7 Kinds of Coughs and What They Might Mean

Allergies? A cold? Acid reflux? No matter what the cause, there’s a simple reason behind all your hacking: “A cough is a protective mechanism to clear your airway,” explains Jonathan Parsons, MD, Director of the Cough Clinic at the Ohio State University Wexner Medical Center.

While it’s impossible to always pinpoint a cough by how it sounds, there are some key differences to give you clues as to what’s going on. Here’s how to tell what that cough really means.

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Postnasal drip

Sounds like: Either a dry or wet cough. It’s caused by mucus dripping down your throat (due to either allergies or a cold), which tickles nerve endings, triggering coughing, Dr. Parsons says.

Other telltale symptoms: The cough is worse at night; there’s a tickly feeling at the back of your throat. If it’s due to allergies you may also have itchy eyes and sneezing.

Diagnosis and Rx: If you suspect allergies, try an over-the-counter antihistamine. But if that doesn’t help after a couple weeks, see your doctor, who can refer you to an allergist for skin testing. If it’s due to a residual cold, you can try natural remedies like saline washes and steam to help relieve congestion, but if the cough lingers for more than a week see your doctor to rule out a sinus infection, which might require antibiotics.

RELATED: Your 12 Worst Allergy Mistakes


Sounds like: A dry cough that ends with a rattle or wheeze. People with asthma have inflamed airways, which can cause difficulty breathing as well as wheezing and coughing.

Other telltale symptoms: The cough gets worse at night or while exercising; chest tightness; shortness of breath; fatigue

Diagnosis and Rx: To check for asthma, your doctor will most likely order spirometry, a lung function test, he says. To treat it, there are two types of medications: quick-relief drugs (bronchodilators like albuterol, which make it easier to breathe) and drugs you take daily to keep asthma under control, such as leukotriene modifiers (like Singulair).

RELATED: 13 Best and Worst Foods for Asthma


Sounds like: A dry, spasmodic cough. Short for gastroesophageal reflux disease, GERD is when acid from your stomach backs up into your esophagus. It’s actually the second most common cause of chronic cough, causing about 40% of cases, according to a 2006 review published in Nature.

Other telltale symptoms: Your cough gets worse when you’re lying down or eating. “The classic sign is coughing that starts as soon as you lie down in bed at night,” says Dr. Parsons. About 75% of GERD patients with chronic cough have no other symptoms, but if you do they can include heartburn and hoarseness.

Diagnosis and Rx: Tests may include an x-ray of your upper GI tract and/or an endoscopy (where your doctor inserts a thin, flexible tube down your throat to examine it). GERD is treated with OTC or prescription meds to reduce acid production, like Pepcid AC, Zantac, or Prilosec.

RELATED: 11 Surprising Symptoms of Acid Reflux


Sounds like: A chronic, hacking cough that produces a lot of mucus, particularly in the morning, Dr. Parsons says. COPD, or chronic obstructive pulmonary disease, includes both chronic bronchitis and emphysema; the main cause is smoking.

Other telltale symptoms: The cough gets better as the day progresses; shortness of breath, especially with physical activity; wheezing, fatigue, and chest tightness.

Diagnosis and Rx: Your doctor will usually recommend lung function tests such as spirometry and a chest x-ray. The disease is treated with meds like bronchodilators and inhaled steroids; it’s also imperative to stop smoking. In extreme cases, you may need oxygen therapy.

RELATED: 10 Crazy Ways Smokers Finally Kicked the Habit

Medication-related cough

Sounds like: A dry cough. A group of drugs known as ACE inhibitors are commonly prescribed to treat high blood pressure; they can cause cough in about 20% of patients.

Other telltale symptoms: Cough begins a few weeks after starting these meds, Dr. Parsons says.

Diagnosis and Rx: Talk to your doctor. If your cough is mild, you may be okay switching to a different ACE inhibitor, he says, but if it’s severe, you’ll want to switch to another type of blood pressure med entirely, such as an angiotensin receptor blocker or ARB, like Cozaar.

