tag:theconversation.com,2011:/global/topics/colds-2924/articlesColds – The Conversation2023-10-20T12:24:28Ztag:theconversation.com,2011:article/2138472023-10-20T12:24:28Z2023-10-20T12:24:28ZDoes chicken soup really help when you’re sick? A nutrition specialist explains what’s behind the beloved comfort food<figure><img src="https://images.theconversation.com/files/551547/original/file-20231002-15-bwz0nd.jpg?ixlib=rb-1.1.0&rect=51%2C0%2C5760%2C3776&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A bowl of chicken soup typically contains protein, vegetables and soothing broth. </span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/chicken-soup-with-leek-carrots-noodles-spring-royalty-free-image/709133917?phrase=chicken+soup&adppopup=true">Westend61 via Getty Images</a></span></figcaption></figure><p>Preparing a bowl of chicken soup for a loved one when they’re sick has been a common practice throughout the world for centuries. Today, generations from virtually every culture <a href="https://www.smithsonianmag.com/smart-news/new-book-includes-over-100-soulful-chicken-soup-recipes-180976428/#">swear to the benefits</a> of chicken soup. In the U.S., the dish is typically made with noodles, but different cultures prepare the soothing remedy <a href="https://www.atlasobscura.com/articles/international-chicken-soup-recipes">their own way</a>. </p>
<p>Chicken soup as a therapy can be traced back to 60 A.D. and <a href="https://www.drugs.com/npp/chicken-soup.html">Pedanius Dioscorides</a>, an army surgeon who served under the Roman emperor Nero, and whose five-volume medical encyclopedia was consulted by early healers for more than a millennium. But the origins of chicken soup go back thousands of years earlier, <a href="https://www.slurrp.com/article/chinese-chicken-noodle-soup-for-the-history-famished-soul-1685990523100">to ancient China</a>. </p>
<p>So, with <a href="https://theconversation.com/vaccines-against-covid-19-the-seasonal-flu-and-rsv-are-our-best-chance-of-preventing-a-winter-surge-215390">cold and flu season in full swing</a>, it’s worth asking: Is there any science to back the belief that it helps? Or does chicken soup serve as just a comforting placebo, that is, providing psychological benefit while we’re sick, without an actual therapeutic benefit?</p>
<p>As a <a href="https://udayton.edu/directory/education/hss/teeman-colby.php">registered dietitian and professor of dietetics and nutrition</a>, I’m well aware of the appeal of chicken soup: the warmth of the broth and the rich, savory flavors of the chicken, vegetables and noodles. What gives the soup that distinctive taste is “<a href="https://dictionary.cambridge.org/us/pronunciation/english/umami">umami</a>” – the fifth category of taste sensations, along with sweet, salty, sour and bitter. It is often described as <a href="https://www.umamiinfo.com/">having a “meaty” taste</a>.</p>
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<figcaption><span class="caption">The notion that chicken soup is an elixir goes back centuries.</span></figcaption>
</figure>
<h2>Improved appetite, better digestion</h2>
<p>All that makes sense, because amino acids are the building blocks of proteins, and the <a href="https://doi.org/10.1007/s00726-012-1280-4">amino acid glutamate</a> is found in foods with the umami taste. Not all umami foods are meat or poultry, however; <a href="https://www.epicurious.com/expert-advice/umami-boosting-ingredients-vegetarian-cooking-ideas-article">cheese, mushrooms, miso and soy sauce have it too</a>.</p>
<p>Studies show that taste, it turns out, is critical to the <a href="https://doi.org/10.1080/10408398.2019.1633995">healing properties of chicken soup</a>. When I see patients with upper respiratory illnesses, I notice many of them are suddenly eating less or not eating at all. This is because acute illnesses ignite an inflammatory response that <a href="https://doi.org/10.1017/S0007114520002160">can decrease your appetite</a>. Not feeling like eating means you’re unlikely to get the nutrition you need, which is hardly an optimal recipe for immune health and recovery from illness.</p>
<p>But evidence suggests that the umami taste in chicken soup may help spur a bigger appetite. Participants in one study said <a href="https://doi.org/10.3945/ajcn.113.080929">they felt hungrier</a> after their first taste of a soup with umami flavor added in by researchers. </p>
<p>Other studies say umami may also <a href="https://doi.org/10.3389/fnut.2020.568991">improve nutrient digestion</a>. Once our brains sense umami through the taste receptors on our tongues, our bodies prime our digestive tracts to absorb protein more easily.</p>
<p>This can <a href="https://www.umamiinfo.com/what/whatisumami/#">reduce gastrointestinal symptoms</a>, which many people experience when they’re under the weather. Although most people don’t associate upper respiratory infections with gastrointestinal symptoms, research in children has found that the flu virus increased <a href="https://doi.org/10.1186/1471-2334-10-3">abdominal pain, nausea, vomiting and diarrhea symptoms</a>.</p>
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<figcaption><span class="caption">There are many ways to make chicken soup.</span></figcaption>
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<h2>May reduce inflammation and stuffy nose</h2>
<p><a href="https://theconversation.com/what-is-inflammation-two-immunologists-explain-how-the-body-responds-to-everything-from-stings-to-vaccination-and-why-it-sometimes-goes-wrong-193503">Inflammation</a> is part of the body’s <a href="https://my.clevelandclinic.org/health/symptoms/21660-inflammation">natural response to injury or illness</a>; inflammation occurs when white blood cells migrate to inflamed tissue to assist with healing. When this inflammatory process occurs in the upper airway, it <a href="https://www.mountsinai.org/health-library/diseases-conditions/sinusitis#">results in common cold and flu symptoms</a>, such as a stuffy or runny nose, sneezing, coughing and thickened mucus. </p>
<p>Conversely, lower white blood cell activity in the nasal passages can reduce inflammation. And interestingly, research shows that chicken soup can in fact lower the number of <a href="https://doi.org/10.1378/chest.118.4.1150">white blood cells traveling to inflamed tissues</a>. It does this by directly inhibiting the ability of <a href="https://my.clevelandclinic.org/health/diseases/22367-neutrophilia">neutrophils</a>, a type of white blood cell, to travel to the inflamed tissue. </p>
<h2>Key ingredients</h2>
<p>To truly understand the soothing and healing effects of chicken soup, it’s important to consider the soup’s ingredients. Not all chicken soups are packed with nutritious healing properties. For instance, the ultraprocessed canned versions of chicken soup, both with and without noodles, lack many of the antioxidants found in homemade versions. Most canned versions of chicken soup are nearly devoid of hearty vegetables.</p>
<p>The <a href="https://www.momsmeals.com/our-food/nutrition/the-nutrients-behind-chicken-soup/#">core nutrients</a> in homemade versions of the soup are what set these varieties apart from canned versions. Chicken provides the body with a complete source of protein to combat infection. Vegetables supply a wide array of vitamins, minerals and antioxidants. If prepared the American way, noodles provide an easily digestible source of carbohydrate that your body uses for energy and recovery. </p>
<p>Even the warmth of chicken soup can help. Drinking the liquid and inhaling the vapors increase the temperature of nasal and respiratory passages, which <a href="https://doi.org/10.1007/s11882-005-0044-6">loosens the thick mucus</a> that often accompanies respiratory illnesses. Compared with hot water alone, studies show chicken soup is <a href="https://doi.org/10.1016/S0012-3692(15)37387-6">more effective at loosening mucus</a>. </p>
<p>The herbs and spices sometimes used in chicken soup, such as pepper and garlic, <a href="https://www.uptodate.com/contents/nonallergic-rhinitis-runny-or-stuffy-nose-beyond-the-basics">also loosen mucus</a>. The broth, which contains water and electrolytes, helps with rehydration. </p>
<p>So, to maximize the health benefits of chicken soup, I recommend a homemade variety, which can be prepared with carrots, celery, fresh garlic, herbs and spices, to name a few ingredients. But if you need a more convenient option, look at the ingredients and nutrition facts label, and choose soups with a variety of vegetables over an ultraprocessed, nutrient-depleted kind. </p>
<p>In short, the latest science suggests that chicken soup – though not an out-and-out cure for colds and flu – really helps with healing. Looks like Grandma was right again.</p><img src="https://counter.theconversation.com/content/213847/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Colby Teeman does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Grandma swore by it. Now science weighs in on the healing powers of chicken soup.Colby Teeman, Assistant Professor of Dietetics and Nutrition, University of DaytonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2130652023-09-28T19:59:11Z2023-09-28T19:59:11ZHandkerchief or tissue? Which one’s better for our health and the planet?<figure><img src="https://images.theconversation.com/files/548229/original/file-20230914-15-v07w3f.jpg?ixlib=rb-1.1.0&rect=1%2C0%2C997%2C667&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/woman-allergy-symptom-blowing-nose-272161175">Shutterstock</a></span></figcaption></figure><p>Maybe you have hay fever, COVID, a cold or the flu, and are reaching for a tissue or handkerchief.</p>
<p>But which one’s better at stopping infections spreading? Which has a smaller environmental impact? Is it the hanky, which has been with us since at least Roman times? Or the more recent and widely-used paper tissue?</p>
<p>You might be surprised at the results.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-whats-the-right-way-to-blow-your-nose-74977">Health Check: what's the right way to blow your nose?</a>
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</em>
</p>
<hr>
<h2>A short history of the handkerchief and tissue</h2>
<p>Today, we think of hankies as something to wipe noses, and catch coughs and sneezes. But such a simple square of cloth has a complex history.</p>
<p>In the first century, the Romans <a href="http://margaretroedesigns.com/wp-content/uploads/HandkerchiefHist.pdf">used</a> a <em>sudarium</em> (Latin for sweat cloth) to wipe off sweat, or to mask the mouth and face.</p>
<p>Over time, people have used what we now call a handkerchief or hanky, as a head covering, as a veil and for disguise, to clean hands, for wounds and to staunch blood. </p>
<p>Wealthy people have used them to signify class and manners, and for discretely wiping away phlegm rather than smearing snot on sleeves or down skirts. Royalty have used them to indicate wealth and power through their gifts of fine linen and silk handkerchiefs to favoured subjects. Henry VIII owned an extensive collection, some embossed with gold and silver.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/548254/original/file-20230914-27-p9amxj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Soldier picks up the handkerchief which a young lady has dropped and hands it back to her" src="https://images.theconversation.com/files/548254/original/file-20230914-27-p9amxj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/548254/original/file-20230914-27-p9amxj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=427&fit=crop&dpr=1 600w, https://images.theconversation.com/files/548254/original/file-20230914-27-p9amxj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=427&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/548254/original/file-20230914-27-p9amxj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=427&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/548254/original/file-20230914-27-p9amxj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=537&fit=crop&dpr=1 754w, https://images.theconversation.com/files/548254/original/file-20230914-27-p9amxj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=537&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/548254/original/file-20230914-27-p9amxj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=537&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The handkerchief was once a token of love, such as between this lady and the soldier.</span>
<span class="attribution"><a class="source" href="https://wellcomecollection.org/works/enpm4vak/images?id=mwb4mevj">Wellcome Collection</a></span>
</figcaption>
</figure>
<p>Handkerchiefs have also been <a href="https://www.bl.uk/collection-items/italian-handkerchief">markers of</a> love, fidelity and sexual preferences. In the late 19th century the “handkerchief code” was a system of colour coding and handkerchief placement used to indicate sexual preferences, <a href="https://www.refinery29.com/en-au/lgbtq-secret-handkerchief-code-language">which is still active</a> in LGBTQ+ communities today.</p>
<p>We can <a href="https://www.euppublishing.com/doi/epub/10.3366/cult.2020.0214">trace the origins</a> of paper tissue to China in the 2nd century BC. But it wasn’t until the 1920s that tissue as we know it today <a href="https://www.kleenex.co.uk/kleenex-history">was developed</a> to remove make-up and wipe
runny noses from hay fever.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-do-hay-fever-treatments-actually-work-and-whats-best-for-my-symptoms-213071">How do hay fever treatments actually work? And what's best for my symptoms?</a>
</strong>
</em>
</p>
<hr>
<h2>So, which one is better for our health?</h2>
<p>More than 100 years ago, a cloth hanky was considered a “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5248216/pdf/hosplond73063-0008b.pdf">little flag of Death</a>” because of the germs it carried and how it contaminated pockets it was left in. Later, we were urged to use a hanky <a href="http://resource.nlm.nih.gov/101449736">as</a> “coughs and sneezes spread diseases”.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/548255/original/file-20230914-17-yogj0f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Coughs and sneezes spread diseases poster" src="https://images.theconversation.com/files/548255/original/file-20230914-17-yogj0f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/548255/original/file-20230914-17-yogj0f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=923&fit=crop&dpr=1 600w, https://images.theconversation.com/files/548255/original/file-20230914-17-yogj0f.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=923&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/548255/original/file-20230914-17-yogj0f.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=923&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/548255/original/file-20230914-17-yogj0f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1160&fit=crop&dpr=1 754w, https://images.theconversation.com/files/548255/original/file-20230914-17-yogj0f.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1160&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/548255/original/file-20230914-17-yogj0f.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1160&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">This 1960s poster from New Zealand urges us to use a hanky.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/archivesnz/21665866709/in/photolist-238NiVN-z1xem2-2jmC8YU-2iFV9CP-2iEYm5C-2iLnkGm-2iLkHAp-2iJP3pk-2iLL4Wc-JrEbjz-2iLnkTP-2iLhUHs-2iLhUKG-2iLkHHo-2iLhUJE-2iLhULy-2iLkHzn-2iLnkRe-DoShu-e6nLop-e6nLkz-e6toYU-e6tp2j-2iLkHN8-2iLhUNN-e6toVu-4mEw9J">Archives New Zealand</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>Today, we know nasal secretions harbour cold-type viruses that can be <a href="https://onlinelibrary.wiley.com/doi/10.1002/jmv.22027">transferred</a> to a <a href="https://www.abc.net.au/health/talkinghealth/factbuster/stories/2011/06/02/3231404.htm">range of surfaces</a> – hands, handkerchiefs, tissues, door knobs, keyboards – sometimes surviving <a href="https://doi.org/10.1093/oxfordjournals.aje.a113473">long after</a> the initial exposure.</p>
<p>So blowing your nose into a reusable cotton hanky, then touching another object, means these viruses can spread. Even if you put your cotton hanky in the wash immediately, you’d likely contaminate surfaces on the way, such as doorknobs, and use your infected hands to operate the washing machine.</p>
<p>Viruses don’t tend to <a href="https://doi.org/10.1093/infdis/146.1.47">survive so long</a> on tissues. As long as you throw tissues away after using them, and don’t leave them lying around for others to pick up, the chance of passing germs to others from a used tissue is far lower.</p>
<p>Then there’s the question of whether hankies or tissues are effective barriers to coughing and respiratory spray. </p>
<p>Basic cloth coverings, such as handkerchiefs or bandannas, can catch sputum, as can tissues. But several studies have shown they do not effectively <a href="https://doi.org/10.1021/acs.nanolett.0c02211">filter</a> <a href="https://aaqr.org/articles/aaqr-13-06-oa-0201.pdf">respiratory aerosols</a>, or <a href="https://doi.org/10.1177/153567601001500204">stop you inhaling</a> pollutants, pathogens or <a href="https://doi.org/10.1016/j.ijheh.2018.03.012">small airborne particles</a>.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/we-know-hand-dryers-can-circulate-germs-through-the-air-why-are-they-still-used-everywhere-157410">We know hand dryers can circulate germs through the air. Why are they still used everywhere?</a>
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</p>
<hr>
<h2>Which one is better for the planet?</h2>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/548258/original/file-20230914-17-rgpxzb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Cotton hankies on a washing line" src="https://images.theconversation.com/files/548258/original/file-20230914-17-rgpxzb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/548258/original/file-20230914-17-rgpxzb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/548258/original/file-20230914-17-rgpxzb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/548258/original/file-20230914-17-rgpxzb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/548258/original/file-20230914-17-rgpxzb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/548258/original/file-20230914-17-rgpxzb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/548258/original/file-20230914-17-rgpxzb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Surely, cotton hankies are better for the planet than tissues? Let’s see.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/using-reusable-textile-pure-cotton-colourful-1107810197">Shutterstock</a></span>
</figcaption>
</figure>
<p>If you want to look at environmental considerations, US company Ecosystem Analytics <a href="https://ecosystem-analytics.com/wp-content/uploads/2013/10/Complete-LCA-Facial-Tissue-Handkerchief.pdf">compared</a> resusable cotton hankies to disposable paper tissues using a <a href="https://doi.org/10.1007/BF02978505">lifecycle analysis</a>. It considered four measures of environmental impacts associated with production, transport, use and disposal:</p>
<ul>
<li><p>climate change (sum of greenhouse gases: carbon dioxide, methane, water vapour, nitrous oxide and CFCs)</p></li>
<li><p>ecosystem quality (chemical pollution of land and water)</p></li>
<li><p>human health (carcinogenic and non‐carcinogenic toxicity to humans)</p></li>
<li><p>resources (total energy requirements of non‐renewable energy and mineral extraction). </p></li>
</ul>
<p>The verdict? Across the four measures, a cotton hanky had five to seven times greater impact than an equivalent tissue.</p>
<p>And, by far, the greatest impacts were related to the production of each of these products, rather than using or disposing of them.</p>
<p>If you’re still keen to use a cotton hanky, you could opt for organic cotton, which has a <a href="https://www.sei.org/publications/ecological-footprint-water-analysis-cotton-hemp-polyester/">lower ecological footprint</a> compared to standard cotton produced in the same location. But organic cotton production has <a href="https://www.nytimes.com/wirecutter/blog/is-organic-cotton-better-for-the-environment/">lower yields</a> than its conventional equivalent, meaning more land is needed to produce an equivalent amount, compounding the total environmental impact.</p>
<p>If you want to feel better about using tissues, ones made from recycled material may be a better option. Their manufacture leads to <a href="https://doi.org/10.1007/s11367-013-0597-x">fewer</a> greenhouse gas emissions compared with making regular tissues.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/sustainable-shopping-for-eco-friendly-jeans-stop-washing-them-so-often-75781">Sustainable shopping: for eco-friendly jeans, stop washing them so often</a>
</strong>
</em>
</p>
<hr>
<h2>The verdict</h2>
<p>Wiping our noses with paper tissues we dispose of properly after use (and don’t store in our pocket), made from recycled material, is preferable from both a health and environmental perspective. </p>
<p>But tissues don’t quite have the same panache as the historic and versatile cloth hanky.</p><img src="https://counter.theconversation.com/content/213065/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Mark Patrick Taylor is a full-time employee of EPA Victoria, appointed to the statutory role of Chief Environmental Scientist. He is also an Honorary Professor at Macquarie University, Sydney.</span></em></p><p class="fine-print"><em><span>Hester Joyce does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The answer might surprise you.Mark Patrick Taylor, Chief Environmental Scientist, EPA Victoria; Honorary Professor, School of Natural Sciences, Macquarie UniversityHester Joyce, Adjunct Associate Professor, Creative Arts, La Trobe UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2072862023-07-12T12:38:49Z2023-07-12T12:38:49ZStrep throat can easily be confused with throat infections caused by viruses – here are a few ways to know the difference<figure><img src="https://images.theconversation.com/files/536374/original/file-20230707-23-bxbi1g.jpg?ixlib=rb-1.1.0&rect=0%2C9%2C6640%2C4220&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Strep is most common in children between the ages of 5 and 15.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/male-pediatrician-examining-little-child-patients-royalty-free-image/1306247195?phrase=doctor+checking+for+strep&adppopup=true">aquaArts studio/E+ via Getty Images</a></span></figcaption></figure><p>“My sore throats, you know, are always worse than anybody’s.”</p>
<p>So declares Mary to Anne in “<a href="https://jasna.org/austen/works/persuasion/">Persuasion</a>,” Jane Austen’s 1817 book. Most of us can relate to this feeling. There is no such thing as “just a sore throat.” The pain, headache, fever and aches associated with a sore throat can make you feel terrible.</p>
<p>While sore throats can occur at any time of year, strep throat is <a href="https://www.cdc.gov/groupastrep/surveillance.html#">more common in the fall, winter and early spring</a>.</p>
<p>I am a <a href="https://facultyprofiles.tufts.edu/allen-shaughnessy">professor of family medicine</a>, a pharmacist and an expert on evidence-based medicine. My work involves the evaluation of research performed by others, and I have been following and analyzing research findings on strep for the past 30 years. </p>
<p>Many people incorrectly assume that all sore throats are due to strep throat, a bacterial infection of the pharynx, the middle throat area behind the nose and mouth, and patients often come to our family medicine office wanting to be checked and treated for strep with antibiotics.</p>
<p>However, neither testing nor treatment is always needed for a sore throat. Regardless of the cause, rest and pain relievers form the cornerstone of sore throat treatment.</p>
<p>Here’s some guidance on whether and when testing is necessary.</p>
<h2>Bacterial versus viral sore throats</h2>
<p>Most <a href="https://www.cdc.gov/antibiotic-use/sore-throat.html">sudden-onset sore throats</a> are caused by viruses – the same ones that cause the common cold, the seasonal flu and COVID-19. There are <a href="https://www.nih.gov/news-events/nih-research-matters/understanding-common-cold-virus#">more than 200 viruses</a> that can cause sore throat and other symptoms related to the common cold. </p>
<p>But bacteria can also be the culprits behind a sore throat. One of the most common examples is <a href="https://www.cdc.gov/groupastrep/diseases-hcp/strep-throat.html#">strep throat</a>, or <a href="https://www.cdc.gov/streplab/groupa-strep/index.html">group A pharyngitis</a>.</p>
<p>Strep is caused by certain strains of <em>Streptococcus pyogenes</em> bacteria.
