Cold Watch

JANUARY 13, 2012

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Pregnant Women Urged to Use Caution When Taking Cold Medications

Because of the potential harm that common cold medications pose to women who are pregnant or breast-feeding, experts from the California Teratogen Information Service (CTIS) Pregnancy Health Information Line, an organization housed at the University of California, San Diego, compiled a list of tips on how to safely battle colds.

“There are certain ingredients in over-the-counter medications women need to watch out for that could be harmful to their developing babies,” said Sonia Alvarado of CTIS.

Alvarado and Christina Chambers, PhD, MPH, CTIS’ program director, offer the following tips for pregnant and breast-feeding women regarding which medications they can take and which to avoid:

1. Patients should only take medications that are recommended for their specific symptoms. For example, if the major complaint is a cough, a combination drug that also includes a nasal decongestant should not be taken.

2. Although data show that oral decongestants can be safely used during the first trimester, it is still recommended that patients avoid them due to a very low risk for vascular issues in the fetus. Saline drops or nasal spray decongestant alternatives should be considered.

3. Use caution with OTC medications containing herbal ingredients, as some have not been studied in pregnant women.

4. Throat lozenges may contain other ingredients, such as zinc or vitamin C. Be aware that the recommended daily allowance in pregnancy is 80 to 100 mg per day for vitamin C and 11 mg per day for zinc.

5. Some cough syrups contain up to 10% alcohol. Use alcoholfree cough syrup.


Gene Linked to Herpes-Related Cold Sores

A team of researchers have identified the first gene associated with frequent herpes-related cold sores.

Herpes simplex labialis (HSL) is an infection caused by herpes simplex virus type 1 (HSV-1). HSV-1 remains in the immune system after infecting the body and lies dormant until it is reactivated, at which point it causes a cold sore to develop on or around the mouth. The 3 factors believed to contribute to HSV-1 reactivation are the virus itself, exposure to environmental factors, and genetic susceptibility, according to John D. Kriesel, MD, of the University of Utah School of Medicine.

Dr. Kriesel and colleagues had previously identified a region of chromosome 21 containing 6 genes significantly linked to HSL disease. In the current study, which is published in the December 1, 2011, issue of the Journal of Infectious Diseases, researchers analyzed the chromosome region using a test designed to identify differences in genetic makeup between individuals.

“We were able to identify 45 DNA sequence variations among 618 study participants, 355 of whom were known to be infected with HSV-1,” said Dr. Kriesel. The authors utilized linkage analysis and transmission disequilibrium testing to determine whether there was a genetic link between DNA sequence variations, and to ascertain the likelihood of experiencing frequent outbreaks.

The investigators found that an obscure gene called C21orf91 was associated with susceptibility to HSL. They also identified 5 major variations of the gene, 2 of which appeared to protect against HSV-1 reactivation and 2 of which seemed to increase the likelihood of cold sore outbreaks.

“The C21orf91 gene seems to play a role in cold sore susceptibility,” Dr. Kriesel noted. If this data is confirmed, it could have “important implications for the development of drugs that affect cold sore frequency.”


CDC Warns Against Taking Antibiotics for Viral Infections

Taking antibiotics for viral infections may do more harm than good, according to the Centers for Disease Control and Prevention (CDC).

Although antibiotics are effective against bacteria and not viruses, they are often administered to children to help fight colds, sore throat, and other infections that are caused by viruses. Because of improper use, antibiotics are the most common cause of emergency department visits for adverse events among children.

As part of a new campaign designed to educate patients about inappropriate antibiotic use, the CDC recommends the following options for more safety treating viruses such as the cold:

• Increase fluid intake

• Get adequate rest

• Relieve congestion with a saline nasal spray or a cool-mist vaporizer

• Soothe a sore throat with ice chips, throat spray, or lozenges

• Consult a pharmacist about OTC medications that provide relief

Patients are also reminded not to ask a physician for antibiotics if they aren’t recommended, and never to take antibiotics that are prescribed for someone else. PT

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