A self-treatment guide for colds and flu

www.chic.org.uk

In the Dark Ages, when the UK was in the grip of the Black Death, the mere suggestion of a sneeze was enough to send people running to get out of your way. Thats because a sneeze was one of the earliest symptoms of the Bubonic Plague. These days, upper respiratory tract infections - that is colds and flu - are the most common of all infections; on average every adult can expect to get two a year, and children even more. But there is usually no need to go to your doctor, or to suffer in silence, as a cold is not serious and you can ease the misery and get through it with the help of over-the-counter medicines. This leaflet will tell you how.

Know your enemy what are colds and flu?

Lets start by sorting out the difference between colds and flu, because there is a difference, although both are virus FACT: The cold season lasts from September to infections. Antibiotics have no effect on viruses, March. 80% of all annual colds are contracted during so there is no point in this time period. trying to get some from in the same way and has similar your doctor to cure a cold. In fact symptoms, flu is quite a nasty there is no cure, you just have to illness and it can lead to serious wait while your bodys natural complications in vulnerable people, defences fight off the virus. This will take several days, but you can such as the elderly and people effectively treat the symptoms and with certain long-term medical conditions. Luckily, just just three make yourself more comfortable types of virus cause flu and a with over-the-counter medicines. vaccine is available. You should be Colds are caused What makes us sneeze? by more than 100 Sneezing may seem like a straightforward different viruses, so many that it is procedure, but, in fact, the tickling in your nose impossible to make that starts a sneeze off is just the beginning a vaccine that of a complicated chain of events. Tickling in would stop us nose message to sneeze centre in brain from getting them. message to all muscles involved ie. Colds are caught abdominal (belly) muscles, chest muscles, by breathing in diaphragm, the muscles that control your vocal microscopic cords, muscles in the back of your throat and droplets of fluid containing the your eyelid muscles SNEEZE! virus sneezed or coughed out by a person who has vaccinated every year if a cold. You can also pick up on you are over 65, or if you your fingers infected droplets that have bronchitis, asthma, fall onto surfaces, and then put emphysema, heart disease, them into your body by touching kidney disease or diabetes, your nose or eyes. Colds are most or if your immune system common in the winter months, but is weakened by disease can occur at any time of year. or treatment.

Medically, there is no such illness as flu, but it is now accepted as the common term for the illness Influenza. Flu is caused by different viruses from those that cause colds. Although it is caught

SNEEZING FACT: The record for the longest sneezing bout ever goes to a Donna Griffiths, from Worcestershire. Donna started sneezing on 13 January 1981 and didnt stop for 987 days; her next sneeze-free day was 16 September 1983.

In the case of flu, symptoms come on quickly with shivering, headache, muscle aches in the back and legs and dizziness. A high temperature always develops, but should go down within 48 hours. Symptoms similar to a cold then develop and may be accompanied by loss of appetite, nausea and even vomiting. The worst is usually over in 4-5 days but complete recovery can take up to 10 days. The course of a cold is easier to plot - here is a timeline guide to the course of a cold, showing you what you can do to help yourself at each stage, and medicines you can take to get through it with the minimum of discomfort. Not everybody gets all the symptoms, or with the same severity or for the same length of time; it depends on the virus causing the infection and the individual.

Day 1-2
Symptoms
This is the incubation stage and there are no symptoms to tell you that you have been infected.

Day 2-3
Symptoms
Things start with a tickle or soreness in the nose and/or throat and sometimes in the eyes. The soreness in the throat gets worse and a dry cough might start, as if your throat was trying to clear something stuck in it. You start sneezing and your nose starts to run.

Whats happening to your body

Colds are caused by more than 100 different viruses, so many that it is impossible to make a vaccine to stop us from getting them. They are caught by breathing in microscopic droplets of fluid containing the virus sneezed or coughed out by a person who has a cold. As a good sneeze can carry more than the length of a bus or underground railway carriage you cant really get out of the way of them. You can also get infected droplets on your fingers by contact with a person who has a cold, of from objects and surfaces that they have fallen on to. You then put them into your body by touching your nose or eyes. Some get past the bodys first line of defence the hairs and mucus in the nose, which traps them and invade the cells of the airways. Their only aim in life is to take over your cells and to use them to reproduce by the million. Your body must now mobilise its defences to fight them off.

