptoms - bailing out the water.
Before finding the best way to treat or prevent colds, though, he had to figure out how the viruses were transferred.
You may have heard about his infamous ``isolation room,'' experiments at U.Va., in which he treats college students to a free weekend stay in a hotel room, complete with room service, cable - and a hefty dose of nasty cold viruses. A nurse comes by once a day to collect their used tissues and record symptoms, which Gwaltney uses to identify viruses and how they're spread.
He's studied how many times people put their fingers into their eyes or nose. Seated subjects around a table and had them sneeze and cough onto each other. Sucked the mucous out of sick peoples' noses and examined it under a microscope.
He'll tell you that most colds are passed through hand-to-hand contact. You touch someone with a cold, pick up the virus, finger your nose or eyes - which we touch at least once every three hours during the day - and, a few days later, your nose starts running.
So he searched for ways to keep cold viruses off our hands. Just washing doesn't work. That removes a virus for a short time, but the next time you touch someone, there it is again.
What did work - albeit not very practically - was painting a person's hand with iodine.
In one study, he found that mothers who painted their fingers with iodine had 60 percent fewer colds than those who used only food dye. ``That was the first direct evidence that colds spread by this method,'' he says.
But who wants to go around with orange fingers? And what about the viruses that spread by coughing and sneezing?
So it was back to the drawing board.
At the same time, another leading cold researcher, Elliot Dick of the Respiratory Virus Research Laboratory at the University of Wisconsin, was inventing the magic tissue.
``The idea was that if the virus came out of the nose and mouth, and you covered it with a tissue to kill the virus, it would help prevent the spread of the virus,'' Gwaltney explains.
The tissue worked in the lab, but not in real life. Ever try to get a 3-year-old to blow his nose?
These days, Gwaltney is focusing on early treatment of colds, trying to minimize their effects and hasten their demise.
He's researching the effects of interferon, a natural substance made in the body that stops viruses from growing. And also looking at the effects of standard remedies like decongestants and antihistimines. It may be, he says, that we need a whole new kind of drug to treat colds.
And he doesn't dismiss an eventual cure. ``Look up `cure' in the dictionary,'' he says, ``and you'll see it's defined as a treatment. That's where we're going.''
Cold or flu?
Your head is splitting. Your fever is high. You ache everywhere. This is no ordinary cold.
Check the calendar. While it may say Dec. 30, it should say: Start of flu season.
Also a viral illness, flu causes more discomfort than a cold and, in older people and those with immune problems, it can lead to pneumonia and even death. Nationally, 37 million people will contract influenza this year, and about 20,000 will die, according to the Centers for Disease Control in Atlanta.
In Texas, the flu hit early in November, says Dr. W. Paul Glezen, who runs the Influenza Research Center at Baylor College of Medicine in Houston.
He's spent the 20 years working with flu viruses and has his own thoughts on how they are spread and what we should do about them.
His staff is working on better, more effective flu vaccines, he says, especially ones that can be given through nose droplets, which would make them easier to inoculate children.
``Our studies show that children are the most important spreaders of flu,'' he says. ``So if we can immunize children, then we should diminish the spread of flu and decrease the risk of exposure for elderly and high-risk patients.''
There are two strains of flu hitting the country this year, he says. One began in Johannesburg, South Africa, the other in Texas. Because the East Coast had a dose of the Johannesburg flu last year, he says, we may be spared a severe season because many of us are now immune to it.
But the country as a whole is overdue for a flu pandemic, like the one that killed 20 million people worldwide in 1918. The last time we had a major flu pandemic was in 1968. These intense outbreaks occur when a totally new strain of influenza appears - one to which no one has immunity and for which no vaccine exists.
Earlier this month, the International Congress on Influenza Pandemic Preparedness met in Bethesda, Md., to figure out how to get ready for this unavoidable crisis. The group couldn't predict when the pandemic would strike - that's like predicting an earthquake, Glezen says - but it could plan to deal with its effects.
Like how to produce and distribute huge amounts of flu vaccine once the virus is identified, and anti-viral drugs. For that, the group figured, the military would have to be called out.
Glezen can't say enough about the importance of flu vaccines. They're available at public health centers or private physicians' offices. The only people who shouldn't get them are those allergic to eggs, because the vaccine is grown in an egg culture.
It's not too late to get the vaccine this winter, even though flu season has already begun. But it takes two weeks for the immunities to kick in, Glezen says. So if you've already been exposed to the flu, he cautions, you might also want to get a prescription for the anti-viral medications amantadine or rimantadine. They can also help minimize the flu's effects once you've contracted the virus, but they must be given soon after exposure.
Treating a cold or flu
For those of us who, despite preventative measures, pay a visit, there's lots of advice out there on how to escape from Cold-and-Flu Land.
Feed a cold. Starve a fever.
Take massive doses of Vitamin C.
Drink echinacea tea, made from an herb.
Or just load up on over-the-counter syrups, pills and lozenges.
David M. Levin, assistant professor of family and community medicine at EVMS, offers this advice:
Never starve anything. Your body needs fuel to fight an infection. ``Part of taking care of yourself and maintaining a good immune response is adequate nutrition,'' he says. That includes drinking lots of liquids.
And that's where Mom's chicken soup comes in. ``Actually, a bit of research shows that it may have some beneficial effects,'' Levin says. It's a liquid, which is helpful for thinning mucous secretions.
As for drugs (see related story), Levin takes the view that ``to some degree, all medicines are poisons, so you don't want to take what you don't need.'' He recommends targeting symptoms as specifically as possible. If you only have a runny nose, don't load up on cough medicines. If you have a dry cough, don't take something meant for a phlegmy one.
For fever and aches, he recommends acetaminophen (like Tylenol), or ibuprofen (like Motrin). Don't give children under 16 aspirin, because it could cause a potentially fatal disease called Reye's syndrome.
And don't ignore other simple remedies. Hot tea with lemon is wonderfully soothing, he says. Also, hot showers can be very therapeutic.
As for Vitamin C. . . U.Va.'s Gwaltney says research shows it may have mild benefits in reducing cold symptoms, although the results are still controversial.
And since the body excretes vitamin C it doesn't need, overdosing is just a waste of money, Levin says.
Echinacea, a popular herbal drug sold in health food stores, ``is a fraud,'' Gwaltney says. ``No one has tested that,'' he says. ``It's a quackery.''
Elizabeth Barrett, assistant state epidemiologist with the Virginia Health Department, offers her own advice: ``Do what your mother always told you to do. Stay home and in bed. Rest. And drink plenty of fluids.'' MEMO: [For a related story, see: IN SEARCH OF THE BEST REMEDY FOR YOUR
AILMENT, also on page E1 of THE DAILY BREAK for this date.]
ILLUSTRATION: SAM HUNDLEY
The Virginian-Pilot
Color illustration
KEYWORDS: COLDS FLU VIRUS by CNB