Talk:Common cold/Archive 4

Human coronaviruses

@Jmh649:. Please don't keep reverting the edits regarding the HCoV's as sources of the common cold. The citation I used mentions the epidemiological study that finds the HCoV causes 15-30% of common colds. Therefore it is a secondary source. I'm not using the source as evidence of destruction of dentritic cells, I'm only using their mention of the epidemiology study which they did not conduct. Malke 2010 (talk) 11:29, 10 November 2013 (UTC)

@Jmh649:, what about this source: http://www.medicalnewstoday.com/articles/256521.php. Malke 2010 (talk) 11:37, 10 November 2013 (UTC)

The first is a primary source not a secondary source. Please use secondary sources per WP:MEDRS. Feel free to ask for a second opinion at WT:MED.

The secondary is a popular press piece. Also not a suitable source. Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:41, 10 November 2013 (UTC)

It can be used. The study has nothing to do with the epidemiological study the authors mention. It is well-established that these two human coronaviruses cause the common cold and this fact is frequently mentioned in other coronavirus studies. There is no reason per WP;MEDRS why they can't be used. Malke 2010 (talk) 13:19, 10 November 2013 (UTC)

We should be using review articles to support content. We already mention that 10-15% is from coronoviruses using emedicine. This is not the best secondary / tertiary source but better than the primary one and new source. Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:21, 10 November 2013 (UTC)

I checked with the reliable sources noticeboard and the consensus is that in this context it's okay to use the article in the Journal of Virology because in this context it's a secondary source. [1]. I did find tertiary sources that mention the particular HCoVs that cause the common cold and will use them, but in stating the percentages of colds caused by HCoVs, the J.Virl is most up to date. The source being used now for the human coronavirus statistic does not appear reliable for that as the sources it quotes do not appear to mention the human coronaviruses, only the rhinoviruses. Malke 2010 (talk) 17:36, 16 November 2013 (UTC)

We should be able to find a better secondary source. I will look unless you beat me to it. Our current one says "followed by coronaviruses (10-20%),"Doc James (talk · contribs · email) (if I write on your page reply on mine) 09:24, 17 November 2013 (UTC)

This ref says about 15%.[2] Have added it and formatted properly. Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:03, 18 November 2013 (UTC)

Have removed the 10-30% added in this edit [3] as it was specifically for winter colds only and not all year. Have replaced with another ref. Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:54, 18 November 2013 (UTC)

This is becoming quite tiresome. You've rejected and edit warred over an obviously reliable secondary source. The first time you reverted I'd already provided a reliable, peer reviewed, academic secondary source. You rejected that. I took it to the RS noticeboard. The consensus was it is a reliable secondary source for the context in which it was being used. I let you know that here, yet you still insisted on another source. I found a tertiary source that you now reject again. I've provided two superior sources, and yet you cannot stop reverting. The human coronaviruses are well known for causing 10-30% of common colds. You can't reject the figure because you decide that the source is referring to winter colds. Malke 2010 (talk) 06:02, 18 November 2013 (UTC)

You also do not recognize that there are only two human coronaviruses responsible for the common cold. You can't simply say, 'coronavirus' as this can confuse the reader with the far more seriuous CoV's that cause SARS, and MERS, etc. These are not zoonotic viruses. And there is no reason not to identify them and link to their Wikipedia articles. Malke 2010 (talk) 06:07, 18 November 2013 (UTC)

In addition, the textbook your are using for the percentage figure is a general microbiology text. It is not a specific text for the coronaviruses like I've used. Malke 2010 (talk) 06:23, 18 November 2013 (UTC)

You have not addressed the concern I had. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:29, 18 November 2013 (UTC)

Are you claiming that the academic source and the information about the human coronaviruses can't be used in the article because the source mentions that the HCoV's cause the common cold in winter? Are you aware that viruses are seasonal? So you're saying that the viruses that 85-100% of the adult population have antibodies for, can't be included in this article on the common cold because they cause the common cold in winter? Malke 2010 (talk) 06:58, 18 November 2013 (UTC)

This is directly from Common cold, under 'weather,' Some of the viruses that cause the common colds are seasonal, occurring more frequently during cold or wet weather. Since cold weather usually occurs in winter, the Coronavirus textbook mentioning that the HCoVs cause more winter colds would seem to be reliable. Malke 2010 (talk) 07:05, 18 November 2013 (UTC)

I am saying that a source that stats 10-30% of colds in the WINTER are do to a virus cannot be used to state what percentage overall are due to said virus. Anyway the source we have now is fine. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:11, 18 November 2013 (UTC)

You don't understand. These viruses only cause colds in the winter. The statistic is correct. Viruses are seasonal. These particular HCoV's are seasonal. They display marked seasonality between December and April. Those are the winter months. Malke 2010 (talk) 07:16, 18 November 2013 (UTC)

People get colds in the summer. This virus primarily causes colds in the winter when of course colds are more common. Current stats are fine. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:24, 18 November 2013 (UTC)

