Nothing to Sneeze At

Throat sore? Head feel stuffy and dull? Nose running like a leaky tap and you feel a chill down to your toes? No need to ask a doctor what you have, because you know only too well. You are starting another cold, maybe your second or third this year, and one of scores you have suffered and will suffer throughout your life. If you are like most people, you may wonder from time to time why, in an age of medical miracles, someone has not come up with a cure for this most persistent and most common of human afflictions.

Frustrated and miserable as you may feel, you can take heart in some good news about colds and other, more serious infections that resemble colds in one way or another, such as flu. After centuries of unscientific gossip and decades of scientific wanderings, researchers have in recent years begun to make major discoveries about the causes of colds.

Colds, it turns out, are not a single disease that strikes over and over again but are instead perhaps as many as 200 separate, look-alike diseases, which are set in motion by any of 200 different submicroscopic agents called viruses. Cold specialists also now know a great deal about how infections are transmitted: For example, you do, indeed, "catch" a major share of the colds you suffer—with your hands. By touching tiny drops of virus-laden mucus—either on the body of a carrier who already has a cold, or on some surface that he has recently contaminated, perhaps with a sneeze or his hand—and then rubbing your own nose or eyes, you conveniently deliver the cold virus to the site where colds begin.

The growing body of knowledge about viruses and their interactions with your body may eventually lead to ways of preventing and curing colds, as this knowledge already has produced treatments for flu and many serious complications of colds. But for the moment, the central fact of ordinary colds is that no miracle cure, no antibiotic drug, no magic medicine and no omniscient physician can alter the course of a cold once you have it.

Even the National Aeronautics and Space Administration has had its nose rubbed—so to speak—in this undeniable fact: It can put a man into outer space, but it cannot cure the common cold. On February 27, 1969, on the eve of a flight to orbit the earth, the countdown procedure at Cape Kennedy came to an abrupt halt when all three of the Apollo 9 crew showed the classic symptoms: stuffed-up noses, sore throats and cold-related fatigue. NASA postponed the launch at an estimated cost of $500,000—the first time in 19 manned flights that astronaut illness, rather than bad weather or technical trouble, caused a lift-off to be delayed. The three men recovered enough to lift off on Monday, March 3—thus confirming the well-known proverb: Treat a cold and it will end in seven days, do nothing and it will last a week. (Partly because other space crews were isolated from contamination before launch, none suffered a repetition of the expensive 1969 outbreak of the common cold.)

Apollo 9's colds may well have been the most expensive in history, but the common cold must be ranked as a costly disease in its own right. The colds contracted by Americans alone result in an estimated 300 million days of lowered efficiency, 60 million days of lost school attendance and almost 50 million days lost on the job. Add to that the money spent on cold pills, cough syrups, nose drops, visits to the doctor and mountains of tissues, and colds cost Americans about five billion dollars a year. Not surprisingly, the British and the Dutch suffer comparable losses to the affliction. Flu, of course, can be not only costly, but deadly; in 1918 and 1919 it caused an epidemic that spread far more rapidly than the Black Death of the Middle Ages.

Fortunately for the world economy, most colds and flu can be identified and treated adequately at home. The first step is to be sure that what seems to be a cold is, in fact, that transient disease and not something worse. Physicians define a cold as an acute viral infection characterized by stuffiness, swelling and discharge (runny nose), and sore throat. Except in children, a fever is rare, and the disease takes care of itself without the intervention of doctors or medications, usually, as in the case of the Apollo 9 crew, in about a week.

The symptoms of a true cold are the same for everyone, young and old, male and female, in all parts of the world. But not everyone is equally likely to suffer from them. The frequency of colds, it appears, has as much to do with who you are and what you do as with the viruses that cause the disease.

Among the social, economic and psychological factors that may play a part in susceptibility to colds, age is one of the most critical. A six-year study in Tecumseh, Michigan, made by specialists at the University of Michigan School of Public Health, revealed some particulars that seem to hold true for the general population. Infants are the most cold-ridden group, averaging more than six colds and similar respiratory illnesses in the first months of life. Boys have more colds than girls up to the age of three, a fact consistent with the higher rate of all illnesses among male children in those years. After the age of three, girls are more susceptible than boys; teenage girls average three colds a year to boys' two, and the greater susceptibility of females prevails thereafter. The general incidence of colds continues to decline into maturity, elderly people in otherwise good health having as few as one or two colds annually.

The Tecumseh study also found that economics plays an important role. As income increases, the frequency with which colds are reported within a family decreases. Families with the lowest incomes suffer about a third more colds than families at the other end of the scale. Lower income generally forces people to live in smaller apartments than those typically occupied by wealthier people, and crowding greatly increases the opportunities for cold viruses to travel from person to person. Low income may also adversely influence diet. The degree to which poor nutrition affects susceptibility to colds is not yet clearly established, but an inadequate diet is suspected of lowering resistance generally.

Life style may be another critical factor in cold susceptibility. Extensive though still controversial research has suggested that people who experience great stress in their work and personal lives—who live each day on borrowed energy—can set off a chain of physiological events that inhibit the body's natural defenses against disease.