There are many species of strep; other common forms of strep that cause different infections in humans include “<a href="https://www.cdc.gov/groupbstrep/index.html">group B strep</a>” and “<a href="https://www.icliniq.com/articles/infectious-diseases/group-d-streptococcus-infections">group D strep</a>.” Group A strep usually lives peacefully among the many other types of bacteria growing on our skin and doesn’t cause any problems, until we get a break in the skin such as a cut or a scrape. This allows it to overwhelm the immune system’s ability to keep it in check.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/536145/original/file-20230706-18-5qdns0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A teenage girl is lying on a sofa, feeling unwell and holding a thermometer in her mouth to check her temperature." src="https://images.theconversation.com/files/536145/original/file-20230706-18-5qdns0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/536145/original/file-20230706-18-5qdns0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/536145/original/file-20230706-18-5qdns0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/536145/original/file-20230706-18-5qdns0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/536145/original/file-20230706-18-5qdns0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/536145/original/file-20230706-18-5qdns0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/536145/original/file-20230706-18-5qdns0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Fever, headache and confusion can be symptoms of a severe case of strep.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/sick-teenager-resting-at-home-and-monitoring-royalty-free-image/1482421648?phrase=strep+throat&adppopup=true">RealPeopleGroup/E+ via Getty Images</a></span>
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<p>Group A strep can also live in the back of the throat – up to 30% of people without any evidence of a sore throat will have <a href="https://doi.org/10.3389/fcimb.2019.00137">this strain in their throat</a>. <a href="https://www.cdc.gov/groupastrep/diseases-public/strep-throat.html#">Up to 3 in 10 children and 1 in 10 adults</a> feeling sick with a sore throat due to a virus or other cause will test <a href="https://doi.org/10.1371/journal.pntd.0006335">positive for group A strep</a>. That means that people with a sore throat caused by a virus could also be positive for strep, even if it’s not causing the symptoms.</p>
<p>Not all group A strep bacteria are the same, though. Some varieties are better at evading the immune system than others and can grow quickly. Others produce byproducts that can cause a sore throat and sometimes lead to <a href="https://www.mayoclinic.org/diseases-conditions/tonsillitis/symptoms-causes/syc-20378479">tonsillitis</a>, an infection of the tonsils, or cause ear or <a href="https://www.cdc.gov/antibiotic-use/sinus-infection.html">sinus infections</a>. </p>
<p>Still other strep strains produce a toxin that can cause a characteristic <a href="https://www.cdc.gov/groupastrep/diseases-public/scarlet-fever.html">skin rash</a> or lead to effects on the <a href="https://www.cdc.gov/groupastrep/diseases-public/rheumatic-fever.html">heart</a>, <a href="https://www.cdc.gov/groupastrep/diseases-public/post-streptococcal.html">kidneys</a> or even the <a href="https://www.nimh.nih.gov/health/publications/pandas">brain</a>. </p>
<p>Rarer still, group A strep can enter the bloodstream and cause <a href="https://www.mayoclinic.org/diseases-conditions/toxic-shock-syndrome/symptoms-causes/syc-20355384">toxic shock syndrome</a>, a life-threatening, overwhelming infection. These latter conditions are examples of invasive strep, meaning that the infection is in parts of the body typically free from germs; they <a href="https://www.cdc.gov/groupastrep/igas-infections-investigation.html">seem to be on the rise</a> after a marked <a href="https://www.cdc.gov/groupastrep/igas-infections-investigation.html">reduction in their occurrence during the COVID-19 pandemic</a>. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/W50S0dCCFPs?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Like other illnesses that made a comeback after COVID-19 prevention measures were relaxed, strep cases have returned to pre-pandemic levels.</span></figcaption>
</figure>
<h2>To test or not to test</h2>
<p>Doctors or other clinicians can easily test for strep by using a swab to collect a bit of the fluid from the back of the throat. This sample can identify group A strep in about a minute. </p>
<p>While researchers have been studying group A strep <a href="https://www.ncbi.nlm.nih.gov/books/NBK333430/">for over 75 years</a> and there are thousands of research papers focused on infections caused by strep, there is still <a href="https://www.nice.org.uk/guidance/ng84/chapter/Summary-of-the-evidence">controversy</a> over whether it needs to be tested for and treated. </p>
<p>To decide whether to test for group A strep, clinicians use a set of criteria based on <a href="https://www.mdcalc.com/calc/104/centor-score-modified-mcisaac-strep-pharyngitis">five questions</a> that can help determine whether strep testing is needed. These are:</p>
<p>– How old is the patient? Strep throat is most common in children <a href="https://www.cdc.gov/groupastrep/diseases-public/strep-throat.html#">between ages 5 and 15</a> and least common in <a href="https://www.cdc.gov/groupastrep/diseases-hcp/strep-throat.html#">adults over age 45</a>. </p>
<p>– Are the tonsils swollen or do they have a white or yellow coating? Both conditions often accompany strep. However, this question alone isn’t definitive, since viruses can also affect the tonsils.</p>
<p>– Are the <a href="https://www.verywellhealth.com/cervical-lymph-nodes-2252142">cervical lymph nodes</a> swollen or tender? Normally these bumps, which are in the front of the neck along the sides of the windpipe, cannot be seen or felt, but are often palpable when strep is present.</p>
<p>– Does the person have a fever? Lack of a fever makes strep less likely.</p>
<p>– Does the person have a cough? A cough is indicative of a viral cause and makes strep the less likely cause of the sore throat.</p>
<p>While none of these questions alone can provide a clear answer, taken together they can tell your clinician whether strep is more or less likely. </p>
<p>Using this scoring tool, an adult with a sore throat but without changes to the tonsils or lymph nodes, without a fever and with a cough has only a <a href="https://www.mdcalc.com/calc/104/centor-score-modified-mcisaac-strep-pharyngitis">1 in 40 chance, or 2.5%, of having strep throat</a>. For such patients, a strep test is not necessary. </p>
<p>On the other hand, when a first grader meets all five of these criteria, there is a 50% chance that strep is causing his or her sore throat. Based on recent research I have reviewed, by using these questions <a href="https://doi.org/10.7326/0003-4819-159-9-201311050-00003">adults can determine</a> when strep is the likely cause of a sore throat. </p>
<p>In the <a href="https://www.nice.org.uk/guidance/ng84">United Kingdom</a> and <a href="https://doi.org/10.1370/afm.741">other European countries</a>, doctors do not routinely test for strep. Antibiotic treatment can at times <a href="https://www.cdc.gov/antibiotic-use/community/pdfs/aaw/au_arent_always_the_answer_fs_508.pdf">cause allergic reactions, rash, diarrhea, stomach upset, yeast infections and other side effects</a>. Authorities in these countries feel any benefit of testing and treatment does not outweigh these risks.</p>
<h2>Treatments for strep</h2>
<p>Once group A strep is confirmed, doctors may prescribe an antibiotic treatment. </p>
<p>Penicillin or amoxicillin are the most commonly prescribed antibiotics for strep. These medicines will not reduce pain or tiredness but may help symptoms resolve earlier, typically by <a href="https://www.nice.org.uk/guidance/ng84/chapter/Summary-of-the-evidence">about a day</a>. Doctors may also suggest use of a pain reliever such as acetaminophen or ibuprofen to help relieve symptoms.</p>
<p>Antibiotic treatment does not seem to lower the likelihood of <a href="https://doi.org/10.1136/bmj.38503.706887.AE1">spread of the infection between children</a> – which is common in schools and dormitories – <a href="https://doi.org/10.1136/bmj.f6867">or adults</a>.</p>
<p>Health care practitioners recommend staying home until fever has subsided. They also recommend taking the full course of antibiotics, even if the symptoms have abated. </p>
<p>With sore throats causes by viruses – against which antibiotics are ineffective – few treatments exist aside from using pain relievers to help soothe immediate symptoms. For this reason and because <a href="https://www.cdc.gov/antibiotic-use/index.html">antibiotic overuse is a major problem in the U.S.</a>, it is best not to assume that your sore throat is caused by strep and to treat it accordingly.</p><img src="https://counter.theconversation.com/content/207286/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Allen Shaughnessy does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Despite an abundance of research on strep, there is still a great deal of debate in the scientific community over whether and when people should get tested and treated for it.Allen Shaughnessy, Professor of Family Medicine, Tufts UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2053962023-05-15T04:06:09Z2023-05-15T04:06:09ZMy child has a cough, so what’s wrong with using cough syrup?<figure><img src="https://images.theconversation.com/files/526078/original/file-20230515-124801-1buxmk.jpg?ixlib=rb-1.1.0&rect=26%2C0%2C5955%2C3997&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/little-girl-sick-lies-bed-coughs-1878376429">Shutterstock</a></span></figcaption></figure><p>As winter approaches, many parents will be bracing for the cold and flu season. Young children typically get at least <a href="https://raisingchildren.net.au/toddlers/health-daily-care/health-concerns/colds">six colds a year</a>. </p>
<p>In previous generations, parents might have reached for the cough syrup to relieve a dry or chesty cough. </p>
<p>But we now know cough syrups <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001831.pub5/full">aren’t very effective</a> at treating children’s coughs.</p>
<p>And amid <a href="https://pubmed.ncbi.nlm.nih.gov/19101060/">mounting evidence of harms</a> from poisoning and deaths, many countries including Australia have restricted cough medicines so they can’t be given to children aged under six. </p>
<h2>What’s in cough medicine?</h2>
<p>Active ingredients in cough syrups vary depending on their claimed benefit. They can contain cough suppressants (dampening the body’s cough reflex), expectorants and mucolytics (both of which help clear phlegm). </p>
<p>Other medicines marketed for cold and flu often contain decongestants (to relieve a blocked nose) and sedating antihistamines to relieve sneezing, stop a runny nose and to aid sleep. </p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-why-do-i-have-a-cough-and-what-can-i-do-about-it-119172">Health Check: why do I have a cough and what can I do about it?</a>
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<p>The riskiest medications are those with a <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1440-1754.2010.01780.x">sedative action</a>, such as sedating antihistamines or opioid-based cough suppressants. While sedation may be a desired effect for parents with a sleepless child, young children are particularly at risk of serious harm or death. Sedatives can also cause agitation and hyperactivity. </p>
<p>While cough syrups that don’t contain sedatives are likely safer, there are very few studies of safety and efficacy of these products in children. Adverse events including <a href="https://pubmed.ncbi.nlm.nih.gov/10195488/">agitation and psychosis</a>
have been reported, especially with overuse. </p>
<p>Overuse may result from parents misreading the label, intentionally using more in the hope it will work better, inadvertent extra doses and the use of inaccurate measuring devices such as household spoons. </p>
<h2>How are cough syrups restricted?</h2>
<p>Young children under two years old are <a href="https://pubmed.ncbi.nlm.nih.gov/19101060/">most at risk of a fatal overdose</a> from cough syrups. But Australia’s drug regulator <a href="https://web.archive.org/web/20140717013231/http://tga.gov.au/industry/otc-notices-cough-cold-review-outcomes.htm#.U8cntK3P0Q8">recommends against</a> using cough syrups for anyone under six years of age. As such, there are no dosing instructions for children under six years on the labels of these products.</p>
<p>Cough syrups are still available for older children and adults. Pharmacists are likely to ask the age of the person who will take it and provide guidance on dosing and appropriate use. </p>
<figure class="align-center ">
<img alt="Person pours cough syrup onto a spoon" src="https://images.theconversation.com/files/526082/original/file-20230515-201419-kifs2s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/526082/original/file-20230515-201419-kifs2s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/526082/original/file-20230515-201419-kifs2s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/526082/original/file-20230515-201419-kifs2s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/526082/original/file-20230515-201419-kifs2s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/526082/original/file-20230515-201419-kifs2s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/526082/original/file-20230515-201419-kifs2s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Dosing errors can be made when using a household spoon.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/healthcare-people-medicine-concept-woman-pouring-657897406">Shutterstock</a></span>
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<p>Our research, published today in the <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.51865">Medical Journal of Australia</a>, shows restricting the use of cough and cold medicines in children results in a significant and sustained decrease in poisonings. </p>
<p>Our study looked at dosing errors, adverse events at correct doses, and accidental “exploratory ingestions”, such as when a toddler helps themselves to the medicine cabinet. </p>
<p>The government mandated labelling changes in 2012 and 2020 for these products. In 2012, labels for medicated cough and cold products could no longer list dosing instructions for children under six, and had to carry additional warnings. In 2020, warnings were put on sedating antihistamines saying they were not to be used in children under two years for <em>any</em> reason (including allergy and hayfever). </p>
<p>This resulted in a halving of the rate of poisons centre calls, and a halving in the rate of hospitalisations. Despite this, hundreds of calls are still made to Australian poisons centres per year regarding these products in young children.</p>
<h2>When is it OK to use cough syrups?</h2>
<p>Harms have mostly been documented in younger children. This is likely due to their smaller size, meaning it takes less medicine to cause harm, and also their susceptibility to sedative effects due to their developing brains. </p>
<p>Cough syrups can be used for in children aged six to 11 years, however <a href="https://web.archive.org/web/20140717013231/http://tga.gov.au/industry/otc-notices-cough-cold-review-outcomes.htm#.U8cntK3P0Q8">caution is still needed</a>. These products should only be given in consultation with a doctor, pharmacist or nurse practitioner.</p>
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Read more:
<a href="https://theconversation.com/health-check-do-cough-medicines-work-62425">Health Check: do cough medicines work?</a>
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<p>Some herbal products are available and marketed for children, such as <em>Hedera helix</em> (ivy leaf extract). Unfortunately, there is no convincing evidence these medications <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8275562/">meaningfully improve cough symptoms</a>. But the risk of poisoning is low. </p>
<p>Simple syrups containing no medication can also be effective: <a href="https://link.springer.com/article/10.1007/s00408-019-00305-5">up to 85% of the effectiveness</a> of cough medicines has been put down to the “placebo effect”. This could be due to syrups coating the throat and dampening that irritating tickling sensation.</p>
<h2>So what can I do for my kid?</h2>
<p>The best thing you can do for your child is give them rest and reassurance. </p>
<p>Antibiotics will only be needed if a doctor diagnoses them with <a href="https://www.healthdirect.gov.au/pneumonia#:%7E:text=Bacterial%20pneumonia%20may%20be%20caused,Haemophilus%20influenzae%20and%20Moraxella%20catarrhalis.">acute bacterial pneumonia</a> or with a chronic cough due to a bacterial infection, such as protracted bacterial bronchitis, whooping cough or a <a href="https://healthinfo.healthengine.com.au/lung-abscess">lung abscess</a>.</p>
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<img alt="Girl with a fever looks at her Dad, whose arm is touching her head" src="https://images.theconversation.com/files/526085/original/file-20230515-154092-smbbsw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/526085/original/file-20230515-154092-smbbsw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/526085/original/file-20230515-154092-smbbsw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/526085/original/file-20230515-154092-smbbsw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/526085/original/file-20230515-154092-smbbsw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/526085/original/file-20230515-154092-smbbsw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/526085/original/file-20230515-154092-smbbsw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Treat fevers with over-the-counter medicines such as paracetamol.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/girl-sleeping-sickness-on-bed-796939429">Shutterstock</a></span>
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<p>Paracetamol or ibuprofen can be used if they have fever, aches and pains along with their cough. Check the correct dosage on the packaging for your child’s weight and age.</p>
<p>If your child is older than 12 months and has a wet cough (producing phlegm in their throat), consider giving them honey. There is growing evidence <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4264806/">honey can reduce the production of mucus</a> and therefore, the amount of coughing.</p>
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<em>
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Read more:
<a href="https://theconversation.com/still-coughing-after-covid-heres-why-it-happens-and-what-to-do-about-it-179471">Still coughing after COVID? Here's why it happens and what to do about it</a>
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<img src="https://counter.theconversation.com/content/205396/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Rose Cairns receives funding from the National Health and Medical Research Council (NHMRC, Investigator Grant). She is also the recipient of an untied educational grant from Reckitt to fund a PhD stipend into over-the-counter analgesic research. She has previously recieved honoraria/speaker fees from Reckitt, HealthEd and The Pharmacy Guild of Australia for giving educational presentations on poisoning.</span></em></p><p class="fine-print"><em><span>Associate Professor Wheate in the past has received funding from the ACT Cancer Council, Tenovus Scotland, Medical Research Scotland, Scottish Crucible, and the Scottish Universities Life Sciences Alliance. He is a Fellow of the Royal Australian Chemical Institute, a member of the Australasian Pharmaceutical Science Association, and a member of the Australian Institute of Company Directors. Nial is the chief scientific officer of Vairea Skincare LLC, a director of SetDose Pty Ltd a medical device company, and a Standards Australia panel member for sunscreen agents.</span></em></p>Children aged under six years shouldn’t have cough syrup. It’s not only ineffective, it can be harmful.Rose Cairns, Lecturer in Pharmacy, University of SydneyNial Wheate, Associate Professor of the Sydney Pharmacy School, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2041192023-04-23T20:04:31Z2023-04-23T20:04:31ZFlu or COVID? You can now test for both at home with a single swab. Here’s what you need to know<figure><img src="https://images.theconversation.com/files/522244/original/file-20230421-22-d7zbfx.jpg?ixlib=rb-1.1.0&rect=2%2C5%2C995%2C660&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-sick-woman-home-african-lying-1631753728">Shutterstock</a></span></figcaption></figure><p>If you have respiratory symptoms as we head towards winter and flu season, could it be COVID or the flu? Or something else entirely?</p>
<p>Now, we have a <a href="https://www.sbs.com.au/news/article/combination-flu-and-covid-rapid-tests-have-hit-store-shelves-how-useful-are-they/pmh4bx4rk">range of home tests</a> that can distinguish between flu and COVID with one swab. They use technology you might be used to. They’re rapid antigen tests or RATs.</p>
<p>Here’s what you need to know about the tests, why they might be useful, and what they don’t tell us.</p>
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<h2>What’s new about these tests?</h2>
<p>Most people were introduced to RATs while testing at home for COVID.</p>
<p>But RATs to detect the flu have been available for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6156320/">years</a>, albeit used by health workers to test patients.</p>
<p>The latest RATs are different for two reasons. One, they detect both COVID and flu with one swab (a “combo” test). Two, they can be used at home.</p>
<p>The first of these combo home tests for flu/COVID was approved in <a href="https://www.tga.gov.au/news/media-releases/first-combination-covid-19-and-influenza-self-tests-approved-australia">September 2022</a>. Now several are on the market.</p>
<p>These tests let you check, with one test kit, if you are infected with two types of flu (influenza A and B) and SARS-CoV-2 (the virus that causes COVID).</p>
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Read more:
<a href="https://theconversation.com/are-flu-cases-already-100-times-higher-than-last-year-heres-what-we-really-know-about-the-2023-flu-season-201559">Are flu cases already 100 times higher than last year? Here's what we really know about the 2023 flu season</a>
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<h2>How do they work?</h2>
<p>These RATs contain antibodies that can detect influenza A, influenza B, and SARS-CoV-2.</p>
<p>Some kits have a test cassette with one well to add drops to and one window labelled: C (control), A (influenza A), B (influenza B) and T (test for COVID). </p>
<p>Some tests have two wells and two test windows. You view the influenza results in one window and the COVID results in the other.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/522242/original/file-20230421-14-aaner7.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Test cassette of combined flu/COVID rapid antigen test" src="https://images.theconversation.com/files/522242/original/file-20230421-14-aaner7.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/522242/original/file-20230421-14-aaner7.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=603&fit=crop&dpr=1 600w, https://images.theconversation.com/files/522242/original/file-20230421-14-aaner7.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=603&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/522242/original/file-20230421-14-aaner7.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=603&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/522242/original/file-20230421-14-aaner7.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=757&fit=crop&dpr=1 754w, https://images.theconversation.com/files/522242/original/file-20230421-14-aaner7.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=757&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/522242/original/file-20230421-14-aaner7.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=757&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Some test cassettes have two wells, like this one.</span>
<span class="attribution"><a class="source" href="https://www.tga.gov.au/sites/default/files/2023-02/covid-19-rapid-antigen-self-tests-are-approved-australia-ifu-404854_0.pdf">TGA</a></span>
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<p>In the influenza window you will see markings C, A and B. If a line becomes visible at A (and C), you have tested positive for influenza A. If a line becomes visible at B (and C), you are positive for influenza B. If lines are visible at A, B and C you have tested positive for both influenza A and B. </p>
<p>If either A or B has a line but not C, or if none of them do, the test is invalid and you will need to take a new one. </p>
<p>The COVID window works the same way as in a standard RAT for COVID. If a line becomes visible at C and T, you are COVID-positive. If there is a line at C but not T, you are COVID-negative. If there is no line at C the test is invalid. </p>
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Read more:
<a href="https://theconversation.com/is-my-rat-actually-working-how-to-tell-if-your-covid-test-can-detect-omicron-196210">Is my RAT actually working? How to tell if your COVID test can detect Omicron</a>
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<h2>Why take the test? 3 reasons</h2>
<p>If you have respiratory symptoms, there are some practical reasons for knowing whether you are positive for COVID or flu. </p>
<p>One, if you know you have COVID, this will affect the timing of your booster vaccine. The Australian Technical Advisory Group on Immunisation recommends adults wait <a href="https://www.health.gov.au/news/atagi-2023-booster-advice">six months</a> after a COVID infection to get a booster to increase the time you have protective immunity. So it helps to know if you have been infected.</p>
<p>Two, if you need antiviral treatment, the medications differ depending on whether you have <a href="https://www.ncbi.nlm.nih.gov/books/NBK459363/">flu</a> or <a href="https://www.nps.org.au/radar/articles/nirmatrelvir-and-ritonavir-paxlovid-for-mild-to-moderate-covid-19">COVID</a>. </p>
<p>Three, knowing you have flu or COVID means you can take steps to protect others. This could mean working at home, avoiding contact with vulnerable people, and wearing a mask in company.</p>
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<a href="https://images.theconversation.com/files/522245/original/file-20230421-22-f0mwfd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Woman's holding Paxlovid pill in one hand, glass of water in other, Paxlovid, thermometer in background" src="https://images.theconversation.com/files/522245/original/file-20230421-22-f0mwfd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/522245/original/file-20230421-22-f0mwfd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/522245/original/file-20230421-22-f0mwfd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/522245/original/file-20230421-22-f0mwfd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/522245/original/file-20230421-22-f0mwfd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/522245/original/file-20230421-22-f0mwfd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/522245/original/file-20230421-22-f0mwfd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">If you know you have COVID, you may be eligible for antiviral treatment.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/female-taking-paxlovid-prescription-treating-covid19-2161258693">MargJohnsonVA/Shutterstock</a></span>
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<h2>Which test to use? When to use it?</h2>
<p>The Therapeutic Goods Administration (TGA) lists <a href="https://www.tga.gov.au/products/covid-19/covid-19-tests/covid-19-rapid-antigen-self-tests-home-use/covid-19-rapid-antigen-self-tests-are-approved-australia">approved tests</a> on its website. Type the term “combination” in the search box. All combo tests currently listed use nasal swabs to collect the sample.</p>
<p>Most are listed as “very high sensitivity”. This means they get the same result in detecting positive cases as the gold standard PCR test 95% of the time. The others have “high sensitivity” (90% agreement with a PCR).</p>
<p>The <a href="https://www.tga.gov.au/qas-combination-rapid-antigen-self-tests">best time</a> to take the test is within four days of developing symptoms, as this is when it is easiest to detect both flu and COVID. The tests are more reliable if <a href="https://www.tga.gov.au/qas-combination-rapid-antigen-self-tests">you have symptoms</a>. </p>
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Read more:
<a href="https://theconversation.com/15-things-not-to-do-when-using-a-rapid-antigen-test-from-storing-in-the-freezer-to-sampling-snot-176364">15 things not to do when using a rapid antigen test, from storing in the freezer to sampling snot</a>
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<h2>What if I have symptoms but the test is negative?</h2>
<p>One possibility is that your viral load was not high enough to be detected. You could take another test a day or so later to check again.</p>
<p>Another is you may have a different virus. Viruses that cause respiratory symptoms include <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3553670/">rhinoviruses</a>, adenoviruses, <a href="https://www.health.gov.au/diseases/respiratory-syncytial-virus-rsv-infection">respiratory syncytial virus</a> and <a href="https://journals.lww.com/pidj/Fulltext/2022/03000/Proving_Etiologic_Relationships_to_Disease_.18.aspx">common cold coronaviruses</a>. </p>
<p>Other pathogens (disease-causing microorganisms) or health conditions can also cause respiratory symptoms. If you are concerned, consult your doctor for medical advice. </p>
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<strong>
Read more:
<a href="https://theconversation.com/havent-had-covid-or-a-vaccine-dose-in-the-past-six-months-consider-getting-a-booster-199096">Haven't had COVID or a vaccine dose in the past six months? Consider getting a booster</a>
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<h2>What else should I know?</h2>
<p>As each test differs, make sure you <a href="https://theconversation.com/15-things-not-to-do-when-using-a-rapid-antigen-test-from-storing-in-the-freezer-to-sampling-snot-176364">follow the instructions</a> for that specific test.</p>
<p>The price of combo kits advertised online varies from A$8.95 to $59 (excluding delivery) so it pays to shop around.</p>
<p>It’s worth trying to avoid catching the flu rather than testing for it later. Flu vaccination reduces your chances of catching the flu by <a href="https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm">40-60%</a> when the vaccine is well matched to circulating strains. Flu vaccines for the 2023 flu season are available now.</p><img src="https://counter.theconversation.com/content/204119/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Thea van de Mortel teaches into the Master of Infection Prevention and Control program at Grififth University. </span></em></p>Knowing if you have COVID or the flu can affect when you get vaccinated, need a particular antiviral, or if you need to work from home. But these combination tests can be expensive.Thea van de Mortel, Professor, Nursing, School of Nursing and Midwifery, Griffith UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1971512023-01-09T11:12:07Z2023-01-09T11:12:07ZColds, flu and COVID: how diet and lifestyle can boost your immune system<figure><img src="https://images.theconversation.com/files/503417/original/file-20230106-9921-bqlyvc.jpg?ixlib=rb-1.1.0&rect=44%2C11%2C7425%2C4973&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Most of us are eager to avoid getting sick this time of year.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-sick-woman-sitting-on-sofa-667211476">baranq/ Shutterstock</a></span></figcaption></figure><p>Every day we are exposed to a wide array of potentially harmful microorganisms – such as colds, the flu and even COVID. But our <a href="https://www.niaid.nih.gov/research/immune-system-overview">immune system</a> – a network of intricate pathways within our body – helps protect us against these microorganisms and other potential diseases. Essentially, it recognises foreign invaders, such as viruses and bacteria, and takes immediate action to defend us.</p>
<p>Humans have two types of immunity: innate and adaptive. <a href="https://www.niaid.nih.gov/research/immune-system-overview">Innate immunity</a> is the body’s first-line of defence, primarily consisting of physical barriers (such as skin), and secretions – including mucus, stomach acid and enzymes in saliva and sweat which prevent microorganisms getting inside the body. It also consists of cells that attack all foreign invaders entering the body.</p>
<p><a href="https://www.niaid.nih.gov/research/immune-system-overview">Adaptive immunity</a> is a system that learns to recognise a pathogen. It’s regulated by cells and organs in our body such as the spleen, thymus, bone marrow and lymph nodes. When a foreign substance enters the body, these cells and organs create antibodies and <em>multiply</em> the immune cells specific to that harmful substance in order to attack and destroy it. They also remember the pathogen for future reference.</p>