People don't get that many colds in the summer. Viruses are seasonal. The HCoV's aren't the only seasonal viruses. The influenza viruses are seasonal too, in the winter. The stats are not fine, they are poorly sourced, and they are not accurate. You are rejecting, accurate, well-sourced edits out of hand. There is no rationale to reject those edits. Please revert yourself. Malke 2010 (talk) 07:31, 18 November 2013 (UTC)

Feel free to try a RfC. Colds do occur in the summer just not as many. Have added human to the viruses name. The 2012 Cecil's states "suggest that coronaviruses are associated with about 15% of cases of the common cold" [4] and will update Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:13, 18 November 2013 (UTC)

Colds are seasonal. The rhinoviruses are more likely in fall and spring. The human CoV's in winter, same for the influenza viruses. None of your sources speak to summer and therefore I don't understand why you keep changing the goal posts here. First you didn't like the source because you claimed it was primary. I took it to RS noticeboard who see it as secondary. You still wanted another source. I found it. Now the goal you've set is that all sources must include summer colds. Yet none of your sources do that. Sources that mention the seasonality would seem more desirable given the article itself does mention seasonality. And in RL, they call it 'cold and flu season' for a reason. Malke 2010 (talk) 23:29, 18 November 2013 (UTC)

So you want to say that 10-30% of colds are due to Human coronaviruses based on a source that states that "10-30% of colds in winter are due to coronaviruses"? Approximately 15% is sufficient is it not? Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:59, 18 November 2013 (UTC)

The reliable sources I've presented use the range of 10-30% or 15-30%. The source I used in my original edit supports those figures. You claimed it was a primary source. The RS noticeboard consensus is that it is a secondary source. Btw, the Gold source you are using also refers to the winter incidence of colds caused by HCoVs, the very thing for which you rejected the coronavirus textbook I then used to appease your rejection of the RS noticeboard decision.

You're rejecting academic, peer-reviewed sources because you are insisting that the only percentage of HCoV's acceptable to you is 15% when the coronavirus literature says 10-30% or 15-30%. HCoVs are an important cause of the common cold. Nearly every adult will test positive for antibodies. And depending on the sampling, researchers have actually found 100% of study subjects to test positive for these HCoVs. The percentages I've mentioned accurately reflect that reality. I'm going to action the edit based on the RS noticeboard consensus. I'm also going to add a source that mentions the year-round prevalence of the coronaviruses since that seems to be so important to you, despite the fact that none of the sources for the other viruses mentions their seasonality.

Please don't continue to revert. Instead, it might be a good idea for you to review WP:OWN. This is a simple, well-sourced edit that should not have taken this much discussion to action. Malke 2010 (talk) 18:23, 20 November 2013 (UTC)

Wikipedia is based on consensus. Feel free to get other opinions. When different sources disagree we need to figure out how to balance them.Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:43, 20 November 2013 (UTC)

Issues

• This ref does not appear to support the text in question [5]
• This ref [6] is a primary source and we do not use primary sources to refute secondary ones per WP:MEDRS. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:53, 20 November 2013 (UTC)

More information needed

Two key issues need more information:

• The contagiousness of the common cold has only one reference, a few years old. Updated and additional sources would be helpful. Also, the duration and numbers of subjects and hypothesis p values in referenced studies need to be stated so we can have some idea of the actual study results and reliability.

• The effects of Vitamin D3 on the common cold, based on a single study, is stated to have no benefit. The parameters of this study, such as the number of subjects and the hypothesis p values, need to be included here so we can have some idea of the actual study results and reliability.

There is no need to limit articles to content that can be understood by everyone, so long as that content is useful. See the WP articles on advanced mathematics for hundreds of examples. David Spector (talk) 13:44, 30 January 2014 (UTC)

We do not typically include "number of subjects and the hypothesis p values" as it is overly details. People can read the refs to determine this. Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:53, 30 January 2014 (UTC)

Impact of the common cold on Human evolution

I am interested in the lack of reference to two factors. 1) The common cold may be known to infect animals but the symptoms are considerably less. 2) disease that has been known since 'antiquity' and affecting primarily humans but all races equally with little geographical variation that could not otherwise be explained by nutrition and insults to the immune system.

This leads me to suggest three causalities, directly attributable to the common cold.

1) The variation in spoken languages across the globe (when the impact of population migration is discounted can be attributed to differentiation in common cold symptoms due to differently evolved strains of the virus group.

2) The evolution of sophisticated levels of thought and communication (thereby differentiating mankind with other animals of similar brain size and genetic makeup) arises from the prevalence of the common cold and its impact on communications.

3) A secondary impact is mankind's ability to tolerate wide ranges of environmental temperature and brain and body cooling. The impact of the common cold creating laboratory conditions that resulted in natural selection of those individuals with insensitivity to internal temperature variations.