RELATED: 10 Natural Ways to Lower Blood Pressure


Sounds like: Initially a dry cough which after a few days turns to a wet cough with yellow, green, and/or red or rust-tinged mucus.

Other telltale symptoms: Fever, chills, trouble breathing, pain when breathing in deeply or coughing

Diagnosis and Rx: Your doctor can usually tell if you have pneumonia by listening to your chest with a stethoscope, although she may order an x-ray and blood tests to determine if it’s viral or bacterial, Dr. Parsons says. Treatment for the latter is antibiotics; if it’s viral, the only remedy is rest, OTC cough meds, and chicken soup.

RELATED: 5 Ways to Tell if You Need an Antibiotic

Whooping cough (pertussis)

Sounds like: A severe, hacking cough that ends with a whooping sound as you breathe in. While this disease used to be extremely rare thanks to vaccines introduced back in the 1940s, it’s now seeing an upswing—in 2012, there were more than 48,000 cases reported, the most since 1955, according to the CDC.

Other telltale symptoms: The first symptoms are similar to the common cold: stuffy, runny nose, watery eyes, fever, and cough. But after about a week the classic coughing signs emerge, with hacking so intense you may throw up or turn red or blue, he says.

Diagnosis and Rx: Pertussis is diagnosed with blood tests and a chest X-ray. It’s treated with antibiotics.

Two Vaccines Every Pregnant Woman Should Get

When you’re pregnant, you pay extra-close attention to nearly everything you put into your body, from a tuna fish sandwich to everyday pain medication. So you might also feel extra nervous about getting a flu shot or other vaccines. But some vaccines are actually crucial during pregnancy: “Being immunized not only protects the health of a pregnant woman, it protects her baby from the day it’s born,” says Sonja Rasmussen, MD, editor-in-chief of the Morbidity and Mortality Weekly Report for the Centers for Disease Control and Prevention (CDC).

Thanks to antibodies that are passed from mother to baby in utero, getting certain vaccines when you’re pregnant can actually help defend your newborn from potentially deadly diseases. Keep yourself and your baby healthy by getting these two shots:

RELATED: Adult Vaccines: What You Need and When

Influenza (aka flu)

Flu vaccines are recommended for everyone 6 months and older, including pregnant women. Pregnant women get sicker from the flu and are especially vulnerable to complications from the flu, including hospitalization and death.

Getting the flu while pregnant can also lead to preterm birth, low birth weight, and other problems for the baby. Yet only about 50% of women get vaccinated during pregnancy, Dr. Rasmussen noted recently at a press event sponsored by the March of Dimes.

That stat is all the more alarming considering that a flu vaccine not only protects the mother, it also protects her baby from getting the flu up to 6 months (the age at which babies can be vaccinated themselves). And infants under 6 months are at especially high risk of complications from the flu, such as pneumonia.

The American College of Obstetricians and Gynecologists also urges all pregnant women to get a flu shot, during any stage of pregnancy. (Pregnant women should not get the nasal spray form of the flu vaccine, which contains a weakened live virus.)

RELATED: 10 Biggest Myths About the Flu

Tdap (tetanus, diphtheria, and pertussis)

Pertussis (the “p” in Tdap), otherwise known as whooping cough, is a highly contagious illness that causes violent, uncontrollable coughing. It can lead to serious complications, including pneumonia and trouble breathing, especially in infants and young children. (Listen to this super scary recording of a baby with whooping cough at Sounds of Pertussis.)

Recent years have seen a surge of whooping cough cases, peaking in 2012 with nearly 50,000 cases reported to the CDC. There were also 20 deaths, the majority of them babies younger than 3 months old.

Because of these dangers, experts now advise that pregnant women get a Tdap vaccine during every pregnancy. Research shows that Tdap is safe during pregnancy and helps protect babies until they are old enough to be vaccinated themselves (starting at 2 months). Yet only 14% of pregnant women get a pertussis vaccine, Dr. Rasmussen says.

