Talk:Common cold/Archive 2

Treatment

For those of you who have access to Uptodate here is a great ref: http://www.uptodate.com/online/content/topic.do?topicKey=pc_id/5093&selectedTitle=3~116&source=search_result#19 --Doc James (talk · contribs · email) 00:33, 5 April 2009 (UTC)

Name

I have also seen "acute nasopharyngitis. Is this in error? 75.118.170.35 (talk) 17:11, 15 May 2009 (UTC)

Citation needed?

Treatment that may help alleviate symptoms include: analgesics, decongestants, and cough suppressants,[citation needed]

I think that by definition, a cough suppressant, will suppress cold, therefore alleviating one of the symptoms. The same can be said about the others. I really don't see a need for a citation, since no specific product is being mentioned. Diego bf109 (talk) 12:00, 15 June 2009 (UTC)

This is actually controversial. Little evidence shows that cough suppressant actually do anything.--Doc James (talk · contribs · email) 03:42, 10 July 2009 (UTC)

History of the common cold

Just a litle note to say that in the History section only goes back to the 16th Century, I'd like to point out that the Ancient Egyptians had a word for cough and the common cold (though I don't know what they are) and Hippocrates described it in the 5th century BC. m w (talk) 21:52, 13 October 2009 (UTC)Phthinosuchusisanancestor

Reference it and add to the article. WP is a work in progress.Doc James (talk · contribs · email) 16:15, 2 November 2009 (UTC)

Cold Weather

Quote from the article:

An ancient belief still common today claims that a cold can be "caught" by prolonged exposure to cold weather such as rain or winter conditions, which is where the disease got its name. Although common colds are seasonal, with more occurring during winter, experiments so far have failed to produce evidence that short-term exposure to cold weather or direct chilling increases susceptibility to infection, implying that the seasonal variation is instead due to a change in behaviors such as increased time spent indoors at close proximity to others.

I call shenanigans in regards to this phrase, seems like it's deliberately misleading. The studies mentioned do not disprove the "Ancient belief" as it does not concern short-term exposure. No one thinks that going on the balcony for five minutes in winter will make you sick, and I somehow doubt that in those studies they had people in damp clothes spending 30+ minutes in <10C or under Maxim K (talk) 00:56, 10 November 2009 (UTC)

Feel free to change the first one to "short"Doc James (talk · contribs · email) 05:01, 10 November 2009 (UTC)

Reference

Looking at this ref [[1]] it says "It should be noted that 62% ethanol, contained in many commercial hand sanitizers, is also ineffective for complete removal of rhinovirus from the hands and would be expected to be ineffective for the prevention of rhinovirus infection."

Other papers also find incomplete removal but removal of many viruses more than soap and water [[2]]. It looks like they pull the "expected to be ineffective" out of thin air.Doc James (talk · contribs · email) 14:05, 1 December 2009 (UTC)

It specifically said it doesn't eliminate rhinovirus, so why remove a fact? And why make it look like hand sanitizers actually DO prevent rhinovirus in the common cold article, by saying something vague like "Alcohol-based hand sanitizers also reduce viruses significantly and are recommended as a method in health care environments"?

Why did you delete a good reference? Because you didn't like what it said?

And why'd you use Twinkle? I didn't vandalize anything.

And why did you remove the "citation needed" tag from the statement "patients with common colds often seek professional medical help"? Even though that's unlikely, since it's "generally mild and self-limiting". It's like you have an interest in giving doctors business...

Oh wait! You are a doctor!

But you win. I don't have the patience to have edit wars with strong-willed people with ulterior motives.

Let's see how you talk your way out of all this; after all, you're a doctor, so you have UNQUESTIONABLE authority. Usernamefortonyd (talk) 16:05, 1 December 2009 (UTC)

Would recommend you AGF. See the new references which contradict the previous one. They are of better quality. BTW not every point needs to be refed. That info was in the wrong section. Under economics it is explained fully. If you wish to discuss this topic feel free otherwise have a nice day.Doc James (talk · contribs · email) 16:08, 1 December 2009 (UTC)

Vitamin D

This edit adds little to what came before it. The previous reference is better as it cites the actual journal article. The number of people involved in the study is not of particular significance: The study, involving 1900 adults and children, found that people with the lowest blood vitamin D levels reported having significantly more recent colds or cases of the flu. The risks were even higher for those with chronic respiratory disorders, such as asthma and emphysema. The authors reported that asthma patients with the lowest vitamin D levels were five times more likely to have had a recent respiratory infection; while among COPD patients, respiratory infections were twice as common among those with vitamin D deficiency. However, the authors stress that the study's results need to be confirmed in clinical trials before vitamin D can be recommended to prevent colds and flu.

Doc James (talk · contribs · email) 03:20, 13 December 2009 (UTC)

• I did keep the previous reference, and I added a second. I think that it is worth noting that the study included 1900 people. As simple as "serum blood level" may seem to you, it may seem to a non-medical person that it suggests a disease condition, and that's why I want to have the wording, "people with the lowest blood vitamin D level" in the article. I also want the reference I have used because it is easier to understand than the abstract. Gandydancer (talk) 14:11, 14 December 2009 (UTC)

If we added the number of people enrolled in every study for every point we presented Wikipedia would quickly become unreadable. The number 1900 is not notable and is a reasonable for the study done.

Added that wording in the sentence above.Doc James (talk · contribs · email) 17:38, 14 December 2009 (UTC)

• Yes, I see what you mean. I have instead changed the wording to "the largest and most representative", which is better. Gandydancer (talk) 21:50, 14 December 2009 (UTC)

It may be the largest now but may not be in a few years. This is a time sensitive term. "the largest and most representative" is not NPOV. Just state the conclusion. If people wish more details they may look at the original article. I hope what we have now is a compromise.Doc James (talk · contribs · email) 21:58, 14 December 2009 (UTC)

• No, I can not agree. I understand that the size of every study is not necessary, but it can and should be used if it is sigfificant, and in this case it is since it is the largest and most representative to date. That's not my POV, it is a fact. Will it change over time? Of course, just like every thing else in Wikipedia it will change. As for the way I reference, I have been told that it is acceptable. Gandydancer (talk) 22:32, 14 December 2009 (UTC)

The size of this study is not significant. It is neither a large study nor a small study. Therefore stating it size is not significant. For citing please see Wikipedia:Citation_templates and here is a useful tool for generating them [3] Doc James (talk · contribs · email) 22:56, 14 December 2009 (UTC)

• It is significant in that it is the largest to date.

