Pathogens & People: Do these 4

things and you might avoid the

common cold
EDWARD McSWEEGAN, For The Capital
Published December 07, 2008

The cold and flu season is almost upon us.

We worry about the flu and many of us will take the annual vaccine and try to
avoid people who may have the flu. Colds, on the other hand, are viewed as mild
irritants. Colds are just a few days of scratchy throats, running noses, coughs and
maybe some mild fever. There's not much to do about a cold and not much to
worry about either.

Or is there?

Last year, the Centers for Disease Control and Prevention reported 140 cases of
an unusually severe type of cold. Five percent of the patients died.

The "common cold" is caused by hundreds of common viruses. Most colds are
caused by a group of viruses called rhinoviruses. Coronaviruses, parainfluenza
viruses, adenoviruses, enteroviruses and some influenza viruses also can cause
colds.

There are about 50 types of adenoviruses that infect people. The adenoviruses are
very hardy and can survive outside a human host long enough to be picked up by
another unlucky victim. Some of these adenoviruses are able to cause persistent,
but asymptomatic, infections of the tonsils and intestines. Still others are able to
cause bronchitis, pneumonia and a sometimes fatal respiratory illness.

One of these 50 adenovirus types is called Ad14 or serotype 14. This is the killer
cold virus that was identified by CDC as the cause of outbreaks in four states in
2007. Ad14 was first seen among military recruits in 1955, but since then has
rarely been seen in the U.S. So the 2007 outbreaks may represent the emergence
of a new and virulent strain of Ad14.

Newborns, the elderly and people with compromised immune systems would be
the most susceptible to a new and virulent cold virus. The cells of the nose and
throat seem to be the primary targets of viral invasion. The virus triggers local
inflammation and the production of immune regulators such as interferon. These
immune response molecules in turn trigger most of the unpleasant symptoms of
a cold: headache, malaise, fatigue, nausea, congestion and painful sinuses. Over-
the-counter medications don't seem to help much, and antiviral drugs such as
ribavirin and cidofovir don't seem to be very effective against adenoviruses.

The emergence of a new and more virulent Ad14 virus could be especially bad
news for the military. New recruits - crowded together in barracks and under the
24 / 7 stress of boot camp - are ideal candidates for acquiring and spreading
adenovirus infections. The lost training time and medical costs from adenovirus
infections encouraged the Defense Department to fund work on vaccines against
two of the more common culprits, Ad7 and Ad4. An effective combination vaccine
was produced and given to millions of new recruits, but disputes with the
manufacturer led to the end of the military vaccination program in 1999. The
following year, the Institute of Medicine recommended the immediate re-
establishment of an adenovirus vaccine supply. Now, eight years later, Barr Labs
in Virginia soon may be in a position to begin offering a new oral vaccine against
Ad4 and Ad7 adenoviruses.

There is no vaccine for Ad14.

The common cold, and some of the uncommon causes of those colds, present
unique challenges to both patients and physicians. There are too many viruses,
too little understanding of how they spread and cause disease, too few effective
medicines and even fewer available vaccines.

Worse yet, your mother may have been right all along. Remember her telling you
to put on a sweater or jacket "so you don't catch a cold''? In response, you may
have wisely insisted that you couldn't get a cold from being cold. Well, maybe you
do.

According to an article in New Scientist, researchers in the United Kingdom

found more people developed colds after they became chilled. Cool temperatures
prompt the body to redirect blood flow inward, including away from the nasal
passages. The change in blood flow and nasal temperature may make it easier for
viruses to enter via the nose. So mom may have been right again. I can already
hear the "I told you so's."

In the end, the best way to avoid a cold - and Ad14 - may be to keep your nose
warm, wash your hands regularly, avoid small children and … listen to your
mother.

---

Dr. Edward McSweegan has a Ph.D. in microbiology and lives in Crofton. He

works on and writes about infectious disease issues. He may be contacted at
mcsweegan@nasw.org.