Whats happening to your body

Cells in the nose and throat release chemicals to call up the main defence troops the white blood cells. These chemicals irritate the cells and cause itchiness and soreness, and tickling in the nose making you sneeze. By now, a large number of cells have been invaded and killed off by the virus, and the cells in the lining of the nose produce a watery mucus to wash them out. Mounting the counter-attack against the virus takes a lot out of you, and you will feel tired and unwell.

What you can do

Its probably best to stay at home to avoid spreading your cold to others. Take it easy and rest if possible. Keep warm, and keep the atmosphere moist. Drink plenty of fluids, as you will lose a lot through mucus production and possibly perspiration. Avoid smoking if possible, as it will further irritate the throat and the lining of the nose.

What you can do

If you can, stay away from people with colds to avoid getting infected. Do not touch your nose or eyes after being in contact with somebody who has a cold or influenza. If there are colds around, wash your hands often to keep the viruses off them.

Over-the-counter medicines you can take

Suck lozenges or pastilles to ease a sore throat. Some are simply pleasantly flavoured with lemon or blackcurrant, and contain glycerin to lubricate a sore throat, while others are medicated. For very sore throats, when it hurts to swallow, there are lozenges and throat sprays containing local anaesthetics, and a lozenges containing anti-inflammatory ingredients. For a troublesome dry cough, take a linctus containing a cough suppressant such as dextromethorphan. Linctuses containing antihistamines are also for dry coughs and because they tend to cause drowsiness, are useful to take at bedtime if a cough is keeping you awake at night. Sucking lozenges will also help control a dry cough. For that generally awful feeling take ibuprofen or paracetamol.*

Whats happening to your body

The tissues in the nose swell up as your body continues to fight the infection. The mucus gets clogged with white blood cells, dead viruses and cells the viruses have killed. Air spaces (sinuses) around the nose fill up with mucus, and they push on nerves causing pain (sinusitis). Mucus is also produced in the pharynx, causing tissues to swell up.

There are some all-in-one medicines, which contain a combination of ingredients to treat several symptoms. They are convenient and often cheaper than buying individual products.

Day 5-14+
Symptoms
Symptoms usually start to subside. Usually with a cold adults do not get a high temperature, although children may do. If the infection is a really nasty one adults may have a slight fever after a few days.

What you can do

Continue as above. Sleep with your head on a high pillow if your nose is stuffed up at night. Use steam inhalations to liquefy mucus in the nose and chest and help get rid of it.

Whats happening to your body

The virus has been defeated. It is now just a matter of time until things get back to normal. But it may be a couple of weeks until the catarrh has all gone, the coughing stops and the swollen tissues in the nose and chest shrink down again.

Over-the-counter medicines you can take

Decongestants shrink down swollen tissues in the nasal passages and allow air to flow freely through them again. They are available as nose drops and sprays and in syrup and tablet forms. Take pain relievers like ibuprofen and paracetamol for sinusitis pain. For a chesty cough use a linctus containing an expectorant, such as guiaphenesin, which loosens and helps bring up the catarrh that is causing the cough. Some expectorant linctuses also contain a decongestant which helps you breathe easier if you are wheezy as well. Decongestants also help to dry up a runny nose, as do antihistamines and there are some cold treatments that contain both. Inhalations containing menthol, eucalyptus oil and other essential oils also help to unblock the nose. These can be used alone or inhaled in steam.

Day 3-5
Symptoms
The discharge from the nose may change from clear and watery to thicker and yellowish in colour. Your nose starts to feel very stuffy and blocked up, and you might get pain in the forehead and around and behind the eyes. Catarrh produced in the nose drips down the nasal passage into the pharynx (upper windpipe), causing a phlegmy, chesty cough as the body tries to get rid of the catarrh. The tissues in the windpipe also get congested, so that air passes through less easily and you could become wheezy.