Ideally, you should get Tdap during the third trimester—but no later than 36 weeks, to allow at least 2 weeks for your body to build up the maximum levels of protective antibodies, says Dr. Rasmussen. Your antibodies will decrease over time, so if you get pregnant again, you’ll need another Tdap dose to protect that baby, too.

For even more protection, make sure your partner and anyone else who’ll come into regular contact with your baby (grandparents, siblings, caregivers) has been vaccinated, too. The health of your baby is worth it.

RELATED: 7 Kinds of Cough and What They Might Mean

Zika Vaccine Probably Won't Be Ready for 'Years', Officials Say

By Dennis ThompsonHealthDay Reporter

THURSDAY, Jan. 28, 2016 (HealthDay News) — Efforts to create a Zika vaccine are getting a leg up from lessons learned during earlier battles against other mosquito-borne viruses, U.S. health officials reported Thursday.

Researchers are working on two potential vaccines, each based on earlier vaccines created in response to prior outbreaks of West Nile virus and dengue, Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, said during a morning news conference.

“It is to our advantage that we already have existing vaccine platforms to use as a sort of jumping-off point,” Fauci said.

A Zika vaccine could be ready for clinical trial by later this year, but Fauci warned that it will likely take years before the vaccine is ready for market.

“It is important to understand that we will not have a widely available safe and effective Zika vaccine this year, and probably not even in the next few years,” he said.

There have been no outbreaks in the United States so far of Zika virus, but limited U.S. outbreaks are “possible” and “even likely” given that the same sort of aggressive, day-biting mosquito that spreads Zika is present in the southern United States, said Dr. Anne Schuchat, principal deputy director of the U.S. Centers for Disease Control and Prevention.

However, Schuchat emphasized that the main health concern at this point is for pregnant women who are exposed to the virus.

“Increasing lines of evidence suggest that some women who are infected with Zika during their pregnancy may go on to deliver a baby with a serious brain injury,” Schuchat said.

That’s why the CDC has issued a health warning urging pregnant women to avoid the more than 20 countries in Central and South America where Zika infection is active, she said. Zika virus also is present in two U.S. territories, Puerto Rico and the U.S. Virgin Islands.

“The virus is spreading throughout the Americas, and we expect more countries to be affected,” Schuchat said.

On Thursday, World Health Organization (WHO) Director-General Dr. Margaret Chan declared that Zika is “spreading explosively.” The WHO will hold an emergency meeting of independent experts on Monday to decide whether the outbreak should be declared an international health emergency.

Brazilian health officials noted a dramatic increase during their country’s Zika outbreak of babies born with microcephaly, an abnormal smallness of the head associated with incomplete brain development and lifelong disability.

CDC lab tests “strongly suggest” a link between Zika virus and at least some of the more than 3,500 babies born with this condition in Brazil last year, Schuchat said.

But Schuchat emphasized that the virus does not present a strong health risk to the average person.

“About four of five people who get infected with Zika never have symptoms at all,” she said. “Those who do get sick usually have very mild symptoms — fever, rash, joint pain and red eyes or conjunctivitis. Symptoms typically last a couple of days, up to a week.”

Schuchat said that “it’s very rare for a person with Zika to get seriously ill or to die” from it.

And, she added, there’s no evidence that the virus lingers in a person’s system, potentially affecting future pregnancies.

Schuchat did note that health authorities in Brazil also have reported an increase in Guillain-Barre syndrome, a rare neurological disorder that causes muscle weakness and paralysis lasting as long as a few years. Researchers are now investigating whether there is any link between Zika virus and Guillain-Barre.

Fauci said his researchers are pursing at least two different approaches for a Zika vaccine, each based on earlier outbreaks of other viruses.