<p>There are many things we can do to support our immune system and even improve its function. Simple changes to your diet and lifestyle can all play a big role in helping you avoid getting sick.</p>
<h2>We are what we eat</h2>
<p>The nutrients we get from the foods in our diet play key roles in both building and maintaining our immune system.</p>
<p>Take for example the amino acid <a href="https://academic.oup.com/jn/article/137/6/1681S/4664953?login=false">arginine</a>. This is essential for generating nitric oxide within immune cells, which is an important defence molecule against organisms. <a href="https://pubmed.ncbi.nlm.nih.gov/33377367/">Vitamin A and zinc</a> are crucial in the rapid reproduction of immune cells. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707683/">Vitamin C</a> contributes to immune defence by supporting the cell functions of both immune systems. Similarly, <a href="https://www.mdpi.com/2072-6643/10/11/1614">vitamin E</a> has been shown to enhance immune responses in animals and humans and to provide protection against several infectious diseases, such as flu, COVID and the common cold. </p>
<p>A varied diet including fruits and vegetables, wholegrains, nuts, seeds, dairy products, as well as fish, meat, or plant protein alternatives, will all contain these key nutrients which support our immune health.</p>
<p>The vast combination of microorganisms that live in our gut – <a href="https://ep.bmj.com/content/102/5/257">known as our microbiome</a> – also have significant effects on our health and wellbeing, despite their tiny size. In fact, the microbiome is often referred to as the “<a href="https://www.sciencefocus.com/the-human-body/a-gut-feeling-meet-your-second-brain/">second brain</a>” due to the extensive relationship it has with the body’s organs and systems. </p>
<p>One particular role the microbes in our gut play is supporting <a href="https://www.nature.com/articles/s41422-020-0332-7">immune function</a>. They help to control inflammation, the process the immune system uses to protect us from harmful pathogens. Ensuring the microbiome is healthy can improve immune function.</p>
<figure class="align-center ">
<img alt="A bowl of greens with a two pieces of grilled salmon on top." src="https://images.theconversation.com/files/503419/original/file-20230106-21-oixeb2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/503419/original/file-20230106-21-oixeb2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/503419/original/file-20230106-21-oixeb2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/503419/original/file-20230106-21-oixeb2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/503419/original/file-20230106-21-oixeb2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/503419/original/file-20230106-21-oixeb2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/503419/original/file-20230106-21-oixeb2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">The Mediterranean diet can help support the microbiome.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/grilled-salmon-fillet-fresh-vegetable-salad-1934626109">Sea Wave/ Shutterstock</a></span>
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<p>There are many ways we can support our microbiome through the foods we eat. For example, research has shown <a href="https://www.mdpi.com/1422-0067/19/12/3720">a Mediterranean diet</a>, which is rich in vitamins, minerals and dietary fibre, has an anti-inflammatory effect in the gut, which can help boost the body’s immune function. </p>
<p>This effect may be explained by a strain of bacteria known as <em>Faecalibacterium prausnitzii</em> which is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359750/">key to immune regulation</a>. This bacteria tends to be low in the western diet but abundant in the Mediterranean diet. You should also avoid too many refined cereals, sugars and animal fats, which can all <a href="https://www.nature.com/articles/nm.3444">heighten inflammation</a> in the body which weakens the immune response.</p>
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Read more:
<a href="https://theconversation.com/mediterranean-diet-increases-gut-bacteria-linked-to-healthy-ageing-in-older-adults-131928">Mediterranean diet increases gut bacteria linked to healthy ageing in older adults</a>
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<p>Probiotics (supplementary blends of live bacteria) may also have benefits. Research has even shown a probiotic blend of bacterial strains <em>Lactiplantibacillus plantarumand</em> and <em>Pediococcus acidilactici</em> <a href="https://www.tandfonline.com/doi/full/10.1080/19490976.2021.2018899">reduced the amount of virus</a> detected in the nose and lungs, as well as the duration of symptoms, in COVID patients.</p>
<h2>Living a healthy lifestyle</h2>
<p>Your lifestyle can also have a big affect on immune function.</p>
<p>For example, smoking <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5352117/">affects both innate and adaptive immunity</a>, causing it to both overreact to pathogens and lower it’s immunity defences. Alcohol has also been shown to increase susceptibility to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590612/">both bacterial and viral infections</a>. It does this by altering the way our immune system defends against infections. Even moderate drinkers may have lower immunity. </p>
<p>Sleep is also crucial for maintaining immune function. Studies show that frequent, poor sleep causes inflammation in the body. This may worsen immune response, <a href="https://www.nature.com/articles/s42003-021-02825-4">increasing infection risk</a> and worsening infections. Adolescents who only get around six hours of sleep are also more likely to suffer from common illnesses, such as <a href="https://onlinelibrary.wiley.com/doi/10.1111/jsr.12096">cold, flu and gastroenteritis</a>.</p>
<p>Stress is another factor known to have a large impact on the immune system. It isn’t just chronic stress that suppresses the immune system either – even <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361287/">brief periods of stress</a> (such as an exam) can worsen immune function. Fortunately, mindfulness meditation (which can help manage stress) may be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4940234/">beneficial for the immune system</a> – though it isn’t entirely clear yet why.</p>
<p>Exercise has also been shown to affect immune function, with research showing <a href="https://journals.physiology.org/doi/full/10.1152/physrev.2000.80.3.1055?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org">moderate-intensity physical activity</a> in particular (such as a brisk walk or ballroom dancing) can improve immune response. However, it’s important to strike the right balance as long, intense exercise without sufficient rest between workouts can actually worsen immune function and make you more likely to catch an infection. And according to some data, this decrease can happen after only <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387807">90 minutes</a> of moderate- to high-intensity physical activity. </p>
<p>Of course, <a href="https://www.who.int/news-room/questions-and-answers/item/vaccines-and-immunization-what-is-vaccination">vaccination</a> remains the best way to prevent infection from many common diseases, such as the flu. But a good diet and lifestyle – alongside other <a href="https://www.gov.uk/government/publications/health-protection-in-schools-and-other-childcare-facilities/preventing-and-controlling-infections">preventative measures</a>, such as washing your hands or wearing a face mask – help support your immune system and the effectiveness of vaccines.</p><img src="https://counter.theconversation.com/content/197151/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Philippe B. Wilson is Chief Scientific Officer of NHS Willows Health.</span></em></p><p class="fine-print"><em><span>Samuel J. White does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Here are some simple things you can do everyday to help your immune system fight off infections.Samuel J. White, Senior Lecturer in Genetic Immunology, Nottingham Trent UniversityPhilippe B. Wilson, Professor of One Health, Nottingham Trent UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1966822022-12-19T16:27:40Z2022-12-19T16:27:40ZPets can get colds too – here’s how to keep them safe<figure><img src="https://images.theconversation.com/files/501861/original/file-20221219-16-tgjzxn.jpg?ixlib=rb-1.1.0&rect=12%2C0%2C4311%2C2217&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The symptoms of a cold or flu in pets is very similar to those humans get. </span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/jack-russell-dog-sleeping-bed-high-275877062">Javier Brosch/ Shutterstock</a></span></figcaption></figure><p>With winter comes <a href="https://www.annualreviews.org/doi/10.1146/annurev-virology-012420-022445">cold and flu season</a>, making coughs and sneezes rife. But it isn’t just humans who get struck down by these seasonal illnesses – our pets can too.</p>
<p>While many of us have an arsenal of home remedies that we can use to combat these illnesses, the same doesn’t necessarily exist for pets. So what can we do for our four-legged companions if they become ill – and how can we prevent seasonal illnesses in the future?</p>
<h2>Cold and flu</h2>
<p>In the same way that coughs, colds and other respiratory illnesses spread more easily when we’re indoors with other people, the same applies to our pets. Dogs often pick up illnesses after staying in kennels, attending indoor training classes or at competitive events where they’re <a href="https://doi.org/10.1016/j.jcpa.2020.02.005">in close contact with other dogs</a>. Infections can quickly spread via airborne particles, by sharing drinking water or from contaminated surfaces. </p>
<p>We may also inadvertently carry infections to our pets, especially if we have previously handled or stroked an infected animal. Some disease-causing organisms can even remain viable on our clothes and footwear for several hours. Washing your hands, changing your clothes, and good hygiene remain <a href="https://www.aafp.org/pubs/afp/issues/2016/1115/p794.html">simple but effective ways</a> of limiting the spread of many infections, especially if you’re regularly in contact with several animals. </p>
<p>Occasionally, diseases can also be passed between species, <a href="https://doi.org/10.1098/rstb.2016.0167">including from animal to human and vice versa</a>. These are called zoonotic diseases and can range from mild infections to more deadly diseases, such as <a href="https://doi.org/10.1146/annurev-virology-100114-055157">rabies</a>. In such cases, more extreme control measures are needed to control the virus – such as quarantining animals. </p>
<p>But if you do have a cold, your pet won’t catch it from you. The viruses that cause colds are specific to humans, though there are dog and cat versions that may cause <a href="https://doi.org/10.1016/j.cvsm.2019.10.009">similar cold symptoms in our canine companions</a> and our <a href="https://www.mdpi.com/1999-4915/13/8/1435">feline friends</a>. The good news is that they also cannot share their cold with us. </p>
<p>Similarly, <a href="https://virologyj.biomedcentral.com/articles/10.1186/s12985-022-01888-x">flu tends to be species-specific</a>, although the influenza virus is good at mutating and occasionally “jumping” the species barrier. While rare, this does mean that there is a theoretical risk of <a href="https://doi.org/10.1111/zph.12723">flu transmission between animals and humans</a>. This why good hygiene and minimising close contact with <a href="https://doi.org/10.1093/bmb/ldz036">other species during outbreaks</a> is a good idea.</p>
<h2>Cold symptoms</h2>
<p>If your dog or cat does contract a cold, the symptoms are very similar to what we experience: sneezing, runny nose, coughing, possibly fever, tiredness and often reduced or lost appetite. </p>
<p>If you think your pet is sick, it’s best to speak to your vet first to ensure you get the correct diagnosis. Your pet may also need specific treatment (such as antibiotics). Never be tempted to treat your pet with human medications, however. Over-the-counter medications that are safe for us can be potentially toxic for our pets. Ibuprofen, for example, is <a href="https://doi.org/10.1016/S0167-5877(98)00051-8">dangerous for dogs</a>.</p>
<figure class="align-center ">
<img alt="A grey cat is laying on a bed wrapped in blankets." src="https://images.theconversation.com/files/501864/original/file-20221219-18-54k1cg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/501864/original/file-20221219-18-54k1cg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/501864/original/file-20221219-18-54k1cg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/501864/original/file-20221219-18-54k1cg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/501864/original/file-20221219-18-54k1cg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/501864/original/file-20221219-18-54k1cg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/501864/original/file-20221219-18-54k1cg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Make sure your pet has a warm, quiet place to rest.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/cat-wrapped-plaid-lying-on-bed-2214544635">VH-studio/ Shutterstock</a></span>
</figcaption>
</figure>
<p>There are many easy things you can do to help your pet when they’re sick. First, make sure they’re warm and comfortable, as this is essential for helping them recover. You can do this by providing extra bedding, or even pet-safe clothing for them. Many older dogs benefit from coats both indoors and out to keep old joints warm. Just make sure to wash or change their bedding regularly, to keep a pleasant environment for them to recover in. This will also help <a href="https://www.mdpi.com/2076-2615/8/4/59">reduce the risk</a> of the infection spreading to other pets in the household.</p>
<p>Rest is important. Make sure your pet has a quiet, safe space – perhaps away from people and other animals. Reducing exercise is also a good idea, especially if your pet has a respiratory infection so you don’t stress their body further. </p>
<p>Make sure fresh, clean drinking water is always available. If the weather is very cold, consider adding some warm water to encourage drinking. This is especially important for pets who live outdoors.</p>
<p>If your dog starts to cough, especially when waking – and might even gag or retch – it’s <a href="https://doi.org/10.1016/j.prevetmed.2003.10.001">possible they’ve picked up kennel cough</a>. This is highly infectious, and a coughing dog should be kept well away from other dogs until the coughing has stopped and they have recovered. This includes not taking a coughing dog into your vet’s waiting room. However, kennel cough cannot spread to other species of pets (such as cats).</p>
<p>For most otherwise healthy pets, seasonal illnesses are mild and self-limiting. Most pets recover quickly – within a few days. But if you’re at all concerned, your pet is very young or old, or suffers from other health conditions, always seek prompt advice from your vet. </p>
<h2>Keeping pets healthy</h2>
<p>There are many things you can do to reduce a pet’s likelihood of becoming ill.</p>
<p>First, keep their <a href="https://www.cambridge.org/core/journals/epidemiology-and-infection/article/use-of-vaccines-and-factors-associated-with-their-uptake-variability-in-dogs-cats-and-rabbits-attending-a-large-sentinel-network-of-veterinary-practices-across-great-britain/F9ED2C4B0E2E6D6C57A3B95C6ED71A5A">vaccinations up to date</a> and ask your vet if there are any local diseases that may be of concern. While vaccinations won’t prevent everything, they will help support your pet’s health and reduce the risk of severe illness.</p>
<p>Keeping pets <a href="https://doi.org/10.1016/j.jcpa.2017.03.006">lean and at a healthy weight</a>, feeding a <a href="https://www.frontiersin.org/articles/10.3389/fvets.2021.748776/full">balanced diet</a> and making sure they always have clean drinking water are also simple, effective measures of supporting pet health. Keeping their sleeping area and <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0259478">food and water bowls clean</a> can also reduce disease risk further. </p>
<p>We might share our homes, lives and sometimes beds with our pets, but fortunately, we don’t need to worry about sharing our seasonal coughs and colds with them.</p><img src="https://counter.theconversation.com/content/196682/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jacqueline Boyd is affiliated with The Kennel Club (UK) through membership, as Chair of the Activities Health and Welfare Subgroup, member of the Dog Health Group and Chair of the Heelwork to Music Working Party. Jacqueline also writes, consults and coaches on canine matters on an independent basis, in addition to her academic role.</span></em></p>There are many things you can do to help your pet when they’re sick.Jacqueline Boyd, Senior Lecturer in Animal Science, Nottingham Trent UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1957882022-12-14T13:13:59Z2022-12-14T13:13:59ZAs viral infections skyrocket, masks are still a tried-and-true way to help keep yourself and others safe<figure><img src="https://images.theconversation.com/files/499681/original/file-20221207-12-ly6akr.jpg?ixlib=rb-1.1.0&rect=147%2C61%2C8032%2C5346&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Masks are an easy and low-cost way to reduce the amount of virus entering the air and spreading to others.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/multiracial-people-in-the-city-wearing-face-mask-royalty-free-image/1369532854?phrase=masks%20&adppopup=true">william87/iStock via Getty Images Plus</a></span></figcaption></figure><p>The cold and flu season of 2022 has begun with a vengeance. Viruses that have been unusually scarce over the past three years are <a href="https://www.cdc.gov/surveillance/nrevss/rsv/index.html">reappearing at remarkably high levels</a>, <a href="https://www.washingtonpost.com/wellness/2022/12/07/face-masks-tripledemic-flu-covid-rsv/">sparking a “tripledemic”</a> of COVID-19, the flu and respiratory syncytial virus, or RSV. This November’s national hospitalization levels for influenza were the <a href="https://www.cdc.gov/flu/weekly/index.htm">highest in 10 years</a>. </p>
<p>We are <a href="https://sph.umich.edu/faculty-profiles/martin-emily.html">infectious disease epidemiologists</a> and <a href="https://sph.umich.edu/faculty-profiles/eisenberg-marisa.html">researchers</a>, and we have spent our careers focused on understanding how viruses spread and how best to stop them. </p>
<p>To respond to the COVID-19 pandemic, we and our public health colleagues have had to quickly revive and apply decades of evidence on respiratory virus transmission to chart a path forward. Over the course of the pandemic, epidemiologists have <a href="https://doi.org/10.1073/pnas.2014564118">established with new certainty</a> the fact that one of our oldest methods for controlling respiratory viruses, the face mask, remains one of the <a href="https://theconversation.com/evidence-shows-that-yes-masks-prevent-covid-19-and-surgical-masks-are-the-way-to-go-167963">most effective tools</a> in a pandemic. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/wg8HmJ0i-H4?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Day care centers, college dorms and public gatherings can promote superspreader events.</span></figcaption>
</figure>
<h2>A slew of circulating viruses</h2>
<p>Unlike the many past waves of COVID-19 since the spring of 2020, this fall’s surge of respiratory disease is not due to a single novel virus. Rather, now that masks and other measures have gone by the wayside, the U.S. has returned to the classic cold and flu season pattern. In a typical year, many viruses cocirculate and cause similar symptoms, leading to a wave of illness that includes ever-shifting combinations of <a href="https://doi.org/10.1093/infdis/jiu327">more than 15 types and subtypes of viruses</a>. </p>
<p>Nowhere is this pattern more obvious than in young children. Our research has shown <a href="https://doi.org/10.1093/infdis/jiy232">that classrooms house many viruses at once</a>, and that individual kids can be infected with <a href="https://doi.org/10.1093/infdis/jis934">two or three viruses</a> even during a single illness. </p>
<p>While mere inconveniences for most people, respiratory viruses like the seasonal flu are responsible <a href="https://doi.org/10.1097/JOM.0000000000001120">for missed work</a> and school. In some cases they can lead to severe illnesses, especially in very young children and older adults. After years of fighting one virus, parents are now exhausted by the reality of battling many, many more.</p>
<p>But there is a straightforward way to cut down on the risk for ourselves and others. When it comes to individual decisions, masks are among the most low-cost and most effective steps that can be taken to broadly reduce transmission of a multitude of viruses. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/XBU8QpnC9Zc?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">As of early December 2022, the Centers for Disease Control and Prevention is now recommending that people wear masks indoors in five New York counties.</span></figcaption>
</figure>
<h2>The latest research</h2>
<p>Long before the COVID-19 pandemic, researchers were studying the effectiveness of masks at reducing transmission of other respiratory viruses. Meta-analyses of viral spread during the <a href="https://doi.org/10.1056/NEJMoa030685">original SARS epidemic in 2002-2003</a> showed that one infection <a href="https://doi.org/10.1136/bmj.39393.510347.BE">was averted for every six people wearing a mask</a>, and for every three people who were <a href="https://www.fda.gov/medical-devices/personal-protective-equipment-infection-control/n95-respirators-surgical-masks-face-masks-and-barrier-face-coverings">wearing an N95 mask</a>. </p>
<p>Mask-wearing by health care workers has long been considered a primary strategy for <a href="https://doi.org/10.1086/313960">protecting young at-risk infants</a> from RSV infection transmitted in hospital settings. Scientific evaluation of the effectiveness of masks has historically been clouded by the fact that mask-wearing is often used in conjunction with other strategies, such as hand-washing. Nonetheless, the use of personal protective equipment, including masks, as well as gowns, gloves and possibly goggles in the health care setting, has been commonly <a href="https://doi.org/10.1111/irv.12379">associated with reduced transmission of RSV</a>. </p>
<p>Similarly, one of the largest pre-COVID-19 randomized studies of mask-wearing, conducted with over a thousand University of Michigan residence hall students in 2006 to 2007, found that symptomatic respiratory illness was reduced among mask-wearers. This was especially true when <a href="https://doi.org/10.1086/650396">masks were combined with hand hygiene</a>. </p>
<p>More recently, researchers measured the amount of virus present in exhaled breath from people with respiratory symptoms to study how well masks blocked the release of virus particles. Those who were randomly selected to wear a mask had lower levels of respiratory shedding for influenza, rhinovirus – which causes the common cold – and non-SARS coronaviruses, <a href="https://doi.org/10.1038/s41591-020-0843-2">than those with no mask</a>.</p>
<p>Now, three years into the pandemic, evidence around masks and our experience using them has grown enormously. Laboratory studies and outbreak investigations have shown that masks <a href="https://doi.org/10.1126/science.abc6197">lower the amount of virus that enters the air</a> and reduce the quantity of viruses <a href="https://doi.org/10.1126/science.abd9149">that enter our airways when we breathe</a>. Recent studies have shown that wearing a surgical mask in an indoor public setting <a href="http://dx.doi.org/10.15585/mmwr.mm7106e1">reduces the odds of testing positive for COVID-19</a> by 66%, and wearing an N95/KN95 type of mask lowers the odds of testing positive by 83%. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/500119/original/file-20221209-34318-dcc7sc.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Chart showing the relative odds of testing positive for COVID-19 depending on mask-wearing and mask type." src="https://images.theconversation.com/files/500119/original/file-20221209-34318-dcc7sc.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/500119/original/file-20221209-34318-dcc7sc.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=337&fit=crop&dpr=1 600w, https://images.theconversation.com/files/500119/original/file-20221209-34318-dcc7sc.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=337&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/500119/original/file-20221209-34318-dcc7sc.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=337&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/500119/original/file-20221209-34318-dcc7sc.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/500119/original/file-20221209-34318-dcc7sc.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/500119/original/file-20221209-34318-dcc7sc.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A study of mask-wearing in public indoor settings found that people who wore surgical masks were 66% less likely to contract COVID-19 than those who wore none.</span>
<span class="attribution"><span class="source">Centers for Disease Control and Prevention</span></span>
</figcaption>
</figure>
<h2>Infections drop when schoolchildren are masked</h2>
<p>Our own research has shown the major impact of mask-wearing on transmission of SARS-CoV-2 – the virus that causes COVID-19 – and other viruses. During the circulation of the <a href="https://theconversation.com/delta-variant-makes-it-even-more-important-to-get-a-covid-19-vaccine-even-if-youve-already-had-the-coronavirus-164203">highly transmissible delta variant</a> in the fall of 2021, we found that schoolwide mask requirements were <a href="https://www.michigan.gov/-/media/Project/Websites/coronavirus/Folder21/20211109_Data_and_modeling_update_vFINAL.pdf?rev=7559c12956754727abe039594f179c25">linked to a reduction in COVID-19 infections</a>. School-age children living in districts without mask requirements were infected at a higher rate that increased faster in the early weeks of the school year than their counterparts in districts with complete or partial mask requirements. Similar patterns occurred in other states coinciding with the <a href="https://doi.org/10.1056/NEJMoa2211029">lifting of school mask requirements</a> in spring 2022.</p>
<p>Our preliminary work in a community with frequent mask-wearing behavior has found that the <a href="https://doi.org/10.1101/2022.12.08.22283268">rate of non-COVID respiratory illness in families fell by 50%</a> during 2020 and 2021 compared with earlier years. In our study, as participants reported the relaxing of mask-wearing and other mitigation behaviors in early 2022, the viruses that are now gripping the U.S. began to return. This resurgence started, curiously enough, with a reappearance of the four “common cold” seasonal coronaviruses.</p>
<figure class="align-center ">
<img alt="A graph showing that COVID-19 infection rates were significantly higher in school districts without mask requirements." src="https://images.theconversation.com/files/500487/original/file-20221212-116135-2cfnvi.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/500487/original/file-20221212-116135-2cfnvi.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=287&fit=crop&dpr=1 600w, https://images.theconversation.com/files/500487/original/file-20221212-116135-2cfnvi.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=287&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/500487/original/file-20221212-116135-2cfnvi.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=287&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/500487/original/file-20221212-116135-2cfnvi.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=361&fit=crop&dpr=1 754w, https://images.theconversation.com/files/500487/original/file-20221212-116135-2cfnvi.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=361&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/500487/original/file-20221212-116135-2cfnvi.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=361&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Michigan school districts without mask requirements experienced higher COVID-19 case rates in fall 2021 during the two months after back-to-school.</span>
<span class="attribution"><span class="source">Michigan.gov Data and Modeling Updates, Eisenberg and Martin Research Groups, University of Michigan, Ann Arbor</span></span>
</figcaption>
</figure>
<p>Unfortunately, vaccines are only available for two of the major causes of respiratory illness: <a href="https://www.cdc.gov/coronavirus/2019-ncov/vaccines/index.html">SARS-CoV-2</a> and <a href="https://www.cdc.gov/flu/prevent/flushot.htm">influenza</a>. Likewise, antiviral treatments are also more commonly available for SARS-CoV-2 and influenza than for RSV. RSV vaccines, which have been in development for many years, are expected to <a href="https://www.path.org/resources/rsv-vaccine-and-mab-snapshot/">become available soon</a>, but not in time to stem the current wave of illness. </p>
<p>In contrast, masks can reduce transmission for all respiratory viruses, with no need to tailor the intervention to the specific virus that is circulating. Masks remain a low-cost, low-tech way to keep people healthier throughout the holiday season so that more of us can be free of illness for the time that we value with our family and friends.</p><img src="https://counter.theconversation.com/content/195788/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Emily Toth Martin receives funding from the National Institutes of Health, the Centers for Disease Control and Prevention, and Flu Lab.</span></em></p><p class="fine-print"><em><span>Marisa Eisenberg receives funding from the National Institutes of Health, National Science Foundation, Michigan Department of Health and Human Services, and the Centers for Disease Control and Prevention. </span></em></p>Decades of research show that respiratory illnesses are dramatically reduced when people wear face masks.Emily Toth Martin, Assistant Professor of Epidemiology, University of MichiganMarisa Eisenberg, Associate Professor of Complex Systems, Epidemiology and Mathematics, University of MichiganLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1904292022-09-29T20:05:08Z2022-09-29T20:05:08ZWhy has my cold dragged on so long? And how do I know when it’s morphed into something more serious?<figure><img src="https://images.theconversation.com/files/483890/original/file-20220912-7256-6grcdr.jpg?ixlib=rb-1.1.0&rect=0%2C9%2C6120%2C4076&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.pexels.com/photo/woman-lying-on-bed-while-blowing-her-nose-3807629/">Photo by Andrea Piacquadio/Pexels</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p>Common colds are caused by viruses. There are no effective cures, and antibiotics do not work on viruses, so treatment is targeted at managing the symptoms until your immune system has cleared the cold.</p>
<p>So why might someone go to a doctor at all for a cold?</p>
<p>Well, occasionally a cold might turn into something more serious requiring assessment and specific treatment, and a GP visit could be warranted. Or you may just want reassurance and advice.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/sore-throats-suck-do-throat-lozenges-help-at-all-184454">Sore throats suck. Do throat lozenges help at all?</a>
</strong>
</em>
</p>
<hr>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/483887/original/file-20220912-54657-jcnlj0.jpg?ixlib=rb-1.1.0&rect=0%2C50%2C6709%2C4416&q=45&auto=format&w=1000&fit=clip"><img alt="A woman blows her nose." src="https://images.theconversation.com/files/483887/original/file-20220912-54657-jcnlj0.jpg?ixlib=rb-1.1.0&rect=0%2C50%2C6709%2C4416&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/483887/original/file-20220912-54657-jcnlj0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/483887/original/file-20220912-54657-jcnlj0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/483887/original/file-20220912-54657-jcnlj0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/483887/original/file-20220912-54657-jcnlj0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/483887/original/file-20220912-54657-jcnlj0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/483887/original/file-20220912-54657-jcnlj0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Occasionally a cold might turn into something more serious requiring assessment and specific treatment.</span>
<span class="attribution"><a class="source" href="https://www.pexels.com/photo/woman-blowing-nose-7195040/">Photo by Karolina Grabowska/Pexels</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<h2>Don’t rush to the GP for something totally normal</h2>
<p>Problems arise when there too many unwarranted visits to GPs for cold symptoms.</p>
<p>Studies have shown <a href="https://www.annfammed.org/content/11/1/5">antibiotics</a> are <a href="https://onlinelibrary.wiley.com/doi/abs/10.5694/mja16.01042">still prescribed widely</a> for viral colds, even though they don’t help, and this contributes to antibiotic resistance. It hastens the arrival of an era when many antibiotics simply don’t work at all.</p>