To illustrate my point that size really does matter ;-), see the following paragraph from the cancer/vit D article:

A 2006 study using data on over 4 million cancer patients from 13 different countries showed a marked difference in cancer risk between countries classified as sunny and countries classified as less–sunny for a number of different cancers.[76] Research has also suggested that cancer patients who have surgery or treatment in the summer — and therefore make more endogenous vitamin D — have a better chance of surviving their cancer than those who undergo treatment in the winter when they are exposed to less sunlight.[77] Another 2006 study found that taking the U.S. RDA of vitamin D (400 IU per day) cut the risk of pancreatic cancer by 43% in a sample of more than 120,000 people from two long-term health surveys.[78][79] A randomized intervention study involving 1,200 women, published in June 2007, reports that vitamin D supplementation (1,100 international units (IU)/day) resulted in a 60% reduction in cancer incidence, during a four-year clinical trial, rising to a 77% reduction for cancers diagnosed after the first year (and therefore excluding those cancers more likely to have originated prior to the vitamin D intervention).[80][81] Research has also indicated beneficial effects of high levels of calcitriol on patients with advanced prostate cancer.[82]

I am not speaking of the 4 million number here, but of the 1,200 and 120,000 numbers. When you read numbers like that, the reaction is quite different than if it had just said, "a study". And that is why the numbers were included, and rightly so. Gandydancer (talk) 23:06, 14 December 2009 (UTC)

It is not such a cut and dried issue. The type of study is equally if not more important. Who funded the study is also significant. There is an entire post grad course on determining the quality of a research paper and number of participants is only one of a dozen or so important aspects. For a page giving a general overview this degree of detail is not important IMO.Doc James (talk · contribs · email) 23:35, 14 December 2009 (UTC)

• I am aware that every study is not equal, and have said nothing to suggest that I am not. The words "the largest and most representative", are certainly not going into any great detail. I searched Wikipedia for editing advise on this and could not find anything. Could you please direct me to the guidelines that you are using? Gandydancer (talk) 16:38, 15 December 2009 (UTC)

We are supposedly writing for a generally audience. They do not care the number of people in relation to the type of study. Or the author, or were the study was done, or how it was funded etc. All important but not for a generally page. Maybe on a subpage or the one specifically about vitamin D.Doc James (talk · contribs · email) 17:54, 15 December 2009 (UTC)

• I have stated my reasons why "the largest and most representative" should be included and you have stated your reasons why it should not. Since you have been unable to show any Wikipedia guideline that supports your position, it comes down to my opinion against your opinion. I want Wikipedia readers to know that this was a large study and thus I will include that information. Gandydancer (talk) 16:13, 16 December 2009 (UTC)

No were in the article does it say "the largest and most representative" thus this is original research therefore please remove.Doc James (talk · contribs · email) 16:27, 16 December 2009 (UTC)

The study should be included, it has interesting findings and is of significant enough size to be a reliable source in my opinion. However, I agree with Doc James that the phrase "the largest and most representative" should not be added because it is POV pushing by giving it undue emphasis via original research.--Literaturegeek | T@1k? 16:50, 16 December 2009 (UTC)

Google this information and you will find that it is reported to be the largest and most nationally representative study to date. I have changed the site to include this information, that actually seems to be included in ALL of the other sites...except the one I was using. It is not original research. Gandydancer (talk) 17:06, 16 December 2009 (UTC)

The term "largest" is (in principle) simply for any reader to verify: the term "most representative" is complete PoV! Largest does not mean most representative, and representative is a subjective term. A large study can also be completely unrepresentative ("bullet and shrapnel injuries", taking a World War II data set, for example). Physchim62 (talk) 17:31, 16 December 2009 (UTC)

It is not encyclopedic and there is not consensus for its addition. If used this wording for every study Wikipedia would fall to pieces.Doc James (talk · contribs · email) 17:34, 16 December 2009 (UTC)

I think the present wording misrepresents what happened. Adit Ginde analysed data collected 15 years ago by the National Health and Nutrition Examination Survey and found a correlation between low serum levels of vitamin D and incidence of common cold. This is not quite the same as conducting a study to capture and then analyse data, and is far short of a clinical trial (which Ginde admits is needed). The Medical News article states that this is "the largest and most nationally representative study ...", but you will notice near the bottom of the page: "The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News-Medical.Net." and as far as I can see, the writer is unnamed. If the source used to support the article text is an anonymous opinion, then I doubt it will meet WP:RS, let alone WP:MEDRS – which indicates a strong preference for reviews or other secondary sources when writing text in medical articles. Frankly, I'd like to see the whole paragraph re-written: "the study found an association ..." implies an association exists – "suggested" would be more appropriate; the phrase "people with the lowest blood vitamin D levels reported having 40% more ..." seems to give the impression of people reporting to the study, rather than to a survey that was analysed much later, and so on. Can someone with access look at Ginde's study and try to unpick the spin that these "news" reports seem to have put on it? --RexxS (talk) 19:27, 16 December 2009 (UTC)

Doc James is right: Wikipedia recommends against peacocking study descriptions. Unless the study gives you good reasons to doubt it (=you think it's a lousy study, but you need to mention it), then you should just assert the conclusion as a fact, and move on. From WP:MEDMOS#Writing_style:

Do not provide a detailed analysis of an individual study unless the analysis itself is taken from a published reliable source. Wikipedia should concisely state facts about a subject. It should not discuss the underlying literature at any length. Generally speaking, the facts will be found in the conclusions or results section of a study, not in the detailed methodology. Articles that rely on secondary sources are less likely to fall into the trap of discussing the size of a single study, its methodology, its biases, and so forth. Thus, "washing hands after defecating reduces the incidence of diarrhea in the wilderness", not "An uncontrolled survey involving 132 experienced long-distance backpackers on the Applachian trail in 1997 concluded that washing hands after defecating reduces the incidence of diarrhea in the wilderness."

Study details in this article are not WP:DUE; this is not [[Research methods used in the common cold]].