One is a DNA-based vaccine using a strategy very similar to one employed in a vaccine for West Nile virus, Fauci said. In this vaccine, a piece of Zika’s genetic structure would be inserted into another harmless virus, and used to prompt an immune response.

Another is a more traditional live attenuated vaccine, building on a similar approach used to create a vaccine for dengue virus, Fauci said.

Health officials are using every outbreak to further their knowledge of mosquito-borne illnesses and create platforms of knowledge from which they can respond quickly to future threats, he explained.

“We need to look at Zika virus in its context, as the latest in a series of mosquito-borne diseases that have expanded their reach in the last 20 years or so,” Fauci said. “There will almost certainly be others. We need vaccine platforms that can be quickly modified for protection against emerging new threats, and we need broad-spectrum antiviral drugs effective against whole classes of viruses.”

The CDC has identified 31 travel-associated cases of Zika virus in the United States, Schuchat said. All of the cases, which are in 11 states and the District of Columbia, involve people becoming infected outside the country and then traveling to the United States.

There also have been 19 lab-confirmed cases of Zika virus in Puerto Rico and one in the U.S. Virgin Islands, she said.

Although health officials view a U.S. outbreak of Zika as likely, the United States enjoys certain advantages that should keep such an outbreak limited to a small area, Schuchat said.

Urban areas in the United States are less congested than they are in other countries of the Americas, making it more difficult for mosquitos to spread disease hopping from one person to the next, she said.

Also, people in the United States are more likely to have their windows shut, thanks to air conditioning, or to have screens on open windows, which keep mosquitos from invading their homes, she added.

More information

For more information on Zika virus, visit the U.S. Centers for Disease Control and Prevention.

CDC Confirms Zika Virus Infection in Minnesota Woman

A case of the Zika virus has been confirmed Wednesday in a Minnesota woman who traveled to Central America, health officials said.

The Minnesota Department of Health and the Centers for Disease Control and Prevention say the woman began showing symptoms Jan. 1, after she traveled to Honduras. The woman was not hospitalized and officials say they expect her to make a full recovery.

This is the first Zika virus infection in Minnesota since 2014 and state health officials advised travelers not to panic but to be wary when going to regions where infections are common.

“Zika virus is not a health threat for people in Minnesota, but it is a reminder that anyone traveling to a different part of the world should be mindful of the health issues present in that region,” Minnesota health commissioner Ed Ehlinger said in a statement. “Since some regions where Zika is circulating are popular destinations for Minnesota travelers in the winter, we expected we might see cases of Zika in the state.”

Zika virus has put American travelers on notice, as several cases of infection have been reported in January. The virus, a mosquito-borne disease currently ravaging South America, has been reported to cause birth defects in children.

CDC Broadens Zika Virus Travel Alert for Pregnant Women

TUESDAY, Jan. 26, 2016 (HealthDay News) — The U.S. Centers for Disease Control and Prevention on Tuesday added two more destinations—the U.S. Virgin Islands and the Dominican Republic—to the list of places that pregnant women may want to avoid due to potential infection with the Zika virus.

Since last May, 23 countries and territories in the Americas have reported cases of mosquito-borne Zika, which is linked to a brain disorder called microcephaly. Babies with the condition have abnormally small heads, resulting in developmental issues and, in some cases, death.

Already, the CDC had advised pregnant women to avoid trips to Bolivia, Brazil, Cape Verde, Colombia, Ecuador, El Salvador, French Guiana, Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Saint Martin, Suriname, Samoa, Venezuela, and Puerto Rico. The agency also recommended screening for women who have recently traveled to these places while pregnant.

On Sunday, the World Health Organization warned that the Zika virus, which has harmed thousands of babies born in Brazil, will likely spread to all but two countries in North, Central and South America.

Transmission is probable because the Aedes mosquitoes, which spread the virus, populate the entire region except for Canada and continental Chile. Also, the “population of the Americas had not previously been exposed to Zika and therefore lacks immunity,” according to a WHO statement released Sunday.

