How to Prevent the Common Cold

Avoid / Cure A Cold Fast

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Pathogenicity and Clinical Features of Infection

Both EAV and PRRSV can cause either asymptomatic infections or induce various disease symptoms such as respiratory disease, fever, necrosis of small muscular arteries and abortion. The severity of disease caused by EAV and PRRSV depends on the strain of virus as well as the condition and age of the host animal. The most common symptoms of natural EAV infections in horses are anorexia, depression, fever, conjunctivitis, edema of the limbs and genitals, rhinitis, enteritis, colitis and necrosis of small arteries. If clinical symptoms occur, they are most severe in young animals and pregnant mares. Infections in pregnant mares are often inapparent, but can result in a high percentage (50 ) of abortions. Young animals sometimes develop a fatal bronchopneumonia, but natural infections are usually not life-threatening. In contrast, about 40 of pregnant mares and foals experimentally inoculated with EAV die as a result of the infection.

Discharge And Home Healthcare Guidelines

Allergic purpura can occur at any age, but it is most common in children between the ages of 3 and 10 the condition is more common in males than females. In North America, the disease occurs mostly from November to January. In one-half to two-thirds of children, an upper respiratory tract infection precedes the clinical onset by 1 to 3 weeks, and children are mildly ill with a fever. Whites are more affected than blacks African Americans.

What is the difference between an intervention in a clinical trial and in an observational study

The major goals of medical treatment are to reduce or eliminate the symptoms and signs of a disease, to slow or halt disease progression, or to prevent specific complications, including premature death. The natural history of most diseases is unpredictable in individual patients. Several acute conditions such as the common cold are self-limiting other diseases such as multiple sclerosis are often intermittent with unpredictable remissions. The time course of many chronic conditions is highly variable and the risk of complications of degenerative conditions such as atherosclerosis is unpredictable, although one can differentiate between low- and high-risk subjects. Consequently, distinguishing between real treatment effects and the natural course of a disease can be a major challenge. By using comparable groups of study subjects in a clinical trial, one receiving the new treatment and the other not, we are able to make a good estimate of both favorable and unfavorable treatment effects.

Why is blindingmasking so important

A classic illustration is a placebo-controlled vitamin C trial for the prevention and treatment of the common cold that was conducted among employees at the National Institutes of Health.4 Many of the enrollees could not resist the temptation to analyze the content of their blinded study medications. Among the participants who did not break the blind, the mean duration of colds was similar in the two groups. In contrast, participants who knew they were taking vitamin C reported shorter cold durations than those who knew they took placebo

Description Of The Infection Spectrum

Bacterial colonization of ciliated respiratory epithelia in the trachea and bronchi. The incubation period is 6-20 days. Classical pertussis is an illness of three stages. It starts with a catarrhal stage, with nonspecific symptoms similar to those of the common cold (duration 1 to 2 weeks). At the paroxysmal stage (duration 2 to 6 weeks), the cough becomes more prominent with staccato attacks, postussive whooping, and vomiting. At the convalescent stage (duration several weeks), the frequency and severity of coughing attacks gradually decrease. The most severe cases of whooping cough occur in unvaccinated children under 1 year of age. This group accounts for most deaths. 1,2

Expansion into Therapies for Other Viruses

A spin-off from this work with HIV has led to inhibitors of other families of viruses, particularly hepatitis B virus (HBV). Lamivudine and adefovir have become the treatments of choice for HBV. Meanwhile, there seemed to be progress discovering compounds active against picorna-viruses (which include rhinoviruses causing the common cold). These compounds bind into a pocket within the viral capsid. The best example is pleconaril although unacceptable side effects stopped its development. However, the viruses quickly became resistant and some strains even became dependent on the 'antiviral' compound. Therefore, this approach has not resulted in any clinically useful drugs.

Occupation and smoking

Respiratory diseases have known associations with those working in the food and food-related industries. These include occupational asthma, occupational rhinitis and hypersensitivity pneumonitis. Skin diseases such as contact dermatitis and contact urticaria are also associated with work in these industries.

Host Receptor Recognition Site

Animal viruses have to recognize a specific host cellular receptor for entry during infection. Host receptor binding is the initial step of virus life cycle and could be an effective target for preventing virus infection. Based on the atomic structure of animal viruses, it was found that the receptor recognition site is located in an area surrounded by hyper-variable regions of the antigenic sites. Usually, the area is in a depression (called the 'canyon') on the viral surface that may be protected from recognition by host antibodies. This structural feature is, for instance, present in human rhinovirus (also known as the common cold virus), and the active site of influenza virus hemag-glutinin (HA). The receptor-binding site on influenza virus HA does not have a deep depression, but it is surrounded by antigenic sites. The receptor-binding area on the surface of the viral capsid is conserved for recognition by the receptor, whereas the sites recognized by antibodies are distinct from...

Clinical Features and Infection

Echoviruses together with coxsackieviruses cause more than 90 of cases of aseptic meningitis. Infants under 3 months of age have the highest rates of recognized aseptic meningitis. Pharyngitis and other symptoms of upper respiratory tract infections are often present during the meningitis. Symptoms of encephalitis sometimes complicate the course of aseptic meningitis. In perinatally acquired echovirus

Taxonomy and Classification

Foot-and-mouth disease viruses (FMDVs) are a species within the genus Aphthovirus of the family Picornaviridae. The nature and organization of the genome, mode of replication, and structure of the virion are, in general, similar to other viruses in the family. The subdivision of the Picornaviridae into four genera, Enterovirus, Rhinovirus, Cardiovirus, and Aphthovirus, was originally based on phys-icochemical properties such as susceptibility to acid inactivation, buoyant density of CsCl solution, and the nucleotide composition. Analyses of evolutionary relationships by nucleotide sequence comparisons have largely endorsed the original classifications however, the family has now expanded to include nine genera. Of special note is the recent inclusion of equine rhinitis A virus (ERAV) in the genus Aphthovirus. Properties which distinguish the FMDVs are (1) extreme sensitivity to acid inactiva-tion (< pH 6.8 in low ionic strength buffer) (2) high buoyant density in CsCl (1.43-1.50 gcm...

What are the advantages of casecontrol studies

In a case-control study of women aged 18 to 49 years,3 it was reported that the use of phenylpropanolamine for weight reduction was associated with an odds ratio of 16.6 (95 confidence interval (CI)1.5-182 p 0.02) for subarachnoid or intracerebral hemorrhage for the indication common cold, the OR was 3.1 (95 CI 0.86-11.5 p 0.08). If these study findings are true, is the temporary symptomatic relief of a common cold worth the risk of a rare but potentially fatal adverse event

Enterovirus Serotype 68 EV68

The first and prototype isolate of EV68 is known as 'Fermon virus'. This virus was one of four similar agents isolated in California in 1962 from oropharyngeal swabs of infants with lower respiratory tract illnesses. The isolation of these viruses is relatively rare apart from the California isolates, countries that reported to the World Health Organization (WHO) in Geneva on a surveillance of virus diseases for the years 1975-1983 showed that, of 864 infections caused by the new human enteroviruses, only three were EV68. The California strains were isolated from infants aged between 10 months and 3 years with pneumonia and bronchiolitis. In addition, one isolate was obtained from a young adult with upper respiratory tract infection in Australia. It appears therefore that virus transmission is via the respiratory-oral route with virus affinity for epithelial cells of the oropharynx and respiratory tract producing pneumonia and bronchiolitis. EV68 in clinical specimens produces...