As for more research being needed -- "staying indoors a lot" and "having lower Vitamin D levels" are not only correlated but have a proven causal relationship, and "staying indoors" is a well-established risk factor for viral transmission (specifically for those viruses that produce colds). Vitamin D levels may prove to be nothing more than a marker for how much time a person spends in the high-transmission-risk environment called "being indoors". Furthermore, we don't know if the researchers adequately controlled for seasonal variations (and in the country where the research was performed, there is a definite seasonal pattern to staying indoors, vitamin D levels, and respiratory infections). Consequently -- while we also don't want to fill Wikipedia with meaningless "more research is needed" statements -- I'd go softly in any assertions I made. Something like this might be justifiable:

In one study, people with the lowest levels of vitamin D reported significantly more recent colds or cases of the flu. The risks were even higher for those with chronic respiratory disorders, such as asthma and emphysema. However, this statistical correlation does not prove that low levels cause increased susceptibility to viral infections, and the study did not investigate whether vitamin supplements provided practical benefits.[4]

WhatamIdoing (talk) 21:06, 16 December 2009 (UTC)

We do have the ref to the actual study just above it and if anyone wishes a copy let me know. I agree with WIAD wording and have changed it to match.Doc James (talk · contribs · email) 21:26, 16 December 2009 (UTC)

• Clearly it is time for me to stop attempting to fight city hall and I will not waste my time or yours by arguing item by item, however just for the record I do not agree with these opinions. See this paragraph for example which used the National Health and Nutrition Examination Survey as well:

Mortality Using information from the National Health and Nutrition Examination Survey a group of researchers concluded that having low levels of vitamin D (<17.8 ng/ml) was independently associated with an increase in all-cause mortality in the general population.[96] The study evaluated whether low serum vitamin D levels were associated with all-cause mortality, cancer, and cardiovascular disease (CVD) mortality among 13,331 diverse American adults who were 20 years or older. Vitamin D levels of these participants were collected over a 6-year period (from 1988 through 1994), and individuals were passively followed for mortality through the year 2000.

It would seem that this wording, according to the opinion of Doc James et al, may well cause Wikipedia to "fall to pieces" at any moment. Gandydancer (talk) 00:48, 17 December 2009 (UTC)

I do find that difficult to read and would edit it to make it significantly simpler. I mainly work on medical diseases rather than treatments so will leave this issue to someone else.Doc James (talk · contribs · email) 01:27, 17 December 2009 (UTC)

Gandydancer, your argument is essentially Wikipedia:Other stuff exists, or Two wrongs make a right. The fact that some other article doesn't comply with Wikipedia's manual of style is not a good argument for doing it wrong here. WhatamIdoing (talk) 01:31, 17 December 2009 (UTC)

A problem arises when drawing unwarranted conclusions from analysis of raw data. Low vitamin D levels may be caused by lack of sunlight; so I wouldn't be surprised if the morbidity result indicated nothing more than that very ill people tend to spend more time indoors. We need better studies to establish any solid conclusions. --RexxS (talk) 02:10, 17 December 2009 (UTC)

• Rexxs, perhaps you should read the study before you comment on it. WhatamIdoing, no my argument was that I felt that the size of the study should be included because it was significant in that it was the largest and most nationally representative study to date. I noted the above study re vit D and other diseases because I feel that it is fairly well written according to wikipedia guidelines. IMO, an article should briefly discribe a study, mention the size, etc., WHEN APPROPRIATE rather than expect the reader to look up every study to understand what it involved. In the past Doc James has correctly pointed out to me that I have included information that was not needed, and I continue to try to learn how to best handle information. Gandydancer (talk) 15:21, 18 December 2009 (UTC)

I do not think the study is as good as the newpapers make out. Thus I prefer that we just go with what the actual article says.Doc James (talk · contribs · email) 17:13, 18 December 2009 (UTC)

• The numerous newspaper accounts did not hype it up. They quoted the authors, who seem quite excited about it. I'd like to go with the actual article as well, which shows that it was the largest study to date and that the results were quite astounding! To quote the author's advise "clinical trials need to be done, etc." would have sufficed quite well. Gandydancer (talk) 17:49, 18 December 2009 (UTC)

This is one reason why there is peer review for journals. It is to keep the authors more objective. Newspapers do not have this. They also often take stuff out of context and sensationalize it. I would know :-) Cheers Doc James (talk · contribs · email) 17:59, 18 December 2009 (UTC)

Gandy, your argument really is more with wikipedia's guideline for medicine related articles, WP:MEDRS. They state, Wikipedia:Reliable_sources_(medicine-related_articles)#Popular_press that news sources should generally be avoided and in the following subsection that as much as possible Wikipedia articles should cite the literature directly. Also you don't appear to have editorial consensus on this talk page for your view to cite the news source rather than directly the peer reviewed publication. I personally do find the research very interesting but I also know that further research will need to be done to rule out confounding variables and find what if any correlations exist and the reasons for these results and their implications for catching the common cold. We need to be mindful of WP:UNDUE when citing primary sources as well and stick closely to what the source says.--Literaturegeek | T@1k? 20:17, 20 December 2009 (UTC)

Is it common to insert comments above the last reply like this? It makes it seem that my reply (below) was in answer to you and not DJ. As for my source, I would think that Wikipedia would have no problem accepting a Mass Gen press release. This encyclopedia is for everybody, not just people who can access studies. Surely you are not suggesting that the authors of the study and the hospital would lie in their press release? As for the need to do trials, I included that information when I wrote my paragraph (that Doc James deleted). I got that information from the article that I referenced. Apparently on second thought Doc James decided to use that information as well, with the reference that I had used. Which is interesting, since it seemed fine to use it to state that the authors cautioned that trials needed to be done, but not ok when it came to mentioning that it was "the largest and most representative" study. Gandydancer (talk) 04:52, 23 December 2009 (UTC)

It's okay to insert comments in between if is seems sensible. Sometimes I'll "over-indent" to make it clear that it's a little "out of order"; other people do other things. I think there's even a template system for marking comments that are out of chronological order.

Nobody's suggesting that the hospital publicity department would tell deliberate lies, but there is a solid body of evidence indicating that the non-scientists in hospital, government, and academic publicity departments make mistakes of both omission and commission very frequently. Much of Ben Goldacre's publications are directly or indirectly complaints about this problem.