The CDC has also said that cases of the neurological disorder Guillain-Barre syndrome have been reported in patients with probable Zika virus infection in Brazil and French Polynesia, although more study is needed to confirm the link.

Meanwhile, organizers of the Summer Olympics 2016 in Brazil said they’ll be on high alert to prevent Zika transmission.

According to the Associated Press, the committee plans daily inspections of the Olympic and Paralympic sites to seek out stagnant waters where Zika-spreading mosquitoes could breed. The games are scheduled for Aug. 5-21.

“Rio 2016 will continue to monitor the issue closely and follow guidance from the Brazilian Ministry of Health,” the committee said in a statement.

Preventing mosquitoes from breeding, and protecting yourself from mosquito bites, is the best protection, the WHO said.

The American College of Obstetricians and Gynecologists (ACOG)—the largest organization representing obstetricians and gynecologists in the United States—said last week that it supports the guidelines aimed at shielding pregnant women from the mosquito-borne Zika virus.

According to a statement, ACOG is urging pregnant women and those planning a pregnancy to follow Zika virus travel and health guidelines recently issued by the CDC.

“Travel to regions with ongoing Zika virus outbreaks is not recommended for women who are pregnant or women who are considering pregnancy,” ACOG President Dr. Mark DeFrancesco said in the statement.

The CDC said doctors should ask all pregnant patients about recent travel and specific symptoms, such as a sudden fever or rash. If Zika virus infection is possible, doctors should have the patient tested for the virus.

If tests reveal signs of infection, ultrasounds should be considered to monitor the fetus’ development, and referral to a maternal-fetal medicine or infectious disease specialist with expertise in pregnancy management is also recommended, the CDC advised.

There is no vaccine or treatment for Zika, and symptoms are usually mild in healthy adults.

According to DeFrancesco, “there is much that we do not yet know about the Zika virus and its effects during pregnancy, for example, whether pregnant women are of greater risk of infection than non-pregnant individuals. However, because of the associated risk of microcephaly, avoiding exposure to the virus is best. That’s why pregnant women and women who are considering pregnancy should delay planned travel to areas where Zika virus outbreaks are ongoing.”

Because there is no treatment for Zika virus at this time, “women should be counseled about all options available to them,” he said. “When possible, delivery at a center with the appropriate levels of neonatal expertise may be warranted,” he suggested.

More information

The U.S. Centers for Disease Control and Prevention has more about the Zika virus.

Certain Antibiotics Shouldn’t Be Prescribed for Uncomplicated Infections, FDA Says

TUESDAY, July 26, 2016 (HealthDay News) — The U.S. Food and Drug Administration announced Tuesday that it’s strengthening label warnings on a class of antibiotics called fluoroquinolones because the drugs can lead to disabling side effects, including long-term nerve damage and ruptured tendons.

The agency also cautioned that these bacteria-fighting drugs—including levofloxacin (Levaquin) and ciprofloxacin (Cipro)—shouldn’t be prescribed for sinusitis, chronic bronchitis, or simple urinary tract infections unless no other treatments options exist.

“Fluoroquinolones have risks and benefits that should be considered very carefully,” Dr. Edward Cox said in an FDA news release. He’s director of the Office of Antimicrobial Products at the FDA’s Center for Drug Evaluation and Research.

“It’s important that both health care providers and patients are aware of both the risks and benefits of fluoroquinolones and make an informed decision about their use,” Cox said.

A safety review revealed that potentially permanent side effects involving tendons, muscles, joints, nerves and the central nervous system can occur hours or weeks after exposure to fluoroquinolone pills or injections. Also, two or more serious side effects can occur together, the FDA said.

Because of this, the FDA recommends reserving these antibiotics for serious bacterial infections, such as anthrax, plague and bacterial pneumonia.

In these cases, “the benefits of fluoroquinolones outweigh the risks and it is appropriate for them to remain available as a therapeutic option,” the agency said.