Clinical Features of Infection

EHV-1 and EHV-4 cause outbreaks of upper respiratory disease ('common cold') in young horses (mainly EHV-4 in adult horses) with no previous exposure to the viruses. Infection is characterized by a short incubation time (< 1day) followed by fever (39-41 C), which can last between 1 and 4 days, sometimes with a second spike approximately 1 week after the primary pyrexia, and animals suffer from serous nasal discharge and congestion of the nasal mucosa and conjuctiva. Less frequently, one can detect a transitory period of anorexia, enlargement of the submandibular lymph nodes, and edematous swelling of the lower parts of the body and the extremities. An initial leukopenia is followed by leukocytosis before the temperature falls. Recovery is usually uneventful and occurs within 1 week. Older horses show few or no clinical signs, although increased sensitivity is seen in stressed horses.

Adverse Effects Interactions and Pharmacokinetics

Dosages of up to 30 mg rhDNase I per day were well tolerated in healthy volunteers and CF patients 69,87 . Severe bronchospasms or anaphylactic reactions, as seen after inhalation of bovine DNase I, have never been observed with rhDNase I. The most common adverse effects reported after daily inhalation of 2.5 mg rhDNase I were voice alterations (hoarseness), pharyngitis, rash, laryngitis, and conjunctivitis 74,76,78 . All these events are generally mild and transient. In patients with severe pulmonary disease (FVC < 40 ), rhinitis, fever, dyspepsia, dyspnea, and an FVC decrease of > 10 have also been reported 76,88 . Facial edema has been reported to an exceptional degree in patients receiving 2.5 or 10 mg rhDNase I twice daily 70 . It has also been shown that rhDNase I may increase airway inflammation by releasing elastase and proinflammatory cytokines that are bound to DNA in the airway secretions 89-91 . However, other studies did not confirm this observation 92-94 . Antibodies...

Echoviruses and the Concept of Enteroviruses

Any one type may cause any of several syndromes, and a typical 'enteroviral' syndrome may be caused by any of many serotypes. Besides the well-known associations of enteroviruses with diseases such as poliomyelitis, meningitis, encephalitis, epidemic pleurodynia, rashes, hand-foot-and-mouth disease, myocarditis, herpangina and acute hemorrhagic conjunctivitis, as well as minor malaises and undifferentiated febrile illnesses, these viruses are also associated with diseases of the respiratory tract more frequently than is usually recognized. Enterovirus-associated respiratory diseases include pneumonitis of infants, pneumonia and bronchiolitis, as well as the common cold and other upper respiratory illnesses. It should be mentioned that not only polioviruses, but also a number of other enteroviruses may at times be etiologically associated with paralytic disease. Fortunately such cases are rare.

Metabolism of Chemotherapeutic Agents

While most significant associations between GST genotypes and clinical phenotype have not been replicated, a minority have been independently confirmed. For example, GSTP1 Val105 Val105 has been associated with reduced risk of airway hyperresponsiveness (odds ra-tio 0.23-0.38) in three studies in asthmatic adults and children. 20 This genotype is also protective against childhood respiratory illness. 21 The advent of high-throughput genotyping, availability of new SNP, and ease of deriving haplotypes should place an emphasis on large studies incorporating some assessment of reproducibility. Furthermore, assessment of further allelic GST sites associated with binding of peptides involved with cell signaling warrants further investigation.

Headache see specific sections in Chapter 8 for International Headache Society criteria

Attacks of severe, strictly unilateral pain, orbital, supraorbital, and or temporal, usually lasting 15-180 minutes and occurring from at least once every other day up to eight times per day. Associated with one or more of the following conjunctival injection, lacrimation, nasal congestion, rhinorrhea, forehead and facial sweating, miosis, ptosis, eyelid edema. Attacks occur in series for weeks or months (cluster periods), separated by remissions of usually months or years.

Host Range and Viral Propagation

Experimental hosts include ferrets, which develop febrile rhinitis after infection with influenza A and B viruses. Ferrets have been used extensively to study the biology of influenza viruses and as a source of reference antisera. Other experimental animals include mice, monkeys and New World primates. Mice are not naturally infected with influenza viruses, but both influenza A and B viruses can be adapted to mice. The virus replicates in the upper and lower respiratory tract and, after adaptation can cause pneumonia and death. Most strains of mice can support influenza virus after adaptation, and inbred strains have been valuable in elucidating cell-mediated immune re-

Other Nonprimate Cytomegaloviruses

Swine cytomegalovirus is endemic in swine herds worldwide, and has also been shown to reactivate from pig-to-baboon xenotransplants. It causes rhinitis in young swine and is able to cross the placenta, resulting in generalized disease, runting, and fetal death. Initial sequence analysis of the DNA polymerase complex genes suggests that this virus is more closely related to HHV-6 than to CMVs. Tree shrew herpesvirus has been sequenced and has been found to resemble MCMV and other betaher-pesviruses. A CMV has been isolated from deer mice (Peromyscus maniculatas) in North America, and has been characterized as a CMV based on physical and biological properties and genetic homology with several genes of other CMVs. CMVs have also been isolated from European and American ground squirrels, and designated as sciurid herpesvirus 1 and sciurid herpesvirus 2, respectively.

Transmission and Tissue Tropism

Little information is available regarding the syndrome of the primary infection. The initial infection generally occurs during childhood and is largely asymptomatic. BKV infection has been linked to cystitis and an acute respiratory illness among immunocompetent children clinical illness has not been clearly associated with a primary JCV infection. Preliminary data indicate that JCV and BKV may infect tonsillar tissue in vivo, and tonsillar stromal cells do support JCV replication in culture.

Other symptomatic treatment

Ketotifen with antihistaminic and anti-inflammatory properties has been used in food allergic reactions such as urticaria and bronchospasm. It may be useful as an additional therapy in some patients. Beta-2 agonists such as salbutamol or terbutalin may be used when bronchospasm is a prominent feature in an allergic reaction. These drugs can be delivered by inhalation through a metered dose inhaler, in an aerosol form through a nebuliser, or by intravenous route. Food-related eczema and rhinitis should be treated along the standard line with topical steroids and antihistamine in addition to allergen avoidance.

Immunity and Vaccination

Immunity (the ability to resist infection based on mobilization of the immune system) to many diseases can result from a prior infection of the same agent. Getting the measles, for example, protects the host from being infected again later. Thus, a person can contract many diseases only once. Colds and influenza, on the other hand, stem from viruses that continue to produce new strains that avoid the body's predeveloped defenses, so that they may be contracted repeatedly. Prior exposure also does not protect against many microbial toxins, such as those involved in botulism food poisoning or against some parasitic infections, such as schistosomiasis, tapeworm, and athlete's foot.