Explaining 2) in more detail: Accept the philosophical concept that the evolution of the human brain (with its levels of plasticity) has occurred as the result of the exchange of information and ideas through the use of verbal clues that can be exchange to represent those ideas. Accept that protection and promotion of basic human life relies on the ability to exchange a very small range of sounds and thoughts. (danger-up - danger-left, danger-right. The impact of a period of suffering from the cold means that an individual has to hone their physical and intellectual capability to generate those sounds, because their output is less effective. When the symptoms of the cold abate, those now improved capabilities do not diminish because the common cold symptoms persist long enough for that enhanced capability to become the newly established median level or, just the effect of muscle memory takes over. With that new improved 'communication tool' primitive mankind is able to move away from subsistence. There is also a further impact. The ability to communicate emotion and responses to emotion provide a negative feedback loop to correct mental stress and depression that would otherwise further depress the immune system.

This set of hypotheses and particularly 2) arises from observing 2 children/young adults with Cerebral Palsy who's ability to make intelligible sound deteriorated during periods of common cold symptoms, but when the cold symptoms had abated their speech, in terms of cognition and and clarity improved significantly relative to the levels before the cold affected them and if engagement was made with that improved communication the impact was long lasting.

Apologies if this is not a topic for Wikipedia as it empirical and speculative. — Preceding unsigned comment added by Waschrisb802 (talk • contribs) 22:39, 6 February 2014 (UTC)

Research

I really don't know why you reverted my edit, since the Research directions section is obviously outdated. The BTA-798 study finished and some results were published in December 2013. Unfortunately, I didn't have time to make the update myself and to update the Romanian page as well. The other infos on that section might also be outdated. I'll check them tomorrow if I can spare some time. Regards, Winter^eu (user talk) 23:07, 11 March 2014 (UTC)

There was no indication of what was missing. Also here on the English Wikipedia we more or less stick with secondary sources such as review articles.

The common cold is not an active area of research. Which BTA-798 are you referring to? Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:38, 12 March 2014 (UTC)

I was talking about Vapendavir. You can read a review article here. I was wrong about the date. The study ended much earlier. --Winter^eu (user talk) 06:27, 12 March 2014 (UTC)

All is see is the heraldsun? Were is the review article? Pubmed comes up with nothing [7] Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:01, 12 March 2014 (UTC)

I know, but you can find it on PubChem, here. You might also be interesed in reading the following related articles as well: Drugs.com and Biotapharma.com. The first of them is talking about the study results (which were very good), while the second is the official page of the product (the last 2 paragraphs). --Winter^eu (user talk) 11:15, 12 March 2014 (UTC)

Yes but we need a high quality secondary source. Two of the refs do not work for me. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:14, 12 March 2014 (UTC)

Well, there's the official report of the phase II trial. Obviously, even though results were very good until now, there is still a long way ahead. By the way, in Medicines in Development - Infectious Diseases Report you can find all the antivirals which are subject to clinical trials and their status so far (just in case you're curious to see them all). --Winter^eu (user talk) 23:10, 12 March 2014 (UTC)

So looks like this line "A number of antivirals have been tested for effectiveness in the common cold; however as of 2009 none have been both found effective and licensed for use" is still true. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:16, 13 March 2014 (UTC)

Apparently, Pleconaril development was halted, according to the American Society for Microbiology (AAC Issue, May 2013). Regarding the Vapendavir (BTA798), please read the official report (cited by ATS Journals, May 2013) and the PharmaVentures article (Issue 10, February 2014). Other sources may be found as well.

--Winter^eu (user talk) 11:01, 13 March 2014 (UTC)

Regarding the tag, the Research directions section contains information through 2011, that is not so wildly out of date as to require an article-wide tag. If it needs updating please just update it rather than tagging it. Zad68 13:13, 12 March 2014 (UTC)

Breast feeding

Currently says:

"Breast feeding decreases the risk of acute otitis media and lower respiratory tract infections among other diseases[37] and it is recommended that breast feeding be continued when an infant has a cold.[38] In the developed world breast feeding may not however be protective against the common cold in and of itself.[39]"

Can we clarify this a bit? It seems to be saying that breast feeding decreases the risk in poor countries, but in developed ones it only helps prevent middle ear infections and pneumonia or bronchitis - not the cold. Snori (talk) 17:48, 4 May 2014 (UTC)

Folklore about the common cold cause by lowered body temperature

This article is semi-protected so I was unable to correct it. Please consider:

When it comes to what the average person believes about colds, there seems to be as many misconceptions as cold medicines on a drugstore shelf. And now that the winter cold and flu season is in full swing, we turned to Thomas Tallman, DO, an emergency medicine physician and cold and flu expert at the Cleveland Clinic, to set us -- and you -- straight on prevention and treatment.

(...)

Cold weather also does not cause colds -- at least not directly. Despite its name, the common cold is not caused by cold. "It doesn't have any effect at all," says Tallman. "There's no correlation." In fact, you may be more likely to "catch your death of cold" indoors, where it's warm and crowded than outdoors in the chilly air. People in close quarters are more readily exposed to carriers of the viruses that cause colds. "If one person in a household gets sick, it will spread easily," Tallman says.