<p>On average, children have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7152362/">four to six colds</a> per year, while in adults the average is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7152362/">two to three</a>.</p>
<p>Some people are more <a href="https://www.sciencedirect.com/science/article/abs/pii/S1530156705601189?via%3Dihub">prone</a> to colds, but we don’t know exactly why.</p>
<p>The usual cold persists about one week, although 25% last two weeks. In one <a href="https://journals.asm.org/doi/10.1128/jcm.35.11.2864-2868.1997">study</a> with 346 adults, the infection lasted 9.5 to 11 days. </p>
<p>Cold symptoms may last longer in younger children. One <a href="https://publications.aap.org/pediatrics/article-abstract/87/2/129/56810/Upper-Respiratory-Tract-Infections-in-Young?redirectedFrom=fulltext">study</a> showed an average duration of colds ranged from 6.6 to 9 days. But symptoms lasted more than 15 days in 6.5% of 1-3 year old children in home care, and 13.1% of 2-3 year old children in day care.</p>
<p>A cough tends to last longer than other symptoms, and often beyond the actual viral infection. The average <a href="https://www.annfammed.org/content/11/1/5">duration</a> of a cough is about 17.8 days.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/483889/original/file-20220912-54657-4uy5r1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A man coughs into his elbow." src="https://images.theconversation.com/files/483889/original/file-20220912-54657-4uy5r1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/483889/original/file-20220912-54657-4uy5r1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/483889/original/file-20220912-54657-4uy5r1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/483889/original/file-20220912-54657-4uy5r1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/483889/original/file-20220912-54657-4uy5r1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/483889/original/file-20220912-54657-4uy5r1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/483889/original/file-20220912-54657-4uy5r1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A cough tends to last longer than other symptoms.</span>
<span class="attribution"><a class="source" href="https://www.pexels.com/photo/a-sick-man-covering-his-mouth-4031634/">Photo by Edward Jenner/Pexels</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<h2>Discoloured sputum, cough or snot</h2>
<p>Discoloured mucus in snot or cough is a common trigger for requesting antibiotics from a GP. But as we know, antibiotics are useless against a virus. They only work against bacterial infection. </p>
<p>In fact, thick or coloured nasal mucus secretion is common following colds. Only a tiny proportion <a href="https://europepmc.org/article/pmc/pmc7151789">involve</a> bacterial infection.</p>
<p>When it happens, this is termed <a href="https://www.nps.org.au/australian-prescriber/articles/treating-acute-sinusitis-3">acute rhinosinusitis</a>. But antibiotics are not recommended unless it lasts more than ten to 14 days and there are <a href="https://europepmc.org/article/pmc/pmc7151789">signs</a> of bacterial sinusitis infection, such as:</p>
<ul>
<li>symptoms worsening after improvement in the original cold</li>
<li>return of fever and</li>
<li>strong facial pain.</li>
</ul>
<p>A prolonged cough after colds is usually caused by an irritated throat or the clearing of sticky mucus coming down from the nose. The cough may sound moist (so wrongly called “chesty”) due to the phlegm, but only small amounts of phlegm are coughed up. </p>
<p>Yellow or green coloured mucus is often interpreted as a <a href="http://theconversation.com/health-check-what-you-need-to-know-about-mucus-and-phlegm-33192">sign</a> of bacterial infection.</p>
<p>But yellow or green sputum alone <a href="https://www.tandfonline.com/doi/full/10.1080/02813430902759663">does not</a> mean you have a serious bacterial infection. One study found being prescribed antibiotics under these circumstances <a href="https://erj.ersjournals.com/content/38/1/119">failed</a> to shorten recovery time. </p>
<p>Nasal saline sprays and washes can be used to rinse out the nose and sinuses and possibly <a href="https://dtb.bmj.com/content/57/4/56">shorten</a> rhinosinusitis and cough after colds.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/483891/original/file-20220912-68568-ej88qo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/483891/original/file-20220912-68568-ej88qo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/483891/original/file-20220912-68568-ej88qo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=429&fit=crop&dpr=1 600w, https://images.theconversation.com/files/483891/original/file-20220912-68568-ej88qo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=429&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/483891/original/file-20220912-68568-ej88qo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=429&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/483891/original/file-20220912-68568-ej88qo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=539&fit=crop&dpr=1 754w, https://images.theconversation.com/files/483891/original/file-20220912-68568-ej88qo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=539&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/483891/original/file-20220912-68568-ej88qo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=539&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A cold can make you feel rubbish for quite a while.</span>
<span class="attribution"><a class="source" href="https://www.pexels.com/photo/apartment-bed-carpet-chair-269141/">Photo by Pixabay, via Pexels</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<h2>Could it just be hayfever, or another underlying issue?</h2>
<p>Hayfever or allergic rhinitis is a common cause for prolonged symptoms after a cold, especially cough and nasal congestion and maybe also sneezing. </p>
<p>The damage in the upper airways following a viral infection may allow airborne allergens to trigger hayfever. Self-medicating with antihistamines, nasal saline spray or intranasal steroids is worthwhile if <a href="https://theconversation.com/health-check-why-do-i-have-a-cough-and-what-can-i-do-about-it-119172">allergic rhinitis</a> is suspected. </p>
<p>There may be other reasons for persistence of cough, such as exacerbation of underlying asthma or chronic lung disease. If so, this may require a visit to your GP.</p>
<h2>What about bronchitis or pneumonia?</h2>
<p>Many people worry about developing a chest infection after a cold. </p>
<p>Acute bronchitis is a self-limiting infectious disease characterised by acute cough with or without sputum but without <a href="https://www.nhs.uk/conditions/pneumonia/">signs of pneumonia</a> (such as high temperatures and feeling breathless). Most acute bronchitis cases are caused by viruses. Antibiotics are often prescribed, but produce <a href="https://www.tandfonline.com/doi/full/10.1080/14787210.2016.1193435">no significant clinical improvement</a> compared with placebo, so are not recommended.</p>
<p>Pneumonia is a potentially serious secondary disease that <a href="https://pubmed.ncbi.nlm.nih.gov/28159155/">may follow</a> an episode of flu in a small number of cases, but is <a href="https://www.ncbi.nlm.nih.gov/books/NBK532961/">relatively rare</a> following a cold. Symptoms and signs of pneumonia feature heavily in the list of warning signs that signal the need for a medical assessment. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/486977/original/file-20220928-12-fzoana.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A man looks at his phone." src="https://images.theconversation.com/files/486977/original/file-20220928-12-fzoana.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/486977/original/file-20220928-12-fzoana.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/486977/original/file-20220928-12-fzoana.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/486977/original/file-20220928-12-fzoana.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/486977/original/file-20220928-12-fzoana.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/486977/original/file-20220928-12-fzoana.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/486977/original/file-20220928-12-fzoana.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Sometimes, contacting your GP is a good idea.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<h2>When should I seek medical help for a cough or a cold?</h2>
<p>Contact a GP if you experience:</p>
<ul>
<li>shortness of breath or trouble breathing</li>
<li>feeling faint or dizzy</li>
<li>chest pain</li>
<li>dehydration </li>
<li>fever or cough symptoms that improve but then return or worsen</li>
<li>worsening of chronic medical conditions such as asthma.</li>
</ul>
<p>This is not a complete list, but may guide you on what to expect and what to watch out for. </p>
<p>You might also contact your GP (perhaps for a telehealth consult) if you are finding your symptoms very unpleasant, or are concerned your condition is more serious or prolonged than expected. You might just need reassurance and education about self care options.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/forget-nose-spray-good-sex-clears-a-stuffy-nose-just-as-effectively-and-is-a-lot-more-fun-167901">Forget nose spray, good sex clears a stuffy nose just as effectively — and is a lot more fun</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/190429/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>David King does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Problems arise when there are too many unwarranted visits to GPs for cold symptoms. Occasionally, though, a cold might turn into something that needs specific diagnosis and treatment.David King, Senior Lecturer in General Practice, The University of QueenslandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1889322022-08-19T05:10:24Z2022-08-19T05:10:24ZSummer colds: this may explain why so many have suffered them this year<figure><img src="https://images.theconversation.com/files/479883/original/file-20220818-639-d99p6k.jpg?ixlib=rb-1.1.0&rect=51%2C8%2C5760%2C3819&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Enteroviruses and parainfluenza 3 virus are more common in summer.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/picture-beautiful-women-bikini-handkerchief-sick-676784800">Estrada Anton/ Shutterstock</a></span></figcaption></figure><p>Most of us associate colds and the flu with colder weather. But that doesn’t mean you can’t still catch a cold during the summer. Some viruses are even more common in summer than in the winter. </p>
<p>The flu virus and respiratory syncytial virus (RSV) are <a href="https://www.annualreviews.org/doi/10.1146/annurev-virology-012420-022445">more common in the winter months</a>, as the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4097773/">colder temperatures</a> and more time spent indoors around other people provide them with favourable conditions to spread.</p>
<p>But in the summer, enteroviruses and parainfluenza 3 virus are <a href="https://www.annualreviews.org/doi/10.1146/annurev-virology-012420-022445">much more common</a>, with infections from these viruses tending to peak in <a href="http://dx.doi.org/10.15585/mmwr.mm6718a2">summer and early autumn</a> when the weather is <a href="https://link.springer.com/article/10.1007/s00705-013-1863-8">warmer</a> and <a href="https://www.sciencedirect.com/science/article/pii/S1386653216305509">more humid</a>.</p>
<p>Both viruses cause typical cold symptoms, including a runny nose, low energy, muscle aches, cough, headaches and sore throat. Parainfluenza can sometimes cause <a href="https://www.cdc.gov/parainfluenza/about/index.html">bronchitis and pneumonia</a> in people who have a poorly functioning immune system. While these symptoms are similar to allergies, the telltale difference is that <a href="https://www.mayoclinic.org/diseases-conditions/common-cold/expert-answers/common-cold/faq-20057857">allergies tend not to cause</a> fevers or body aches, and rarely cause coughs. Colds last from a few days to two weeks, but, depending on what triggered the allergy, allergy symptoms can last all summer for some people.</p>
<p>It seems counter-intuitive that certain viral infections are more common in warmer months when we spend more time outdoors. But in the warmer months, we also socialise and travel more – meaning we’re mixing with a greater number of people, sometimes from different parts of the world. Many of us also gravitate towards air-conditioned indoor environments when the weather is hot.</p>
<p>But the structure of a virus may also explain why some spread more easily in the warmer months.</p>
<p>For a virus to spread and infect healthy cells, it needs to survive both outside and inside the body – and it also needs to use the machinery of human cells (such as their DNA) to create copies of itself.</p>
<p>Viruses are surrounded by a protein “coat”, called a capsid, which not only gives the virus its shape but also protects the genetic material inside. The capsid also helps the virus attach to human cells to cause infections.</p>
<figure class="align-center ">
<img alt="A digital illustration of enteroviruses." src="https://images.theconversation.com/files/479884/original/file-20220818-1579-tnodgw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/479884/original/file-20220818-1579-tnodgw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/479884/original/file-20220818-1579-tnodgw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/479884/original/file-20220818-1579-tnodgw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/479884/original/file-20220818-1579-tnodgw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/479884/original/file-20220818-1579-tnodgw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/479884/original/file-20220818-1579-tnodgw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Enteroviruses don’t have an envelope.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-illustration/illustration-enterovirus-d68-which-causes-respiratory-346238837">Kateryna Kon/ Shutterstock</a></span>
</figcaption>
</figure>
<p>Some viruses (called “enveloped viruses”) are also surrounded by a lipid (fatty acid) envelope. This viral envelope helps the virus to avoid being destroyed by the immune system. It also plays a role in interacting with human cells to cause infection. </p>
<p>Many “winter” viruses (including influenza and RSV) are enveloped viruses. Enveloped viruses tend to be <a href="https://www.nature.com/articles/s41598-018-37481-y">more vulnerable to heat and dryness</a> than viruses that lack envelopes. This is one of the reasons why it’s thought that these winter cold viruses survive best in colder winter environments. </p>
<p>While some summer colds (such as enteroviruses) lack an envelope, others (parainfluenza virus 3) have an envelope. In fact, parainfluenza virus 3 is more common when <a href="https://www.nature.com/articles/s41598-018-37481-y">temperatures are high and humidity is low</a> (though it can survive in a range of different humidities). This suggests that other parts of a virus’s structure, aside from the envelope, may play some role in what conditions it can best survive and spread in – but more research will be needed to better understand this.</p>
<p>The interplay between temperature and the immune response to a virus may also play a role. One study found that mice exposed to <a href="https://www.pnas.org/doi/10.1073/pnas.1815029116%23:%7E:text=Here%252C%2520we%2520demonstrated%2520that%2520exposure,responses%2520to%2520influenza%2520virus%2520infection">temperatures of 36°C</a> have a diminished immune response against the flu virus. However, more research is needed to confirm this finding in humans.</p>
<h2>Immune response</h2>
<p>Many people have reported suffering from summer colds this year, leaving many to wonder why this is the case and if the pandemic has played a role.</p>
<p>Immunity to common cold viruses is short-lived. So each season, when we are exposed to new variants, our immune system has to adapt. But during the pandemic, various lockdown measures, such as distancing and wearing masks, limited the exposure that many people had to these viruses. </p>
<p>When we gathered again after lockdown, <a href="https://theconversation.com/qanda-is-the-common-cold-really-much-worse-this-year-170338">cold viruses began to circulate</a>, but our immunity had not been boosted by exposure to that virus the previous year. While the predictability of seasonal viruses has changed since the emergence of COVID, the increases in summer colds seen this year are probably due to us travelling more, more social mixing, less mask wearing and distancing, and less exposure to respiratory viruses the previous year.</p>
<p>This year many parts of the world have also seen extremely hot temperatures and a spate of heatwaves. These temperatures and humidity fluctuations may have played a role in the transmission of common cold viruses this year. These factors will also become even more relevant in the future and may even change what time of year we see certain viruses. Climate change may further <a href="https://camilo-mora.github.io/Diseases/">worsen the spread</a> of <a href="https://www.nature.com/articles/s41558-022-01426-1">viruses in the future</a>.</p>
<p>Since there’s no vaccine for summer colds, the best thing you can do to avoid getting one is to stay away from people who are sick (if possible), wash your hands and avoid touching your face. If you’re unlucky enough to have gotten one, the advice for getting over a cold is the same as it would be if you caught one in the winter: drink plenty of fluids, get lots of rest and eat nutritious foods. To protect others, coughing or sneezing into your elbow or tissues is also recommended.</p>
<p>It may also be worthwhile thinking about how you can protect yourself from getting sick as the temperatures cool in the coming months. The flu vaccine is recommended each winter for certain people, so it’s wise to check if you are due for a flu vaccine this year. This year the flu has been particularly bad for Australia, and predictions suggest it will <a href="https://www1.health.gov.au/internet/main/publishing.nsf/Content/cda-surveil-ozflu-flucurr.htm/$File/flu-09-2022.pdf">be the same</a> for many parts of the world this winter.</p><img src="https://counter.theconversation.com/content/188932/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Fidelma Fitzpatrick does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Some viruses even tend to be more common in the summer than in the winter.Fidelma Fitzpatrick, Consultant Microbiologist, Beaumont Hospital, Dublin, Ireland and Head of Department, Clinical Microbiology, RCSI University of Medicine and Health SciencesLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1844542022-07-14T04:53:28Z2022-07-14T04:53:28ZSore throats suck. Do throat lozenges help at all?<figure><img src="https://images.theconversation.com/files/473778/original/file-20220713-24-cq702n.jpg?ixlib=rb-1.1.0&rect=32%2C40%2C5431%2C3596&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://image.shutterstock.com/image-photo/cough-drops-on-white-background-600w-637019440.jpg">Shutterstock</a></span></figcaption></figure><p>It’s hard to get through a winter without suffering sore throat, but luckily they normally get better within a <a href="https://www.safetyandquality.gov.au/sites/default/files/migrated/Patient-Decision-Aid-Sore-Throat-Nov-2016.pdf">few days</a>. </p>
<p>Sore throat is a common symptom of COVID and its <a href="https://www.bmj.com/content/377/bmj.o922#:%7E:text=The%20large%20community%20cohort%20study,infected%20with%20the%20delta%20variant.">newer variants</a>. And of course, many sore throats are caused by viral colds or flu, so they can be treated at home. </p>
<p>The most common treatment is probably throat lozenges – but do they really work any better than sucking on a hard lolly?</p>
<h2>Why does my throat hurt so much?</h2>
<p>A sore throat can fall anywhere between slight discomfort to a sensation of “swallowing razor blades”. Occasionally it hurts so much to swallow that people dribble saliva from their mouths, rather than swallowing it. </p>
<p>Bacteria and viruses can invade the thin moist skin (mucosa) lining the throat. This kills many lining cells and triggers <a href="https://www.ncbi.nlm.nih.gov/books/NBK519550/">inflammation</a>, which appears as redness, swelling and increased secretions.</p>
<p>Infections in the nose also cause thick mucus to travel down the back of the throat and cause further irritation. This is referred to as “post-nasal drip”. A blocked nose causes reliance on mouth breathing, which tends to dehydrate the already inflamed throat. Ouch. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/473775/original/file-20220713-20-prkevj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="woman lies sick in bed with remedies and medications at bedside" src="https://images.theconversation.com/files/473775/original/file-20220713-20-prkevj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/473775/original/file-20220713-20-prkevj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/473775/original/file-20220713-20-prkevj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/473775/original/file-20220713-20-prkevj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/473775/original/file-20220713-20-prkevj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/473775/original/file-20220713-20-prkevj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/473775/original/file-20220713-20-prkevj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Post nasal drip can be one cause of a dry, sore throat.</span>
<span class="attribution"><a class="source" href="https://image.shutterstock.com/image-photo/medicament-cup-tea-lemon-foreground-600w-649599124.jpg">Shutterstock</a></span>
</figcaption>
</figure>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/when-rat-testing-for-covid-should-you-also-swab-your-throat-184732">When RAT-testing for COVID, should you also swab your throat?</a>
</strong>
</em>
</p>
<hr>
<h2>What do lozenges do?</h2>
<p>Lozenges are a solid medication intended to be dissolved or disintegrated slowly in the mouth. They consist of one or more active ingredients and are flavoured and sweetened to make them pleasant tasting. Hard <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/lozenge">lozenges</a> are generally formed using sucrose or other sugars similar to the process for hard candy confections.</p>
<p>There are many active ingredients added to lozenges, including antiseptics; pain relievers; menthol and eucalyptus oil; cough suppressants such as <a href="https://medlineplus.gov/druginfo/meds/a682492.html">dextromethorphan</a> and soothing compounds. “Cough drops” and sore throat lozenges are <a href="https://quantumhealth.com/blog/post/throat-lozenges-vs-cough-drops">almost identical</a> but may contain different proportions of these ingredients.</p>
<p>Different brands of lozenges advertise a confusing choice of formulations. It is more common now to see brands with “triple action” ingredients that promise to be anaesthetic (to numb pain), antiseptic (to kill germs) and anti-inflammatory (to reduce redness). </p>
<p>Unfortunately, clinical trials directly comparing the benefit of different medication types for most common conditions (head to head trials) are rarely undertaken. This is likely due to the added complexity of such trials compared with placebo controlled trials, and medication research often being <a href="https://doi.org/10.1016/j.jclinepi.2014.12.016">funded by the pharmaceutical manufacturer</a> of the products. So, we have to rely on indirect comparisons instead. </p>
<p>The traditional approach to treating sore throat is to assume lozenges or gargling with antiseptics will reduce sore throat by treating the infection causing it. </p>
<p>However, a limited number of trials of antiseptic lozenges (such as Strepsils and Betadine lozenges) produced only a <a href="https://doi.org/10.1186/1471-2296-12-6">small reduction</a> in sore throat pain (a difference of one unit in a ten-point pain scale compared with placebo). So they do seem to provide <a href="https://www.compoundchem.com/2015/04/02/throat-lozenges/">a small degree of relief</a>, and continue to be sold. </p>
<p>More and more brands are including other medications beyond antiseptics in their range of throat lozenges</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/473779/original/file-20220713-22-7p7h1u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="woman gestures to sore throat." src="https://images.theconversation.com/files/473779/original/file-20220713-22-7p7h1u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/473779/original/file-20220713-22-7p7h1u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/473779/original/file-20220713-22-7p7h1u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/473779/original/file-20220713-22-7p7h1u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/473779/original/file-20220713-22-7p7h1u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/473779/original/file-20220713-22-7p7h1u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/473779/original/file-20220713-22-7p7h1u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A sore throat can make swallowing painful.</span>
<span class="attribution"><a class="source" href="https://image.shutterstock.com/image-photo/asian-woman-having-sore-throat-600w-2105319332.jpg">Shutterstock</a></span>
</figcaption>
</figure>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-do-cough-medicines-work-62425">Health Check: do cough medicines work?</a>
</strong>
</em>
</p>
<hr>
<h2>Checking the effects</h2>
<p>There are some other explanations for the apparent effectiveness of any treatment for a self-limiting infection. How do we know if the symptom or infection would have lasted longer if we hadn’t used that treatment? To tell, we’d need a control group who didn’t receive the treatment, and a large sample size to overcome the role of chance causing the difference.</p>
<p>Relief might come from something other than the active ingredient. After all, sucking on a sweet, hard lozenge could soothe a dry throat by increasing saliva release. To test this effect, we’d need a true placebo medication – identical in every respect apart from the active ingredient.</p>
<p>Several well-designed and well-conducted controlled clinical trials show some active ingredients provide significantly better pain relief than placebo lozenges. These medications fall into two main groups: local anaesthetics (such as benzocaine) and anti-inflammatory agents (flurbiprofen).</p>
<p>A <a href="https://doi.org/10.1007/s00405-011-1802-9">study</a> comparing benzocaine lozenges, (now offered in many brands of lozenges) to placebo lozenges found quicker pain relief (20 minutes for benzocaine compared to more than 45 minutes for the placebo). More study participants felt relief using the medication, though very few reported complete pain relief. </p>
<p>A systematic <a href="https://pubmed.ncbi.nlm.nih.gov/31920372/">research review</a> found nine studies that supported the benefit of flurbiprofen lozenges (available in Australia in Strepfen Intensive lozenges) for a range of sore throat conditions. In <a href="https://doi.org/10.2217/pmt-2015-0001">one of the reviewed studies</a>, flurbiprofen produced greater reductions in sore throat pain (47%) as well as difficulty swallowing (66%) and swollen throat (40%) over the first 24 hours compared with placebo. </p>
<p>One of the common sore throat treatments sold in Australia is Difflam, which contains the anti-inflammatory medication benzydamine. One <a href="https://www.academia.edu/16837321/Effects_of_chlorhexidine_benzydamine_mouth_spray_on_pain_and_quality_of_life_in_acute_viral_pharyngitis_a_prospective_randomized_double_blind_placebo_controlled_multicenter_study">clinical trial</a> found a greater than two point reduction in the ten point pain scale by day three in those using benzydamine versus placebo.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/473785/original/file-20220713-16-wobs8o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="young person sprays throat" src="https://images.theconversation.com/files/473785/original/file-20220713-16-wobs8o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/473785/original/file-20220713-16-wobs8o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/473785/original/file-20220713-16-wobs8o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/473785/original/file-20220713-16-wobs8o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/473785/original/file-20220713-16-wobs8o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/473785/original/file-20220713-16-wobs8o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/473785/original/file-20220713-16-wobs8o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Some people prefer throat sprays.</span>
<span class="attribution"><a class="source" href="https://image.shutterstock.com/image-photo/teenage-girl-schoolgirl-student-warm-600w-2106634292.jpg">Shutterstock</a></span>
</figcaption>
</figure>
<h2>Are lozenges better than sore throat sprays?</h2>
<p>A <a href="https://pubmed.ncbi.nlm.nih.gov/19222617/">study</a> using radioactive labelled medication demonstrated more prolonged and complete delivery of medication in the mouth for lozenges compared to spray and gargle. This seems to be the basis for the claim that sprays are less effective than lozenges. </p>
<p>However, drawing conclusions from such evidence is less accurate than a study that directly compares the effectiveness of the various modes of delivery on actual pain. One <a href="https://pubmed.ncbi.nlm.nih.gov/28740426/">study</a> compared flurbiprofen and found similar pain relief benefit between lozenges and spray. </p>
<p>So the choice of delivery method can be based on personal preference, including the taste of the product.</p>
<h2>The takeaway</h2>
<p>Sore throat lozenges and sprays provide some additional relief for the pain of sore throat, particularly those with anti-inflammatory or local anaesthetic ingredients. They are often combined with an antiseptic agent, which may or may not add any significant benefit. </p>
<p>Used as directed, these agents seem safe and have negligible adverse effects. They are also affordable and readily available. </p>
<p>But this shouldn’t stop us using other treatments we know also soothe sore throats, such as a small <a href="https://www.researchgate.net/publication/312104274_Role_of_honey_as_adjuvant_therapy_in_patients_with_sore_throat">spoonful of honey</a>. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-to-actually-fix-a-lost-voice-according-to-science-hint-lemon-and-honey-doesnt-work-158230">How to actually fix a lost voice, according to science (hint: lemon and honey doesn't work)</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/184454/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>David King does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Some lozenges are more effective than others at soothing a sore throat.David King, Senior Lecturer in General Practice, The University of QueenslandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1731342022-02-01T13:14:34Z2022-02-01T13:14:34ZWhy taking fever-reducing meds and drinking fluids may not be the best way to treat flu and fever<figure><img src="https://images.theconversation.com/files/439010/original/file-20211226-36920-246w3v.jpg?ixlib=rb-1.1.0&rect=7%2C0%2C5128%2C3426&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Using fever reducers or drinking too much fluid while battling the flu may upset the body's delicate balancing act. </span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/sick-woman-taking-her-temperature-royalty-free-image/88689538?adppopup=true">Sam Edwards/OJO Images via Getty Images</a></span></figcaption></figure><p>As flu season progresses, so does the <a href="https://www.cdc.gov/flu/prevent/index.html">chorus of advice</a>, professional and otherwise, to drink plenty of fluids and take fever-reducing medications, like acetaminophen, ibuprofen or aspirin. </p>
<p>These recommendations, <a href="https://doi.org/10.1001/archpedi.1982.03970470017003">well-intentioned and firmly entrenched</a>, offer comfort to those sidelined with fever, flu or vaccine side effects. But you may be surprised to learn the science supporting these recommendations is speculative at best, harmful at worst and comes with caveats. </p>
<p><a href="https://education.wayne.edu/profile/gr7894">I am an exercise physiologist</a> who specializes in studying how the body regulates fluids and temperature. And based on a wide body of evidence, I can tell you that increased fluid intake and taking fever reducers, whether aspirin, acetaminophen or ibuprofen, may not always help in your recovery. In fact, in some cases, it could be harmful.</p>
<p>There’s a reason why people say fevers should be lowered when sick or after a vaccine. Both aspirin and acetaminophen, such as Tylenol, <a href="https://doi.org/10.1016/j.clinthera.2005.06.002">reduce fever, headaches and muscle aches</a>. But at the same time, <a href="https://doi.org/10.1093/infdis/162.6.1277">seminal</a> and <a href="https://doi.org/10.1098/rspb.2013.2570">newer studies</a>, including broad meta-analysis studies, show that <a href="https://doi.org/10.1258/jrsm.2010.090441">these medications</a> may weaken the immune response to infection or <a href="https://doi.org/10.1001/archinte.160.4.449">have unwanted side effects</a>.</p>
<h2>What is a fever?</h2>
<p>First, some background: Fevers are a regulated increase in core body temperature as a response to unwanted microbial invaders.