Antirhinoviral Strategies

Although the common cold is usually mild, with symptoms lasting a week or less, it is a leading cause of physician visits and of school job absence in addition to several more severe exacerbations like asthma (see above). Initial studies that employed monoclonal antibodies to define candidates of viral receptors demonstrated a surprising 'immunological resistance' of rhinoviruses. On the one hand this is due to the fact that over 100 different rhinoviral serotypes have been isolated and antibodies raised against one serotype after immunization are not necessarily protective against a different serotype. However, the identification of the so-called 'canyon' allowed an additional explanation if this 'canyon' represents the predominant site of receptor interactions, it is difficult to block with antibodies since the canyon is too narrow to enable interactions with the antigen. Both findings seem to rule out vaccination as a standard antirhinoviral treatment. Hence, the canyon structure...

Pharmacologic Highlights

General Comments Phenylephrine and antitussive agents such as terpln hydrate with codeine are often prescribed to relieve nasal congestion and coughing. In patients with influenza that is complicated by pneumonia, antibiotics may be administered to treat a bacterial superinfection.

Scientific and Public Health Implications

Currently, a substantial fraction of human disease, with a presumed viral cause, goes without a clinical diagnosis. This is especially true for common ailments, such as upper respiratory tract infections, where despite advances in PCR assays, the etiology of 30-60 of infections remains unidentified. Without considering the complexities of diagnostic regulatory approvals, an unbiased DNA microarray approach to the detection of viral pathogens should substantially increase the number of successful diagnoses, and as a consequence, may lead to improved therapeutics and supportive care. It should be noted that use of a virus microarray extends beyond the analysis of clinical samples. The wide scope of detection and the power to discover new pathogens has broad application to agriculture, veterinary medicine, ecology, and environmental genomics. While it is impossible to accurately predict the number of undiscovered viral pathogens remaining on this planet, tools such as virus-detection DNA...

Henoch Schonlein Purpura

Henoch-Schonlein purpura (HSP) is a disease that manifests symptoms of purple spots on the skin, joint pain, gastrointestinal symptoms, and glomerulone-phritis. HSP is a type of hypersensitivity vasculitis and inflammatory response within the blood vessel. It is caused by an abnormal response of the immune system. The exact cause for this disorder is unknown. The syndrome is usually seen in children, but people of any age maybe affected. It is more common in boys than in girls. Many people with HSP had an upper respiratory illness in the previous weeks. Purpuric lesions are usually over the buttocks, lower legs, and elbows. Besides purpuric lesions, nephritis, angioedema, joint pains, abdominal pain, nausea, vomiting, diarrhea, and he-matochezia can be seen. The scrotum can also be affected in 13 -35 of cases (Ioannides and Turnock 2001). While the testis and or scrotum can rarelybe involved, usually the scrotum is diffusely tender with erythema distributed all over the scrotum....

High Altitude Sickness

Acute mountain sickness (AMS) encompasses a wide spectrum of ill effects ranging in severity from minor discomfort to life-threatening emergencies. The two major life-threatening manifestations of AMS are pulmonary edema and cerebral edema. These are extremes in a continuum of which milder forms of AMS are common and probably underrecognized. The incidence, severity, and duration of AMS are highly correlated to the speed of ascent, the ultimate height reached, and the level of physical exertion. The syndrome is not seen in normal healthy subjects below an altitude of 2500 m. True incidence is difficult to estimate because the size of the population at risk is not known, but figures as high as 30 of those exposed to 3000 m and 75 at 4500 m have been reported 14 . The incidence of AMS is unrelated to gender or to recent respiratory illness however, the development of high altitude pulmonary edema (HAPE) is related to strenuous exercise, exposure to cold, and the presence of underlying...

Other Clinical Sources of Data

Specific general practitioner (GP) surveillance systems are useful to provide data of epidemiological value for infections that are not notifiable, such as the common cold or chick-enpox (in UK). They are of course clinically based, but are nevertheless useful, and often surprisingly accurate, possibly because those GPs who subscribe to a surveillance system are motivated to do so. GP surveillance systems are often sentinel-based, that is, based on a sample of GPs in a country, region, or area. Thus, they are good for common infections which to make notifiable would possibly be wasteful, for example, chickenpox. Moreover each sentinel would normally provide complete reporting. In the English system, GPs provide data on the base populations of their practices, so that rates of infection can be provided as a routine, a feature that is almost unique among surveillance systems. GP surveillance systems also tend to be good for timeliness and completeness.

Clinical Manifestations

Members of HEV-B species are among the most common causes ofmeningitis that may occur as sporadic cases as well as large epidemics. Typically, the symptoms and signs include fever, headache, nausea, stiffness of the neck, and may be associated with respiratory illness, rash, or myalgia. The manifestations may also exhibit signs of meningoen-cephalitis. Paralysis is a rare consequence of echovirus infection although some cases have been reported. Echoviruses are associated with mild respiratory infections (e.g., common cold, bronchiolitis, and herpangina) that cannot be clinically distinguished from illnesses caused by other viral respiratory pathogens. Entroviruses cause macu-lopapular rashes with similar manifestations caused by other infections. Roseola-like skin manifestations can also occur during enterovirus infections and the 'Boston exanthem', caused by echovirus 16, was the first one of these infections recognized. Although echoviruses and other enteroviruses replicate in the...

Future Perspectives

There are currently no vaccines available against other human picornaviruses except polioviruses and hepatitis A virus. The number of echovirus and other enterovirus serotypes makes vaccine development particularly challenging, since the protection from infection is primarily thought to be mediated by serotype-specific neutralizing antibodies. The most promising chemotherapeutic agent developed against clinical picornavirus infections so far has been pleconaril, a capsid-stabilizing small molecule. It has been successfully used in severe enterovirus infections but due to side effects observed in a treatment study against common cold it is not in general use. Other molecules, based on a similar principle, as well as inhibitors of the virus-specific proteases have also been developed, and they are likely to become tools for the treatment of enterovirus infections in the near future. Since echoviruses, with a few exceptions, do not replicate in experimental animals, testing of antiviral...

Pathology and Histopathology

Pulmonary congestion and edema are frequently observed in such cases. In the larger air passages, viral capsids and viruses may be seen in bronchial and bronchiolar epithelium, lymphocytes and alveolar macrophage. Swine that recover from PR may shed virus sporadically in their nasal secretions. Others from which virus cannot be isolated by conventional means may yield virus after cocultivation of tonsillar or trigeminal ganglia with susceptible cells. That recovered swine are latently infected may also be shown by demonstrating PRV DNA or RNA in trigeminal ganglia. In situ hybridization techniques with polymerase chain reaction-generated probes are particularly useful for this purpose.

Vaccines and Chemotherapy

Mitted via the respiratory route, are absolutely dependent upon viremic spread to their target organs elsewhere in the body. In contrast, it is a much more challenging assignment to develop effective vaccines against viruses whose pathogenicity is essentially confined to the respiratory tract. The major reasons for this are that (1) secretory IgA memory is relatively short-lived, and (2) numerous antigenically distinct strains or serotypes are capable of causing the same clinical syndrome. Thus, a common cold vaccine might need to contain dozens of different serotypes of rhinoviruses ( coronaviruses). An inactivated vaccine is used to protect the aged and other risk groups against the currently prevalent strains of influenza, but its composition must be updated regularly to keep abreast of antigenic drift and shift and, even so, its efficacy in the aged is only of the order of 50-80 . The incorporation into vaccines of mucosal adjuvants, e.g. low-toxicity mutants or individual...