Source: Cold, Flu, & Cough Health Center

There are many more sources like this:

We spoke with two experts -- Dr. Sorana Segal-Maurer, chief of the Dr. James J. Rahal Jr. Division of Infectious Disease at New York Hospital Queens, and Dr. Brian P. Currie, vice president and senior medical director of the Montefiore Medical Center in New York -- to find out the truth once and for all.

(...)

The verdict: Cold weather does not cause colds

Source: CNN: does cold weather cause colds?

So...Given the prevailing scientific consensus, what to do about this sentence?

There is some controversy over the role of body cooling as a risk factor for the common cold; the majority of the evidence suggests that it may result in greater susceptibility to infection.[30]

Like hell it does. This sentence can be considered misleading or even false. — Preceding unsigned comment added by 83.161.1.44 (talk) 20:25, 28 February 2014 (UTC)

That is a strong claim. Most doctors believe that exposure to cold affects the immune system, whether there is evidence or not. Do you have any references to evidence that cold does not create susceptibility? I wonder whether any experimentation has been done at all. Without evidence, anyone can claim anything. David Spector (talk) 17:27, 11 March 2014 (UTC)

Adjusted text. It is referring to hypothermia rather than exposure to low temps. Doc James (talk · contribs · email) (if I write on your page reply on mine) 17:37, 11 March 2014 (UTC)

Recent evidence has come to light in a a study in mice has shown that the strength of antiviral immune response in infected cells also varies according to temperature, being strongest at higher temperatures and diminished at lower, and therefore physiology underpins notion that colds are caught more readily in cool weather. — Preceding unsigned comment added by 82.5.211.56 (talk) (signed by Mr. Swordfish (talk) 12:35, 21 January 2015 (UTC))

Semi-protected edit request on 22 March 2016

I am an RN with 20 years experience, & have studied widely into health and nutrition. Susceptibility to colds & flus can be lessened by a healthy immune system & healthy teeth. Consume foods containing iron & minimum sugar (unless you are an iron retainer) A daily multivitamin (5mg iron), adequate protein, fresh vegetables & low sugar diet can help reduce the incidence of colds. If you DO get a cold - try to cut out all sugar. Increase salt & multivitamin intake. The vapour mist of essential oils, in a humidifier or at minimum heat in a pan of hot water at back of stove, or vapours inhaled from a cup of hot water, can help with the lungs & sinuses - lavender, eucalyptus etc. Elderberry extract is an ancient remedy that can cut the duration of a cold in half.

110.23.81.58 (talk) 03:14, 22 March 2016 (UTC)

We base our content on references in well respected medical sources. Doc James (talk · contribs · email) 05:48, 22 March 2016 (UTC)

Cough medicine

At present the article is extremely dismissive of cough medicines as a symptomatic treatment. While this may be true of OTC preparations without any real active ingredients, it seems pretty obvious that an antitussive such as codeine will suppress coughing, at least to an extent. I'm not a medical professional so won't modify the article myself, but it would be helpful if an expert editor could clarify it. --Ef80 (talk) 18:59, 20 October 2016 (UTC)

There is no evidence that codeine is safe or effective. In fact evidence in children is it is harmful with a fair number of deaths in children. So yes this article is rightfully dismissive. Doc James (talk · contribs · email) 21:15, 20 October 2016 (UTC)

I am not suggesting that opioids are safe or appropriate, particularly for children, but they will certainly stop you coughing. In fact, if you take enough they will stop you breathing. --Ef80 (talk) 23:24, 20 October 2016 (UTC)

There have been no good studies of opioids for cough. Here is one review that comments on that for children [8]. And one for acute cough generally.[9] Doc James (talk · contribs · email) 23:52, 20 October 2016 (UTC)

Both those studies are Cochrane meta-analyses of OTC preparations and are not really relevant. However, I've been around WP for long enough to recognise a lost cause when I see one. Best wishes. --Ef80 (talk) 00:09, 21 October 2016 (UTC)

You have references to discuss? Codeine is OTC. Doc James (talk · contribs · email) 01:44, 21 October 2016 (UTC)

Reference 54 (Singh M) for zinc

The publication referenced for the section about zinc has been withdrawn by the journal it was published in.

It is not established that zinc may or may not help reduce the severity of the cold.

Link proving withdrawal — Preceding unsigned comment added by 134.174.140.208 (talk) 16:07, 3 November 2016 (UTC)

Decongestants

I am new to wikipedia editing, and noticed a new Cochrane review that would fit into this article (. doi:10.1002/14651858.CD009612.pub2. {{cite journal}}: Cite journal requires |journal= (help); Missing or empty |title= (help)). This wikipedia article uses a 2007 Cochrane reference and states that "Other decongestants such as pseudoephedrine are effective in adults.[67]" under the Management- Symptomatic heading.