As "the encyclopedia for everybody," Wikipedia should be telling people what the proper studies say, even if that means that individual editors have to go to the trouble of asking around to get copies. If a reader really wants to know what a press release says, they can ask their FWSE. WhatamIdoing (talk) 05:18, 23 December 2009 (UTC)

Thanks for the FWSE information, I will read it when I have time. As for the report I used, it was linked right to Mass Gen's press release and I really do find it extremely hard to believe that they would be confused about the study on their very own site. It generated 3 or 4 of Google pages. Furthermore, as i already said, Doc had no problem with using it for information that he wanted included in the article here, it seems tthat the validity of the information only comes into question when it is related to the information that I wanted to use. Gandydancer (talk) 01:14, 24 December 2009 (UTC)

I don't know how many times I have to say this over and over again - I AM NOT USING MEDIA ACCOUNTS FOR THIS INFORMATION, I AM USING THE VERY SAME REFERENCES THAT YOU HAVE INCLUDED. While the number of people in a study may not always be significant, in this instance it is in that it is the LARGEST AND MOST REPRESENTATIVE. Futhermore, it is under the heading "Vitamin D", which suggests that more info is appropriate as opposed to the info being listed as one of many studies listed under a different heading. I have read the many suggestions that it is not appropriate and find no substance in any of them. If I have not answered them all, item by item, I would be glad to do so. In the mean time, I feel that the readers of Wikipedia should be aware that this was a large study. Gandydancer (talk) 14:45, 22 December 2009 (UTC)

Wikipedia works via consensus. You have not gotten this for your version. Please return it to the previous. Were in the original reference does it say "LARGEST AND MOST REPRESENTATIVE"? Thanks Doc James (talk · contribs · email) 17:53, 22 December 2009 (UTC)

It's word-for-word out of the News-Medical.net webpage. WhatamIdoing (talk) 21:18, 22 December 2009 (UTC)

Yes I realize that it is in the news commentary of the paper but were is it in the actually publication pmid=19237723 . I am referring to this statement above "I AM NOT USING MEDIA ACCOUNTS" Doc James (talk · contribs · email) 22:05, 22 December 2009 (UTC)

You should interpret my statement above as a polite way of saying "The assertion that it is not taken from media account has been verified to be false." I assume it is merely a careless error instead of either confusion about what constitutes a media account or a deliberate effort to deceive. WhatamIdoing (talk) 22:29, 22 December 2009 (UTC)

Ah thanks for the clarification... Doc James (talk · contribs · email) 23:09, 22 December 2009 (UTC)

I want to emphasize: we all make mistakes like this on occasion. Mentally juggling three sources each, times five or ten articles, means that we all have, and will, drop a few eggs. WhatamIdoing (talk) 01:04, 23 December 2009 (UTC)

• If by consensus you mean calling a few "buddies" in to back you up, as you have done, no that is not how Wikipedia works. At least, I hope that that is not how Wikipedia works. Gandydancer (talk) 18:40, 22 December 2009 (UTC)

I did not want it used for any reason. But keep the other stuff as it was not to bad. I did not add anything from these news sources.Doc James (talk · contribs · email) 03:25, 24 December 2009 (UTC)

Vitamin C

I don't care if there are none of my contributions on the page. But isn't it a bit strange that there is not even one mention of the vitamin C in the article? —Preceding unsigned comment added by Jocorok (talk • contribs) 11:29, 17 January 2010 (UTC)

Was lost in editing. Replace line regarding vitamin C. ThanksDoc James (talk · contribs · email) 18:34, 17 January 2010 (UTC)

Epidemiology

The article attributes the increased rate of incidence during the fall and winter to indoor crowding and cites http://www3.niaid.nih.gov/topics/commonCold/overview.htm. Since that reference says, "Seasonal changes in relative humidity also may affect the prevalence of colds. The most common cold-causing viruses survive better when humidity is low—the colder months of the year. Cold weather also may make the inside lining of your nose drier and more vulnerable to viral infection," and that a related study about influenza published in PLoS Pathogens in October, 2007, shows that the influenza virus spreads more easily at a lower temperature and humidity, I think that these potential causes should be added to the epidemiology section of the article. (Yes, I do know that the flu isn't the cold, but since I have not seen nor heard of any studies that support the indoor crowding hypothesis, I don't see why the cold & dry hypothesis shouldn't be mentioned in the article.) I couldn't find a link to the influenza study, so I'm posting this Popular Science article which briefly summarizes the study. http://www.popsci.com/scitech/article/2008-03/science-confirms-obvious-2008 --Humanist Geek (talk) 01:00, 28 February 2010 (UTC)

Various Comments

1. Introduction suggests that recommend treatments are "drinking plenty of warm fluids, keeping warm, etc." - I can't find any reliable sources to support "keeping warm". Also recommendation is absent on NIAID page: http://www3.niaid.nih.gov/topics/commonCold/treatment.htm.
2. "Often, influenza and the common cold are mistaken for each other" suggests that Influenza and Common Cold don't overlap although later there is a statement "5-15% are caused by influenza viruses". This seems to be inconsistency
3. Sleep/common cold link refers to a weak study without randomization. All it shows is that the same group of people had sleeping issues and got sick more often; could be causality, could be another common cause. Needs to be replaced with stronger study.
4. Humidity/common cold spread link claim is backed by reference to the study which talks exclusively about Influenza and doesn't mention common cold. Although this may be ok if the two indeed overlap

Audrius (talk) 03:44, 22 January 2010 (UTC)

1. In risk factors, the role of humidity is not clear in the sentence: "Humidity may play a role in viral transmission. One theory is that dry air causes evaporation of water, thus allowing small viral droplets to disperse farther and stay in the air longer."

Bmomeni (talk) 12:02, 8 May 2010 (UTC)

Contradiction?