Clinical manifestation

Spread by nasal droplet infection incubation period of 14-19 days, with onset of rash usually on the 15th day disease contagious from a few days before to 5-7 days after the appearance of the exanthem most contagious when rash is erupting may have no prodrome in children, with rash being first manifestation in adults, fever, sore throat, and rhinitis may occur discrete macules on the face that spread to the neck, trunk, and extremities, with coalescence into plaques exanthem lasts 1-3 days, first leaving the face nonspecific enanthem (Forscheimer's spots) of pinpoint red macules and petechiae visible over the soft palate and uvula just before or with the exanthem

Prevention and Control

At present, there is no generally available means of protecting against or treating common colds produced by rhinoviruses. The large number of serotypes apparently precludes conventional vaccines and few attempts have been made to pursue this approach. Most effort has been expended on the development of chemical antivirus agents, but of the many shown to have antirhinovirus activity in vitro, none has yet proved clinically useful, although some are currently at the clinical trials stage. An alternative approach is interferon, produced in large amounts by recombinant DNA means. High, intranasal doses, initiated several days before virus challenge, have proved to be effective in preventing illness. However, side effects limit long-term use and as symptoms are only reduced if treatment is commenced before virus infection, interferon has limited applicability. It may prove useful in the family context when it is important to prevent virus spread to specific individuals, e.g. asthmatics...

Patients And Methods

Clinical examination of the 5-day regimen of azithromycin was done from September 1989 to February 1990 at the ENT clinic of the University Hospital in Bratislava. A total of 51 patients aged 18-67 (mean 41.5) years were entered into the randomized study Otitis media was present in 19 and 32 presented with upper respiratory tract infections. The drug was administered to 26 patients with acute disease and 25 with acute exacerbation of chronic inflammation (Table 1). Separate protocols were established for each diagnosis. The main data were case history, local findings, bacteriology specimens, blood picture, ESR, blood biochemistry, and x-ray in some cases. After the completion of therapy on the 11th day, these examinations were repeated. Clinical examination of the 3-day regimen of azithromycin was performed from February to November 1995 at the same outpatient department. A total of 40 patients aged 10-75 (mean 29) years were entered into this randomized study, 9 with otitis media and...

Selected Issues in Clinical Development

Randomized, double-blinded, placebo-controlled clinical trials, while generally regarded as the gold standard for scientific proof of the efficacy and safety of most new drugs, are limited in their application by ethical, scientific, and practical considerations (Fig. 8.38). In certain instances, while generally accepted effective standard treatment does exist, withholding it and using placebo may be acceptable, as in, for example, antihistamines in allergic rhinitis. In other clinical settings as, for example, in virtually all serious infections, the sequelae of withholding treatment would be medically unacceptable, thus mandating the use of a positive control of currently available approved therapy.

Respiratory disorders

This is a chronic condition affecting up to 50 of infants born at 26 weeks or less. Premature delivery, pre- and postnatal inflammation and infection, ventilation, oxygen and poor nutrition are among the many factors contributing to the development and persistence of BPD. The underlying problem is an arrest in alveolar and peripheral vascular development. The severity is variable ranging from the need for supplementary oxygen for several weeks to prolonged respiratory support with a ventilator or continuous positive airways pressure and death. A small proportion of babies are discharged home on supplementary oxygen most outgrow the need by 12 months of age. All babies born prematurely have an increased risk of respiratory illness within the first few years of life. This is increased in the group with BPD and respiratory problems may persist into adult life.

Medicinal Annonaceae

Abortion and childbirth since very early times. The leaves of Goniothalamus macrophyl-lus Hook. f. & Thoms. are used to abrogate fever, and a decoction of the roots is given as a postpartum remedy and to cause abortion. The roots of Goniothalamus giganteus Hook. f. & Thoms. (Fig. 102) are used to abort and treat colds, and the heated leaves are applied to swellings. A decoction of Goniothalamus scortechinii King is given as a postpartum protective remedy. The roots of Goniothalamus tapis Miq. (Fig. 103) are used as an abortifacient during early months of pregnancy. In Indonesia, an infusion of the roots is used to treat typhoid fever. In Taiwan, the seeds of Goniothalamus amuyon Merr. are used to treat scabies. In the Philippines, the seeds are used to treat rheumatism and tympanites, and the fruit is stomachic. None of the uses mentioned here has been substantiated yet via pharmacological experimentation however, these species are well-known for their phytochemical...

Angioedema and Urticaria

INTRODUCTION Angioedema and urticaria are common transient phenomena that result from mast cell degranulation with the release of mediators that promote vascular permeability, causing proteins and fluids to extravasate into the extracellular space. In urticaria fluid collects within the dermal tissue, whereas in angioedema fluid collects in the deeper subcutaneous space. The causes of mast cell degranulation are varied and include both immunologic and nonimmunologic mechanisms. Systemic involvement may include rhinitis, bronchospasm, or anaphylaxis. Severe reactions may lead to syncope, bronchial asthma, and hypotension. In rare cases both urticaria and angioedema may be triggered by exercise. Acute cases reach a peak in one to three days and usually fade in 7-21 days. In chronic cases the condition waxes and wanes for months or may even persist for years. There may be recurrent attacks separated by months to years. Inciting allergens are numerous and include foods, cosmetics,...

Food Intolerance and Allergy

In the blood stream are called basophils. Basophils and mast cells contain granules filled with active chemicals (mediators) thatcanbereleasedduringanallergicor inflammatory response. The mechanism hypersensitivity (Type I Figure 10.1), is composed of two major events. The first event or sensitization is when an allergen(antigen)isconsumed.Otherroutes of exposure can be portals for Serum concentration of IgE is low comparedwiththatofotherimmunoglobulins, and its serum half-life is relatively short (Table ).Once theallergenisconsumed, the individual become sensitized. Sensitization results in production of allergen-specific IgE antibodies, which then bind to local tissue mast cells and on entering the circulation bind to circulating mast cells, basophils, and other tissue mast cells distal to the original site of entrance. The second event occurs after subsequent exposures or reexposure to the allergenic material, whereupon the allergen crosslinks two IgE antibodies on the surface...

Veterinary Uses Of Plants

It is well-known as being severely toxic to animals (Forsyth), causing cirrhosis of the liver, from which the animal cannot recover. The trouble is that animals will not usually eat it, so it flowers and seeds undisturbed, and the effect is eventually to produce more ragwort than grass in a pasture. The condition is known in Canada as the Pictou cattle disease, and the scientific name is seneciosis. The problem is that the plant seems to have been used as a curing agent this is St James's Wort, and St James is the patron saint of horses. The use of Ragwort in veterinary practice seems to be confirmed by other names, such as Staggerwort, that is, the herb that cures staggers in horses. Sir Edward Salisbury, for one, stated clearly that staggers was actually caused by Ragwort. If both views are correct, here is an example of homeopathic magic at work, of like curing like. East Anglian horsemen favoured the use of FEVERFEW on their charges. A way to control unruly...

Was the result for the primary outcome clearly stated in the conclusion and supported by the confidence interval

Karlowski TR, Chalmers TC, Frenkel LD, et al. Ascorbic acid for common cold. A prophylactic and therapeutic trial. JAMA 1975 231 1038-42. 2. Karlowski TR, Chalmers TC, Frenkel LD, et al. Ascorbic acid for common cold. A prophylactic and therapeutic trial. JAMA 1975 231 1038-42.

