您现在的位置: 纽约时报中英文网 >> 华尔街日报中英文版 >> 医疗 >> 正文


更新时间:2014-4-16 13:52:41 来源:华尔街日报中文网 作者:佚名

Sick Again? Why Some Colds Won't Go Away

About a month ago Sharon Gilbert was hit with a runny nose, sore throat and a cough. The whole snotty works.

A few weeks later she thought she had recovered. Then her husband Derek got sick, and bam. 'Suddenly I started getting all the symptoms [again] and it was worse,' said Ms. Gilbert, a 61-year-old writer in Charleston, Ill.

In the winter that seems to have no end in many parts of the country, people like Ms. Gilbert have been plagued with the seemingly everlasting cold.

That's partly because the common cold can last longer than many people think -- up to two weeks for the principal symptoms and perhaps weeks more for a cough that lingers even after the virus has been cleared away. There's also the possibility of secondary infections such as bacterial sinusitis.

And some patients might get back-to-back colds, doctors say. It isn't likely people will be reinfected with the same virus because the body builds some immunity to it. But people can pick up another of the more than 200 known viruses that can cause the common cold, some of which are worse than others.

'When you hear people who have the cold that 'won't go away,' those are typically back-to-back infections of which we see a lot of in the cold weather when people are cohorting together,' said Darilyn Moyer, a physician at Temple University Hospital and chairwoman-elect of the American College of Physicians Board of Governors.

Influenza may get all the attention, but the common cold is the leading cause of doctor visits, according to the National Institutes of Health. Each year, people in the U.S. get about one billion colds, and 22 million school days are lost to the stubborn viruses.

Experts say adults on average get two to five colds a year; school children can get as many as seven to 10. The elderly tend to get infected less because they've built up immunity to many viruses. And adults who live or work with young children come down with more colds.

Don't I know it. For more than a month now my family seems to be playing a game of pass-the-nasty-cold. My husband had a cold and lingering cough for weeks, which we suspect he gave to our infant. Finally I succumbed.

We blamed the purveyor of all germs, our kindergartner. Just as we were all recovering, the infant started day care and brought home a virus and we're all on round two of apparently a different cold.

Experts say it's possible that the carrier of germs -- in this case our kindergartner -- can infect others without having symptoms himself.

'At any given moment if we were to swab you. . .we'd probably come up with five different rhinoviruses sitting in your nose but you're not sick,' said Ann Palmenberg, a researcher at the Institute of Molecular Virology at the University of Wisconsin-Madison. Rhinovirus is the most common viral cause of the common cold, accounting for 30% to 50% of adult colds, and there are more than 150 strains of it.

To get infected, the so-called ICAM receptors, which the rhinovirus attaches to in order to enter the nasal cells, need to be open, Dr. Palmenberg said.

'Rhinos are out there all the time, it's just a question of when you are susceptible,' she said. Factors such as stress, lack of sleep and people's overall health can make them more likely to get infected. More than 150 strains or genotypes of the rhinovirus have been identified and researchers believe there are probably many more.

Rhinovirus replicates best in the relatively lower body temperatures of the upper respiratory area, such as the nasal passages, sinuses and throat.

Other viruses, such as the less-common adenovirus, can replicate and attach to receptors in the upper and lower respiratory tracts, causing a more serious illness.

Other viruses -- including the coronavirus, respiratory syncytial virus and enterovirus -- have also been identified as causing cold symptoms. 'The most confounding thing of all is that we still haven't identified the cause of 20% to 30% of adult common colds,' said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health.

Sometimes a cold that never seems to end could be a sign of something more serious. A cold may result in a sinus infection, bronchitis or pneumonia. And cold symptoms are at times confused with seasonal allergies.

A usually dry cough that lingers after a cold is typically due to bronchial hyperreactivity or tracheal inflammation, doctors say. 'After you go through an infection in your respiratory system, you can almost have a transient form of asthma where your bronchial tubes are very highly reactive and very irritated and inflamed,' said Dr. Moyer, of Temple University Hospital.

A review of various studies, published last year in the journal Annals of Family Medicine, found that coughs on average last about 18 days. The report also said a survey of nearly 500 people found that most participants expected a cough should disappear in about a week and believed antibiotics from their doctor would help them. (A big no-no!)

Some experts believe having one cold virus and a weakened immune system could make catching another virus easier. Because the epithelial linings in the nose are weakened when you have a cold, the broken down mucus-membrane barrier may be more prone to picking up another virus.

But others suggest that proteins such as interferons, which are secreted during a cold to help fight the virus, may also boost resistance to getting infected by a second virus, according to Dr. Fauci, of the NIH.

What can a person do to prevent or shorten a cold? Nearly everyone knows someone who swears by taking echinacea or zinc or downing packs of vitamin C.

But doctors say the evidence isn't conclusive that any of these remedies helps. Some research indicates that exercise and meditation could help prevent colds.

The good news is spring is here, at least officially, so the worst of the winter cold season should be over. Come summer, however, a new batch of viruses emerge and you might find yourself saying hello to the pesky summer cold.

《华尔街日报》—大约在一个月前,莎伦·吉尔伯特(Sharon Gilbert)出现了流涕、咽喉疼痛、咳嗽等一系列令人烦恼的症状。





天普大学医院(Temple University Hospital)医生、美国医师协会(American College of Physicians)理事会候任主席达尔琳·莫耶(Darilyn Moyer)说:“如果你听到别人得了‘永不见好’的感冒,那通常就是连续性感染,这种情况在人们常窝在一起的寒冷季节较多见。”

美国国家卫生研究院(National Institutes of Health,简称“NIH”)称,流感吸引了人们所有的注意力,但普通感冒才是人们就医的首要原因。美国每年约有10亿人次得感冒,学生们因顽固的感冒病毒共停课2,200万天。




威斯康星大学麦迪逊分校(University of Wisconsin-Madison)分子病毒学研究所(Institute of Molecular Virology)的研究员安·帕尔门伯格(Ann Palmenberg)说:“在任何时候,要是我们用棉签擦拭你的鼻子,大概都能发现它里面存在着五种不同的鼻病毒,但是你也并没有生病。”鼻病毒是引发普通感冒最常见的病毒,占成年人感冒诱因的30%至50%,而且它的种类超过了150种。




包括冠状病毒、呼吸道合胞病毒和肠道病毒在内的其他病毒也被确认会引发感冒症状。NIH的分支、美国国家过敏症与传染病研究所(National Institute of Allergy and Infectious Diseases)主任安东尼·福西(Anthony Fauci)说:“最令人困惑的事情是,还有20%至30%成年人普通感冒病症的原因未查明。”



去年发表于《家庭医学年鉴》(Annals of Family Medicine)的一篇论文对多项不同研究进行了综述,它发现咳嗽平均持续18天左右。该研究还指出,针对近500人的调研发现,大多数调研参与者认为咳嗽症状应该会在一周左右后消失,并相信医生开给他们的抗生素对他们有帮助。(实际上是大大的不可能!)