Besides Cipro and Levaquin, other fluoroquinolones include moxifloxacin (Avelox), ofloxacin (Floxin) and gemifloxacin (Factive).

The new labeling action will include an updated boxed warning and revisions to the Warnings and Precautions section of the label. Also, a medication guide that patients receive describes the safety issues tied to these drugs, the agency said.

The FDA has reported concerns about fluoroquinolones since 2008. At that time, it added a boxed warning because of increased risk of tendinitis and tendon rupture.

Almost three years later, the FDA warned that the drugs could worsen symptoms of the neuromuscular disease myasthenia gravis. The potential for serious nerve damage (irreversible peripheral neuropathy) was detailed in 2013.

Finally, last year an FDA advisory committee said uncomplicated sinus, urinary and bronchial infections should be treated with other options.

More information

The U.S. Centers for Disease Control and Prevention explains how to treat a urinary tract infection.

Flu Vaccine Doesn't Protect Seniors From Pneumonia

THURSDAY, July 31 (HealthDay News) — Flu vaccine may not protect older people from pneumonia once they get the disease, researchers report.

Older, frail adults are more susceptible to getting the flu, even if they have been vaccinated, and once getting the flu, they are more susceptible to such complications as pneumonia. It had been thought that flu vaccine would prevent flu—and pneumonia—across all groups of seniors, but this benefit appears to be largely confined to younger, healthier seniors.

“In seniors, flu vaccine was not linked to a reduced risk of pneumonia,” said lead researcher Michael L. Jackson, a postdoctoral fellow at the Group Health Center for Health Studies in Seattle.

Jackson still recommends that seniors get flu vaccine, however. “There have been good randomized trials that show, at least in healthy seniors, that the vaccine reduces the risk of influenza,” he said. “However, earlier studies have overestimated how well the vaccine works in reducing complications of influenza. So, the vaccine may not reduce the risk of complications as much as previously thought,” he said.

Among young healthy seniors, the vaccine reduces the risk of flu, Jackson said. “When you look at the total population of seniors, which includes people over 75 and people that have chronic health diseases — lung disease, heart disease, diabetes, and things like that — we don’t know if the vaccine is effective in the seniors,” he said. “People with these chronic diseases are more susceptible to getting the flu, and they are more likely to develop pneumonia if they do get influenza.”

The report is published in the Aug. 2 issue of The Lancet.

For the study, Jackson’s team collected data on 1,173 people between the ages of 65 and 94 who developed pneumonia They compared these individuals with 2,346 people who did not get pneumonia. Both groups had similar rates of flu vaccination over the three seasons of studies, the researchers say.

The researchers found that vaccinated seniors who got the flu were as likely to develop pneumonia as unvaccinated seniors who got the flu.

Dr. Pascal James Imperato, dean of the master of public health program at the State University of New York Downstate Medical Center in New York City, was not surprised by these results.

“We know that elderly people do not form sufficient antibodies to certain vaccines, the flu vaccine included,” Imperato said. “In addition, people in their 70s and 80s and 90s are more prone to pneumonia with or without influence. A number of these pneumonias may be secondary to other causes aside from influenza.”

Even though many of the elderly will not develop sufficient antibodies to the flu vaccine, getting the shot is still worthwhile, Imperato said. “Having many people vaccinated builds up a herd immunity to disease, and you create barriers to transmission,” he added.

Dr. Marc Siegel, a clinical associate professor of medicine at New York University School of Medicine in New York City, said the results of this study fly in the face of prevailing wisdom.

Siegel noted that 36,000 people in the United States die each year from the flu. “Over 90 percent of them are elderly,” he said. “We give the flu shot primarily to prevent elderly deaths.

The effectiveness of the flu vaccine varies year to year, however, depending on how good a match it is for the circulating strains of influence. “In the best years, the flu vaccine is really only 40 to 60 percent effective,” Siegel added.

In addition, Siegel thinks that the flu vaccine protects against other complication including respiratory diseases, which can also be fatal. “There are plenty of flu-related complications that are life-threatening besides pneumonia,” he said.