Paramyxoviruses

Because the mortality of RSV pneumonia in bone marrow transplant recipients is as high as 85 , a number of strategic approaches using drugs approved for other RSV indications have been tried. Although aerosolized ribavirin seems nonbeneficial once pneumonia is established, the results of an open label study suggested that the combination of aerosolized ribavirin with intravenous immunoglobulin reduced mortality below the expected rate, and may provide benefit as pre-emptive treatment. When symptoms of upper respiratory tract infection are observed and myxo- or paramyxovirus involvement is documented, then treatment with either ribavirin or rimantadine may be tried to prevent the progression of upper respiratory tract infection to lower respiratory tract disease.

Picornaviruses

Although there is an abundance of human picornaviruses, including enteroviruses and the rhinoviruses, to date there are no approved antiviral agents. Yet there have been extensive studies on the structure of the virus capsids and also of the mechanisms of replication, providing attractive potential targets for antiviral intervention and resulting in the identification of novel experimental antiviral agents. The single-stranded picornavirus RNA genome is transcribed into a single polyprotein, which is cleaved by an essential protease into functional subunits, one of which is the RNA polymerase. Enviroxime, a benz-imidazole derivative which inhibits rhinovirus polymerases and was promising in cell culture studies, was disappointing in the clinic against the common cold. However, studies are continuing with further modifications of enviroxime to increase oral bioavailability while retaining antirhinoviral potency and reduced toxicity. Ninety percent of rhinoviruses use ICAM-1 as their...

Asafoetida

(Ferula assa-foetida) To prevent colds, tie a small bag of it round the neck. Sometimes the asafoetida would be soaked in camphor first (Stout). Tied round a baby's neck, it will help it to cut teeth without pain. Wear asafoetida to keep the itch away (Stout) - or to keep diphtheria away - or cure whooping cough - or, in Maryland, for hysteria (Whitney & Bullock).

Basil

It was used as a strewing herb (Brownlow), and it counters headaches and colds, either by an infusion, taken hot at night (Quelch), or by taking it as snuff. Dried basil leaves in that form have been used for nervous headaches and head-colds for centuries (Hemphill). In Britain, basil, mixed with blacking, has been used to get rid of warts (Leyel. 1926).

Bee Balm

But it is in the sphere of popular medicine that balm is important. A tale from Staffordshire tells how Ahasu-erus, the Wandering Jew, knocked at the door of a cottage, and found the occupant ill. The Jew was asked in and offered a glass of ale. In return, the patient was told to gather three balm leaves and to put them in a cup of ale, and to drink it, refilling the cup when it was empty, and adding fresh leaves every fourth day. He was cured in twelve days (M Baker. 1980). Aubrey. 1696 mentions a story that is probably the same as the Staffordshire legend, about an old man who was cured of his lameness by taking balm leaves in beer. But balm tea is the most widely used medicine, for stomach upsets or colic in Gloucestershire, but more commonly elsewhere for colds, especially if feverish, for it has the effect of promoting sweating (Conway). It makes a pleasant drink for influenza patients (A W Hatfield. 1973), and has even been recommended for bronchitis (Fluck). Fresh leaves are...

Bronchitis

A Somerset bronchitis remedy was to make an ointment of lard and GARLIC, and rub it on to the soles of the feet at night (Tongue), a recipe that was recorded as recently as 1957. Garlic has always been in great demand for chest complaints, and there are similar prescriptions for whooping cough, coughs and colds, asthma, and even tuberculosis. Gypsies in this country have used CUCKOO-PINT, either by root decoction or by an infusion of the dry, powdered flowers, to cure croup and bronchitis (Vesey-Fitzgerald). Another gypsy remedy for this complaint involved peeling the bark, boiling it in a saucepan of water, and then allowing it to cool. After sugar was added, the liquor could be drunk as needed (Page. 1978). FENNEL tea is still taken sometimes for the complaint, and BALM tea has been recommended as an expectorant, as has a tea from dried HOLLYHOCK flowers (both Fluck), and PENNYROYAL tea is often taken (Beith). SWEET CICELY too, is taken for chest complaints and bronchial colds in...

Pathology

Human respiratory coronaviruses related to HCoV-229E or HCoV-OC43 infect the epithelial cells in the upper respiratory tract and cause colds. Infection of young asthmatic children can exacerbate wheezing, and lower respiratory tract coronavirus infection has occasionally been observed in adults. Reinfection is frequent, even in volunteers inoculated with the same strain of human coronavirus. Infection is usually demonstrated by RT-PCR or by rising serum antibody titers because primary isolation of these viruses from respiratory washings is difficult. It is not yet clear how many coronavirus strains cause human respiratory disease or whether coronaviruses may play a role in other human diseases.

Chickweed

Gypsies use a leaf infusion to cure coughs and colds (Vesey-Fitzgerald), and it is an old Irish remedy for whooping cough (O Suilleabhain), while in Skye the feet and ankles of a fever patient were at one time washed in warm water in which chickweed had been put, as a means of getting the patient to sleep (Martin). The plant is used by herbalists in the treatment of stomach ulcers, and as an aid to digestion (Conway). A lotion made of chickweed and rose leaves is used in Somerset for sore eyes (Tongue. 1965), or it could be used with unsalted lard as an ointment. There is a strange usage from Japan an infusion of the leafy shoot with sugar is given internally to stop a nosebleed (Perry & Metzger). The name Chickweed has a fairly obvious derivation. Chickens like it - chickens and birds love to pick the seed thereof (Coles). It is, in fact, a rich iron tonic, long given to cage birds, too.

Chickens

Several alternatives to conventional cages are being investigated, varying from more intensive systems like modified battery cages containing perches, dustbaths, and nestboxes to more extensive systems like aviaries (similar to battery cages, but tiered so that the hens can occupy several levels) and freerange production systems. Problems in more extensive systems include higher egg costs, reduced egg quality, increased feather pecking and cannibalism, and, in indoor systems, poorer air quality leading to respiratory illness in both hens and farm workers.

Respiratory System

The upper respiratory system includes the nose and nasal cavity, the nasal sinuses, and the pharynx. The sinuses are open chambers in the face, connected to the nasal cavity by passages. Their function is to lighten the head, add timbre to the voice, and to produce mucus to moisten and lubricate the surfaces of the nasal cavity. Air passing through the nasal cavity is warmed, humidified, and filtered of large particles. The pharynx is the part of the respiratory system shared with the digestive system, extending from the back of the mouth down to the larynx.

Dog Rose

Making whereof I commit to the cunning cookes, and teeth to eat them in the rich man's mouth (Gerard). The hips contain large amounts of Vitamin C, and they were systematically gathered during World War 2 so that the vitamin content could be exploited. The hips have always been used as a medicine in one way or another. The conserve is of some efficacy against coughs (Hill), or a tea made from them was taken for fatigue, and dropsy among other complaints (Fluck), including the common cold (Thomson. 1978). To prevent a wound going bad hips of Dog Rose chewed, then let it drop on the wound (Cockayne). The leaves, too, were used to put on a cut in Essex (V G Hatfield), and a charm from Ireland to cure a stye required the stye to be touched nine times with a rose thorn (Buckley).

