Child: Fending Off Upper Respiratory Tract Infection

By Dr. JOSIAH CHILD
Medical Director
LAMC Emergency Department
 
As the flu season kicks into full gear, braving airplanes and winter get togethers can provide germaphobes with a daunting onslaught of fearsome exposures.
 
So for those who understand that months of isolation can take its own toll, here are some tips for defense against upper respiratory infections.
 
Flu shots: while flu shots do not provide perfect protection against the flu, the trivalent vaccine for the average population and the quadrivalent vaccine for at- risk populations represent the best protection against getting sick this winter.
 
Hand washing and masks may be helpful in high risk situations while antiviral prophylaxis with tamiflu is only recommended in outbreak situations or for immunocompromised patients.
 
While studies are controversial concerning Zinc lozenges, some data shows a reduction in duration of common cold symptoms by a day when taken during the first 24 hours of symptoms.
 
Much to everyone’s disappointment, Echynasia has not been proven helpful in either treating or preventing the common cold.
 
There are always big questions about Vitamin C. To date there is not convincing evidence of the efficacy of large doses of vitamin C in treating colds however, regular doses (100- 500mg) may be effective in reducing symptoms especially for those exposed to physical stress.
 
For those looking for more esoteric preventive measures,  scientists at the University of Pennsylvania have shown that exposure to bitter taste leads to immune system boosting in the upper airways. “When the T2R38 receptor detects these molecules, it activates local defensive maneuvers to increase mucus clearance and kill the invading bacteria.”   
 
More recent studies have also shown that sweet tastes suppress innate immunity in the sinus system. While this lends some intuitive credence to the idea of not overdoing it on sweets, we are still a ways from recommending one bitter tasting tea over another. 
 
J Clin Invest. 2012;122(11):4145–4159. doi:10.1172/JCI64240. 
J Clin Invest. 2014;124(3):1393–1405. doi:10.1172/JCI72094.
Cochrane Review: Vitamin C for preventing the common cold 
Echinasia for Preventing and Treating the common cold 
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