Second sentence in the first paragraph in the section "Signs and symptoms" states that "Fever is often present", however the first sentence in the next paragraph states the complete opposite, "the cold is not generally accompanied by fever". They both refer to the same source which is an article in the Lancet. However somehow this doesn't add up. —Preceding unsigned comment added by 90.228.198.76 (talk) 20:13, 20 March 2010 (UTC)

You "beat me to the punch". I caught the same thing, ie contradiction

There is another one. At the top it says common cold ... caused primarily by rhinoviruses and coronaviruses. then at the bottom it says, "pleconaril, that targets picornaviruses, the viruses that cause the majority of common colds." —Preceding unsigned comment added by 67.167.85.108 (talk) 12:10, 8 July 2010 (UTC)

References

We need to make sure we used peer reviewed source. see WP:MEDRS Doc James (talk · contribs · email) 18:35, 8 November 2009 (UTC)

Your being overzealous with the refrencing, under prognosis i mentioned that in conjunction with other chronic or acute conditions death rates are higher with people with the cold. For everyone that is common knowledge and needs no refrence, i also gave the case of AIDs as an example of this. Your moderations need to be at least sensible —Preceding unsigned comment added by 86.10.65.114 (talk) 10:37, 18 January 2010 (UTC)

This addition was not [5] was really understandable and as it was unref I was unable to verify it. A good place to find high quality references is [6] You can than take the PMID number and place it into this tool [7]. The result that is generated can then be cut and pasted to support the statement added. If you have any questions feel free to drop me a note. CheersDoc James (talk · contribs · email) 14:57, 28 February 2010 (UTC)

Prevention

This line "Probiotics in children 3 – 5 years old were found effective in decreases cold symptoms when taken over 6 months.[29]" and its reference are dubious but are presented too bluntly as fact.

The study has had limited critism but as with any study which reports almost perfect results that haven't been reproduced, caution should be used when referencing it. The sample size of 300 children is also too small to be able to state this so unequivocally. Further there is no data on eligibility criteria and the results were by parental reporting which is known to be affected by many confounding factors.

A more accurate assessment would be:

"An initial study of 300 children aged 3-5 years has indicated that probiotic consumption may have an effect on the incidence of cold and influenza-like symptoms when taken for prolonged periods (6 months). However, these results have yet to be reproduced elsewhere and should be treated with caution as the mechanism by which probiotics work to give the observed effect is unclear." —Preceding unsigned comment added by 77.44.40.236 (talk) 14:42, 1 April 2010 (UTC)

Agree Doc James (talk · contribs · email) 20:30, 13 April 2010 (UTC)

symptoms...

Could swollen tonsils, swollen neck lymph glands and ear ache also qualify for symptoms. I know that these symptoms are not very common but some people are more prone to these symptoms than others (i for one suffer these symptoms along with a cold despite my colds clearing up much faster than average). Could someone please find out and reference this for inclusion? I am feeling a little to run-down to care. Wuku (talk) 09:30, 6 August 2010 (UTC)

Cause of a common cold?

Is it really true that you get a cold just by exposing to a cold weather? My parents always tells me that this is true, but more i read about it on the internet, it is more likely false. But i still have some confusion on this. —Preceding unsigned comment added by 98.220.226.219 (talk) 18:55, 22 November 2009 (UTC)

No, one needs to be infected by a virus in order to have a cold. However, this virus is more likely to "survive" long enough to infect a host in colder, dryer weather. In addition, colder temperatures probably weaken one's immune system to some degree, which increases one's risk of infection even more. --Humanist Geek (talk) 01:10, 28 February 2010 (UTC)

Your blood from the extremitys is restricted to lessen heat loss, thus the number of available immune response is dimished somewhat, pnumonia is a case of this —Preceding unsigned comment added by 86.10.65.114 (talk) 10:39, 18 January 2010 (UTC)

This statement seems suspect to me: " Because strong immune responses cause cold symptoms, "boosting" the immune system increases cold symptoms." It implies that there's something one can do to boost immunity, and that this will increase cold symptoms. The article cited by Jennifer Ackerman says that there's "scant evidence that [supplements] bolster protection against infection by cold viruses." It does not say that one can actually "boost" one's immune system or that doing so would increase cold symptoms, although it offers a hypothesis that "People with more active immune systems may be especially prone to cold symptoms." However, to support that statement in the Wikipedia article, I think some more direct research would need to be cited demonstrating that people whose immune systems are more effective at fighting disease actually get more cold symptoms. Newbis (talk) 03:01, 23 November 2010 (UTC)

Immunity from any given virus?

I perused the article looking for answer to whether one obtains immunity from any given virus after having had a cold caused by it. Perhaps I missed it, but it would be good for a knowledgeable person to address this in the article itself. Casey (talk) 12:52, 30 September 2010 (UTC)

Yes, usually, but it is not necessarily lifelong. WhatamIdoing (talk) 02:41, 21 November 2010 (UTC)

Well, even if immunity against a given cold virus should last a lifetime, that won't do you much good since there are literally hundreds of different cold viruses out there and they mutate fairly frequently, so matter how many different cold viruses you may have become immune to, there are hundreds of others that are waiting to get you. JimFarm (talk) 15:55, 12 December 2010 (UTC)

minor change of wording

Does anybody object to changing "average two to four infections a year in individual adults and up to 6–12 in individual children" to "average two to four infections a year in adults and up to 6–12 in children"? I cannot see that the word "individual" creates/denotes any meaningful distinction or clarification. Bj norge (talk) 19:11, 16 October 2010 (UTC) I made the change. Bj norge (talk) 14:27, 21 October 2010 (UTC)

humidity and temperature

My Understanding is humidity drops when temperatures get close to or below freezing. Even if it's not causing water vapor to freeze, it causes it to condense on surfaces that present a gradient. This leaches much of the effective moisture out of the air around us, even if there is high humidity at higher altitudes in snow clouds. Probably explains why people get colds more often in winter, besides being in close proximity to others. Also, the immune system of the upper respiratory system likely does not work as well when it's very cold. -Reticuli 66.178.144.59 (talk) 19:17, 24 November 2010 (UTC)

Do you have references? Doc James (talk · contribs · email) 19:22, 24 November 2010 (UTC)

First para of symptomatic treatments section

The first paragraph of symptomatic treatments seems to be offering advice which is not supported by the references cited, or at least goes beyond what the references say. The conclusions do more than put 2 and 2 together, and strike me as constituting personal opinion. I'll quote the paragraph here:

Treatments that help alleviate symptoms include simple analgesics and antipyretics such as ibuprofen[37] and acetaminophen / paracetamol. Evidence does not show that cold medicines are any more effective than simple analgesics[38] and are not recommended for use in children due to no evidence supporting their effectiveness and the potential of harm,[39][40] as may a chest vapor rub.[41]

Reference 37 comes to a conclusion only about NSAIDs releiving pain symtons. ("The authors recommend NSAIDs for relieving discomfort or pain caused by the common cold. Further research is needed to investigate the effect of NSAIDs in relieving respiratory symptoms such as cough and nasal discharge.")