The 2016 article looked at decongestants used in monotherapy to see if they ease nasal congestion symptoms in people with colds. Quoting from the 2016 Cochrane article, the authors concluded that "We were unable to draw conclusions on the effectiveness of single-dose nasal decongestants due to the limited evidence available. For multiple doses of nasal decongestants, the current evidence suggests that these may have a small positive effect on subjective measures of nasal congestion in adults with the common cold. However, the clinical relevance of this small effect is unknown and there is insufficient good-quality evidence to draw any firm conclusions. Due to the small number of studies that used a topical nasal decongestant, we were also unable to draw conclusions on the effectiveness of oral versus topical decongestants. Nasal decongestants do not seem to increase the risk of adverse events in adults in the short term. The effectiveness and safety of nasal decongestants in children and the clinical relevance of their small effect in adults is yet to be determined."

Does anyone have any suggestions on changes that should be made to the decongestants comment? I feel as though this is an important section of the article, given how many individuals are interested in using medication in order to alleviate cold and cold-like symptoms. Would it also be worth adding this article to the "Decongestant" and "pseudoephedrine" wikipedia pages?

I greatly appreciate feedback and comments. I am just learning how to edit wikipedia :) Thank you! JenOttawa (talk) 17:55, 4 November 2016 (UTC)

Sounds like a good idea. How do you think we should paraphrase the Cochrane review? Doc James (talk · contribs · email) 17:38, 5 November 2016 (UTC)

I think perhaps this is a case where we should exercise some editorial judgement. The effects of decongestants are so thoroughly understood that there is little interest in studying them; consequently there aren't many high-quality clinical trials to work with. If we treat that Cochrane review as the last word on the subject we run the risk of looking silly. Looie496 (talk) 18:02, 5 November 2016 (UTC)

We know a fair bit about rebound with decongestants.

This seems like a fair conclusions "For multiple doses of nasal decongestants, the current evidence suggests that these may have a small positive effect on subjective measures of nasal congestion in adults with the common cold."

Adjusted to [10] Doc James (talk · contribs · email) 04:55, 6 November 2016 (UTC)

Thanks for the feedback. I appreciate you doing the edit Doc James. How do you feel about adding in a sentence about use in children? "The safety and effectiveness of nasal decongestant use in children has not been proven clinically." from the same 2016 reference? JenOttawa (talk) 12:59, 6 November 2016 (UTC)

Sounds good. Doc James (talk · contribs · email) 13:02, 6 November 2016 (UTC)

Thanks again. I made the addition regarding children. Doc James, I like how you changed the wording of the sentence from "are" to "appear". Did you refrain from adding your summary of the new Cochrane Review in order to keep the text simple, and not overwhelm an individual reading it who does not have a medical background? Thanks for your help and support! What a terrific community! JenOttawa (talk) 17:38, 6 November 2016 (UTC)

I took a look at the Pseudoephrine page, and there is a place for my sentence re children under "precautions", unless anyone has another suggestion. Thanks JenOttawa (talk) 17:44, 6 November 2016 (UTC)

Simplified a bit. Looks good. Doc James (talk · contribs · email) 19:09, 6 November 2016 (UTC)

References

Semi-protected edit request on 1 February 2017

The article claims that aerosols do not "seem" to be the chief contributor to the spread of rhinovirus infection.

However an experiment has shown (with a p less than .001 by two-tailed Fisher exact tests) that it is chiefly aerosols which spread rhinovirus.

https://www.ncbi.nlm.nih.gov/pubmed/3039011 Biflindi (talk) 12:23, 1 February 2017 (UTC)

Small and fairly old ref. But interesting. Doc James (talk · contribs · email) 13:07, 1 February 2017 (UTC)

The full sentence in the article is "Which of these routes is of primary importance has not been determined; however, hand-to-hand and hand-to-surface-to-hand contact seems of more importance than transmission via aerosols." Doc James (talk · contribs · email) 13:09, 1 February 2017 (UTC)

Not done: please provide additional reliable sources that support the change you want to be made.  Paine Ellsworth  ^u/c 18:00, 8 February 2017 (UTC)

Semi-protected edit request on 28 February 2017

[ The most commonly implicated virus is a rhinovirus (30%–80%), a type of picornavirus with 99 known serotypes. ] There is a grammar problem I believe, instead of a comma in the middle there should be a semi colon. Mapps (talk) 20:38, 28 February 2017 (UTC)

Not done: The comma seems correct. "A type of picornavirus with 99 known serotypes" is not an independent clause. Gulumeemee (talk) 06:08, 1 March 2017 (UTC)

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Zinc study (cite # 55) is officially WITHDRAWN

Hi! Complete wiki noob here, I'm terribly sorry if the formatting is weird.