Feverfew

East Anglian horsemen favoured the use of feverfew on their charges. In Cambridgeshire, the way to control unruly horses was to rub the freshly gathered leaves (or those of rue) on their noses (Porter. 1969), while Suffolk horsemen used it for colds, and for giving their horses an appetite (G E Evans. 1960).

The SFragment

The presence of a poly(C) tract within the 50-UTR (see Fig. 2) is common to the aphthoviruses FMDV and equine rhinitis A virus (ERAV) and most cardioviruses (except Theiler's murine encephalitis virus). Typically field strains of FMDV have a poly(C) tract of about 150-200 nt (Brown et al. 1974 Harris and Brown 1977). Within laboratory strains,

Ginger

(Zingiber officinale) great Quantities of it are us'd by the Hawkers and Chandlers in the Country, who mix it with pepper they reduce it to Powder, and then call it white Spice (Pomet). Apart from its use as a spice and as a base for alcoholic liquors of one kind or another, ginger has for a very long time enjoyed a reputation for medicinal use, from the prescription of Arabian and Persian doctors for impotence (Dalby), to its still popular reputation as a stomach settler, and this use dates from the earliest records (Lloyd). Ginger tea, even ginger biscuits, help to combat travel sickness, or morning sickness and nausea generally (M Evans). Parihar & Dutt point out that ginger jam is still a favourite for colds and coughs, and it is even used to treat diabetes. In this case, it is ginger juice that is used, mixed with sugar candy.

Goatweed

A decoction of the leaves and young stems is used in Chinese medicine for common colds, and eczema (Chinese medicinal herbs of Hong Kong vol 1). There is yet another tradition in Africa, to treat a child who cries too often for no known cause, especially at night. Stress is put on the requirement that the plant should be collected at night, especially when witchcraft is suspected. The procedure is described as follows the plant is found during the day, and in the dead of night the collector approaches the plant and chews 9 or 7 seeds (for male or female respectively) of Melegueta Pepper (Aframomum melegueta). The chewed grains are spat on the plant while the appropriate incantations are recited. After that the plant is plucked, taken home and warmed over a fire before the juice is expressed. Palm oil is added to this, and the two mixed together are used to rub the child all over the body (Sofowora).

Ground Elder

Boil ground ivy and drink the water is an Irish cold cure (Moloney). Actually, Gill-tea, as it was called, mixed with honey or sugar to take away the bitterness, has always been a favorite remedy for coughs and colds (Clair). It could be combined with wood sage in a tea to treat a cold - that is a New Forest gypsy remedy (Boase).

Headache

Even migraine will succumb, so it is claimed (V G Hatfield). RED CLOVER, being mildly sedative, has been traditionally used for curing a headache (Conway), and RED POPPY too, being sedative, is also a headache and migraine remedy. It is actually called Headache (Grigson. 1955 etc.,), and the belief was that picking it could cause the headache, so it is interesting to find that the cause can also be the cure. The leaves of the CASTOR OIL PLANT have been used for headaches. African peoples like the Mano of Liberia rub the leaves in water, and bathe the head with the result (Harley), while in the southern states of America, a similar practice merely involves wrapping the forehead in the leaves, which will treat a fever as well (Puckett). A RHUBARB leaf held to the forehead will relieve the headache (V G Hatfield. 1994), though any large leaf will probably do as well. A prescription from the Physicians of Myddfai is more of a charm than a genuine remedy. We are told...

Heather

Heather used to be quite important in medicine it is a diuretic, and is still used in homeopathy for the treatment of infections of the kidneys and urinary tract (Schauenberg & Paris). An infusion of four or five flower sprays in a pint of boiling water is drunk as a tea for insomnia it was even just applied to the head for insomnia, and a heather pillow is still used to give refreshing sleep (Beith). It is also good for calming the nerves and the heart. A stronger brew sweetened with heather honey is an old Highland remedy for coughs and colds (A W Hatfield). (see also WHITE HEATHER)

Holy Thistle

(Carduus benedictus) When a plant is called holy or blessed (Blessed Thistle is recorded for this (Ellacombe)), it means it has the power of counteracting poison, or so it was supposed (herba benedicta, Avens, that is, is better known for this property). Langham could say the leafe, juice, seede, in water, healeth all kindes of poyson Everybody knew it as a heal-all. Langham, indeed had four pages of recipes under this head, for practically every malady, including plague, for which it was regarded as a specific. Thomas Hill had a very similar list. Culpeper, too, was enthusiastic. Wesley was more restrained, but could still say, Coldness of the Stomach. Take a spoonful of the Syrup of the Juice of Carduus Benedictus, fasting, for three or four Mornings. A warm infusion is used for bad colds or intermittent fevers. That same infusion is used in America for dyspepsia and as an appetite restorer (Henkel), which probably is the equivalent of John Wesley's advice above. But Shakespeare...

Hypertension

ARNICA, in minute doses, has also been prescribed (Wickham). WATERMELON is said in Americe to be good for the condition, the treatment being to drink a tea made from the seeds (R B Browne). SHEPHERD'S PURSE has been adopted in Chinese medicine to treat hypertension, as well as colds and fevers, and enteritis (Chinese medicinal herbs of Hong Kong vol 2 1981).

Novel treatments

Peptides have been synthesised which are able to bind to the IgE receptors. This will competitively inhibit IgE binding to the receptor. These peptides, therefore, have the capacity to block IgE-mediated reactions non-specifically. They may be useful in patients with multiple food allergies or other IgE-mediated diseases such as asthma and rhinitis. Several such peptides are in the developmental phase.

Jujube

Up into lozenges, and were widely exported such lozenges are still called jujubes (Mitton). This plum is an excellent Pectoral, and opens the Body It expectorates tough Flegme, and is good against Coughs, Colds, Hoarseness, Shortness of Breath, Wheezings, Roughness in the Throat and Wind-Pipe, Pleurisies (Pomet). The seeds are used in Chinese medicine to give sleep, and also to benefit the nervous system (R Hyatt).

Respiratory symptoms

Difficulty and bronchospasm as part of a systemic reaction. Mild laryngeal symptoms are more frequently seen in food allergic patients and include throat tightness, itching in the throat or a dry cough. Patients at risk of systemic reactions should be very vigilant in avoidance and may need to carry a preloaded adrenaline syringe if there is a history of severe bronchospasm or respiratory difficulty. Some highly atopic patients with atopic dermatitis, in addition to asthma or rhinitis, may develop respiratory symptoms following ingestion of foods. This should be established, by history or double-blind challenge if required, and appropriate avoidance should be practised.

Incidence

Almost all children have acute OM at some time, but between 5 and 20 of children have chronic and recurrent OM with effusion. OM is most prevalent between the ages of 3 months and 3 years and is the most frequent reason for clinic visits in children younger than 15 years of age. Approximately 66 of children have at least one OM episode by the age of 3 50 have two or more episodes of OM. The younger a child is when the first incidence of OM occurs, the more likely the child is to experience recurrent episodes. OM is fairly common during winter months because of the increased number of people suffering from colds and upper respiratory illnesses. Children with Down syndrome, cleft palate, or other craniofacial anomalies are particularly at risk for OM because of the structure of their eustachian tubes. Approximately 50 of all children with a cleft palate experience recurrent OM. Additional risk factors include family history, bottle-fed as an infant, exposure to second-hand cigarette...