Reference 38 is only about acute cough, and the studies it looks at show some mixed results, and so it urges caution about it conclusion that there is "no good evidence." "There is no good evidence for or against the effectiveness of OTC medicines in acute cough. The results of this review have to be interpreted with caution due to differences in study characteristics and quality."

This certainly does not support comparing the effectiveness of NSAIDs vs OTC cold medications, since we are taking about different symptoms.

I can't access 39, but 40 is a Dr answering a question very briefly and giving not evidence supporting his opinion, though it refers to "New recommendations restricting use in Canada to those older than 6 years of age" which could be used as an authoritative opinion, but it is specifically about children 6 or younger. The statements made in the wikipedia article are made as general advice with no age stipulations.

The last clause "as may a chest vapor rub" makes no grammatical sence and it is not clear what is trying say about it. My first take was that it was saying it was potentially harmful, however reference 41 is positive about its use, saying "the current data indicate that VR helps to fill the therapeutic void. Despite mild irritant adverse effects, VR provided symptomatic relief for children with URIs and allowed them and their parents to have a more restful night." Now I'm no medical expert, nor am I confident of being up on the current state of official medical opinion on these matters, so I am not going to presume to revise this section beyond fixing the grammatically nonsensical vapor rub clause. Perhaps the advice here is actually sound and does represent current official medical opinion, however, if so, references need to be cited that actually demonstrate that. --Ericjs (talk) 19:03, 5 December 2010 (UTC)

Not sure why cough medicine is wikilinked in there, or what was meant by cold medicine, as most "cold medicines" contain analgesics such as ibuprofen and paracetamol along with other drugs such as decongestants. Will have a look for some more refs on combination treatments when I've got the time.--Pontificalibus (talk) 19:31, 5 December 2010 (UTC)

The sentence fragment was uncorrected vandalism. Cleared it up. Doc James (talk · contribs · email) 20:26, 5 December 2010 (UTC)

Transmission

It's undisputed that the two main ways of transmission of rhinovirus are aerosol and hand-to-hand. There's some discussion, however, about which one of these is the more important one. I did some research myself but couldn't find a study supporting either view. Now this article here seems to be in strong favor of the aerosole transmission. But unless someone can come up with some citation/evidence to support this view, I'd feel more comfortable if the article would strike a more neutral tone. Mallexikon (talk) 06:41, 11 January 2011 (UTC)

About Vitamin D

Under ==Risk factors==, we've got the study backwards. At the time of the blood draw, the participants were asked "In the past few days, have you had a cough, cold, or other acute illness?"

Note the key word "past". The results therefore are not "if you already have low Vitamin D, you're at risk for a cold in the future"; the study says something much closer to "People who were sick last week are more likely to have low blood vitamin D levels today than people who have not been sick recently." This is hardly surprising, given that people who are sick tend to stay indoors, away from the sunshine that produces Vitamin D (especially among the 75% of participants who were white Americans). Also, it's complicated by including "cough" and "other acute illness" (e.g., stomach flu). People with asthma (the original targets of the study) frequently complain about coughs, even when they're uninfected.

The ref is Ginde AA, Mansbach JM, Camargo CA (2009). "Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey". Arch. Intern. Med. 169 (4): 384–90. doi:10.1001/archinternmed.2008.560. PMID 19237723. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

We need to fix this, and I started to, but it doesn't belong in the "risk factor" section, and I'm not sure where to put it now. Prognosis, maybe? I'm willing to drop it entirely (a single retrospective study isn't that important), if other people prefer that. WhatamIdoing (talk) 05:31, 12 February 2011 (UTC)

I'd be in favor of dropping it entirely. No causality is shown in a retrospective study, so there's no way to know if it's a risk factor, a part of disease progress, or simply correlated with illness (ie, staying indoors while sick, as you say). Pro crast in a tor (talk) 18:43, 12 February 2011 (UTC)

Cold weather

This stuff about cold weather seems a little dubious to me. It's not exactly a stellar source, and it seems to forget that the common cold is both a year-round phenomenon everywhere, and also that there is no seasonal variation in tropical climates. I've removed the "always Winter" error, but I'm not sure we should be including this at all. WhatamIdoing (talk) 16:07, 18 March 2011 (UTC)

Yes more research is needed here.Doc James (talk · contribs · email) 21:54, 18 March 2011 (UTC)

Minor wording

Should the section 'Risk Factors' read 'In one study, the virus was recovered in 1/13 of sneezes and 0/8 coughs generated by adults with natural rhinovirus (cold) infections.[15]'? 0/8 seems a bit dubious to me. Perhaps it should read '1/8' or '3/8' Thankyou Intheeventofstructuralfailure (talk) 01:49, 26 March 2011 (UTC)

Dormancy and activation

Research indicates the cold virus can stay dormant in your body and be activated by chilling of the body.

Some references:

http://www1.imperial.ac.uk/medicine/news/p5039/

http://health.dailynewscentral.com/content/view/1911/63

http://www.medpagetoday.com/InfectiousDisease/URItheFlu/2136

The jist is, you can get a cold without a recent transmission. Can someone in the know add an appropriate section to the wikipedia standards?

15.203.233.77 (talk) 16:07, 29 March 2011 (UTC)

influenza symptom onset is constant(?)

What is meant by the word "constant" in "...whereas influenza symptom onset is constant and immediate" in the Progression section? I cannot see how an onset can be "constant" in the normal meaning of the word. Is "constant" a technical term in this context? I note that the Influenza article characterises influenza onset as "sudden", and maybe this is what is meant.FrankSier (talk) 23:34, 3 June 2011 (UTC)

Wet weather

The article is contradicting as to humidity facilitates or not virus dispersion in the atmosphere. — Preceding unsigned comment added by 190.97.61.108 (talk) 20:59, 1 August 2011 (UTC)

The article currently says 'Wet weather seems to help the virus because certain levels of humidity affect the ease with which viral particles can be spread in the atmosphere.', however I think this incorrect - I believe cold viruses are transmitted more easily in dry conditions. An article on weather.com, for example, says 'The most common cold-causing viruses survive better when humidity is low -- the colder months of the year.'