I noticed that you make the following two statements in the article:

• "Zinc supplements may help to reduce the prevalence of colds."
• "Zinc has been used to treat symptoms, with studies suggesting that zinc, if taken within 24 hours of the onset of symptoms, reduces the duration and severity of the common cold in otherwise healthy people."

Both of the above statements are backed up in the article with a reference to the following study:

• Singh M, Das RR (February 2011). Singh M, ed. "Zinc for the common cold". Cochrane Database of Systematic Reviews (2): CD001364. doi:10.1002/14651858.CD001364 PMID 21328251.

That very study, however, has since been retracted. Indeed, pressing its very own PMID link (seen above in the cite) provides clear notice of this fact.

Retraction Watch offers the full story. The original withdrawal statement can be read here.

Sorry again if my formatting is odd. "It's my first day" - Homer Simpson.

Thanks in advance! Great moves Wikipedia, keep it up, proud of ya :) 155.4.130.19 (talk) 12:28, 3 April 2017 (UTC)

@155.4.130.19:Thanks for posting here and for noticing this error! I put a message on the WikiProject Medicine talk page, alerting the community about your message. https://en.wikipedia.org/wiki/Wikipedia_talk:WikiProject_Medicine

Great first post. Hope to see you again soon on wikipedia! JenOttawa (talk) 13:07, 4 April 2017 (UTC)

After reading the explanation of the withdrawal, I am reluctant to have any of those Cochrane reviews (Singh & Das) cited at all in Wikipedia. The 2011 review is still being cited. (There is also a different review by Singh being cited.) Axl ¤ [Talk] 12:38, 6 April 2017 (UTC)

I have added the CMAJ review as a reference. There is also this paper, but it cites the Cochrane review as the source of its conclusions. Axl ¤ [Talk] 12:53, 6 April 2017 (UTC)

Thanks and removed

"Zinc has been used to treat symptoms, with studies suggesting that zinc, if taken within 24 hours of the onset of symptoms, reduces the duration and severity of the common cold in otherwise healthy people."

The are requesting sources based on it also be retracted[11] Doc James (talk · contribs · email) 23:46, 9 April 2017 (UTC)

We have a different meta analysis which comes to similar conclusions though[12] Doc James (talk · contribs · email) 23:49, 9 April 2017 (UTC)

Also: just wanted to alert you guys to the fact that the same retracted study is being cited here as well. All the best, 155.4.128.183 (talk) 10:51, 3 May 2017 (UTC)

Updated. Doc James (talk · contribs · email) 19:54, 3 May 2017 (UTC)

References

reference numbering out of whack

Maybe someone who knows how to fix the out-of-sequence reference citations could fix it. JuanTamad (talk) 03:03, 11 June 2017 (UTC)

Epidemiology: colds per year (adults)

Hello, a recent edit (ping User:TylerDurden8823) changed the number of colds per year of the average adult. Currently (edit: and previously), this sentence exists in both (1) the Lead ("introduction") section, and (2) in the Epidemiology section - both state different numbers:

i. The reference in the lead section states "two to four" per year for adults.

ii. The two references in the Epidemiology section state "two to five" and "two to three", respectively.

I feel that that this number, whichever we choose to go by, should be the same in both sections (lead and Epidemiology).

Perhaps, in the Epidemiology section, this could be expanded on (as it is currently with # of colds in children annually, in that very section) to say "two to four or five"/"two to three or even up to five" or something similar, reflecting what multiple/different sources say. This suggestion might cause unnecessary confusion, though (still better than it is now, with conflicting statements).

Thoughts on this? --Treetear (talk) 00:47, 6 January 2018 (UTC)

They already said different things but I agree they're in conflict. TylerDurden8823 (talk) 01:51, 6 January 2018 (UTC)

Oh yes, I'm sorry I wasn't clear at all about that - I only intended to use your edit as a background to why I found this inconsistency :) there was indeed conflicting statements prior to linked edit! --Treetear (talk) 14:19, 6 January 2018 (UTC)

Thanks and have adjusted to the most recent ref. Doc James (talk · contribs · email) 00:45, 15 January 2018 (UTC)

Zinc and the common cold

@Doc James: The "Zinc and the common cold" article is a sub-article of both this article and zinc. Why do you oppose transcluding the lead of that article into a "Common cold#Zinc" section like it is in Zinc#Common cold? Transcluding the lead of that article into this one ensures compliance with WP:SUMMARY STYLE and makes synchronizing the content on this topic in all three articles much simpler than doing this without a transclusion because content synchronization is automated. Seppi333 (Insert 2¢) 00:33, 15 January 2018 (UTC)

All we need is a couple of sentence on zinc. The rest can go on the subpage. The evidence for it is still tentative.

Mayo classifies zinc as alt med and I think it fits fine in that section.[13]

With respect to zinc the Cochrane review also says "but some caution is needed due to the heterogeneity of the data" so the conclusions are less than definite.