The more <a href="https://doi.org/10.1016/j.amjms.2021.01.004">severe the infection, the higher the fever</a>. </p>
<p>Having a fever is not all bad; it’s how the body has evolved to recuperate from an infection. For many species, <a href="https://www.racgp.org.au/afp/2015/januaryfebruary/a-is-for-aphorisms/">fevers are advantageous</a> and beneficial for survival. </p>
<p>But fever comes with a cost. A body temperature that’s too high can be deadly. For every increase of 1.8 degrees Fahrenheit, metabolism goes up 10%; the body begins to burn more calories than normal, temperature continues to rise and the <a href="https://doi.org/10.1111/j.1749-6632.2000.tb05376.x">body releases hormones</a> to keep fever under control. </p>
<p>Many studies demonstrate what can happen when fever reducers are thrust into this complex dance. It turns out aspirin or acetaminophen may cause infected people to feel better, but they also spread more virus while suppressing their own immune response to the infection. </p>
<p>In one double-blind, placebo-controlled study, healthy people infected with a cold virus <a href="https://doi.org/10.1093/infdis/162.6.1277">who took aspirin or acetaminophen</a> for a week had a reduced immune response and an increase in viral shedding – meaning producing and expelling virus particles from the nose. Another study showed that taking aspirin effectively reduced fever symptoms but <a href="https://doi.org/10.1001/jama.1975.03240240018017">increased shedding</a>.</p>
<p>Although some of those traditional studies took place decades ago, their results still hold up today. A recent study warned that if everyone took fever suppressants, there would be even <a href="https://doi.org/10.1098/rspb.2013.2570">more flu cases and flu-related deaths</a>. Furthermore, elevated body temperature – or fever – can help fight COVID-19 by reducing the <a href="https://doi.org/10.1371/journal.%20pbio.3001065">growth of the virus within the lungs</a>. In other words, fevers can help the body fight viruses while reducing the rate of death and disease.</p>
<h2>Drinking fluids</h2>
<p>To prevent dehydration, the Centers for Disease Control and Prevention recommends drinking more fluids when one <a href="https://www.cdc.gov/flu/pdf/freeresources/general/influenza_flu_homecare_guide.pdf?web=1&wdLOR=c20031A15-D755-4A4D-B1B2-40CE51B88D3A">has a fever or infection</a>, or has received <a href="https://www.cdc.gov/coronavirus/2019-ncov/vaccines/expect/after.html#relieve_side_effects">a COVID-19 vaccine</a>. But there is <a href="https://www.washingtonpost.com/lifestyle/2021/11/05/what-do-doctors-mean-when-they-say-drink-plenty-fluids/">scant scientific evidence</a> to support this recommendation. </p>
<figure class="align-center ">
<img alt="A teenage girl with flu drinks a glass of water." src="https://images.theconversation.com/files/439558/original/file-20220105-23-18gcely.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/439558/original/file-20220105-23-18gcely.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/439558/original/file-20220105-23-18gcely.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/439558/original/file-20220105-23-18gcely.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/439558/original/file-20220105-23-18gcely.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/439558/original/file-20220105-23-18gcely.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/439558/original/file-20220105-23-18gcely.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Drinking fluids to excess can lead to overhydration.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/teenager-drinks-water-from-a-glass-indoors-royalty-free-image/1314353664?adppopup=true">Dina Morozova/iStock via Getty Images Plus</a></span>
</figcaption>
</figure>
<p>It’s true that drinking fluids when dehydrated is <a href="https://doi.org/10.1001/archinte.1919.00090240119009">necessary to reduce fever</a>. But not everyone with a fever is dehydrated. For those who aren’t thirsty, forcing fluids <a href="https://doi.org/10.1073/pnas.1403382111">beyond thirst</a>, which is often unpleasant, may not be advisable. </p>
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<p>A study <a href="https://doi.org/10.1002/14651858.CD004419.pub3">that evaluated the advice</a> to “drink plenty of fluids” determined that increasing fluid intake when sick may not offer benefits, and that more high-quality studies are needed. Indeed, there was a potential <a href="https://www.webmd.com/diet/what-is-too-much-water-intake#1">risk from overhydration</a>. For some people, three liters, or about 12 eight-ounce glasses, is too much. Overhydration can cause nausea and vomiting, headaches and cramps; in severe cases, <a href="http://dx.doi.org/10.1136/bcr-2016-216882">excessive fluid intake</a> can cause seizures or coma. </p>
<p>Here’s why this happens. To stop dangerous escalations in fever, the body releases antidiuretic hormones. Urination is diminished, so <a href="https://doi.org/10.2165/11532070-000000000-00000">the body retains water</a> through the actions of the kidneys. So if someone with a fever drinks more water than necessary, water intoxication – or hyponatremia, a potentially fatal medical condition in which a patient’s blood sodium levels are too low – could follow. </p>
<p>One study found that nearly a quarter of patients who came to the hospital with COVID-19 had <a href="https://doi.org/10.1210/clinem/dgab107">hyponatremia upon admission</a>. In that study, hyponatremia increased the need for breathing support in the form of ventilation. And another study showed that the condition can lead to <a href="https://doi.org/10.1007/s40618-020-01301-w">poorer outcomes in COVID-19 patients</a>.</p>
<p>So maybe it’s time to rethink the conventional wisdom. If the fever is mild or moderate, stay warm, even use blankets, rather than try to actively reduce it. Rest, so your body can fight the fever. Conserve energy because your metabolism is already on overdrive. Use fever-reducing medications sparingly. Drink fluids, but only to tolerance, and preferably when thirsty.</p>
<p>And one final suggestion that should be soothing: When fighting a fever or vaccine side effects, consider sipping warm liquids that contain sodium. Broths containing sodium, like bullion, <a href="https://doi.org/10.1097/JSM.0000000000000221">may help avoid hyponatremia</a>. And although the actual scientific evidence is sparse and conflicting, <a href="https://doi.org/10.1016/j.chest.2020.06.062">chicken soup</a> may be a better antidote than water when fending off a fever or flu symptoms.</p><img src="https://counter.theconversation.com/content/173134/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tamara Hew-Butler does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>In some cases, fever reducers and extra fluid intake can weaken the body’s response to infection.Tamara Hew-Butler, Associate Professor of Exercise and Sports Science, Wayne State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1519102020-12-15T20:16:45Z2020-12-15T20:16:45ZWill going out in the cold give you a cold?<figure><img src="https://images.theconversation.com/files/374912/original/file-20201214-13-t6d99c.jpg?ixlib=rb-1.1.0&rect=33%2C0%2C5573%2C3732&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Viruses spread easier during the winter than other times of the year, but being outside isn't the main cause of transmission.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/man-shovels-the-sidewalk-outside-of-his-suburban-royalty-free-image/564190027?adppopup=true">Christopher Kimmel via Getty Images</a></span></figcaption></figure><p>Many of us have heard: “Don’t go outside without a coat; you’ll catch a cold.” </p>
<p>That’s not exactly true. As with many things, the reality is more complicated. Here’s the distinction: Being cold isn’t why you get a cold. But it is true that cold weather makes it easier to get the cold or flu. It is still too early to tell how weather impacts the COVID-19 virus, but scientists are starting to think it behaves differently than cold and flu viruses.</p>
<p>As an <a href="https://www.purdue.edu/aging/faculty/?id=256">associate professor of nursing</a> with a background in public health, I’m asked about this all the time. So here’s a look at what actually happens. </p>
<p>Many viruses, including <a href="https://doi.org/10.1073/pnas.1411030112">rhinovirus</a> – the usual culprit in the common cold – and influenza, remain infectious longer and replicate faster in colder temperatures. That’s why these viruses spread more easily in winter. Wearing a heavy coat won’t necessarily make a difference. </p>
<figure class="align-center ">
<img alt="Two women outside during the winter." src="https://images.theconversation.com/files/374894/original/file-20201214-24-1f7enxs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/374894/original/file-20201214-24-1f7enxs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/374894/original/file-20201214-24-1f7enxs.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/374894/original/file-20201214-24-1f7enxs.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/374894/original/file-20201214-24-1f7enxs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/374894/original/file-20201214-24-1f7enxs.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/374894/original/file-20201214-24-1f7enxs.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The cold weather does have an impact on whether or not you catch a cold.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/two-women-take-a-selfie-photo-in-front-of-a-frozen-fountain-news-photo/899344332?adppopup=true">Spencer Platt via Getty Images</a></span>
</figcaption>
</figure>
<h2>Virus transmission is easier when it’s cold</h2>
<p>More specifically, cold weather can <a href="https://www.nih.gov/news-events/nih-research-matters/flu-virus-fortified-colder-weather">change the outer membrane</a> of the influenza virus; it makes the membrane more solid and rubbery. Scientists believe that the rubbery coating makes person-to-person transmission of the virus easier. </p>
<p>It’s not just cold winter air that causes a problem. Air that is dry in addition to cold has been linked to flu outbreaks. A National Institutes of Health study suggests that <a href="https://www.nih.gov/news-events/nih-research-matters/dry-air-may-spur-flu-outbreaks">dry winter air</a> further helps the influenza virus to remain infectious longer. </p>
<p>How your immune system responds during cold weather also matters a great deal. <a href="https://doi.org/10.1038/nature.2013.13025">Inhaling cold air</a> may adversely affect the immune response in your respiratory tract, which makes it easier for viruses to take hold. That’s why wearing a scarf over your nose and mouth may help. </p>
<p>Also, most people get less sunlight in the winter. That is a problem because the <a href="https://theconversation.com/why-you-need-more-vitamin-d-in-the-winter-128898">Sun is a major source of vitamin D</a>, which is essential <a href="https://doi.org/10.1016/j.mayocp.2013.05.011">for immune system health</a>. Physical activity, another factor, also tends to drop <a href="https://doi.org/10.1007/s10238-020-00650-3">during the winter</a>. People are <a href="https://doi.org/10.1016/j.jshs.2016.07.007">three times more likely</a> to delay exercise in snowy or icy conditions.</p>
<p>Instead, people spend more time indoors. That usually means more close contact with others, which leads to disease spread. Respiratory viruses generally spread within a six-foot radius of an infected person. When you are indoors, it is very likely that you are closer together than six feet. </p>
<p>In addition, cold weather <a href="https://www.texashealthflowermound.com/how-cold-weather-affects-your-ear-nose-throat/">dries out</a> your eyes and the mucous membranes in your nose and throat. Because viruses that cause colds and flu are typically inhaled, the virus can attach more easily to these impaired, dried-out passages.</p>
<figure class="align-center ">
<img alt="A child in bed with a cold." src="https://images.theconversation.com/files/374909/original/file-20201214-19-eqxul0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/374909/original/file-20201214-19-eqxul0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/374909/original/file-20201214-19-eqxul0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/374909/original/file-20201214-19-eqxul0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/374909/original/file-20201214-19-eqxul0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/374909/original/file-20201214-19-eqxul0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/374909/original/file-20201214-19-eqxul0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Spending more time indoors can increase the chances of catching a cold.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/girl-sleeping-with-sickness-on-the-bed-royalty-free-image/926062370?adppopup=true">Rawpixel via Getty Images</a></span>
</figcaption>
</figure>
<h2>What you can do</h2>
<p>While the bottom line is that being wet and cold doesn’t make you sick, there are strategies to help prevent illness all year long. </p>
<ul>
<li><p>Wash your hands often. </p></li>
<li><p>Avoid touching your face, something people do <a href="https://theconversation.com/how-to-stop-touching-your-face-to-minimize-spread-of-coronavirus-and-other-germs-133683">between nine and 23 times an hour</a>. </p></li>
<li><p>Stay hydrated; <a href="https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/water/art-20044256">eight glasses a day</a> of water is a good goal, but that could be more or less depending on lifestyle and the size of the person. </p></li>
<li><p>Eat a well-balanced diet. Dark green, leafy vegetables are rich in immune system-supporting vitamins; eggs, fortified milk, salmon and tuna have vitamin D. </p></li>
<li><p>Stay physically active, even during the winter. </p></li>
<li><p>Clean the hard, high-touch surfaces in your home often. </p></li>
<li><p>If your nose or throat gets dry in the winter, consider using a humidifier.</p></li>
<li><p>Get the flu vaccine. </p></li>
</ul>
<p>And one more important thing this year: When it’s your turn, make sure you get the COVID-19 vaccine.</p>
<p>[<em><a href="https://theconversation.com/us/newsletters/science-editors-picks-71/?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=science-corona-important">The Conversation’s most important coronavirus headlines, weekly in a new science newsletter</a>.</em>]</p><img src="https://counter.theconversation.com/content/151910/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Libby Richards does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Going out in the cold won’t necessarily lead to you getting a cold. But cold weather in general is more hospitable to viruses, so it’s wise to take steps to keep your immune system strong.Libby Richards, Associate Professor of Nursing, Purdue UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1396572020-07-27T20:01:03Z2020-07-27T20:01:03ZSniffles, sneezing and cough? How to tell if it’s a simple allergy rather than The Virus<figure><img src="https://images.theconversation.com/files/344984/original/file-20200701-108321-15zcosh.jpg?ixlib=rb-1.1.0&rect=0%2C14%2C1000%2C651&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/sick-young-woman-sitting-indoors-holding-1354368317">Shutterstock</a></span></figcaption></figure><p>We’re told to stay home if we feel unwell during the COVID-19 pandemic. But what if your sniffles, sore throat or cough aren’t infectious? What if they’re caused by hayfever or another allergic reaction? You may be doing a lot more isolating than you need to. </p>
<p>Although it can sometimes be challenging, there are ways to tell apart respiratory symptoms caused by a virus and those caused by an allergy. This approach may help prevent Australia’s COVID-19 testing capacity from being overwhelmed.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-whats-the-right-way-to-blow-your-nose-74977">Health Check: what's the right way to blow your nose?</a>
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<h2>What causes hayfever?</h2>
<p>Around <a href="https://www.nps.org.au/consumers/managing-hay-fever#what-is-hay-fever?">one in five</a> (21%) of Australians suffer seasonal allergic rhinitis – more commonly known as hayfever. If each of these experiences a few episodes of hayfever annually, that would require between 10 million and 20 million COVID-19 tests to exclude infectious causes from allergies alone. </p>
<p>Hayfever has many of the same symptoms as viral respiratory infections, such as colds and mild flu-like illnesses, as well as COVID-19. This is because rhinitis refers to inflammation of the nose, which has many causes.</p>
<p>Hayfever is <a href="https://www.allergy.org.au/patients/fast-facts/hay-fever-allergic-rhinitis">caused by</a> your nose and/or eyes coming into contact with microscopic allergens in the environment, such as pollens (from grasses, weeds or trees), dust mites, moulds and animal hair. </p>
<p>Your immune system <a href="https://www.mayoclinic.org/diseases-conditions/hay-fever/symptoms-causes/syc-20373039?p=1">identifies</a> these airborne substances as harmful and produces antibodies against them. The next time you come into contact with them, these antibodies signal your immune system to release chemicals such as histamine into your bloodstream, causing the inflammation that leads to hayfever symptoms.</p>
<p>Hayfever traditionally has a <a href="https://www.allergy.org.au/patients/allergic-rhinitis-hay-fever-and-sinusitis/pollen-allergy">seasonal spike</a> in late winter and spring, when pollen counts are highest from flowering trees and grass seeds.</p>
<p>But in many areas of Australia, there may be more hayfever in autumn, due to two common sources of allergies: moulds, and an <a href="https://awareenvironmental.com.au/whats-new/deal-autumn-allergies-asthma/">autumn spike</a> in indoor dust mites.</p>
<p>A warming climate has also <a href="https://link.springer.com/article/10.1007/s40641-015-0018-2">been linked with</a> increased levels of pollens and environmental allergens, and a rise in asthma and hayfever severity.</p>
<h2>What are the symptoms?</h2>
<p>Whether you have seasonal hayfever, longer-term perennial or <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.0108-1675.2004.00388.x">vasomotor rhinitis</a>), or a viral infection, you’re likely to have similar cold and flu-like symptoms.</p>
<p>You’ll have either a runny or stuffy nose. Other symptoms include sore throat; sneezing; cough; post-nasal drip - nasal mucus going down the back of your throat; and fatigue.</p>
<p>But there are two classic <a href="https://www.mayoclinic.org/diseases-conditions/hay-fever/symptoms-causes/syc-20373039?p=1">hayfever symptoms</a> that can help you tell allergies and viruses apart. Hayfever can cause you to have an itchy nose or throat; and when it’s more severe it can cause swollen, blue-coloured skin under the eyes (called allergic shiners).</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/344987/original/file-20200701-108347-zmx7cg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/344987/original/file-20200701-108347-zmx7cg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/344987/original/file-20200701-108347-zmx7cg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=289&fit=crop&dpr=1 600w, https://images.theconversation.com/files/344987/original/file-20200701-108347-zmx7cg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=289&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/344987/original/file-20200701-108347-zmx7cg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=289&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/344987/original/file-20200701-108347-zmx7cg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=363&fit=crop&dpr=1 754w, https://images.theconversation.com/files/344987/original/file-20200701-108347-zmx7cg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=363&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/344987/original/file-20200701-108347-zmx7cg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=363&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Dark circles under your eyes can be a classic symptom of hayfever.</span>
<span class="attribution"><a class="source" href="https://www.mayoclinic.org/diseases-conditions/hay-fever/symptoms-causes/syc-20373039?p=1">www.shutterstock.com</a></span>
</figcaption>
</figure>
<h2>Can we tell them apart?</h2>
<p><strong>Fever, sore muscles or muscle weakness</strong></p>
<p>Hayfever, despite its name, does not cause increased body temperature. Flu-like illnesses do cause fever, and sore muscles (myalgia), malaise and fatigue. </p>
<p>Allergies such as hayfever may cause a slight malaise without the other symptoms, probably due to a stuffy nose and poor sleep.</p>
<p><strong>Snoring, dark circles under the eyes and sleep</strong></p>
<p>The nasal congestion from hayfever and other types of rhinitis often increases the potential to snore during sleep. And if you have those dark circles under the eyes, that’s <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jocd.12549">likely down to</a> chronic poor-quality sleep, as nasal congestion and snoring worsen.</p>
<p><strong>Itchy nose and eyes, plus sneezing</strong></p>
<p>An itchy nose and eyes are classic hayfever symptoms, as is intense, prolonged sneezing.</p>
<p>You can sneeze with a cold or flu, but usually only in the first few days of the infection.</p>
<p><strong>Longer-lasting symptoms</strong></p>
<p>Allergic reactions tend to come and go from day to day, or even from hour to hour, particularly if some environments are the source of the offending allergens. Perennial rhinitis can be present for weeks or months, far longer than any viral cold or flu.</p>
<p>It is rare for a cold to last more than a week, as the body has fought off the virus by that time. Exceptions to this are the cough and sinus symptoms that were triggered by the virus but persist for other reasons. </p>
<p><strong>Antihistamines</strong></p>
<p>If your nasal symptoms <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907832/">improve</a> with antihistamine medication, then you likely have an allergy or hayfever. Antihistamines <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001267/abstract">do not alleviate symptoms</a> of the common cold.</p>
<p>However, if your allergic reaction is more severe, antihistamines alone, even in larger doses than stated on the packet, <a href="https://www.nature.com/articles/s41533-016-0001-y">may be insufficient</a> to fully control symptoms, and a variety of nasal sprays may have to be added to the treatment.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/coronavirus-or-just-a-common-cold-what-to-do-when-your-child-gets-sick-this-winter-140727">Coronavirus or just a common cold? What to do when your child gets sick this winter</a>
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<h2>Why do we need to differentiate viral from allergic causes?</h2>
<p>In “normal” times we usually treat the symptoms of viral infections. However, amid the COVID-19 outbreak we need a clearer picture of what might be causing our symptoms so we get tested when it matters, and not for undiagnosed hayfever.</p>
<p>But it’s not easy to tell viral and allergic rhinitis apart. People with hayfever also get viral colds and flus, further complicating the picture.</p>
<p>If you think your symptoms may be due to allergy, it is safe to try a <a href="https://pubmed.ncbi.nlm.nih.gov/7719897/">double dose of non-sedating antihistamine</a>. Sedating antihistamines should be avoided in young children, and taken with caution in adults. If your symptoms improve significantly within an hour, your symptoms are likely hayfever or another allergic reaction.</p>
<p>However, if your symptoms are different to previous hayfever episodes, or your symptoms don’t improve after taking an antihistamine, that’s another matter. Stay at home until you can get tested for COVID-19.</p>
<p>Anyone with only partially treated and controlled hayfever will need to realise that your sniffles and sneezes are going to be distressing to your fellow commuter, diner or shopper. So you may need some medical assistance to more fully manage your allergic condition.</p><img src="https://counter.theconversation.com/content/139657/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>David King does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Although it can sometimes be challenging, there are ways to distinguish respiratory symptoms caused by a virus and those caused by an allergy.David King, Senior Lecturer in General Practice, The University of QueenslandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1407272020-06-24T20:17:14Z2020-06-24T20:17:14ZCoronavirus or just a common cold? What to do when your child gets sick this winter<figure><img src="https://images.theconversation.com/files/342880/original/file-20200619-41242-1xomyrq.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C6794%2C4525&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>It’s Sunday night, around 8pm, when your ten-year-old tells you she has a sore throat. She doesn’t have any other symptoms, and feels OK. You tell her “let’s see how you feel in the morning” and she happily goes off to sleep. </p>
<p>But you’re left wondering what you’ll do if her throat is still sore the next day — or if she’s developed other symptoms by then. Should you get her swabbed for COVID-19?</p>
<p>Like most Australians, you haven’t recently travelled overseas or been in contact with anyone with COVID-19. And like most kids, your children often get coughs and colds during winter.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/worried-about-your-child-getting-coronavirus-heres-what-you-need-to-know-131909">Worried about your child getting coronavirus? Here's what you need to know</a>
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<hr>
<h2>COVID-19 symptoms in kids resemble other respiratory infections</h2>
<p>Generally, in their first 12 years, children can experience up to <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1399-3038.2007.00688.x?casa_token=nneK-1mapJsAAAAA%3A-5kcukD-IZDBZtTAahXa_0A4Gmja2TLPf2jZythl9vXwvDsGXkAklt7FjS-LaIMRFBdz8wCYwmeRKOTu">four to eight</a> respiratory tract infections, or “colds”, per year. This number is highest among the youngest children.</p>
<p>One-quarter of all <a href="https://www.mja.com.au/system/files/issues/202_05/bie00090.pdf">GP visits</a> in children under five in Australia are for respiratory tract infections.</p>
<p>A recent <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/apa.15270">review</a> showed COVID-19 symptoms in children were typical of most acute respiratory infections and included fever, cough, sore throat, sneezing, muscle aches and fatigue.</p>
<p>In general, COVID-19 in children is <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/apa.15270">less severe</a> than in adults.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/342896/original/file-20200619-41213-noca8e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/342896/original/file-20200619-41213-noca8e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=397&fit=crop&dpr=1 600w, https://images.theconversation.com/files/342896/original/file-20200619-41213-noca8e.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=397&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/342896/original/file-20200619-41213-noca8e.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=397&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/342896/original/file-20200619-41213-noca8e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=499&fit=crop&dpr=1 754w, https://images.theconversation.com/files/342896/original/file-20200619-41213-noca8e.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=499&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/342896/original/file-20200619-41213-noca8e.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=499&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">In children, the symptoms of COVID-19 might appear like the symptoms of any cold or flu.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<h2>So how do I know if I should get my child tested?</h2>
<p>If your child is unwell you can check their symptoms using healthdirect’s <a href="https://www.healthdirect.gov.au/symptom-checker/tool/basic-details">coronavirus symptom checker</a>.</p>
<p>It will ask you questions based on what we know to be common symptoms of COVID-19, including whether you or the person you’re caring for have: </p>
<ul>
<li><p>a fever of 37.5°C or more; or</p></li>
<li><p>symptoms suggesting fever (such as night sweats or chills); or </p></li>
<li><p>an acute respiratory infection (for example, cough, shortness of breath, sore throat); or</p></li>
<li><p>loss of smell or taste.</p></li>
</ul>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/coronavirus-and-kawasaki-disease-in-children-its-an-intriguing-but-unproven-link-137415">Coronavirus and Kawasaki disease in children: it's an intriguing but unproven link</a>
</strong>
</em>
</p>
<hr>
<p>It’s possible these could also be symptoms of a different respiratory infection. But if your child is displaying any of these symptoms, the current <a href="https://www.health.gov.au/resources/videos/coronavirus-video-stay-covid-free-do-the-3">federal government guidelines</a> recommend they stay at home and get tested. </p>
<p>You can also ask your GP if you’re not sure whether your child needs a test.</p>
<h2>How likely is it my child will test positive to COVID-19?</h2>
<p>Although Victoria is currently experiencing a spike, Australia has largely “flattened the curve”. In the past month there have been <a href="https://www.covid19data.com.au/">less than 40 new cases</a> nationally each day.</p>
<p>Around the country, since the pandemic began, we’ve performed <a href="https://www.covid19data.com.au/">more than two million tests</a> and identified 7,521 cases.</p>
<p>This means fewer than 0.5% of tests have been positive. And only a small proportion of confirmed cases have been in children.</p>
<p>So in our current situation it’s much more likely your child’s fever or runny nose is caused by one of the common respiratory viruses, such as rhinovirus, that we see each winter.</p>
<h2>How sustainable is all this testing?</h2>
<p>We’re now performing more tests each day than we were at the height of the pandemic in late March.</p>
<p><iframe id="tc-infographic-496" class="tc-infographic" height="400px" src="https://cdn.theconversation.com/infographics/496/0598668018a5666e15da133b092ce9a6dc3b6534/site/index.html" width="100%" style="border: none" frameborder="0"></iframe></p>
<p>Australia’s high level of testing has undoubtedly played a significant role in our successful response to the COVID-19 pandemic.</p>
<p>But we now must ask ourselves whether, with potentially diminishing returns, it’s sustainable to keep testing every child with a cold for the foreseeable future. </p>
<p>Let’s remember there are <a href="https://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/3101.0Dec%202019?OpenDocument">4.7 million children</a> in Australia under 15 and each of them, particularly the younger ones, are likely to get multiple respiratory infections each year.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/stupid-coronavirus-in-uncertain-times-we-can-help-children-through-mindfulness-and-play-135317">'Stupid coronavirus!' In uncertain times, we can help children through mindfulness and play</a>
</strong>
</em>
</p>
<hr>
<p>One of the risks of a continued emphasis on COVID-19 testing is that when a child returns a negative result, the parent thinks “all good, my child doesn’t have coronavirus, they can go back to school”.</p>
<p>This risks spreading non-COVID-19 viruses to others, who then develop respiratory symptoms and need to be tested. Many of these viruses spread easily among children, especially where they’re in close contact, such as in childcare centres.</p>
<p>This may lead to an upward spiral of respiratory infections, particularly during winter when colds and the flu are traditional foes.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/342900/original/file-20200619-41242-lnh0fc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/342900/original/file-20200619-41242-lnh0fc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=429&fit=crop&dpr=1 600w, https://images.theconversation.com/files/342900/original/file-20200619-41242-lnh0fc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=429&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/342900/original/file-20200619-41242-lnh0fc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=429&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/342900/original/file-20200619-41242-lnh0fc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=539&fit=crop&dpr=1 754w, https://images.theconversation.com/files/342900/original/file-20200619-41242-lnh0fc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=539&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/342900/original/file-20200619-41242-lnh0fc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=539&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Viral infections can spread easily among children.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<h2>Keep sick kids at home</h2>