See, for example http://infectiousdiseases.about.com/od/respiratoryinfections/a/winter_virus.htm or http://infectiousdiseases.about.com/od/respiratoryinfections/a/winter_virus.htm.

My impression has always been that colds are more common in the winter as the virus does best in cold, dry conditions, and because people tend to be closer together when it is cold outside. Likewise, the reason why there are less colds in tropical climates can be attributed in part to higher levels of humidity.Draykyle (talk) 01:49, 28 August 2011 (UTC)

I think this is a contradiction:

Top paragraph states: There is currently no known treatment that shortens the duration; Then under Vitamin C: Routine vitamin C supplementation does not reduce the incidence or severity of the common cold in the general population, though it may reduce the duration of illness Interesting, since so many "new and improved" common cold treatments keep appearing on the market with added Vitamin C... or is that just more drug company hype and salesmanship too? In my experience it reduces severity & duration and contains no harmful effects at all. Thanks. — Preceding unsigned comment added by 175.38.163.235 (talk) 07:25, 19 August 2011 (UTC)

"There is currently no known treatment that shortens the duration" vs. "though it may reduce the duration of illness". "Known" = proven, "may" = inconclusive results. That you believe it helped you and believe there were no negative effects is immaterial here; double-blinded, placebo-controlled trials have been unable to prove this. Drug companies would add "magic pixie dust" if it increased sales. Since people believe vitamin C helps, it is not at all surprising they add it. (You'll notice inconclusive studies resulted in a market for "homeopathic" zinc lozenges for colds as well.) - SummerPhD (talk) 22:28, 19 August 2011 (UTC)

Alcohol-based hand sanitizers

Someone seems to be insisting on the claim that "Alcohol-based hand sanitizers provide very little protection..." yet neither of the sources cited to support this assertion draw this sort of claim with anything like this sort of discouraging tone. On the contrary, one of the sources encourages the use of sanitizers "in the home" and the other concludes by saying that "[s]chools should consider adopting" "hand sanitizer and surface disinfection". It's true that the sources only found that the sanitizers were demonstrably effective against gastrointestinal illnesses, but a positive conclusion there does not necessarily imply a negative conclusion about efficacy against respiratory illnesses. They could be quite effective, but the studies by this particular author did not find statistically significant evidence. At a absolute minimum one needs to find more authors. The sources support a NON-statement about efficacy against respiratory illnesses or, at best, a statement to the effect that while sanitizers "kill viruses" (one of the sources states clearly that "Alcohol-based hand sanitizers rapidly kill viruses that are commonly associated with respiratory and gastrointestinal (GI) infections"), sanitizer use hasn't been shown to be as effective as for gastrointestinal illness (although even then, there should be evidence that these two studies are typical and not anomalous).--Brian Dell (talk) 07:11, 23 November 2011 (UTC)

Comments by an IP

• The role of body cooling in causing the common cold is controversial. [This is as true as claiming that it is controversial whether monkeys can fly. It is a fact that colds are not caused by body cooling, which is quite obvious and consequential from the knowledge that colds are caused by viruses. Someone should fix this and write about how body cooling after exposure to a cold virus lowers the immune systems defenses and makes one more susceptible to virus allowing more replications, which exacerbate ones symptoms. Virus growth is exponential, and if when you contract a cold virus your body checks it before it even begins then you will not have any symptoms and not even know you were ill. However, if you let your body cool, forcing the body to deal with the most immediate threat of maintaining core body temperature, then the virus can get its grounding if you will making it more difficult for the body to obliterate and resulting in the cold symptoms. (Could someone please fix my poorly written addendum while integrating the superior information.)]

Moved here Doc James (talk · contribs · email) 08:03, 23 December 2011 (UTC)

Changed to "as a risk factor" Doc James (talk · contribs · email) 08:06, 23 December 2011 (UTC)

Risk factors body cooling

Sorry about not using the talk pages. I am new to editing and I did not even know about talk pages. The following section is problematic.

"The role of body cooling as a risk factor the common cold is controversial.[17] It is the most commonly offered folk explanation for the disease, and it has received some experimental evidence. One study showed that exposure to the cold causes cold symptoms in about 10% of those exposed, and that the subjects experiencing this effect report far more colds overall than those who do not.[18] However, a variety of other studies do not show such an effect.[17]"

This can be misleading and cause people to think that they could get a cold from their body being cold without ever having any exposure to the virus. It should be rewritten in a way that makes it clear that cold viruses don't spontaneously come into existence in people below a certain temperature. In addition, the potential for increased susceptibility when one has already been exposed to a cold virus should be mentioned. It should go further in depth about how body cooling effects the immune system and how cool air that one breathes can facilitate cold virus replication in the nasal passage. Here are some sources I found, however not all of them give you access to the entire article.

http://www.rhinologyjournal.com/Rhinology_issues/109_Eccles.pdf

http://informahealthcare.com/doi/abs/10.1080/00016480252814207

http://www.nrcresearchpress.com/doi/abs/10.1139/y98-097 71.202.16.96 (talk) 08:35, 23 December 2011 (UTC)

I just recently noticed the section later in the article title 'Cold Weather' under social and cultural, which contains redundant information. Since that section is under social and cultural, let it only contain only information about what people beliefs have been or are currently and have the scientific information all go under risk factors since it needs to be expanded anyway. 71.202.16.96 (talk) 08:47, 23 December 2011 (UTC)

Sure. Agree. Doc James (talk · contribs · email) 11:10, 23 December 2011 (UTC)

About 0/8 coughs

Either that's the most stupid statistic ever, or someone's made a typo :-) — Preceding unsigned comment added by 86.178.48.17 (talk) 17:49, 14 June 2011 (UTC)

It's in the source. You'll need to take it up with the Journal of Antimicrobial Chemotherapy. - SummerPhD (talk) 20:23, 14 June 2011 (UTC)

Actually, I stand corrected. They're only citing an earlier study. Look s like you'll need to take it up with those hacks at the New England Journal of Medicine. - SummerPhD (talk) 20:26, 14 June 2011 (UTC)