Doc James (talk · contribs · email) 00:40, 15 January 2018 (UTC)

@Doc James: We have a Cochrane review, 2 additional meta-analyses, and a monograph for health professionals published by the NIH's office of dietary supplements all claiming that zinc has efficacy for treating the common cold. How is that tentative evidence? Even you consider Cochrane reviews to be the "gold standard" for evidence-based medicine. I don't particularly care if we put it under "alt-med" (although, IMO, that is rather odd given the level of evidence-based support), but I do still think it should be transcluded. If you want the 2nd paragraph of the lead of Zinc and the common cold to not be transcluded here, I'm fine with that; however, I think transcluding the 1st paragraph would be prudent. Seppi333 (Insert 2¢) 00:48, 15 January 2018 (UTC)

The NIH also says "Although studies examining the effect of zinc treatment on cold symptoms have had somewhat conflicting results, overall zinc appears to be beneficial under certain circumstances."

Combine that with the Cochrane "but some caution is needed due to the heterogeneity of the data"

I think "may shorten the duration and reduce the severity of symptoms" is what the literature supports. Likely but not definitive. Doc James (talk · contribs · email) 00:53, 15 January 2018 (UTC)

@Doc James: Heterogeneity across studies simply makes the standard error of the effect size estimate wider than it would be if the underlying data were homogeneous. The fact that the estimate for the reduction in duration was significant indicates that, despite the heterogeneity, there clearly is an effect of zinc on symptom duration. This form of heterogeneity affects how precise the estimate of the effect is (i.e., heterogeneous data across studies yields a wider confidence interval for an estimate compared to analysis with homogeneous data). The Cochrane review reported a point estimate of −1.03 days with a range of −0.34 days to −1.72 days (i.e., a reduction in symptom duration by somewhere between 8–41 hours). The caution about heterogeneity is relevant because the effect size could be markedly larger or smaller than 24 hours; but, based upon a 5% significance level, there clearly is a statistically significant treatment effect; the magnitude of that effect (NB: you can think of that as "clinical significance") isn't certain due to heterogeneity in the underlying data. A reduction by just 8 hours is fairly trivial, but a reduction by 40 hours is a lot more notable than a reduction by 24 hours. Seppi333 (Insert 2¢) 01:28, 15 January 2018 (UTC)

@Doc James: See the comments in the collapse tab below.

The Cochrane review's commentary on the sources of heterogeneity

Most trials relied on community-acquired infections in which the infecting agent was not identified and as such different agents may have been involved which may have differed in their sensitivity to zinc. – the effect size in the meta-analysis in this case is an unbiased estimate of the effect size for the effect of zinc on symptom duration for colds caused by any pathogen (i.e., not specifically for colds caused by the human rhinovirus). The amount of zinc taken each day by participants varied largely across the trials, and given that some formulations released less zinc ion than others the effective dose of zinc across trials was variable. – if this was indeed an issue in their model, it could only serve to downward bias the estimated treatment effect (i.e., under-predict the effect of zinc on the reduction of cold symptom duration); however, given that they specified a threshold dose in their results (>75mg/day), I suspect that their model addressed/accounted for this potential source of bias. Blinding of treatment may not have been adequately controlled in some trials, thereby increasing the potential for performance and detection bias to occur. – that could be problematic if it was an issue in some studies, since failing to adequately blind the treatment may either upward-bias (placebo effect) or downward-bias (nocebo effect) the estimated treatment effect. The time from onset of cold symptoms to commencement of treatment ranged from one to three days. Given the beneficial effects noted in trials commencing treatment with zinc within 24 hours, the results from all the trials may not be comparable. – if starting treatment between 24-72 hours after the onset of cold symptoms does in fact reduce the treatment efficacy relative to starting it prior to 24 hours after the onset, then including the trials that began treatment after 24 hours in their model could only serve to downward-bias the estimated treatment effect on the reduction in cold symptom duration. However, given that they specified that their estimated effect on cold symptom reduction applied for treatment occurring within 24 hours of the onset of symptoms, I suspect that their model addressed/accounted for this potential source of bias. Last but not the least is the fact that the lifestyle of the study population in all the trials was different and the results might have been affected to some degree by this factor. – if this is indeed a relevant issue with the studies, then it would constitute the form of heterogeneity-associated bias that I was talking about in my discussion of heterogeneity (econometrics) in the note below; i.e., if lifestyle factors affect treatment efficacy, then failing to account for those in the statistical model constitutes a source of omitted-variable bias. Keep in mind that only #1–2 and #4 above were known issues in the underlying studies. #3 and #5 were possible issues in the studies which were not known for certain to be applicable to any of the included studies.

Seppi333 (Insert 2¢) 01:58, 15 January 2018 (UTC)

It is clinical rather than statistical significance people care about.

What are you thoughts on the NIH quote?