<p>While testing is important, physical distancing and hygiene measures have been instrumental in flattening the curve.</p>
<p>And as a bonus, these measures may have led to decreased incidence of other viral infections in the community.</p>
<p>In our hospital in Sydney, we’ve seen fewer hospitalisations for <a href="https://www.rch.org.au/kidsinfo/fact_sheets/Respiratory_syncytial_virus_RSV/">respiratory syncytial virus</a> this year, a common cause of infant hospitalisations.</p>
<p>Nationally, in the first five months of 2020 there were <a href="http://www9.health.gov.au/cda/source/rpt_3.cfm">20,569 influenza notifications</a>, compared to more than 74,000 at the same point last year.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/kids-are-more-vulnerable-to-the-flu-heres-what-to-look-out-for-this-winter-117748">Kids are more vulnerable to the flu – here's what to look out for this winter</a>
</strong>
</em>
</p>
<hr>
<p>Although restrictions are easing, Australians should continue to focus on physical distancing and hygiene throughout winter. </p>
<p>We need to see this pandemic as an opportunity to shift to a new normal: that is, staying at home when you’re sick, and keeping your child at home if they’re unwell (until their symptoms resolve).</p>
<p>We know it’s not always practical, but hopefully this “new normal” will see more flexibility from employers in these circumstances. </p>
<p>Finally, yes, follow public health advice around getting tested for COVID-19. But let’s not view this as the only thing that matters.</p><img src="https://counter.theconversation.com/content/140727/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Nicholas Wood receives funding from National Health and Medical Research Council for a Career Development Fellowship</span></em></p><p class="fine-print"><em><span>Philip Britton receives funding from the National Health and Medical Research Council for an Early Career Fellowship</span></em></p>It’s much more likely your child’s symptoms are caused by a common respiratory virus than COVID-19. But it’s important to follow testing guidelines and keep them home if they’re unwell.Nicholas Wood, Associate Professor, Discipline of Childhood and Adolescent Health, University of SydneyPhilip Britton, Senior lecturer, Child and Adolescent Health, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1283702020-02-20T12:17:45Z2020-02-20T12:17:45ZDo I have to wear a jacket when it’s cold outside?<figure><img src="https://images.theconversation.com/files/315565/original/file-20200215-11000-1f9iyib.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5220%2C3631&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">It's an age-old battle between parents and kids.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/photo-teenage-friends-red-christmas-sweaters-1265217739">Alena Ozerova/Shutterstock.com</a></span></figcaption></figure><figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=293&fit=crop&dpr=1 600w, https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=293&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=293&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=368&fit=crop&dpr=1 754w, https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=368&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=368&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
</figcaption>
</figure>
<p><em><a href="https://theconversation.com/us/topics/curious-kids-us-74795">Curious Kids</a> is a series for children of all ages. If you have a question you’d like an expert to answer, send it to <a href="mailto:curiouskidsus@theconversation.com">curiouskidsus@theconversation.com</a>.</em></p>
<hr>
<blockquote>
<p><strong>Will I get sick if I go out in the cold without a jacket? – Ben P., age 4, South Orange, New Jersey</strong></p>
</blockquote>
<hr>
<p>The answer to this question is: “It depends.”</p>
<p>Cold weather does not get you sick. Feeling chilly because you’re not bundled up does not get you sick.</p>
<p>But being cold – like when you’re outside in wintry weather wearing just a thin shirt – can actually weaken your body and make it easier for you to get sick. Researchers have shown that <a href="https://doi.org/10.1016/j.wem.2011.08.005">cold temperatures weaken your immune system</a> and thus your ability to fight off infections. In fact, the longer time you spend in the cold, the higher your risk of actually getting sick.</p>
<p>To get sick, though, you still must be exposed to a germ. So it’s key to avoid coming into contact with germs as well. Unfortunately, that’s easier said than done.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/315566/original/file-20200215-10980-1gq2rix.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/315566/original/file-20200215-10980-1gq2rix.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/315566/original/file-20200215-10980-1gq2rix.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/315566/original/file-20200215-10980-1gq2rix.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/315566/original/file-20200215-10980-1gq2rix.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/315566/original/file-20200215-10980-1gq2rix.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/315566/original/file-20200215-10980-1gq2rix.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/315566/original/file-20200215-10980-1gq2rix.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Microscopic bacteria and viruses are all around, ready to invade your body’s cells and make you sick.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-illustration/bacteria-viruses-on-surface-skin-mucous-297732359">Kateryna Kon/Shutterstock.com</a></span>
</figcaption>
</figure>
<p>There are <a href="https://www.nih.gov/news-events/nih-research-matters/understanding-common-cold-virus">over 200 viruses that can cause a cold</a>. These viruses are all around us. In the wintertime, people often stay indoors and are closer together in general, which encourages the spread of viruses.</p>
<p>One called rhinovirus is responsible for around a <a href="https://www.nih.gov/news-events/nih-research-matters/understanding-common-cold-virus">third of the cases of runny noses and congestion</a>, but can also cause more serious lung diseases. There’s another group of germs, called <a href="https://www.cdc.gov/coronavirus/types.html">human coronaviruses</a>, that can make you sick. The <a href="https://theconversation.com/us/topics/coronavirus-5830">new virus named 2019-nCoV</a> is one of these.</p>
<p>The cold, <a href="https://doi.org/10.1017/S0022172400039176">dry weather</a> does <a href="https://www.popsci.com/science/article/2013-01/fyi-why-winter-flu-season/">play a role in winter sniffles</a>, because it can strengthen these virus invaders. For example, viruses survive longer and multiply faster in the <a href="https://www.sciencedaily.com/releases/2015/01/150105170014.htm">cooler regions of your nasal passages</a>.</p>
<p>Cooler temperatures also tend to <a href="https://doi.org/10.1073/pnas.1411030112">weaken your body’s antiviral immune responses</a>. In fact, a fever helps your body warm up and invigorates your immune system cells to fight infection.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/315299/original/file-20200213-10985-10aa4ur.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/315299/original/file-20200213-10985-10aa4ur.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/315299/original/file-20200213-10985-10aa4ur.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/315299/original/file-20200213-10985-10aa4ur.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/315299/original/file-20200213-10985-10aa4ur.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/315299/original/file-20200213-10985-10aa4ur.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=504&fit=crop&dpr=1 754w, https://images.theconversation.com/files/315299/original/file-20200213-10985-10aa4ur.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=504&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/315299/original/file-20200213-10985-10aa4ur.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=504&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">An uncovered sneeze blasts germs into the air for other people to breathe in.</span>
<span class="attribution"><a class="source" href="https://phil.cdc.gov/Details.aspx?pid=11162">CDC/Brian Judd</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>Viruses live in the environment all around you. They’re on surfaces such as doorknobs. They’re in the air after someone sneezes. The most common way to expose yourself to these germs is by inhaling virus-filled air or touching your eyes or nose with dirty hands. </p>
<p>The <a href="https://www.cdc.gov/features/rhinoviruses/index.html">best way to avoid catching a cold</a> is to wash your hands as often as possible, avoid anyone who is clearly sick and keep your immune system strong. Tips for boosting your body’s immune power include eating a well-balanced diet, having a healthy sleep routine, balancing stress with enjoyable activities and keeping warm to minimize susceptibility to infection. Don’t forget vaccines are available to help keep you from getting sick with certain viruses, <a href="https://www.cdc.gov/flu/prevent/vaccinations.htm">including influenza</a>.</p>
<p>If you do catch a cold, it is best to rest, drink plenty of water and contact your doctor for any worsening symptoms. And if you go outside in the cold, be sure to bundle up and try to stay warm.</p>
<hr>
<p><em>Hello, curious kids! Do you have a question you’d like an expert to answer? Ask an adult to send your question to <a href="mailto:curiouskidsus@theconversation.com">CuriousKidsUS@theconversation.com</a>. Please tell us your name, age and the city where you live.</em></p>
<p><em>And since curiosity has no age limit – adults, let us know what you’re wondering, too. We won’t be able to answer every question, but we will do our best.</em></p><img src="https://counter.theconversation.com/content/128370/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Carolyn Kaloostian does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Leaving your coat at home on a cold winter day doesn’t automatically mean you’re going to get sick. But it could make you more susceptible to germs.Carolyn Kaloostian, Clinical Assistant Professor of Family Medicine, University of Southern CaliforniaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1191722019-07-22T03:01:07Z2019-07-22T03:01:07ZHealth Check: why do I have a cough and what can I do about it?<figure><img src="https://images.theconversation.com/files/284665/original/file-20190718-116539-sq5hx6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">No wonder you feel so bad. Coughing can be physically exhausting. But it's your body's way of getting rid of irritants or extra mucus.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/1166183737?src=pm3qp893thJlnYFyjEqlBA-1-27&studio=1&size=huge_jpg">from www.shutterstock.com</a></span></figcaption></figure><p>Dry, moist, productive, hacking, chesty, whooping, barking, throaty. These are just some of the terms people use to describe their cough.</p>
<p>While we’re deep into cold and flu season, it’s one of the most common reasons people see their family doctor.</p>
<p>But what is a cough anyway? And what’s the best way to get rid of it?</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-i-feel-a-bit-sick-should-i-stay-home-or-go-to-work-42759">Health Check: I feel a bit sick, should I stay home or go to work?</a>
</strong>
</em>
</p>
<hr>
<h2>What is a cough?</h2>
<p>People can <a href="http://www.mattioli1885journals.com/index.php/actabiomedica/article/view/6182">cough on purpose or spontaneously in a protective reflex action</a>. The aim is to both protect the airways from material that shouldn’t be there (like dust) or to clear the secretions that come with respiratory diseases, such as the mucus and phlegm that come with colds and flu.</p>
<p>Nerve receptors throughout the lungs, and to a lesser extent in the sinuses, diaphragm and oesophagus (food pipe), detect the irritant or mucus. Then, they send messages via the vagus nerve to the brain. The brain, in turn, sends messages back through the motor nerves supplying the diaphragm, chest muscles and vocal cords.</p>
<p>This results in a sudden, forceful expulsion of air.</p>
<p>Your cough may be a one off. Alternatively, you can have a run of repeated coughs, especially in <a href="https://www.health.gov.au/health-topics/whooping-cough-pertussis">whooping cough</a>, which people describe as a bout, attack or episode.</p>
<h2>Which type of cough do I have?</h2>
<p>There are many different types of cough but no one definition that everyone agrees on. This can be confusing as patients classify their cough in descriptive terms like hacking or chesty, while doctors classify them on how long they last: acute (under three weeks), subacute (three to eight weeks) and chronic cough (more than eight weeks). </p>
<p><a href="https://www.sciencedirect.com/science/article/pii/S1094553908001430?via%3Dihub">Neither of these approaches</a> tells us about the cause of the cough.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/284668/original/file-20190718-116557-nc7h43.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/284668/original/file-20190718-116557-nc7h43.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/284668/original/file-20190718-116557-nc7h43.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/284668/original/file-20190718-116557-nc7h43.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/284668/original/file-20190718-116557-nc7h43.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/284668/original/file-20190718-116557-nc7h43.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/284668/original/file-20190718-116557-nc7h43.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/284668/original/file-20190718-116557-nc7h43.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Patients tend to describe coughs using descriptive terms, like hacking or chesty, while doctors talk about how long the cough has lasted.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/174192125?src=7zRjouRyTm8wacVcOWsFUw-1-2&studio=1&size=medium_jpg">from www.shutterstock.com</a></span>
</figcaption>
</figure>
<p>Coughs can also be called wet or dry. <a href="http://jtd.amegroups.com/article/view/25427/19122">Officially</a>, you have a wet cough when you produce more than 10mL of phlegm a day.</p>
<p>For people with chronic coughs, their cough can further be classified after an x-ray — either with lung pathology to indicate something like pneumonia or tuberculosis, or without signs of underlying disease (an x-ray negative cough).</p>
<h2>What caused my cough?</h2>
<p>Whether you have a <a href="https://www.ncbi.nlm.nih.gov/pubmed/29080708">wet or dry cough</a> may tell you what has caused it.</p>
<p><a href="http://jtd.amegroups.com/article/view/25427/19122">A dry cough</a> indicates a non-infectious cough from conditions including <a href="https://www.nationalasthma.org.au/understanding-asthma/what-is-asthma">asthma</a>, <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/emphysema">emphysema</a>, <a href="https://www.healthdirect.gov.au/gord-reflux">oesophageal reflux</a> and <a href="https://bestpractice.bmj.com/topics/en-us/1209">upper airway cough syndrome</a>, previously called post-nasal drip.</p>
<p><a href="http://jtd.amegroups.com/article/view/25427/19122">A wet cough</a> is more common in people with sinus and chest infections, including influenza, bronchitis and pneumonia, and serious infections such as <a href="https://www.health.nsw.gov.au/Infectious/factsheets/Pages/tuberculosis.aspx">tuberculosis</a>.
A smoker’s cough is usually wet, as the precursor to chronic bronchitis. As it progresses, or when complicated with infection, larger amounts of mucus may be coughed up daily.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-what-you-need-to-know-about-mucus-and-phlegm-33192">Health Check: what you need to know about mucus and phlegm</a>
</strong>
</em>
</p>
<hr>
<p>Then there is a dry cough associated with a cold or flu that turns into a moist cough. People tend to describe this as “chesty” and it makes them worry the infection has moved to their lungs. </p>
<p>Yet mostly their lungs are clear of infectious sounds when examined with a stethoscope. Even a small amount of mucus stuck around the vocal cords or back of the throat may produce a moist sounding cough. But this is not necessarily a wet or “productive” (producing lots of mucus) cough.</p>
<p><a href="https://coughjournal.biomedcentral.com/articles/10.1186/1745-9974-2-1">One study</a> showed even doctors struggled to make an accurate diagnosis based only on the sound of the cough. Their diagnosis of the cough was correct only 34% of the time.</p>
<p>For people with chronic “unexplained cough”, a common hypothesis is that cough receptors <a href="https://www.atsjournals.org/doi/full/10.1164/rccm.200905-0665OC">become more sensitive</a> to irritation the more they are exposed to the irritant. These cough receptors are so sensitive that even <a href="https://www.ncbi.nlm.nih.gov/pubmed/20051447">perfumes, temperature changes, talking and laughing</a> may trigger the cough.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/snout-sniff-and-sneeze-the-language-of-the-nose-76043">Snout, sniff and sneeze: the language of the nose</a>
</strong>
</em>
</p>
<hr>
<p>People with <a href="https://bestpractice.bmj.com/topics/en-us/1209">upper airway cough syndrome</a> may feel mucus secretions moving down the back of the throat, causing them to cough. New evidence suggests the cough <a href="https://journal.chestnet.org/article/S0012-3692(19)31122-5/pdf">is caused by</a> the increased thickness of the mucus and slowness of that mucus being cleared by cilia (hair like structures in lining cells whose job is to move mucus along). </p>
<p>This mechanism keeps the chronic cough going through a feedback loop I call the “cough and mucus” cycle. In other words, the more the throat is irritated by the sticky mucus, the more you cough, but the cough is poor at shifting the mucus. Instead, coughing irritates the throat and fatigues the cilia, and the mucus becomes stickier and harder to shift, stimulating further coughing.</p>
<h2>When coughing gets too much</h2>
<p>Coughing is hard work so no wonder you can feel physically exhausted. <a href="https://www.ncbi.nlm.nih.gov/pubmed/7925902">In one study</a>, people with asthma coughed as many as 1,577 times in one 24-hour period. But for people with a chronic cough, it was up to 3,639 times.</p>
<p>The high pressures generated in vigorous coughing <a href="http://jtd.amegroups.com/article/view/25427/19122">can cause</a> symptoms including chest pains, a hoarse voice, and even rib fractures and <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/hernias">hernias</a>. Other complications include vomiting, light-headedness, urinary incontinence, headaches and sleep deprivation. Chronic cough may also lead to people becoming embarrassed and avoiding others. </p>
<h2>Is it true?</h2>
<p>People still seemed surprised and worried when a cough persists after a cold and flu despite the fact cough outlasts other symptoms in most cases. When an <a href="https://search.informit.com.au/documentSummary;dn=380082015528918;res=IELHEA">Australian study</a> followed 131 healthy adults with an upper respiratory tract infection, 58% had a cough for at least two weeks and 35% for up to three weeks.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/curious-kids-why-does-my-snot-turn-green-when-i-have-a-cold-98379">Curious Kids: Why does my snot turn green when I have a cold?</a>
</strong>
</em>
</p>
<hr>
<p>Then there’s the colour of your mucus. Patients and doctors commonly interpret discoloured mucus, particularly if green, as a sign of bacterial infection. But there’s <a href="https://www.tandfonline.com/doi/full/10.1080/02813430902759663">clear evidence</a> that the colour alone is not able to differentiate between viral and bacterial infections in otherwise healthy adults. </p>
<p><a href="https://erj.ersjournals.com/content/38/1/119">Another study</a> found that people with acute cough who coughed up discoloured phlegm were more likely to be prescribed antibiotics, but they did not recover any faster than those not prescribed antibiotics. </p>
<h2>When and how should I treat my cough?</h2>
<p>Due to the multiple causes and types of cough there is not room to cover this question adequately. A safe approach is to diagnose the disease that is causing the cough and treat it appropriately. </p>
<p>For chronic dry coughs and coughs that last after acute upper respiratory tract infections, the cough is no longer serving a useful function and treatments can be targeted at breaking the cycle of irritation and further coughing. The evidence for effective treatments is patchy, but cough suppressants, steam inhalation and saline nasal irrigations, as well as prescribed anti-inflammatory sprays may help. </p>
<p>A spoonful of honey <a href="https://www.ncbi.nlm.nih.gov/pubmed/22869830">reduces cough</a> in children more than placebo and some cough mixtures. It is thought that the soothing effect on the throat is the way this works. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/284669/original/file-20190718-116562-1q8iwh7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/284669/original/file-20190718-116562-1q8iwh7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/284669/original/file-20190718-116562-1q8iwh7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/284669/original/file-20190718-116562-1q8iwh7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/284669/original/file-20190718-116562-1q8iwh7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/284669/original/file-20190718-116562-1q8iwh7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/284669/original/file-20190718-116562-1q8iwh7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/284669/original/file-20190718-116562-1q8iwh7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">There’s no good evidence that cough medicines work, and they could harm children.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/515549014?src=MarXwDpxYfBtHcxpXiXHZw-1-0&studio=1&size=medium_jpg">from www.shutterstock.com</a></span>
</figcaption>
</figure>
<p>However, there is no good evidence for the effectiveness of commonly used over-the-counter medicine (cough medicine or syrup) to alleviate acute cough, yet they are still sold. Some contain drugs with the <a href="https://www.ncbi.nlm.nih.gov/pubmed/25420096">potential to cause harm</a> in children, such as antihistamines, and codeine-like products.</p>
<p>Recent expert panel reports <a href="https://linkinghub.elsevier.com/retrieve/pii/S0012369217314083">don’t recommend the use of these cough medicines</a> for adults and children with acute cough, until they are shown to be effective. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-do-cough-medicines-work-62425">Health Check: do cough medicines work?</a>
</strong>
</em>
</p>
<hr>
<h2>When should I be concerned?</h2>
<p>It is fine to try to treat yourself, but if a cough persists or is bothersome, your doctor may be able to suggest or prescribe treatments to reduce your symptoms. </p>
<p>If you cough up blood or are becoming more unwell, consult a doctor, who will investigate further.</p>
<p>Children who cough up phlegm for more than four weeks <a href="https://www.ncbi.nlm.nih.gov/pubmed/28143696">have been found to benefit</a> from medical investigations and antibiotics.</p><img src="https://counter.theconversation.com/content/119172/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>David King does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Dry, moist, productive, hacking, chesty, whooping, barking, throaty. Which type of cough do you have and why?David King, Senior Lecturer, The University of QueenslandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/995122018-08-10T02:07:43Z2018-08-10T02:07:43ZA strong immune system helps ward off colds and flus, but it’s not the only factor<figure><img src="https://images.theconversation.com/files/231212/original/file-20180809-30446-72yohm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Winter bugs are impossible to escape.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/hand-holding-handle-on-train-taiwan-1135859891?src=uZJW9VVKeaZjAFi8ngnyoQ-2-53">Shutterstock</a></span></figcaption></figure><p>It’s peak flu season. You’re cold, rugged up and squashed on public transport or in the lift at work. You hear a hacking cough, or feel the droplets of a sneeze land on your neck. Will this turn into your third cold this year?</p>
<p>No matter how much we try to minimise our exposure to respiratory viruses, it’s <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5187459/">far more difficult</a> in winter when we spend so much time in close proximity to other people. </p>
<p>On top of this, viruses tend to be more stable in colder and drier conditions, which means they <a href="https://www.nih.gov/news-events/nih-research-matters/flu-virus-fortified-colder-weather">stick around longer</a>. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-how-long-should-you-stay-away-when-you-have-a-cold-or-the-flu-98702">Health Check: how long should you stay away when you have a cold or the flu?</a>
</strong>
</em>
</p>
<hr>
<p>The common cold is caused by more than <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/colds">200 different viruses</a>, the most common of which are rhinoviruses (rhino meaning nose). Rhinovirus infections tend to be mild; you might get a sore throat and a head cold lasting just a few days. </p>
<p>Influenza, or the flu, is generally caused by type A or B <a href="https://www.webmd.com/cold-and-flu/advanced-reading-types-of-flu-viruses">influenza viruses</a>. The flu is far more aggressive and often includes a fever, fatigue and body aches, in addition to all the classic cold symptoms. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/231207/original/file-20180809-30476-1pivwfn.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/231207/original/file-20180809-30476-1pivwfn.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=379&fit=crop&dpr=1 600w, https://images.theconversation.com/files/231207/original/file-20180809-30476-1pivwfn.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=379&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/231207/original/file-20180809-30476-1pivwfn.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=379&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/231207/original/file-20180809-30476-1pivwfn.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=477&fit=crop&dpr=1 754w, https://images.theconversation.com/files/231207/original/file-20180809-30476-1pivwfn.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=477&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/231207/original/file-20180809-30476-1pivwfn.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=477&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The flu tends to be more severe than the common cold.</span>
<span class="attribution"><a class="source" href="https://www.healthdirect.gov.au/cold-or-flu-infographic">healthdirect</a></span>
</figcaption>
</figure>
<p>When it comes to getting sick, there’s always an element of bad luck involved. And some people, particularly those with young children or public transport commuters, are likely to come into contact with more viruses. </p>
<p>But you may have noticed that illness often strikes when you’re stressed at work, not sleeping properly, or you’ve been out partying a little too much. The health of our immune system plays an important role in determining how we can defend against invading cold and flu viruses.</p>
<h2>How the immune system fights viruses</h2>
<p>Your skin and saliva are key barriers to infection and form part of your immune system, along with cells in every tissue of your body, including your blood and your brain. </p>
<p>Some of these cells migrate around to fight infection at specific sites, such as a wound graze. Other cells reside in one tissue and regulate your body’s natural state of health by monitoring and helping with the healing process.</p>
<p>The cells that make up your immune system need energy too, and when you’re low on juice, they’ll be on low-battery mode. This is when our natural immune defences are weakened and normally innocuous bugs can begin to cause strife. </p>
<p>Our immune system requires a lot of energy to defend our bodies. Feeling tired and achy, overheating, and glands swelling are all signs that our immune system is busy fighting something.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/explainer-how-does-the-immune-system-work-27163">Explainer: how does the immune system work?</a>
</strong>
</em>
</p>
<hr>
<h2>Boosting our natural defence system</h2>
<p>Our immune system has evolved to naturally detect and eliminate viral infections. And we can actively <a href="https://www.health.harvard.edu/staying-healthy/how-to-boost-your-immune-system">strengthen our immunity and natural defences</a> by looking after ourselves. This means:</p>
<ul>
<li><p>getting adequate sleep. Sleep deprivation <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3132857/">increases the hormone cortisol</a>, which suppresses immune function when its levels are elevated</p></li>
<li><p>exercising, which <a href="https://medlineplus.gov/ency/article/007165.htm">helps the lymphatic system</a>, where our immune cells circulate, and lowers levels of stress hormones </p></li>
<li><p>eating well and drinking enough water. Your immune system needs energy and nutrients obtainable from food. And staying well hydrated helps the body to flush out toxins</p></li>
</ul>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/231242/original/file-20180809-30458-qhpcs4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/231242/original/file-20180809-30458-qhpcs4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/231242/original/file-20180809-30458-qhpcs4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/231242/original/file-20180809-30458-qhpcs4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/231242/original/file-20180809-30458-qhpcs4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/231242/original/file-20180809-30458-qhpcs4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/231242/original/file-20180809-30458-qhpcs4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Good food feeds your immune system.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/IGfIGP5ONV0">Anna Pelzer</a></span>
</figcaption>
</figure>
<ul>
<li>not smoking. Smoking, or even secondary smoke, damages our lungs and increases the vulnerability of our respiratory system to infection.</li>
</ul>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-should-i-take-vitamin-c-or-other-supplements-for-my-cold-98309">Health Check: should I take vitamin C or other supplements for my cold?</a>
</strong>
</em>
</p>
<hr>
<h2>Educating our immune system</h2>
<p>Natural defences aren’t always enough to keep us safe and we need the help of flu vaccinations.</p>
<p>Vaccines are designed to educate an army of B and T cells which make up your adaptive immune system. This arm of your immune system learns by exposure and provides long-term immunity. </p>
<p>These T and B cells need a bit of time from the initial influenza exposure before they can be activated. This activation lag time is when you feel the brunt of the flu infection: lethargy, body aches, extreme fatigue and unable to get off the couch for a day or two. </p>
<p>To overcome this delay and protect people before they are exposed to potentially harmful flu strains, flu vaccination introduces fragments of the influenza virus into the body, which acts like prior exposure to the bug (without actual infection).</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/231241/original/file-20180809-30458-wgcdo7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/231241/original/file-20180809-30458-wgcdo7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/231241/original/file-20180809-30458-wgcdo7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/231241/original/file-20180809-30458-wgcdo7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/231241/original/file-20180809-30458-wgcdo7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/231241/original/file-20180809-30458-wgcdo7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/231241/original/file-20180809-30458-wgcdo7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">You can still get the flu if you’ve been vaccinated but you might not get as sick.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/caring-man-made-tea-cute-sick-1151493122?src=T6GHODDflT-C25W6avSXHA-1-99">VGstockstudio/Shutterstock</a></span>
</figcaption>
</figure>
<p>Seasonal vaccines are designed to match currently circulating strains and target those strains before you’re infected. </p>
<p>You can still catch the influenza virus if you are vaccinated. But because of this pre-education, the symptoms will likely be milder. The immune system has been trained and the army of B and T cells can move into action quicker. </p>
<h2>Already have a cold or the flu?</h2>