When I first read this I thought there was some sort of mistake, but upon looking at the source of the article I see how it makes sense. It is describing that something occurred in 0 out of 8 patients, which is more information than knowing it happens 0% of the time. Perhaps this should be changed to read '0 out of 8' and the other one would be '1 out of 13', as to make it more understandable. 71.202.16.96 (talk) 23:49, 23 December 2011 (UTC)

It's from a single study that reports information noticeably different from other studies, so it shouldn't be mentioned at all. How much virus you recover depends more on your methodology than anything else. That a study published back in 1973 didn't do so well with its viral detection shouldn't really surprise anyone. WhatamIdoing (talk) 00:01, 24 December 2011 (UTC)

False information under risk factors

Counterintuitively, people with stronger immune systems are more likely to develop symptomatic colds.[23] This is because the symptoms of a cold are directly due to the strong immune response to the virus, not the virus itself. People with less active immune systems—about a quarter of adults—get infected with the viruses, but the relatively weak immunological response produces no significant or identifiable symptoms. These people are asymptomatic carriers and can unknowingly spread the virus to other people. Because strong immune responses cause cold symptoms, "boosting" the immune system increases cold symptoms.[23]

This needs to be removed, but something should take its place explaining why that line of thought is absurd. I am amazed at how many people have been duped by this idea in Jennifer Ackerman's book, which is cited here. Ackerman is an English major who is by no means qualified to comment on this subject let alone attempt to interpret technical articles. It should be removed until we can find something more accurate to take its place. Writers like her need to stick to the plain and obvious and should not be extrapolating. In fact what they should write about should be so plainly obvious that the niche of readers for which they write should not exist. The scientists should be the only ones writing scientific books, and those should be the only ones cited on wikipedia. The only thing worse than ignorance is false information.71.202.16.96 (talk) 09:29, 23 December 2011 (UTC)

You need to provide a source. This current section is sourced to a New York Times article. If you think that is inaccurate or biased, you need more analysis than what you've provided sofar. Same goes for your prior argument above. Shadowjams (talk) 09:39, 23 December 2011 (UTC)

I agree with the IP the NYTs is not accurate for medicine. We need to use review articles / major textbooks per WP:MEDRS . Doc James (talk · contribs · email) 11:10, 23 December 2011 (UTC)

Unfortunately that link appears to be dead. That said, it appears the article's quoting something else. I disagree with your assertion that a major newspaper can't comment accurately about medical phenomenon. Shadowjams (talk) 17:35, 23 December 2011 (UTC)

The NYTimes link is a lay summary of the source, not the actual source. I've updated the link.

I think the problem here is that some people know just enough to get themselves in trouble.

Cold symptoms are produced largely by histamine and other immune system "hormones", not the virus. The more active your immune system, the more histamine you are capable of producing and therefore the more symptoms you are likely to have. What are the existing treatments for cold symptoms? The most commonly used group of medications is a group of known and deliberately selected immunosuppressants called antihistamines, which are effective at stopping the runny nose and sneezing. If you have severe symptoms, the typical prescription-only medications include immune-suppressing corticosteroids (short-term symptom relief), mast cell-suppressing cromolyns, and even more antihistamines.

Having symptoms is not the same thing as having an infection. People with strong immune systems get more cold symptoms; people with weak immune systems get more complications. Everybody is equally likely to get an infection.

Doc James of course can confirm the role of the immune system in affecting the symptoms of infection from his own experience: patients with severely suppressed immune systems (e.g., due to chemotherapy) rarely present in his emergency department with a runny nose, sneezing, and itchy, watery eyes, but they do turn up with viral respiratory infections, and some of those respiratory infections have very few symptoms.

The facts we're presenting here are verifiable to scientific sources like PMID 11166856, which says things like, "The absence of detectable histopathology during rhinovirus infection led to the suggestion that the host response to the virus may play a primary role in the production of common cold symptoms. Evaluation of this hypothesis has produced compelling evidence that the host response plays a role in rhinovirus pathogenesis. The peripheral white blood cell count increases in rhinovirus-infected, ill subjects during the first 2–3 days after virus challenge. This increase in the white blood cell count is the result of an increase in the concentration of circulating polymorphonuclear leukocytes (PMNs). Of note, subjects who are infected but not ill [asymptomatic] have no change in the peripheral white blood cell count. A similar PMN response to rhinovirus infection is seen in the nasal mucosa and nasal secretions. As with the changes in peripheral neutrophil count, the increase in PMNs is seen in infected symptomatic subjects but not in infected asymptomatic individuals…. The observation that a PMN response in both blood and the nasal mucosa was associated with symptomatic infections led to efforts to understand the origin of this inflammatory response… Studies in human volunteers have established an association between IL-8 and common cold symptoms... Furthermore, in experimental rhinovirus infection there is a direct correlation between the severity of common cold symptoms and the concentration of IL-8 in the nasal secretion."

(For the non-geeks among us, all of that adds up to, "the more active your immune system, the worse your cold symptoms." Also, it goes on to say that if you want to do a really good job of faking some cold symptoms, all you have to do is spray human IL-8 into your nose.)

Since this is really a question of pathophysiology rather than treatment efficacy, if you want an gold-plated scientific source, then I'd prefer a textbook rather than a journal article. Gwaltney wrote the chapter on rhinoviruses in Richman's Clinical Virology (which I don't have), and since the mechanisms by which rhinoviruses produce cold symptoms is the focus of his research, it will doubtless provide more detail than the average book. However, this is pretty much window dressing: Ackerman's quoting one of Gwaltney's colleagues in the source we're currently using. The actual material we're presenting will not change significantly just because we put a "scientific" source at the end of the sentence. WhatamIdoing (talk) 19:54, 23 December 2011 (UTC)

BTW, there's a decent lay summary of which compounds cause which symptoms halfway through this article. WhatamIdoing (talk) 20:50, 23 December 2011 (UTC)

This is virus specific. Yes for the rhinovirus there is no tissue destruction and symptoms are due to immune response but a person having a weak immune system which technically means if they are immunocompromised does not mean they have less symptoms per my reading.Doc James (talk · contribs · email) 09:58, 28 December 2011 (UTC)