With the season for respiratory infections at our doorstep, some people are destined to be greeted by a scratchy throat in the near future. Many will find themselves pausing to wonder whether the symptom is an early sign of an unfolding battle against an infectious villain, or simply a byproduct of a particularly lively day, or perhaps just a fluctuation in chronic allergy symptoms. How a person responds to these first notable symptoms will be largely determined by which diagnosis they select for themselves. It is worth considering what traditional advice is effective, which is ineffective, and which may actually be detrimental to the progress of an upper respiratory illness.
No public health recommendation would be complete without mentioning the benefits of rest and supportive care. The person who spent an afternoon cheering for their team in the World Series should have no surprise when their voice the next morning seems to have been left in the ball park. Similarly, a person who chooses to smoke a pack of cigarettes each day should be able to connect the dots.
People who suffer the consequences of allergies will often be aware of their sensitivities. If not, then a visit to a health care provider may help to identify the culprit or culprits. Winter allergies often have to do with house dust or molds, while spring and summer allergies are typically inspired by pollen and grasses. Allergic conditions tend to wax and wane over weeks to months, and so are usually easy to distinguish from infections caused by viruses and bacteria, which deliver their irritations with less patience.
Which brings us to the topic of upper respiratory infections. The “upper respiratory system” is usually considered to include the mouth, nose, throat, and larynx (or voice box). Many organisms which infect the upper airways may also spread to infect the lower airways and lungs if the ill person is unable to rally an effective defense against infection. Alternatively, an illness that causes a large amount of mucous in the upper airway and saps a person’s energy may open the door to a second infection with a different organism which may actually be the more severe illness. This is often what happens when a person is ill with a simple cough and sore throat, and then suddenly develops chills, fever (over 100 degrees) and shortness of breath. This latter condition requires an immediate evaluation by a health care provider.
Virus infections of the upper respiratory system rarely require medications. This point is worth repeating: virus infections of the upper respiratory system rarely require medications. In fact, it has recently been recommended that over-the-counter cough medications should not be used for upper respiratory infections in children under 5 years of age for the simple reason that these medications are ineffective and can rarely cause problems. Believe it or not, one study found that chicken soup was more effective than the long list of cold remedies available in the drug store isle. In addition, chicken soup has no detrimental effects, except to the chicken.
The unnecessary use of antibiotics for viral upper respiratory illness is a critical problem. While antibiotic treatments may be completely appropriate for a diagnosis of influenza or pneumonia (lung infection), it is very unusual for antibiotic prescriptions to have any benefit at all for typical “cold” symptoms consisting of stuffy nose and cough. Nevertheless, many patients expect antibiotic prescriptions after they incur the cost of seeking medical help, and this may drive providers to write prescriptions when they are actually not indicated. Unfortunately, the unnecessary use of antibiotics in virus infections has resulted in some antibiotics being less effective in situations where they would otherwise be valuable. As a result many of our most helpful weapons against infection have become ineffective.
Your best bet for treatment of the common cold is probably not found in your medicine cabinet, but rather is in your pantry. If pharmaceutical companies seek to patent a recipe for chicken soup it will be controversial indeed.