The Common Cold Richard Saint Cyr MD DABFP [email_address] www.myhealthbeijing.com August 2, 2009

Case: A Runny Nose 流鼻涕 liubiti

Case: A Runny Nose It is early March A young kindergarten teacher has two days sore throat Day 3: runny nose, cough, mild headache No fever

It is early March

A young kindergarten teacher has two days sore throat

Day 3: runny nose, cough, mild headache

No fever

Question: What Next? Antiviral pills Antibiotic pills Ganmaoqingrenkeli 感冒清热颗粒 Tylenol Cold pills 泰诺感冒片

Antiviral pills

Antibiotic pills

Ganmaoqingrenkeli 感冒清热颗粒

Tylenol Cold pills 泰诺感冒片

Dx: The Common Cold “ Ganmao” 感冒 Infection of head/upper lungs Cause: many viruses not flu virus! When: winter & spring Adults: 2-4 a year Kids: 6-8 a year

“ Ganmao” 感冒

Infection of head/upper lungs

Cause: many viruses

not flu virus!

When: winter & spring

Adults: 2-4 a year

Kids: 6-8 a year

Why So Common? Very infectious! (droplets, air) Virus spreads to to others: 1 day before symptoms 7 days after symptoms >200 viruses Survive on surfaces for hours

Very infectious! (droplets, air)

Virus spreads to to others:

1 day before symptoms

7 days after symptoms

>200 viruses

Survive on surfaces for hours

Symptoms Common: First: Fatigue, sore throat, low fever Then: runny nose; headache; cough Serious: Pneumonia; secondary infections (bacteria) Usual Course: 2-7 days. Cough can stay for weeks

Common:

First: Fatigue, sore throat, low fever

Then: runny nose; headache; cough

Serious:

Pneumonia; secondary infections (bacteria)

Usual Course:

2-7 days.

Cough can stay for weeks

Prevention No vaccine Good hygiene (wash hands!) Avoid sick person Get 8 hours of sleep Don’t smoke Be healthy (foods, exercise) Humidifiers

No vaccine

Good hygiene (wash hands!)

Avoid sick person

Get 8 hours of sleep

Don’t smoke

Be healthy (foods, exercise)

Humidifiers

Humidifiers Help Beijing in winter very dry Worse indoors Healthy humidity 40% Too dry: Increased infections Itchy skin Cracked furniture Yadu brand ~900RMB Each room!

Beijing in winter very dry

Worse indoors

Healthy humidity 40%

Too dry:

Increased infections

Itchy skin

Cracked furniture

Yadu brand ~900RMB

Each room!

Get 8 Hours of Sleep! Less sleep = lower immunity = more infection Study, 2008: Sleep <7 hours vs >8 hours a night 300% more colds

Less sleep = lower immunity = more infection

Study, 2008:

Sleep <7 hours vs >8 hours a night

300% more colds

Prevention: Herbs? FREE SOURCE: http://www.naturaldatabase.com/

FREE SOURCE: http://www.naturaldatabase.com/

How To Prevent Giving To Others Stay home Wash hands Avoid close contact

Stay home

Wash hands

Avoid close contact

Self Treatment: Cough Cough syrups – none work well (0-20%) Children <2: ineffective; dangerous Banned in USA since 2007 Dextromethorphan is best 右美沙芬 “ Delsym” brand - import Lemon & honey tea Any cough drops Ricola; Strepsils Try sugar-free

Cough syrups – none work well (0-20%)

Children <2: ineffective; dangerous

Banned in USA since 2007

Dextromethorphan is best 右美沙芬

“ Delsym” brand - import

Lemon & honey tea

Any cough drops

Ricola; Strepsils

Try sugar-free

Self Treatment: Congestion Mucus color and thickness does not mean bacteria! Nasal salt spray Nasal spray Rx – 3-5 days max. Oxymetazoline “Afrin” 羟甲唑啉 Pill pseudoephedrine “sudafed” 伪麻黄碱 Combo pills: Bufferin Cold 日夜百服咛 Tylenol Cold 泰诺感冒片 Humidifiers

Mucus color and thickness does not mean bacteria!

Nasal salt spray

Nasal spray Rx – 3-5 days max.

Oxymetazoline “Afrin” 羟甲唑啉

Pill pseudoephedrine “sudafed” 伪麻黄碱

Combo pills:

Bufferin Cold 日夜百服咛

Tylenol Cold 泰诺感冒片

Humidifiers

Self Treatment: Herbals FREE SOURCE: http://www.naturaldatabase.com/

FREE SOURCE: http://www.naturaldatabase.com/

What Clinics Can Do Physical exam Lab test: CBC (bacteria vs. virus); chest x-ray Rx: Symptom relief OTC Rx No antiviral medicine works well Hospital/ER: Complications (pneumonia)

Physical exam

Lab test:

CBC (bacteria vs. virus); chest x-ray

Rx:

Symptom relief OTC Rx

No antiviral medicine works well

Hospital/ER:

Complications (pneumonia)

Why No Antibiotics? Caused by virus, not bacteria Antibiotics kill bacteria, not virus X

Caused by virus, not bacteria

Antibiotics kill bacteria, not virus

What Do I Use When I’m Sick? No antibiotic Start ASAP: Zinc tablets (“Zicam” brand) every 2-4 hours Airborne, or Vitamin C tablets every 2-4 hours Symptom relief, as needed: Tylenol Cold or Bufferin Cold pills Nasal spray Humidifier in winter (always on)

No antibiotic

Start ASAP:

Zinc tablets (“Zicam” brand) every 2-4 hours

Airborne, or Vitamin C tablets every 2-4 hours

Symptom relief, as needed:

Tylenol Cold or Bufferin Cold pills

Nasal spray

Humidifier in winter (always on)

Does “Airborne” Work? USA product “created by a schoolteacher” Dissolves in water

USA product “created by a schoolteacher”

Dissolves in water

Antiviral pills Antibiotic pills Ganmaoqingrenkeli 感冒清热颗粒 Tylenol Cold pills 泰诺感冒片 What Next?

Antiviral pills

Antibiotic pills

Ganmaoqingrenkeli 感冒清热颗粒

Tylenol Cold pills 泰诺感冒片