This review calls it "likely effective"[14] which I would support. Doc James (talk · contribs · email) 02:20, 15 January 2018 (UTC)

I think what the NIH stated - "Although studies examining the effect of zinc treatment on cold symptoms have had somewhat conflicting results, overall zinc appears to be beneficial under certain circumstances." - is essentially the same thing as what the Cochrane review asserted about a minimum dose and the start of treatment occurring within 24 hours of the onset of symptoms. The Cochrane review's conditions for minimum zinc dosage and the start of treatment are very specific circumstances for when zinc supplementation is beneficial. This is the reason why I feel that explicitly stating both the minimum dosage and the time at which treatment begins relative to the onset of symptoms is important. Seppi333 (Insert 2¢) 02:45, 15 January 2018 (UTC)

On an unrelated note, "Some zinc remedies directly applied to the inside of the nose have led to the loss of the sense of smell.[87]" This sentence in the article makes it sound like intranasal zinc products are currently used and/or commercially available. I think it's only worth mentioning the adverse effects of intranasal zinc in the context of the USFDA's ban on those products, because that was their justification for banning them. Seppi333 (Insert 2¢) 03:54, 15 January 2018 (UTC)

Infection paths

In the article it says that "[...]hand-to-hand and hand-to-surface-to-hand contact seems of more importance than transmission via aerosols.", and there is a citation given to Eccles pp. 211, 215.

On p.214 of that book it says:

In summary, it seems that both methods are important in spreading infection through the community. There seems to be no consensus on the relative importance of either one, but nevertheless it might be reasonable to suppose that both are important, and worth exploiting in any preventive intervention.

Full disclosure: I currently have a cold. According to the wording of the introduction to this talk page that would disqualify me from posting here. I assume the wording is off.

--129.247.247.240 (talk) 05:08, 26 April 2018 (UTC)

Thanks. Agree and adjusted. Doc James (talk · contribs · email) 13:52, 26 April 2018 (UTC)

Text

"Patients should drink plenty of water, fruit juice or squash mixed with water is acceptable, patients should get plenty of rest or sleep. Patients should see their doctor if, symptoms do not get better after three weeks, if symptoms suddenly get worse, if temperature is very high or a patient is hot and shivery, if a child's condition causes concern, if a patient has difficulty breething or develops chest pain, if a patient has a chronic medical condition like, diabetes, a heart, lung, kidney or neurological disease, if a patient has a weakened immune system, for example through chemotherapy."

Does not follow WP:MEDMOS. Was already covered in the body of the article as "Getting plenty of rest, drinking fluids to maintain hydration, and gargling with warm salt water are reasonable conservative measures". Doc James (talk · contribs · email) 12:17, 31 December 2018 (UTC)

References

Not a reliable source

I tried the following edit: [15].

It was reverted with the reason that it's not a reliable source.

• It references a number of other studies on the matter. It's thus not a primary source but a secondary source on those studies. And as it's a study only stating one simple thing about hot drinks, any of the 22 citations will satisfy the secondary sourcing of this study as well. Is that is what is then needed?
• The other author is Ronald Eccles. Eccles is referenced by this article about 70 times. He is a fairly reliable source on the topic. Eccles was also interviewed for a BBC article concerning the study. The interview was removed, understandably.
• The journal is Rhinology. This article features studies from journals such as Urologic nursing and The American Academy of Nurse Practitioners, so it's not a question of limiting it just to the top echelon of journals.
• The study itself has been cited 22 times. Again we could limit it to the top echelon of times cited (in the hundreds), but the article is fine with studies in this range and lower.

So, what exactly is the problem again? Concerning the claim that hot drinks may aid, if you happen to suffer from the common cold? Mr. Magoo (talk) 20:22, 14 February 2019 (UTC)

The cited paper was primary research from 2008. Please see WP:MEDRS and maybe WP:WHYMEDRS for background for an explanation of secondary sourcing. Alexbrn (talk) 20:31, 14 February 2019 (UTC)

It seems you didn't bother to read the few lines I wrote. If I reference anything that cites the paper and the claim, it then is a reliable source? Also, as I pointed to Doc James on my talk, this article uses primary sources heartily. That also is not a barrier to entry at this article. Mr. Magoo (talk) 20:41, 14 February 2019 (UTC)

If the article is bad, that's no reason to make it worse adding unreliable sources. I have given links that explain what are considered reliable sources for WP:Biomedical information. We generally don't use the "secondary" bits of primary sources because they are often slanted to serve to purpose of the primary research they are attached to. We use WP:MEDRS instead. Alexbrn (talk) 20:45, 14 February 2019 (UTC)

The article isn't bad. Excessive source-gating is bad. The links you posted lead to extremely vague general guidelines that can be interpreted any way you want and even claim so themselves. Am I then supposed to interpret them in my favor? Is that what you are stating? Mr. Magoo (talk) 20:49, 14 February 2019 (UTC)

Also see WP:DE. Alexbrn (talk) 20:52, 14 February 2019 (UTC)

Posting that link is pretty much just a personal insult. Mr. Magoo (talk) 20:54, 14 February 2019 (UTC)