Pennyroyal

Pennyroyal tea is good for chills and coughs (Vesey-Fitzgerald), extended to include bronchitis and asthma in Scotland (Beith). In Morocco, the dried leaves are powdered and taken with porridge or milk for coughs and colds (Westermarck. 1926). In Wiltshire, it was used as an infusion for all chest and lung complaints (Wiltshire). Wesley recommended it for whooping cough Chin-cough or Hooping-cough give a spoonful of Juice of Pennyroyal mixt with Sugar-candy, twice a day, and Buchan prescribed it for croup. It is used in folk medicine with much confidence in obstruction of the courses, or when these are attended with pain of hysteria (Thornton). In other words, it is a known emmenagogue it is an abortifacient, too (V G Hatfield. 1994). Gypsies used to peddle it in remote country districts for just this purpose (Wiltshire). But this is a very old concept. The Anglo-Saxon version of Apuleius has, for instance, a leechdom for use if a dead-born child be in a wife's inwards, take three...

Polypody

(Polypodium vulgare) A fern, widespread in Britain in woods, especially in the west, where it often grows on trees. It is known in America as Licorice Fern, for the rhizomes have a strong licorice taste, and were once used as a sugar substitute (Turner & Bell). In Scotland, it was made into a medicine for catarrh (Beith), but it was also used for chest complaints, including tuberculosis (Quelch). The Indians of the Pacific north-west of America chewed the rhizomes for stomach troubles, sore throats and colds, as well as eating them as food, either fresh or sun-dried and stored for winter use (Turner & Bell). If this is what is meant by pollypodden, it was used in Ireland for burns. The procedure was to boil the stems with butter. The green juice sets to a jelly, and this is put on the burn (Maloney).

Roman Wormwood

(Artemisia pontica) It has a similar effect when used medicinally, though milder, as A absinthium, when used for colds, or as a tonic, or to expel worms (Sanford). If a root of this wort be hung over the door in any house, then may not any man damage the house (Cockayne).

Sagebrush

(Artemisia tridentata) A North American species, much used medicinally by the Indians. The Klamath, for instance, took the decoction for diarrhoea (Spier), as did the Coahuilla and the Tewa, who also chewed and swallowed the leaves for a cough (Youngken). The Gosiute (Chamberlin) and the Navajo used it for colds and fevers. The same people used it for headaches, which they still say can be cured simply by smelling the plant (Elmore).

Malignancies

Release from mast cells, as well as priming these cells for IgE-induced degranulation (Columbo et al., 1992) and sensitizing their responsiveness to eosino-phil-derived granular major basic protein (Furuta et al., 1998). Among the factors released by activated mast cells are IL-5, granulocyte-macrophage colony-stimulating factor (GM-CSF), and tumor necrosis factor-a (TNF-a), which influence eosinophilic protein secretion (Okayama et al., 1997, 1998). In addition to inducing histamine release from mast cells (Luckacs et al., 1996 Hogaboam et al., 1998), SCF promotes the mast cell production of the eosinophilic chemotactic factor eotaxin (Hogaboam et al., 1998) and eosinophilic infiltration (Luckacs et al., 1996). SCF also directly influences the adhesion of both mast cells (Dastych and Metcalfe, 1994 Kinashi and Springer, 1994) and eosinophils (Yuan et al., 1997), which in turn regulates tissue infiltration. Thus, SCF can influence the primary cells involved in allergy and asthma...

Safety

There were no significant findings or between-group differences in the variety of standard clinical lab studies. Adverse events occurred at similar frequencies in both control and placebo patients, and the most common adverse events were upper respiratory tract infection, rash, and injection site reaction. The most common adverse reactions requiring intervention were infusion-related reactions, particularly flushing. Clinically significant infusion reactions were observed in some patients that were manageable with premedica-tions and infusion slowing. One patient with severe respiratory insufficiency and airway compromise needed an emergency tracheostomy due to an airway problem during a reaction. This event in one patient did end up in the label for Aldurazyme. Antibodies to rhIDU developed in 20 out of 22 patients (91 ), and the mean time to conversion was 52.6 d. By the end of the study, many antibody titers were declining.

Sweet Cicely

The whole plant is very attractive to bees, and was often rubbed over the inside of hives to induce swarms to enter (Northcote). In popular medicine it is taken for flatulence and any digestive ailment (Clair), and is a remedy for chest troubles or bronchial colds (Gibson), and is still used to lower blood pressure (Schauenberg & Paris).

Water Pepper

(Polygonum hydropiper) They say that fleas will not come into a room where this herb is kept (Fernie). Rub it on warts, and throw the plant away (Stout). Herbalists use the tea to treat piles (Thomson. 1978). Tea is also used as a febrifuge in the southern states of America (Puckett), and, taken cold, for colds, in Iowa (Stout). The leaves infused in boiling water, or a strong decoction of them, were applied to bruises and contusions (Barton & Castle), and the juice, they say in Iowa, makes an excellent liniment for sprains (Stout). In Norway, the herb was chewed for toothache (Barton & Castle).

Safety Issues

For some people, proteins in cow's milk may trigger allergic reactions. Whey proteins (beta-lactoglobulin and beta-lact-albumin) and casein are the primary proteins that trigger allergic reactions. Symptoms of a milk allergy may include nasal congestion, hives, itching, swelling, wheezing, shortness of breath, nausea, upset

White Horehound

(Marrubium vulgare) Evelyn recommended the use of white horehound in beer instead of hops, and horehound beer was an East Anglian specialty (Clair). Randall records how his mother would always put a sprig of horehound in her brew, to improve the flavour, and to improve appetite. In Dorset, horehound and wood sage boiled and mixed with sugar made a cooling drink called woodsage beer, which was drunk at harvest time (Dacombe). Candied horehound was made, too (Grieve. 1933). But the herb is best known in folk medicine. This horehound candy was popular in American medicine before it became popular as a confection (Lloyd). The leaf expectorant has always been used (as an expectorant) to cure coughs and colds (Vesey-Fitzgerald Dacombe), and it is still used in lozenges to control a cough (Cameron). As long ago as the Anglo-Saxon period it was prescribed for colds in the head (Cockayne), and leechdoms of similar date are recorded for coughs (Dawson. 1934). Gerard, too, recommended the...

Wild Cherry

The wild cherry had some magical uses to get rid of a fever all one had to do was to lie naked under the tree on St John's Day, and to shake the dew on one's back (Dyer. 1889). This was from Germany, but there was a very similar usage from the south of France, the tree being the peach this time. There were genuine attempts at medicinal usage, though. The distilled water of Cherries, according to Gerard, is good for those that are troubled with heate and inflammation in their stomackes, and prevaileth against the falling sicknesse given mixed with wine. He also noted that the gum of the Cherry tree taken with wine and water, is reported to helpe the stone , something on which Lupton had already reported. Cherry gum dissolved on wine was a remedy for coughs and colds (Earwood). Wild Cherry seems to maintain normal uric acid levels in people suffering from gout, and was much used for the purpose before synthetic treatment was available (Lewis & Elvin-Lewis).