<p>If you’ve been sniffling and sneezing your way through winter, be comforted by the fact that these bugs are strengthening your immune system. Our body remembers the particular strain of rhinovirus or influenza we get, so it can recognise and mount a stronger defence if we encounter it again. </p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/explainer-whats-new-about-the-2018-flu-vaccines-and-who-should-get-one-94514">Explainer: what's new about the 2018 flu vaccines, and who should get one?</a>
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</p>
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<img src="https://counter.theconversation.com/content/99512/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Illness often strikes when you’re stressed at work, not sleeping properly, or you’ve been out partying a little too much. Here’s why.Hui-Fern Koay, Research Fellow in Immunology, The University of MelbourneJesseka Chadderton, PhD Candidate, The University of MelbourneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/983092018-08-06T00:02:18Z2018-08-06T00:02:18ZHealth Check: should I take vitamin C or other supplements for my cold?<figure><img src="https://images.theconversation.com/files/230177/original/file-20180801-136673-1u5k9n7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Once you have a cold, taking vitamin C supplements won't do anything.</span> <span class="attribution"><span class="source">From shutterstock.com</span></span></figcaption></figure><p>Last week I had a shocking cold. Blocked nose, sore throat, and feeling poorly. This made me think about the countless vitamins and supplements on the market that promise to ease symptoms of a cold, help you recover faster, and reduce your chance of getting another cold. </p>
<p>When it comes to the common cold (also called upper respiratory tract infections) there is no magic cure (I wish) but some supplements may deliver very minor improvements. Here is what the latest research evidence says.</p>
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<strong>
Read more:
<a href="https://theconversation.com/health-check-can-you-treat-the-common-cold-25323">Health Check: can you treat the common cold?</a>
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</em>
</p>
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<h2>Vitamin C</h2>
<p>For the average person, taking vitamin C <a href="https://www.ncbi.nlm.nih.gov/pubmed/28353648">does not reduce</a> the number of colds you get, or the severity of your cold.</p>
<p>In terms of how long your cold lasts, some studies have looked at people taking vitamin C every day, while others have focused on participants taking it once they develop a cold.</p>
<p>In 30 studies comparing the length of colds in people regularly taking at least 200 milligrams of vitamin C daily, there was <a href="https://www.ncbi.nlm.nih.gov/pubmed/23440782">a consistent reduction</a> in the duration of common cold symptoms. </p>
<p>However, the effect was small and equates to about half a day less in adults, and half to one day less in children. These types of studies also found a very minor reduction in the amount of time needed off work or school. </p>
<p>Among studies where vitamin C was only started <a href="https://www.ncbi.nlm.nih.gov/pubmed/23440782">once a cold had developed</a>, there was no difference in duration or severity of a cold.</p>
<p>There are some risks to taking vitamin C supplements. They can <a href="https://www.ncbi.nlm.nih.gov/pubmed/26463139">increase the risk</a> of kidney stones in men, and shouldn’t be taken by people with the iron storage disease <a href="https://haemochromatosis.org.au/symptoms/">haemochromatosis</a>, as vitamin C increases iron absorption.</p>
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<p>
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<strong>
Read more:
<a href="https://theconversation.com/feeling-worn-out-you-could-have-iron-overload-76981">Feeling worn out? You could have iron overload</a>
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</em>
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<p><strong>Special considerations</strong></p>
<p>Although in the general population <a href="https://www.ncbi.nlm.nih.gov/pubmed/28353648">vitamin C has no impact</a> on the number of colds people get, there is an exception. For people who are very physically active – such as marathon runners, skiers and soldiers exercising in very cold conditions – vitamin C <a href="https://www.ncbi.nlm.nih.gov/pubmed/28353648">halved their chance</a> of getting a cold. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/230351/original/file-20180802-136646-141mpkf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/230351/original/file-20180802-136646-141mpkf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/230351/original/file-20180802-136646-141mpkf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/230351/original/file-20180802-136646-141mpkf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/230351/original/file-20180802-136646-141mpkf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/230351/original/file-20180802-136646-141mpkf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/230351/original/file-20180802-136646-141mpkf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Many people take vitamin C supplements in hope it will treat their cold.</span>
<span class="attribution"><span class="source">From shutterstock.com</span></span>
</figcaption>
</figure>
<p>A few studies have also found <a href="https://www.ncbi.nlm.nih.gov/pubmed/28353648">some benefit</a> from vitamin C supplements of at least 200 milligrams a day for preventing colds among those with pneumonia. </p>
<p>However, taking vitamin E supplements in combination with a high intake of vitamin C from food markedly increased the risk of pneumonia.</p>
<h2>Zinc</h2>
<p>A review of studies testing zinc supplements in healthy adults found starting daily supplements of at least 75 milligrams within 24 hours of the onset of a cold <a href="https://www.ncbi.nlm.nih.gov/pubmed/23775705">shortened the duration</a> by up to two days or <a href="https://www.ncbi.nlm.nih.gov/pubmed/28515951">by about one-third</a>. It made no difference to the severity of the cold. </p>
<p>There was some variability in the results across trials, with insufficient evidence related to preventing colds. Researchers suggested that for some people, the side effects such as nausea or a bad taste from zinc lozenges might outweigh the benefits. </p>
<p>Take care to stop zinc supplements as soon as your cold resolves because taking too much zinc <a href="https://www.ncbi.nlm.nih.gov/pubmed/26085547">can trigger a copper deficiency</a> leading to anaemia, low white blood cell count, and memory problems. </p>
<h2>Garlic</h2>
<p>Only one study has tested the <a href="https://www.ncbi.nlm.nih.gov/pubmed/25386977">impact of garlic on the common cold</a>. Researchers asked 146 people to take garlic supplements or a placebo daily for 12 weeks. They then tallied the number and duration of their colds.</p>
<p>The group that took garlic reported fewer colds than those who took the placebo. The duration of colds was the same in both groups, but some people had an adverse reaction to the garlic, such as a rash, or found the garlic odour unpleasant. </p>
<p>Because there is only one trial, we need to be cautious about recommending garlic to prevent or treat colds. We also need to be cautious about interpreting the results because the colds were tracked using self-report, which could be biased.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/science-or-snake-oil-will-horseradish-and-garlic-really-ease-a-cold-87602">Science or Snake Oil: will horseradish and garlic really ease a cold?</a>
</strong>
</em>
</p>
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<h2>Probiotics</h2>
<p>In a review of <a href="https://www.ncbi.nlm.nih.gov/pubmed/25927096">13 trials of probiotic supplements</a> that included more than 3,700 children, adults and older adults, those taking supplements were less likely to get a cold. </p>
<p>Their colds were also likely to be of shorter duration and less severe, in terms of the number of school or work days missed.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/230352/original/file-20180802-136664-e188zp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/230352/original/file-20180802-136664-e188zp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/230352/original/file-20180802-136664-e188zp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/230352/original/file-20180802-136664-e188zp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/230352/original/file-20180802-136664-e188zp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/230352/original/file-20180802-136664-e188zp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/230352/original/file-20180802-136664-e188zp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">There is some evidence that probiotics, which can be found in yoghurt, may reduce the incidence of colds.</span>
<span class="attribution"><span class="source">From shutterstock.com</span></span>
</figcaption>
</figure>
<p>Most supplements were milk-based products such as yoghurt. Only three studies used powders, while two used capsules. </p>
<p>The quality of the all the probiotic studies, however, was very poor, with bias and limitations. This means the results need to be interpreted with caution.</p>
<h2>Echinacea</h2>
<p><a href="https://en.wikipedia.org/wiki/Echinacea">Echinacea</a> is a group of flowering plants commonly found in North America. These days you can buy echinacea products in capsules, tablets or drops.</p>
<p>A <a href="https://www.ncbi.nlm.nih.gov/pubmed/24554461">review of echinacea products</a> found they provide no benefit in treating colds. However, the authors indicated <em>some</em> echinacea products may possibly have a <em>weak</em> benefit, and further research is needed.</p>
<h2>Chicken soup</h2>
<p>Yep, I’ve saved the best until last.</p>
<p>In a novel experiment on 15 healthy adults, <a href="https://www.ncbi.nlm.nih.gov/pubmed/359266">researchers measured the participants’ nasal mucus flow velocity</a> – our ability to break down and expel mucus to breathe more clearly. They tested how runny participants’ noses were after sipping either hot water, hot chicken soup or cold water, or sucking them through a straw. </p>
<p>Sipping hot water or chicken soup made participants’ noses run more than cold water, but sipping chicken soup worked the best. The researchers attributed this to the chicken soup stimulating smell and/or taste receptors, which then increased nasal mucus flow. </p>
<p>Another study on <a href="https://www.ncbi.nlm.nih.gov/pubmed/11035691">chicken soup</a> found it can help fight infection and recovery from respiratory tract infections. </p>
<p>Other researchers have shown comfort foods, such as chicken soup, <a href="https://www.ncbi.nlm.nih.gov/pubmed/21537054">can help us</a> feel better.</p><img src="https://counter.theconversation.com/content/98309/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Clare Collins is affiliated with the Priority Research Centre for Physical Activity and Nutrition, the University of Newcastle, NSW. She is an NHMRC Senior Research and Gladys M Brawn Research Fellow. She has received research grants from NHMRC, ARC, Hunter Medical Research Institute, Meat and Livestock Australia, Diabetes Australia, Heart Foundation, Bill and Melinda Gates Foundation, nib foundation and Greater Charitable Foundation. She has consulted to SHINE Australia, Novo Nordisk, Quality Bakers, the Sax Institute and the ABC. She was a team member conducting systematic reviews to inform the Australian Dietary Guidelines update and 2017 evidence review on dietary patterns for the Heart Foundation.</span></em></p>From vitamin C to chicken soup, there are many supposed remedies for treating a cold. Here’s what the evidence says.Clare Collins, Professor in Nutrition and Dietetics, University of NewcastleLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/987022018-07-23T05:26:30Z2018-07-23T05:26:30ZHealth Check: how long should you stay away when you have a cold or the flu?<figure><img src="https://images.theconversation.com/files/228723/original/file-20180722-142411-16ejslw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Symptoms of the flu generally develop more quickly and are more severe than the common cold.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/334592159?src=AXBh6XNSo4tAZC1ZoUd7WA-1-31&size=huge_jpg">By txking/Shutterstock</a></span></figcaption></figure><p>Most adults get around <a href="https://www.cdc.gov/features/rhinoviruses/index.html">two to three colds a year</a>, and children get even more. In terms of the flu, there are around <a href="http://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal)">3-5 million severe cases of influenza</a> worldwide each year and 290,000 to 650,000 deaths.</p>
<p>The symptoms of a cold and the flu are similar, so it’s hard to tell the difference. But the flu is usually more severe and develops more quickly than a cold. </p>
<p>Colds and flus can be easily passed from person to person through the air, when an infected person coughs or sneezes, and touch, when a person touches an infected surface or object like doorknobs and light switches.</p>
<p>So what’s the difference between colds and flus, and how long should you stay away?</p>
<h2>Colds</h2>
<p>Cold <a href="https://www.cdc.gov/features/rhinoviruses/index.html">symptoms</a> include a sore throat, cough, runny or stuffy nose, tiredness and headache.</p>
<p>Most people become contagious with cold symptoms one to two days after exposure to a cold virus. These symptoms usually peak two to four days later. The <a href="https://www.ncbi.nlm.nih.gov/pubmed/17397266">common cold usually lasts</a> about ten days.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/ive-always-wondered-why-is-the-flu-virus-so-much-worse-than-the-common-cold-virus-83495">I've always wondered: why is the flu virus so much worse than the common cold virus?</a>
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<p>There is nothing you can take to shorten the duration of a cold, and most people will get better without needing to see a doctor. But some over-the-counter medications can help alleviate the symptoms. These include anti-inflammatories (to reduce inflammation or swelling), analgesics (to reduce pain), antipyretics (to reduce fever) and decongestants (to relieve nasal congestion). </p>
<p>But be careful you follow the instructions and recommended dosage for these medications. A <a href="https://www.ncbi.nlm.nih.gov/pubmed/29516533">recent study of US adults</a> who used paracetamol, the active ingredient in many cold and flu medicines, found 6.3% of users exceeded the maximum recommended daily dose. This mostly occurred during the cold and flu season. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/228752/original/file-20180723-189341-xkfdq5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/228752/original/file-20180723-189341-xkfdq5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=398&fit=crop&dpr=1 600w, https://images.theconversation.com/files/228752/original/file-20180723-189341-xkfdq5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=398&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/228752/original/file-20180723-189341-xkfdq5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=398&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/228752/original/file-20180723-189341-xkfdq5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/228752/original/file-20180723-189341-xkfdq5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/228752/original/file-20180723-189341-xkfdq5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">For your own and others’ health, the best place for you to be when you’re sick is at home.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/pretty-young-woman-blowing-her-nose-715823824?src=-ZF11WjAnLV6f0YQO_3kFA-1-44">Shutterstock</a></span>
</figcaption>
</figure>
<p>Natural products such as <a href="https://www.ncbi.nlm.nih.gov/pubmed/23440782">vitamin C</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4068831/">echinacea</a> are sometimes recommended to prevent and treat a cold, but there is limited evidence to support their effectiveness. </p>
<h2>The flu</h2>
<p><a href="https://www.cdc.gov/flu/index.htm">Common symptoms of the flu</a> include fever (a temperature of 38°C or higher), cough, chills, sore throat, headache, runny or stuffy nose, tiredness and muscle aches. </p>
<p>An infected person can <a href="https://www.cdc.gov/flu/keyfacts.htm">spread the flu</a> for five to seven days after becoming infected. The infectious period can begin 24 hours before the onset of symptoms. This means you can spread the flu without even knowing you’re sick. </p>
<p>Influenza viruses can cause mild to severe illness in people of all ages. Most people will fully recover within one to two weeks and won’t require any medical attention. Similar to a cold, people can take some over-the-counter medications and other remedies to help alleviate symptoms. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/explainer-whats-new-about-the-2018-flu-vaccines-and-who-should-get-one-94514">Explainer: what's new about the 2018 flu vaccines, and who should get one?</a>
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<p>But some people can become acutely unwell with the flu. They may require <a href="http://www.who.int/features/qa/seasonal-influenza/en/">antiviral medication</a> and, in severe cases, hospitalisation. Those at <a href="http://www.who.int/features/qa/seasonal-influenza/en/">high risk</a> include pregnant women, children, the elderly, and people with certain medical conditions such as HIV/AIDS, asthma, diabetes and heart and lung diseases.</p>
<p>The flu virus strains that circulate usually change every year, so the <a href="https://www.cdc.gov/flu/protect/vaccine/general.htm">best way to prevent getting the flu</a> is to get the annual flu vaccine. The vaccine is <a href="https://www.sciencedirect.com/science/article/pii/S147330991170295X">moderately effective</a> and recommended for adults and children over the age of six months. Some common side effects may occur, such as temporary soreness, redness and swelling at the injection site, fever, headache, muscle aches and nausea. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/228753/original/file-20180723-189313-faf8u9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/228753/original/file-20180723-189313-faf8u9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/228753/original/file-20180723-189313-faf8u9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/228753/original/file-20180723-189313-faf8u9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/228753/original/file-20180723-189313-faf8u9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/228753/original/file-20180723-189313-faf8u9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/228753/original/file-20180723-189313-faf8u9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Wash with soap for at least 20 seconds to kill the germs.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/260417144?src=vDRcJtwMutu4tY5XwXcGxQ-1-0&size=huge_jpg">Shutterstock/Alexander Raths</a></span>
</figcaption>
</figure>
<h2>Avoid passing it on</h2>
<p>If you feel unwell, stay home from work or school and rest (and get plenty of fluids) until you feel better. If you’ve had a fever, <a href="https://www.cdc.gov/flu/takingcare.htm">stay home for at least 24 hours</a> after the fever has broken.</p>
<p>When you go back to work or school, you may still be infectious, so avoid passing the virus on by:</p>
<ul>
<li><p>regularly washing your hands with soap and water for at least 20 seconds and drying them properly – if soap and water are not available, use an alcohol-based hand sanitiser</p></li>
<li><p>practising good cough and sneeze etiquette: cover your mouth and nose with a tissue or your upper shirtsleeve when you cough or sneeze, and throw away used tissues immediately </p></li>
<li><p>not touching your eyes, nose and mouth </p></li>
<li><p>frequently cleaning the surfaces and objects you’ve touched.</p></li>
</ul><img src="https://counter.theconversation.com/content/98702/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Nadia Charania does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Most adults get two to three colds per year, while the flu is less common but more severe. Here’s how to stop spreading them to others.Nadia Charania, Senior Lecturer, Public Health, Auckland University of TechnologyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/983792018-07-10T20:01:49Z2018-07-10T20:01:49ZCurious Kids: Why does my snot turn green when I have a cold?<figure><img src="https://images.theconversation.com/files/223741/original/file-20180619-126556-15boyhk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Ah-choo!</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p><em>This is an article from <a href="https://theconversation.com/au/topics/curious-kids-36782">Curious Kids</a>, a series for children. The Conversation is asking kids to send in questions they’d like an expert to answer. All questions are welcome – serious, weird or wacky!</em> </p>
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<blockquote>
<p><strong>Why does my snot turn green when I have a cold? – Xavier, age 8, Clifton Hill, Victoria.</strong></p>
</blockquote>
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<p>That’s a great question Xavier! The first thing for us to think about is what <em>is</em> snot? When we are healthy, snot is just what scientists call mucus.</p>
<p>Mucus is a gel that lines our nose, our intestines, and even our lungs. It’s very sticky and slippery. This is because mucus is designed to help keep the germs and bugs out of our body. Any bugs that try and get in, should just get stuck in this mucus and then blown out or swallowed (where they would mostly be destroyed by our powerful stomach acids).</p>
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<strong>
Read more:
<a href="https://theconversation.com/curious-kids-why-do-tears-come-out-of-our-eyes-when-we-cry-84361">Curious Kids: Why do tears come out of our eyes when we cry?</a>
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<p>Sometimes this doesn’t work and the germs infect our body. A cold is caused by a virus, and these like to get inside of our cells and make us sick. When we get sick our immune system needs to get rid of the virus and make us better. </p>
<h2>Our immune system</h2>
<p>Our immune system is made up of lots of different parts. One part is a special cell called a “neutrophil”. Neutrophils are a type of cell called a “phagocyte”. Phagocyte means a cell that eats things.</p>
<p>Neutrophils like to eat bugs, or our own cells that are damaged by infections like viruses that cause a cold. When we have a cold, neutrophils are one of the cells that help us get better.</p>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/225421/original/file-20180629-117382-1vaoii.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/225421/original/file-20180629-117382-1vaoii.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/225421/original/file-20180629-117382-1vaoii.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=582&fit=crop&dpr=1 600w, https://images.theconversation.com/files/225421/original/file-20180629-117382-1vaoii.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=582&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/225421/original/file-20180629-117382-1vaoii.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=582&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/225421/original/file-20180629-117382-1vaoii.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=731&fit=crop&dpr=1 754w, https://images.theconversation.com/files/225421/original/file-20180629-117382-1vaoii.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=731&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/225421/original/file-20180629-117382-1vaoii.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=731&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A neutrophil cell.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Blausen_0676_Neutrophil_(crop).png">https://commons.wikimedia.org/wiki/File:Blausen_0676_Neutrophil_(crop).png</a></span>
</figcaption>
</figure>
<p>These neutrophils work very quickly, but they don’t live for very long. Once they die we need to get rid of them, and they end up in our snot.</p>
<p>Neutrophils have different ways of helping us get better. They can eat bugs, they can send out nets and catch bugs, or they can send out chemicals to kill bugs. All of these processes use a special chemical called MPO (that stands for myeloperoxidase but don’t worry, most scientists just call it MPO).</p>
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<strong>
Read more:
<a href="https://theconversation.com/curious-kids-do-astronauts-get-space-sick-when-they-travel-from-earth-to-the-international-space-station-82888">Curious Kids: Do astronauts get space sick when they travel from Earth to the International Space Station?</a>
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<p>MPO is a chemical that makes a type of bleach. Just like you might use bleach when you are cleaning your home, this bleach kills infections. Neutrophils release MPO to kill any germs that it has eaten, or sends it out with its nets, or as one of the chemicals that it releases to kill any bugs.</p>
<p>MPO contains a green colour. And because the dead neutrophils end up in our snot, the MPO in the neutrophils makes our snot look green. </p>
<p>Lots of people think green snot means you are really sick, or that you need antibiotics to treat your infection. But this is not true. Green snot is actually a sign that our immune system is working and that we are getting better. </p>
<hr>
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<figure class="align-middle ">
<img alt="" src="https://images.theconversation.com/files/168011/original/file-20170505-21620-huq4lj.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/168011/original/file-20170505-21620-huq4lj.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=376&fit=crop&dpr=1 600w, https://images.theconversation.com/files/168011/original/file-20170505-21620-huq4lj.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=376&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/168011/original/file-20170505-21620-huq4lj.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=376&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/168011/original/file-20170505-21620-huq4lj.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=472&fit=crop&dpr=1 754w, https://images.theconversation.com/files/168011/original/file-20170505-21620-huq4lj.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=472&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/168011/original/file-20170505-21620-huq4lj.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=472&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="attribution"><a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
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<p><em>Please tell us your name, age and which city you live in. You can send an audio recording of your question too, if you want. Send as many questions as you like! We won’t be able to answer every question but we will do our best.</em></p><img src="https://counter.theconversation.com/content/98379/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kim Murphy does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Many people think green snot means you are really sick, or that you need antibiotics. Not true. Green snot is actually a sign that our immune system is working and that we are getting better.Kim Murphy, Immunology researcher, Monash UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/867642018-01-02T20:51:04Z2018-01-02T20:51:04ZThree reasons to get your stress levels in check this year<figure><img src="https://images.theconversation.com/files/199170/original/file-20171214-27568-nrfd00.jpg?ixlib=rb-1.1.0&rect=0%2C450%2C1879%2C916&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">People who are chronically stressed are more than twice as likely to have a heart attack than those who aren't.</span> <span class="attribution"><a class="source" href="https://unsplash.com/photos/1K9T5YiZ2WU">Tim Gouw</a></span></figcaption></figure><p>It’s difficult not to get stressed in our fast-paced lives. Whether you’re working overtime, battling exams, or caring for a sick relative, chronic stress has become commonplace. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/196461/original/file-20171127-2009-9zdxrs.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/196461/original/file-20171127-2009-9zdxrs.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=823&fit=crop&dpr=1 600w, https://images.theconversation.com/files/196461/original/file-20171127-2009-9zdxrs.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=823&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/196461/original/file-20171127-2009-9zdxrs.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=823&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/196461/original/file-20171127-2009-9zdxrs.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1034&fit=crop&dpr=1 754w, https://images.theconversation.com/files/196461/original/file-20171127-2009-9zdxrs.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1034&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/196461/original/file-20171127-2009-9zdxrs.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1034&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Adrenaline allows us to act quickly.</span>
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<p>When we’re acutely stressed, the fight-or-flight system jumps into action, sending a surge of adrenaline through the body. This product of evolution dramatically increases our reaction speed and once allowed us to escape or fight a predator. </p>
<p>But our bodies are not designed to cope with ongoing activity of these stress pathways. </p>
<p>The psychological effects of stress – such as irritability, loss of appetite, and difficulty sleeping – are obvious to anyone who has been under pressure. But stress also has subtle, underlying effects on almost every part of the body, including the heart, gut and immune system. </p>
<p>Here are just three reasons to get your stress levels in check this year. </p>
<h2>1. You’re at risk of a heart attack</h2>
<p>When activated, the fight-or-flight system causes blood pressure to spike and redirects blood flow away from non-essential parts of the body and into the muscles. </p>
<p>Consistently high blood pressure or frequent spikes strain the coronary arteries serving the heart. Higher blood pressure with each beat causes arteries to slowly stiffen and become clogged, which impedes blood flow to the heart.</p>
<p>One study found people who were chronically stressed, either in their work or home life, were <a href="https://www.ncbi.nlm.nih.gov/pubmed/15364185">more than twice as likely to have a heart attack</a> than those who weren’t.</p>
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<p>
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<strong>
Read more:
<a href="https://theconversation.com/health-check-what-do-my-blood-pressure-numbers-mean-29212">Health Check: what do my blood pressure numbers mean?</a>
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<p>Another effect of stress on the cardiovascular system is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2633295/">hyper-responsiveness</a>. When a person is suffering low but persistent levels of stress, their response to an added source of stress is much more intense than normal, leading to larger spikes in heart rate and blood pressure. </p>
<p>Again, the increased blood pressure damages blood vessels and increases the chances of blockages and heart attacks.</p>
<h2>2. Your bathroom habits are unpredictable</h2>
<p>The same systems that increase blood pressure and heart rate during stress also cause food to be digested more slowly. </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/196637/original/file-20171128-2089-1hj5igm.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/196637/original/file-20171128-2089-1hj5igm.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/196637/original/file-20171128-2089-1hj5igm.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=649&fit=crop&dpr=1 600w, https://images.theconversation.com/files/196637/original/file-20171128-2089-1hj5igm.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=649&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/196637/original/file-20171128-2089-1hj5igm.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=649&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/196637/original/file-20171128-2089-1hj5igm.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=816&fit=crop&dpr=1 754w, https://images.theconversation.com/files/196637/original/file-20171128-2089-1hj5igm.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=816&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/196637/original/file-20171128-2089-1hj5igm.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=816&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Chronic stress can make you constipated or have diarrhoea.</span>
