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Let this season's "cold' war begin

Every year, the cold costs Americans $10-billion in lost wages, and children miss 106-million days of school. Eighty percent of all workdays missed by parents are for their children's illnesses, not their own. Most parents wonder whether anything can be done to keep a child from catching a cold.

Antibiotics will not cure the sniffles and sneezes, and modern science has not discovered a vaccine that will prevent the hundreds of cold viruses from taking up residence in children's noses or throats.

The best way to dodge a cold is to know how colds are spread and to know their cause. Only viruses are responsible for colds, and youngsters contract the illness by encountering the virus from other people. So forget the old wives' tales, like avoiding drafts, standing by an air conditioner, going outside with wet hair and running through puddles without shoes. Do bundle up when it's cold outside, but doing so will not deter a cold virus.

It's not a coincidence that the number of colds skyrockets in October and November, just after school begins. Children coming together after summer vacation bring colorful pencils, new textbooks and many viruses with them into close quarters.

It does not take long for healthy children to come home with runny noses, sniffles and coughs. In addition, when families travel around the country to celebrate the winter holidays, youngsters come across an entirely new set of viruses from their relatives.

Parents can help their child sidestep these new viruses by understanding how colds are passed from child to child. Numerous scientific studies support two theories, namely the "aerosol" and the "hand contact" theory. People used to think that colds were spread only when an infected child coughed and sneezed, releasing virus-filled droplets that were then inhaled by another child. This "aerosol theory" does account for the sharing of colds, but, according to Jack H. Hutto, M.D., director of the Pediatric Infectious Disease Program at All Children's Hospital, "a child's cough rarely spreads virus germs beyond the length of the youngster's arm."

The vast majority of colds are transmitted by hand contact. An infected youngster contaminates his hands by sneezing into his hands or by touching his nose. The child then touches the hands of a healthy child, who infects herself by touching her own nose, mouth or eyes. To make matters worse, viruses can live for a few hours to days on inanimate objects, such as doorknobs, toys and cups. Therefore, a new cold is born when an uninfected youngster plays with a virus-laden toy at nursery school and then puts a hand (or the toy) in her mouth.

Therefore, the most effective way to stop colds from spreading is to encourage children to wash their hands often with soap and water.

"That is the No. 1 way to decrease the incidence of colds among children," Hutto said. Children should have easy access to sinks, and adults in charge of day care facilities and preschools should set a good example by washing their own hands frequently. Instruct children to wash their hands immediately after covering a cough or sneeze with their hands. Not washing will spread a cold faster than anything else since the unwashed hand is covered with concentrated viruses, ready to be transferred to an unsuspecting victim.

Parents should also discourage little ones from putting things into their mouths. The spread of colds can also be dramatically controlled by decontaminating frequently touched surfaces, such as doorknobs, countertops, eating utensils and toys with a disinfectant such as Lysol or hydrogen peroxide. Of course, children should be taught to cover their mouths with tissues when coughing and sneezing and to discard the tissue afterward. Do not let germ-laden tissues accumulate in bathrobe pockets or under pillows.

Other factors influence a child's susceptibility to cold viruses. For example, second-hand cigarette smoke plays a significant role in increasing a child's vulnerability to respiratory infections by damaging the protective lining of the youngster's nose, throat and lungs. It is amazing the number of parents who complain that a child is "sick all the time" and still smoke in the house or expose their children to second-hand smoke at the grandparents' or babysitters' homes.

Parents usually want to know when they can send a youngster with a cold back to school. Hutto says school is okay "even if the child is coughing and sneezing unless they're feeling really miserable. Parents should use their instincts. A good rule of thumb is that any child who is well enough to get around the house is probably well enough to go to school." The severity of the symptoms, not the symptoms themselves, should be a parent's guide.

All parents hope to get their children through the winter without a series of colds. Unfortunately, whenever youngsters gather in groups, their risk of getting a cold increases, and normal children in day care or attending preschool may have eight to 10 colds a winter.

Parents can reduce the cycle of viral transmissions by involving their kids in disease prevention. Since most colds are spread by direct hand transfer of virus-laden droplets, parents should teach children proper hygiene and hand-washing. This will go a long way to reducing the chances that a youngster will be under the weather with life's most frequent illness _ the cold.

This column is meant to draw attention to the issues discussed and should not be relied upon as medical advice. It is not intended to replace the advice of your child's physician. Dr. Bruce A. Epstein has practiced pediatrics in St. Petersburg since 1973. He is a member of the American Academy of Pediatrics. He is married and has three grown children and a granddaughter.

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