Wood Sage

(Teucrium scorodonia) Inhaling an infusion of Wood Sage (if Wood Sage was actually meant) was a Yorkshire remedy for quinsy (Hartley & Ingilby), and it is still used for the complaint in homeopathic medicine. People in the Dursley district of Gloucestershire used to pick the leaves in spring, and dry them, for a tea against rheumatism (Grigson. 1955). The tops, according to Hill. 1754 drank for a continuance, is excellent against rheumatic pains. It is used in Ireland for colic (Moloney), and also for colds and even consumption (O S illeabh in). New Forest gypsies combined Wood Sage and Ground Ivy in a tea for treating colds (Boase), and that tea was taken there to cure swellings, and also for biliousness (Hampshire FWI).

Associated morbidity

Markers of atopy as a whole are associated with an increased risk of developing adverse food reactions. Thus asthma, eczema and rhinitis are increased in children with food allergy compared to the general population (Zeiger and Heller 1995, Hide et al. 1996). The strongest association is between eczema and food allergy, and the risk appears to be greatest in infancy and in those with moderate to severe eczema (Burks et al. 1998, Sampson 1996). The literature appears to be best for peanut allergy. One study found that in peanut-allergic children atopy in some other form was present in up to 96 of subjects (Ewan 1996). In the Isle of Wight birth cohort study half of the children with peanut allergy had asthma and two-thirds had eczema, considerably higher than the rates in the cohort as a whole (Tariq et al. 1996).

Woodruff

Woodruff has been quite important medicinally in its day. To start with, coumarin is an anti-coagulant, so it had been useful for drugs used in heart disease (Mabey. 1972). Put another way, it is a blood-thinner, so woodruff tea was taken as a spring tonic (G B Foster), in the days when that was thought to be necessary. Such a tea, taken by itself or with strawberry leaves, helps to relieve headache and depression (Painter), or in Gerard's language, put into wine, to make a man merry. Herbalists still use it to treat liver infections and jaundice (Grigson. 1955), while in the Highlands of Scotland the liquid in which woodruff had been boiled was given to consumptives (Grant) - indeed, the Gaelic name for it means wasting plant (Beith). It was used for the same complaint in Brittany, where minor ailments like colds were likewise treated with woodruff tea (Grigson. 1955). In Anglo-Saxon times, woodruff and brooklime, both rich in tannin, were applied to a burn, in butter, with Madonna...

Woolly Yarrow

Not surprisingly, they used the plant medicinally for burns (Stevenson). Navajo Indians say that yarrow acts just like iodine when mixed with water and applied to cuts (Elmore), while some of the Plains Indians are quoted as using the leaves as a poultice to cure the bite of a spider the dried flower heads are used as tobacco to form part of a ceremonial smoking mixture (H H Smith. 1945). Saddle sores are treated by Navajo Indians by grinding the plant up and applying the solution (Elmore), while the Cheyenne drank an infusion for coughs, and a tea made from the leaves for colds and nausea (Youngken).

Genetic factors

If either parent has a history of an allergic disease then siblings are at increased risk of developing allergic disease, which includes eczema, asthma, allergic rhinitis and food allergy (Zeiger and Heller 1995). The risk is greater if either parent is atopic, and increases if both parents are atopic. In children with cows' milk allergy, a family history of atopy in first-degree relatives has been found in 23-80 of cases (Goldman 1963, Ventura 1988, Host 1990). Findings from a Danish study looking at skin reactions to foods are presented in Table 10.14, confirming the association of food allergy and family history of atopy (Kjellman 1983).

Influenza A Virus

Influenza A is a major respiratory tract disease affecting millions of people each year. Influenza A is characterized by the abrupt onset of constitutional and respiratory signs and symptoms (e.g., fever, myalgia, headache, severe malaise, nonproductive cough, sore throat and rhinitis) 1 . However, in some persons the infection can cause pulmonary or cardiac disease or lead to secondary bacterial pneumonia or primary viral pmeumonia. Epidemics of influenza occur during the winter months nearly every year and are responsible for an average of approximately 20,000 deaths per year in the United States 2,3 . Influenza A viruses have the ability to undergo changes by the mechanisms of antigenic drift and shift and new evolving strains can be a serious threat to the human population 4 . Thus, pandemic influenza A viruses appeared in 1918 (Spanish H1N1), 1957 (Asian H2N2) and 1968 (Hong Kong H3N2). Given that influenza shifts occur every 20-30 years and that a new lethal variant appeared in...

Coughs

Centuries, from Anglo-Saxon times onwards, either the leaves and root on their own, or with some other ingredient, such as elecampane, or horehound, both renowned cough medicines themselves. ELDER flower tea is good for a cough or for colds and sore throats. Elderflower vinegar used to be saved, too, to use for sore throats (Painter). Coughs can be treated, according to an 18th century prescription from Anglesey, by drinking the result of boiling up a quantity of Liverpool ale with rosemary, honey and salt butter (T G Jones). The nuts, bark and leaves of SWEET CHESTNUT can be used for all kinds of coughs, including whooping cough (Page. 1978), a usage that has been known for a long time. See Gerard, for example, who said that an electuary of the meale of Chestnuts is very good against the cough and spitting of bloud. MALABAR NUT is an Indian plant, but long cultivated in the tropics, and much used as an expectorant or cough reliever (Thomson. 1976). CAROB molasses is another very...

Honeysuckle

The plant is still in use as a heart tonic, and for chest colds, coughs and asthma, rheumatism, liver trouble (the leaves are still used for jaundice in Ireland (Maloney) ), sore throat, etc., (Conway) this last known in Gerard's time - the water is good against soreness of the throat. Gypsies use the juice from the berries to cure the condition, and also canker in the mouth (Vesey-Fitzgerald). Coulton quoted a 14th century manuscript, prescribing for hym that haves the squynancy a remarkable amount of disgusting rubbish, but containing as an ingredient gumme of wodebynde.

Cohoba

GARLIC, boiled, and the juice drunk (Ireland) (Maloney). They have a way of treating a cold in Alabama, either just by eating a spoonful of it, or if the sufferer does not like garlic, take a baked potato, open it, and put the garlic in it then butter it, or put gravy on it, and eat the potato without chewing it (Browne). Dried TURNIP, grated and mixed with honey is an American cold cure (Stout), and a gypsy remedy is to take a leaf infusion of CUCKOO-PINT to treat their chills and colds (Boase). HORSERADISH can be used, too, by smelling it, or rather inhaling the vapour from the grated root (Vickery. 1995). In a similar way, American Indians would burn twigs of VIRGINIAN JUNIPER and inhale the smoke to clear up a cold (Gilmore). ELDER flower tea is good for colds, coughs, etc., as well as for sore throats (so is mulled elderberry wine, which is also said to be good for asthma (Hatfield)). A concoction of elderberries was a Highland cold cure (Thornton), but what better than the wine...

Enterovirus 68 HEVD

EV68 has a clear association with respiratory diseases. Most clinical isolates of EV68 have been obtained from respiratory specimens of patients with respiratory tract infection. Studies on strains EV68 Fermon, HRV87 Corn, and some recent clinical EV68 isolates have shown that these viruses share important biological features with human rhinoviruses, the most prominent causative agents of common colds. Unlike typical EVs, strains of EV68 lose their infectivity in acidic environment and besides, grow more effectively at +33 C than at +37 C. Clinical illness or symptoms described upon isolation of EV68 included pneumonia, bronchiolitis, upper respiratory tract infection, wheezing, asthma, emesis, respiratory distress, crackles, cough, and asthma exacerbation.

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