Treating Different Types of Colds

Treating Different Types of Colds The next here is common cold. The common cold is prevalent in kids because of the daycare settings, the exposure -- otherwise wise in schools to all the siblings, the sibling’s friends. It is extraordinarily prevalent but it’s actually prevalent in all age groups. It has to be differentiated from allergic rhinitis which is allergies of the nose, foreign bodies in the nose which are very important in kids because kids have a way of sticking anything in any orifice. And when they put something in the nose it causes erosion and irritation of the nose. The key is a nasal foreign body gives cold symptoms at a one nostril not both. The process to whooping cough is becoming more and more a concern in all levels of ages and in its early stages before you get the cough paroxysms it really presents like the common cold. There is a rhinitis medicamentosa which is induced by nose drops. If you use Afrin nose drops and you use an Afrin nose drops, any of these nose drops for a long length of time you can induce the rhinitis so that’s why people are given usually a three-day limit on the use of those vasoconsticting nose drops. Sinusitis is interesting entity because studies have revealed that if you do CT scans-CAT scans on patients who have colds 80% somewhat of them will have sinusitis on the CT scan. The difference is almost all the sinusitis is self-limited and disappears. And it has led to the reason we do not give antibiotics for this but rather only treat sinusitis if the symptoms of sinusitis are present for 10 days or more. Structural abnormalities and vasomotor rhinitis are other differential diagnosis. Vasomotor rhinitis means temperature immediate effects on the nose. Now the pathophysiology as it is called meaning how does cold occur is very important to understand because it has led to a lot of confusion in treatment, and if you understand it, you’ll realize why doctors don’t treat this entity and why color of mucus has absolutely no meaning whatsoever in how you handle this disease. The conjunctivae which are the membranes around the eye become the source of the infection. The infection penetrates and then causes redness and congestion of the nose. The first thing that happens is the white blood cell called the neutrophil comes into the area and it gives a yellow light color. So mothers will come in the office and say my child has a purulent nasal discharge, you must need antibiotics. It is obviously an infection or something that needs the antibiotics. The answer -- its only neutrophils being brought into the area of the viral infection which is not treated and you don’t give any medicine. The next thing is enzymatic activity occurring from the neutrophils causes a green color to the nasal congestion. This leads people to think that again, the child needs antibiotics. It may mean that pneumococcus is just growing there. Therefore, you should give them antibiotics, the answer is it’s incorrect. This is caused by enzymatic activity. It has no sign of colorization with the bacteria causing it and the use of antibiotics are not indicated. Viral shedding for cold is usually in the first two to four days and that’s when you're contagious and I mentioned the sinus X-rays or the present CAT scan are positive yet resolved. Symptoms of a cold and I almost forgot to tell you, hoarseness, decreased appetite, lost of smell, decreased sleep, Eustachian tube dysfunction which leads to ear problems in kids and also the rhinorrhoea or runny nose. There are complications of these of course. You can get bloody nose, otitis media which is a very common pediatric entity. Sinusitis, it can trigger asthma and the people who have a predisposition to asthma and in rare case it can go on to pneumonia which takes one of the most serious side effects of some serious consideration. Conjunctivitis which is infection of the eyes, pharyngitis, infection of the throat and in rare cases you can get peritonsillar disease. However, for the most part, colds are totally benign. They are untreatable, they are unfortunately transmitted by small particles, aerosol that are transmitted by coughing and they are inhaled. Large particles are found in the hands that’s why children have got to wash their hands, you’ve got to wash your hands between handling a patient with the colds or avoid cross-contaminating other patients. You can therefore get hand to hand transmission, conjuctival secretions are concentrated in viruses, the saliva itself is very low, the secretions in the mouth and nasal secretions have especially high content of viruses. The other thing is, rhinoviruses can survive in the surface of the hands for two hours. So it isn't just length of time, you have to wash your hands if you have a cold. A nasal secretion on the hands is a way spread the illness. Now what about treatment? Decongestants is the first form of treatment. Decongestants have never shown to be effective. They are not to be used under the age of two because of toxicity. Antihistamines are drying agents but they're mainly made for allergies, they have no role in this. Expectorants are no better than a good fluid intake and therefore another medicine that sounds like you care but it really has no role. Zinc is not shown to be effective. Analgesics and antipyretics are fair game, they are Tylenol, Advil and medicines like that may make you feel more comfortable. The humidified air is reasonable. What it does is it humidifies the air. It causes less nasal secretion viscosity can be of some help. Menthol is to be discouraged. Antibiotics have no role. You can in little babies, use suctioning and nasal saline especially if they're not sleeping or they're not eating well. The use of Echinacea is never been shown to be effective, vitamin C is not effective and lastly the use of certain anticholinergic nasal sprays are not approved for the most of the pediatric age group that we’re talking about. So by and large, the only thing you can do with a cold is supportive care and just wait in time and it will disappear.