<span class="attribution"><span class="source">Marcella Cheng/The Conversation</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
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<p>The chemicals produced by the stomach and intestines change when you’re stressed. Food gets broken down in different ways and the body may have difficulty absorbing the nutrients from it. This can lead to constipation, diarrhoea and general intestinal discomfort. </p>
<p>Chronic stress has <a href="https://www.ncbi.nlm.nih.gov/pubmed/22314561">also been linked</a> to more serious diseases such as irritable bowel syndrome and inflammatory bowel disease. While the reasons for this still aren’t clear, it’s thought that chronic stress causes bowel disease by increasing inflammation from intestinal immune cells called mast cells.</p>
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Read more:
<a href="https://theconversation.com/so-you-think-you-have-ibs-coeliac-disease-or-crohns-heres-what-it-might-mean-for-you-39128">So you think you have IBS, coeliac disease or Crohn’s? Here’s what it might mean for you</a>
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<p>Treatment for these diseases usually revolve around managing the painful and uncomfortable symptoms instead of addressing the underlying cause. However some therapies, <a href="https://www.ncbi.nlm.nih.gov/pubmed/20554042">such as the hormone melatonin</a>, work by reducing the effects of stress on the gut.</p>
<h2>3. You’re more likely to get sick</h2>
<p>We’ve long known that stress makes people more vulnerable to catching minor illnesses but we’ve only begun to understand <em>how</em> stress affects the immune system over the past few decades. </p>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/196650/original/file-20171128-2066-12vxfas.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/196650/original/file-20171128-2066-12vxfas.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/196650/original/file-20171128-2066-12vxfas.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=566&fit=crop&dpr=1 600w, https://images.theconversation.com/files/196650/original/file-20171128-2066-12vxfas.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=566&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/196650/original/file-20171128-2066-12vxfas.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=566&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/196650/original/file-20171128-2066-12vxfas.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=712&fit=crop&dpr=1 754w, https://images.theconversation.com/files/196650/original/file-20171128-2066-12vxfas.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=712&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/196650/original/file-20171128-2066-12vxfas.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=712&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Students who were less stressed when receiving the vaccination had a better immune response than their anxious peers.</span>
<span class="attribution"><span class="source">Marcella Cheng/The Conversation</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
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<p>The best examples of this come from a study of chronically stressed carers who look after patients with Alzheimer’s disease, and another of medical students in the middle of their exam period. </p>
<p>When given the flu vaccine, the stressed caretakers had a lower immune response to the vaccine than normal. </p>
<p>Conversely, when the medical students in the middle of their exam periods were vaccinated against hepatitis, the students with better social support and lower levels of stress and anxiety had a much better immune response to the vaccine than other students.</p>
<p>In other words, when the participants were stressed, their immune system didn’t function as it should to recognise and defend against the virus. The same occurs for colds and flus, other viruses, bacterial infections and even <a href="https://www.ncbi.nlm.nih.gov/pubmed/15465465">cancer</a>.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/explainer-what-is-the-immune-system-19240">Explainer: what is the immune system?</a>
</strong>
</em>
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<p>When stress causes the immune system to break down, a bug that might have been under control can suddenly start flourishing. Once a person begins feeling sick, their stress levels will likely rise and make it <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361287/">harder for the immune system</a> to fight off the disease. This prolongs the illness and increases the risk it will be passed on to another person.</p>
<h2>How to reduce your stress levels</h2>
<p>There are many strategies available to reduce the effects of stress, but their health benefits have only recently started to be researched and understood over the past few decades. </p>
<p>An interesting example of this came from an experiment in 2002, where subjects were given injections of artificial adrenaline to increase their blood pressure and heart rate. But when one of the subjects got bored and started meditating, their heart rate <a href="https://www.ncbi.nlm.nih.gov/pubmed/12372589">suddenly dropped back to normal</a>, even with the researchers attempting to increase it artificially.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/196655/original/file-20171128-2016-18lsj0e.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/196655/original/file-20171128-2016-18lsj0e.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/196655/original/file-20171128-2016-18lsj0e.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=332&fit=crop&dpr=1 600w, https://images.theconversation.com/files/196655/original/file-20171128-2016-18lsj0e.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=332&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/196655/original/file-20171128-2016-18lsj0e.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=332&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/196655/original/file-20171128-2016-18lsj0e.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=417&fit=crop&dpr=1 754w, https://images.theconversation.com/files/196655/original/file-20171128-2016-18lsj0e.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=417&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/196655/original/file-20171128-2016-18lsj0e.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=417&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Meditation helps some people lower their blood pressure.</span>
<span class="attribution"><span class="source">Marcella Cheng/The Conversation</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p>This finding was applied in a 2008 study, where researchers took newly diagnosed breast cancer patients and enrolled them in a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2586059/">mindfulness-based stress-reduction program</a> that focused on breath awareness, meditation and yoga.</p>
<p>After eight weeks of participation in the program, the immune systems of the women had all made a remarkable recovery, and were functioning just as well as a healthy person’s immune system. The women also reported feeling much more optimistic about their future, as well as feeling more connected with their family and friends.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/mindfulness-how-to-be-in-the-moment-right-here-right-now-31576">Mindfulness: how to be in the moment ... right here, right now</a>
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<p>Interestingly, short bursts of acute stress can be beneficial to immune function, particularly of that associated with exercise. While solid evidence is still lacking in humans, <a href="https://www.ncbi.nlm.nih.gov/pubmed/26895752">mice received a huge benefit from frequent exercise</a> while fighting off melanoma.</p>
<p>In the end, it comes down to being aware of your stress levels, and what works for <em>you</em> to get your stress in check. You might be surprised at just how many of your bodily functions benefit from you being a bit more relaxed.</p><img src="https://counter.theconversation.com/content/86764/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Stephen Mattarollo receives funding from National Health and Medical Research Council. Previously received funding from Leukemia Foundation Queensland and Cancer Australia/Cure Cancer Australia. </span></em></p><p class="fine-print"><em><span>Michael Nissen receives funding from the Australian Federal Government in the form of a Research Training Program scholarship.</span></em></p>Stress has subtle, underlying effects on almost every part of the body, including the heart, gut and immune system.Stephen Mattarollo, NHMRC Career Development Fellow, Diamantina Institute, The University of QueenslandMichael Nissen, PhD Candidate in Immunology, The University of QueenslandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/639602016-08-15T19:30:14Z2016-08-15T19:30:14ZHow your body clock helps determine whether you’ll get ill or not<figure><img src="https://images.theconversation.com/files/134123/original/image-20160815-27199-10imdsv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Next time just work with your body clock.</span> <span class="attribution"><span class="source">Marcos Mesa Sam Wordley</span></span></figcaption></figure><p>From vitamin C and echinacea to warm clothes and antibacterial soap, there’s no shortage of ideas about how to prevent and manage colds and flu. Unfortunately, many of these are <a href="http://www.dailymail.co.uk/health/article-1319698/Cold-cures-Why-thought-knew-wrong.html">not based on solid scientific evidence</a>. In fact, medical researchers are only starting to unravel the range of factors that affect our susceptibility to getting an infection. Now we have discovered that our <a href="http://www.pnas.org/content/early/2016/08/10/1601895113.abstract">body clock</a> plays an important role – making us more prone to get infected at certain times of the day. </p>
<p>It is perhaps easy to forget that we have co-evolved on this planet with micro-organisms, including bacteria, which may be either beneficial or harmful to us. Similarly, viruses cannot copy themselves without help from our cells. Without us, they simply wouldn’t exist.</p>
<p>So what happens when a virus encounters a cell? First, it has to get in through a protective barrier called the cell membrane. Then it has to hijack the interior of the “host” cell to subvert it and divert all resources to copy itself millions of times. Once an army of identical clones is formed, it breaks out of the cell, usually destroying it in the process. Imagine millions of these new viruses then being able to do exactly the same to other cells nearby. The cycle goes on, with often rapid amplification of the virus through a tissue, and then through the body. </p>
<p>That’s if the virus had it all its own way … But there is always a battle in play between invading organisms and our bodies. Our immune system counteracts the invading organisms and will invoke mechanisms to stop the virus entering, replicating and spreading. This defence system works at the level of individual cells in the body, but also in specialised tissues of the body that are designed to mount a response to such invasions.</p>
<p>It now turns out that our body clock is also an important gatekeeper of virus infections. The body clock is an amazing piece of evolutionary biology. It’s thought that most organisms on our planet have a <a href="http://www.nature.com/nature/journal/v485/n7399/full/nature11088.html">biological clock</a> that keeps track of the 24-hour day. It can do this by orchestrating chemical reactions and genetic switches that rhythmically control thousands of genes in cells in the cell – turning about 15% of all genes on and off across the day and night.</p>
<h2>Timely experiment</h2>
<p>So why might viruses care about our body clock? Since our cells are miniature factories, making things that the virus must have to copy itself, the virus is less likely to succeed when the production line is shut down. This is what we tested in the laboratory, by infecting cells and mice at different times of the day. We found that viruses are less able to infect in the late afternoon. In contrast, in the early morning, our cells are hives of biosynthetic activity, at least from the virus’s viewpoint. So, if a virus tries to take over a cell in the early day, it is far more likely to succeed, and spread faster, than if it encounters a rather less favourable climate in the evening.</p>
<p>Perhaps even more interestingly, when the clockwork is disrupted, viruses are more prolific at taking over cells and tissues. Such “clock misalignment” can happen when we do shift work, get jet lagged, or experience the phenomenon of “<a href="http://www.webmd.com/sleep-disorders/news/20120510/do-you-have-social-jet-lag#1">social jet lag</a>”, which is caused by changes in our sleep schedule on our days off. Therefore, it’s important to know about these interactions because it will undoubtedly help us to find ways to ensure better health for ourselves. For example, since we know shift workers are more likely to get <a href="http://www.ncbi.nlm.nih.gov/pubmed/12449906">infections</a>, it might be a good idea to give them flu vaccinations.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/134130/original/image-20160815-14904-1ala4uz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/134130/original/image-20160815-14904-1ala4uz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/134130/original/image-20160815-14904-1ala4uz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/134130/original/image-20160815-14904-1ala4uz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/134130/original/image-20160815-14904-1ala4uz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/134130/original/image-20160815-14904-1ala4uz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/134130/original/image-20160815-14904-1ala4uz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Perhaps nightclub germs aren’t so threatening after all.</span>
<span class="attribution"><span class="source">*sax/Flickr</span>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>Knowing about the clock and viruses could also help us to design better public health measures to combat virus spread. You could imagine that during a pandemic limiting exposure during the early daytime could be a small but important intervention to try to prevent viral infection from taking hold. Indeed, a recent study by a team at the University of Birmingham showed that vaccinating people against flu <a href="http://www.birmingham.ac.uk/news/latest/2016/04/vaccinations-more-effective-in-the-morning.aspx">in the morning</a> is more effective than in the evening. This principle could be the same for many unrelated viruses.</p>
<p>The research could also help us crack a longstanding enigma – why do virus infections like flu happen more commonly in the winter months? It turns out that the very same molecular switch – called Bmal1 – that goes up and down in the day and night also changes <a href="http://www.nature.com/articles/ncomms8000">according to the seasons</a>, going up in the summer and down in the winter. When we artificially lower Bmal1 levels in mice and cells, the virus is able to infect more. As occurs on a daily basis, the waxing and waning of Bmal1 in our bodies could be a reason why we’re less likely to cope with viruses like flu in the winter. </p>
<p>So, if you’re desperate to avoid catching a flu virus that’s been going around the office, rather than trying to boost your immune system with various vitamins, you may want to try to simply work from home in the mornings.</p><img src="https://counter.theconversation.com/content/63960/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Akhilesh Reddy receives funding from the Wellcome Trust and the European Research Council.</span></em></p>Stay away from viruses in the early morning – and in winter.Akhilesh Reddy, Wellcome Trust Senior Fellow in Clinical Sciences at the Department of Clinical Neurosciences, University of CambridgeLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/427592015-07-13T04:28:04Z2015-07-13T04:28:04ZHealth Check: I feel a bit sick, should I stay home or go to work?<figure><img src="https://images.theconversation.com/files/87863/original/image-20150709-31590-1ilwy3d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">People aren't productive at work when they're ill and they risk infecting others.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/williambrawley/4867472163/">William Brawley/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p>You wake up on a work day and feel under the weather. If you’re vomiting or have a fever, the decision to stay at home is probably clear cut. But what if you generally feel unwell but are torn about missing work? </p>
<p>We all get minor illness; this is simply a part of the human condition. In winter, the culprit is often the <a href="https://theconversation.com/health-check-when-is-the-flu-really-a-cold-25150">common cold</a>. The average adult gets two or three per year. </p>
<p>The best course of action for the common cold is to rest and stay hydrated. You can use throat lozenges or gargles for sore throats, and the occasional paracetamol for pain. But antibiotics <a href="https://theconversation.com/well-known-antibiotic-amoxycillin-found-to-be-ineffective-cough-treatment-11436">don’t help</a>. And most of the popular treatments for the cold you can buy over-the-counter <a href="https://theconversation.com/health-check-can-you-treat-the-common-cold-25323">don’t work</a> either.</p>
<p>Most people recover fully within ten to 12 days, sometimes much more quickly. </p>
<p>One of the essential activities that we can all do to reduce the risk of passing the cold to others is <a href="https://theconversation.com/washing-our-hands-of-responsibility-for-hospital-infections-10652">good hand hygiene</a>. So wash your hands after coughing, sneezing or handling tissues.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/87866/original/image-20150709-31569-1rlvb9y.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/87866/original/image-20150709-31569-1rlvb9y.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=318&fit=crop&dpr=1 600w, https://images.theconversation.com/files/87866/original/image-20150709-31569-1rlvb9y.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=318&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/87866/original/image-20150709-31569-1rlvb9y.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=318&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/87866/original/image-20150709-31569-1rlvb9y.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=400&fit=crop&dpr=1 754w, https://images.theconversation.com/files/87866/original/image-20150709-31569-1rlvb9y.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=400&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/87866/original/image-20150709-31569-1rlvb9y.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=400&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">For a cold, rest and hydration is best.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/seanfreese/6926759386/">Sean Freese/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
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<p>Self-imposed isolation – staying at home – is an important measure to avoid spreading the virus. With the common cold, we are <a href="http://www.cf.ac.uk/biosi/subsites/cold/commoncold.html">most infective</a> during the early symptoms of sneezing, runny nose and a cough. </p>
<p>The number of days to take off work depends on the severity of the illness, and the nature of the work and workplace. It’s important for an intensive care nurse, for instance, to avoid any contact with critically ill patients while they have symptoms. An office worker? Perhaps a few days if you have uncontrolled sneezing and coughing, and feel unwell.</p>
<p>What about <a href="https://theconversation.com/explainer-what-is-stomach-flu-15412">gastroenteritis</a>? “Gastro” causes nausea and vomiting, diarrhoea, tummy cramps and pain. People suffering from the typical viral gastroenteritis in Australia recover within five to seven days.</p>
<p>Like the common cold, it’s important to wash your hands. This is crucial around the preparation and handling of food. Viral gastroenteritis is highly contagious and the virus can be spread for at least <a href="http://www.health.gov.au/internet/publications/publishing.nsf/Content/cda-cdna-norovirus.htm-l%7Ecda-cdna-norovirus.htm-l-app2">two days after</a> diarrhoea or vomiting stops. </p>
<p>The amount of time to take off work depends on the individual’s illness and the risk to public health. As GPs, we would insist, for instance, that a chef not return to work until at least two days after their last vomit or loose bowel motion.</p>
<p>We’ve recently had many discussions with worried parents about <a href="http://www.rch.org.au/kidsinfo/fact_sheets/Hand_foot_and_mouth_disease_coxsackie_virus/">hand, foot and mouth disease</a> (HFMD). This mild viral infection is particularly common in children in childcare and school. As indicated by its name, it can cause small blisters on the hands, feet, the inside of the mouth and tongue, and also around the nappy area. </p>
<p>HFMD can be spread from the fluid inside the blisters, but also from coughing and sneezing. The virus is in the bowel motions as well.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/87869/original/image-20150709-10899-y1n6tm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/87869/original/image-20150709-10899-y1n6tm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=466&fit=crop&dpr=1 600w, https://images.theconversation.com/files/87869/original/image-20150709-10899-y1n6tm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=466&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/87869/original/image-20150709-10899-y1n6tm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=466&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/87869/original/image-20150709-10899-y1n6tm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=586&fit=crop&dpr=1 754w, https://images.theconversation.com/files/87869/original/image-20150709-10899-y1n6tm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=586&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/87869/original/image-20150709-10899-y1n6tm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=586&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Children should stay away from childcare or school until blisters are dry.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-139906510/stock-photo-group-of-kids-playing-with-colorful-constructor-on-floor.html?src=jOM96hT-X0MVweyh_bMJHg-1-69">Olesya Feketa/Shutterstock</a></span>
</figcaption>
</figure>
<p>Again, hand-washing is important to stop the spread. Don’t pop the blisters, and avoid sharing cups, plates and eating utensils. </p>
<p>The blisters are no longer contagious once they dry, and the usual recommendation is for children to stay at home from childcare until they do. Unfortunately for parents, this can take seven to ten days. </p>
<p>What about <a href="https://theconversation.com/craig-thomson-saga-shows-doctors-certificates-are-a-sick-joke-3354">sick notes</a>? </p>
<p>For the most part, the number of days to take off work for minor illnesses that resolve without treatment is a matter of common sense. As GPs, we’re often bemused by the mutual waste of time that occurs every winter as people see us for no other reason than needing a sick note.</p>
<p>As a society, we need to move away from <a href="https://theconversation.com/craig-thomson-saga-shows-doctors-certificates-are-a-sick-joke-3354">requiring a sick certificate</a> from the doctor for minor work absences. You don’t need to doctor’s “permission” to be sick so you shouldn’t need it to take sick leave. </p>
<p>People aren’t productive at work when they’re ill and they risk infecting others. The responsibility for this should lie with employers and employees – after all, they know their own workplaces best. </p>
<p><em>Dr Alan Huynh, a general practice registrar from the General Practice Unit, Fairfield Hospital, co-authored this article.</em></p><img src="https://counter.theconversation.com/content/42759/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michael Tam does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>You wake up and feel under the weather. If you’re vomiting or have a fever, the decision to stay at home is probably clear cut. But what if you generally feel unwell but are torn about missing work?Michael Tam, General Practitioner, and Conjoint Senior Lecturer, UNSW SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/364812015-05-08T03:45:39Z2015-05-08T03:45:39ZThe low-down on ‘cold and flu’ tablets<figure><img src="https://images.theconversation.com/files/80271/original/image-20150504-2081-1htuo8r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Cold and flu tablets won’t cure a cold.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/_flood_/6414786713">Flood G./Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span></figcaption></figure><p>Winter is approaching. Your nose is stuffy and you feel a cold coming on. You head to the pharmacy to find an aisle full of cold and flu tablets. </p>
<p>Each year Australians spend more than <a href="http://www.asmi.com.au/media/12687/asmi945_ar_13-14-single_pages_final.pdf">A$500 million</a> on cold and flu medicines. Choosing between the <a href="http://www.tga.gov.au/otc-cough-and-cold-medicines-available-australia">hundreds of different</a> cold and flu tablets available in Australia can be difficult, as each product may contain three or four different medicines. </p>
<p>So, which product is the best one for your symptoms? And will it really help you feel better?</p>
<h2>No cure</h2>
<p>Cold and flu tablets won’t cure a cold. Colds are <a href="https://theconversation.com/health-check-when-is-the-flu-really-a-cold-25150">caused by viruses</a> and symptoms <a href="http://www.nps.org.au/conditions/respiratory-problems/respiratory-tract-infections/for-individuals/conditions/common-cold/for-individuals/symptoms">generally resolve</a> within ten days. Getting plenty of rest and keeping your fluids up may help you feel better.</p>
<p>There is <a href="http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004976.pub3/abstract">some evidence</a> that combination cold and flu tablets may provide relief from general symptoms in adults but not everyone will benefit. </p>
<p>The small benefits from treatment also need to be weighed up against the risk of side effects and the cost of the medicine.</p>
<h2>How do cold and flu tablets work?</h2>
<p>Cold and flu tablets may contain decongestants, pain relievers, antihistamines and cough suppressants. And tablets marketed for “daytime” symptoms often contain different medicines to “night-time” tablets.</p>
<p><strong>Decongestants</strong> such as <a href="http://www.nps.org.au/medicines/respiratory-system/cough-and-cold-medicines/for-individuals/cough-and-cold-medicines-active-ingredients/phenylephrine-hydrochloride-cough-and-cold-medicines">phenylephrine</a> or <a href="http://www.nps.org.au/medicines/respiratory-system/cough-and-cold-medicines/for-individuals/cough-and-cold-medicines-active-ingredients/pseudoephedrine-hydrochloride">pseudoephedrine</a> may help to relieve a blocked nose. These medicines work by narrowing the blood vessels. The reduction in blood flow reduces swelling and congestion in the nose. </p>
<p>Decongestant tablets can have effects beyond the nose and may exacerbate other medical conditions such as <a href="http://archinte.jamanetwork.com/article.aspx?articleid=765664">high blood pressure</a>, so speak to your pharmacist before taking these medicines. These medicines can also cause sleeplessness, nervousness or dizziness. </p>
<p>In Australia, cold and flu tablets containing phenylephrine can be purchased from the pharmacy or supermarket. Products containing pseudoephedrine can only be supplied after consultation with the pharmacist or on a prescription.</p>
<p>Cold and flu tablets often contain <strong>paracetamol</strong> for relieving aches and pains. Other products marketed for joint pain, headaches, back pain and period pain also contain <a href="http://www.nps.org.au/medicines/pain-relief/simple-pain-reliever-and-fever-medicines/paracetamol">paracetamol</a>, so check labels carefully to avoid taking more than recommended.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/80272/original/image-20150504-2077-hr7fuy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/80272/original/image-20150504-2077-hr7fuy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/80272/original/image-20150504-2077-hr7fuy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/80272/original/image-20150504-2077-hr7fuy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/80272/original/image-20150504-2077-hr7fuy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/80272/original/image-20150504-2077-hr7fuy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/80272/original/image-20150504-2077-hr7fuy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Decongestant tablets can have effects beyond the nose.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/micahrr/5386083144">findingtheobvious/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p><strong>Antihistamines</strong> such as <a href="https://www.nps.org.au/medicines/respiratory-system/cough-and-cold-medicines/for-individuals/cough-and-cold-medicines-active-ingredients/chlorpheniramine-maleate-phenylephrine-hydrochloride">chlorpheniramine</a>, <a href="http://www.nps.org.au/medicines/allergic-disorders/antihistamine-medicines/dexchlorpheniramine-maleate">dexchlorpheniramine</a> or <a href="http://www.nps.org.au/medicines/brain-and-nervous-system/sedatives-and-medicines-for-sleep-problems/doxylamine-succinate">doxylamine</a> may help with allergic symptoms such as sneezing. These medicines work by blocking the effects of histamine in the body. </p>
<p>Antihistamines can cause drowsiness and are often included in “night-time” cold and flu tablets. If your sleep is affected by decongestant tablets, try avoiding the decongestant late in the day or switch to a decongestant nasal spray, rather than taking a tablet containing an antihistamine and a decongestant.</p>
<p>Cold and flu tablets may also contain <strong>cough suppressants</strong> such as <a href="http://www.nps.org.au/medicines/respiratory-system/cough-and-cold-medicines/for-individuals/cough-and-cold-medicines-active-ingredients/dextromethorphan-hydrobromide">dextromethorphan</a>. These medicines are used to relieve symptoms from a dry cough by acting on the “cough centre” in the brain. </p>
<p>Cough suppressants can sometimes cause drowsiness and are best avoided when coughing up mucous (a “wet” cough).</p>
<h2>Which cold and flu product is best for me?</h2>
<p>Think about your main symptoms when selecting a product and read the label carefully. </p>
<p>Avoiding medicines you don’t need will reduce the risk of side effects. A decongestant-only tablet or nasal spray, for instance, may be better than a combination product when your main symptom is a blocked nose. </p>
<p>It’s best not to use more than one cold and flu product at the same time without checking with your doctor or pharmacist.</p>
<p>Cold and flu products may not be suitable for some people. Always ask your pharmacist for advice if you have pre-existing medical conditions, or you are pregnant or breastfeeding. </p>
<p>Cold and flu medicines are <a href="http://www.tga.gov.au/behind-news/cough-and-cold-medicines-children-changes">not suitable</a> for children under six years of age and should only be given to children aged six to 11 years after discussion with a doctor or pharmacist.</p>
<h2>The fine print</h2>
<p>Cold and flu products are intended for short-term use only. <a href="https://www.nps.org.au/__data/assets/pdf_file/0004/211567/NPS-Cold-and-Flu-Brochure-May-2014.pdf">See your doctor</a> if your symptoms get worse.</p>
<hr>
<p><em>If you have specific questions about cold and flu tablets, ask your pharmacist for further advice, check the <a href="http://www.nps.org.au/topics/how-to-be-medicinewise/finding-information-on-medicines/what-is-consumer-medicine-information">consumer medicines information</a> (CMI) for the specific product, or call <a href="http://www.nps.org.au/contact-us/medicines-line">Medicines Line</a> on 1300 633 424.</em></p><img src="https://counter.theconversation.com/content/36481/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Janet Sluggett has received funding from the Australian Commission on Safety and Quality in Health Care, and works on a national quality improvement program funded by the Australian Government Department of Veterans' Affairs. Janet is a member of a national working group that makes recommendations about the advisory labels affixed to medicines when they are dispensed.</span></em></p>Pharmacies have aisles full of cold and flu tablets. But which product is the best one for you? And will it really help you feel better?Janet Sluggett, Research Fellow: Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute for Health Research, University of South AustraliaLicensed as Creative Commons – attribution, no derivatives.