What you can do

Go back to your normal activities. Keep on with medication if you need to until the symptoms have gone completely. If you still have a raised temperature take ibuprofen or paracetamol.*

Digging in how to make yourself more comfortable

Colds
Treat symptoms with over-the-counter medicines (see previous page) and warm drinks There is no need to reduce normal activities, although going in to work may just spread the infection and the misery You might become tired more easily and need to rest.

The fall back position when you might need to see a doctor
Nearly all colds and flu will clear up on their own, but there are some situations where you might need to see a doctor:
If you have had a cough for more than two weeks, or if it is getting worse over a shorter period If the catarrh that you bring up is thick and a dark yellow, brownish or greenish colour, or has spots of blood in it If you have a noticeably raised temperature with a cold, or if you have flu and your temperature has not gone down after 48 hours If you get shortness of breath, especially if you are elderly If you feel severe pain in the chest when you breathe in or cough If you have had a sore throat that is not getting better after a week, or a sore throat with persistent hoarseness, a rash, a stiff neck, or difficulty in swallowing If you have earache If you suffer from asthma or bronchitis, as a cold may lead on to a more serious bacterial infection and need treatment with an antibiotic

Flu
Treat symptoms with appropriate over-the-counter medicines Stay in bed, rest and try to get plenty of sleep Drink as much fluid as possible, but not alcohol Avoid smoking if possible.

Dont forget that in pharmacies a pharmacist is always readily available to give you advice on symptoms and treatment. He or she will also make sure that a medicine is safe for you to take, because there are some cold remedies that should be avoided by people with certain medical conditions, and some that can react with and cause problems with some prescribed medicines. The pharmacist will also advise on cold treatments available for babies and children, and what is suitable for pregnant women and elderly people.
Always Read the label. *Do not exceed the dose stated on the pack of any medicines you are taking.

Calling up the reserves where you can get information and advice as well as from your pharmacist or doctor
For further information on colds and flu, visit the Consumer Health Information Centre website at www.chic.org.uk For information on particular over-the-counter products to treat colds and flu visit the Medicine-Chest website at www.medicinechestonline.com For information on vitamins, minerals and other health supplements visit the Health Supplements Information Service website at www.hsis.org or call the helpline on 020 7370 2233.

www.chic.org.uk

Myths and Legends

Old wives tales exist in abundance when it comes to cold and flu.
Cold weather causes colds and flu
Cold weather has never been proved as the cause of a cold. Some theories suggest that the increase of the occurrence of the common cold during colder months is because more people gather indoors with little circulation where the viruses are more likely to spread.

Going out with wet hair will give you a cold

This will probably give you the shivers, but not a cold. In one experiment volunteers were drenched with water and placed in cold draughts. They were no more likely to catch a cold than the fortunate volunteers who stayed warm and dry.

Feed a cold and starve a fever

Appetite is often lost during a fever, so there is a natural tendency not to eat, but you should actually try to eat something nutritious to help give you energy to fight the virus. Feeding a cold has no basis either: sufferers should merely seek to eat a healthy, well-balanced diet and drink plenty of fluids, in order to stay well nourished to effectively fight off the cold.

Taking over-the-counter medicines each time you have a cold will make you immune to them
This is not the case. Some medicines such as antibiotics do lose their effectiveness if they are used inappropriately or too often. Cold and flu remedies work in a different way; by relieving symptoms. They will continue to be effective when treating your occasional bouts of colds and flu.

You only need to take over-the-counter medicines for the first day or two of a cold
There is no cure for a cold but you can make yourself feel much better if you take medicines to combat the symptoms while your body is fighting off the infection. Symptoms may last from just a day or two to perhaps two weeks and you need to treat them for as long as you have them, otherwise they can just carry on being a nuisance. But do not exceed the maximum length of treatment recommended on the pack.

Using a cold or flu remedy will make the infection last longer and delay the symptoms
Whatever you do, it takes between 4 and 14 days for your body to clear out the virus causing the problem. By relieving the symptoms with the most appropriate remedy you will feel better and able to get on with the things you want to do, while letting the cold or flu run its course.