“This study is a reminder that flu vaccines are not a panacea, but they are valuable, because they cut down on the incidence of influenza,” Siegel said. “Flu shots definitely cut down on the number of flu-related deaths.”

More information

For more about seasonal flu vaccine, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Michael L. Jackson, Ph.D., M.P.H., postdoctoral fellow, Group Health Center for Health Studies, Seattle; Marc Siegel, M.D., clinical associate professor of medicine, New York University School of Medicine, New York City; Pascal James Imperato, M.D., distinguished service professor and dean, master of public health program, State University of New York Downstate Medical Center, New York City; Aug. 2, 2008, The Lancet

Last Updated: Aug. 01, 2008

Copyright © 2008 ScoutNews, LLC. All rights reserved.

Makers Say Cold and Cough Medication Should Not Be Used in Children Under 4

TUESDAY, Oct. 7 (Health.com) — The manufacturers of over-the-counter cough and cold medicines said Tuesday that such products should not be used in children under 4.

The leading makers of the products decided to voluntarily change the label after consulting with the Food and Drug Administration (FDA), according to the Consumer Healthcare Products Association, an industry trade group.

While pediatric versions of cough and cold remedies will still be available in supermarkets and pharmacies, they will have a new label that warns against use in children under 4. The labels will still recommend an appropriate dose for older children.

“In addition, for products containing certain antihistamines, manufacturers are voluntarily adding new language that warns parents not to use antihistamine products to sedate or make a child sleepy,” Linda Suydam, president of the Consumer Healthcare Products Association, said in a statement.

Expect to see such label changes during the 2008–2009 cough and cold season, the group said.

The use of cough and cold medications in very young children has come under scrutiny in recent years.

In January 2008, the FDA said such products should not be given to children under 2 years of age. Some children, mostly under 2, have died due to the misuse of the remedies. The Centers for Disease Control and Prevention estimates that 7,000 children under 11 are treated in emergency rooms each year due to problems with cough or cold remedies.

Parents could accidentally administer an overdose to children by using multiple products that contain similar ingredients, or by giving children the incorrect dose.

The FDA met last week to discuss the issue, and is considering a ban on such products for children ages 2–6.

Manufacturers are trying to do a better job of educating parents and caregivers. In addition to other recommendations, they say that caregivers should:

• Follow dosing recommendations exactly and use the measuring device sold with the product• Avoid combining medicines that contain the same ingredients• Never use such products to make a child sleepy



By Theresa Tamkins

Related Links:Cold Meds for Kids Back in the SpotlightFDA Wants More Time to Study Cold Meds for Kids14 Ways to Avoid Colds and FluOTC Cold Medicines Sending Children to Emergency Rooms

Holiday Health Myths: Sugar, Suicides, and Cold

By Amanda MacMillanWEDNESDAY, Dec. 17, 2008 (Health.com) — The holiday season is a great time for family, friends, and well, old wives’ tales: Who hasn’t been told to wear a hat because you lose the most heat from your head? Or to keep kids away from poisonous poinsettias?

There are some real holiday health hazards (see 11 of them here), but other much-discussed fears appear to be false, say two researchers. Their analysis, published Wednesday in the British Medical Journal, shows that your mother’s—or even your doctor’s—advice may not always have rock-solid evidence to back it up.

Rachel Vreeman, MD, and Aaron Carroll, MD, professors of pediatrics at the Indiana University School of Medicine, in Indianapolis, set out to show that even widely held medical beliefs require scientific examination. They pored over medical literature databases, and in some cases, conducted Google Internet searches, to find evidence that supported or refuted these ideas.

Here’s what they found.

Myth: Sugar makes kids hyperactiveRelease the candy canes! In at least 12 placebo-controlled studies, children who were given different amounts of sugar reacted no differently than those who had none, report Dr. Vreeman and Dr. Carroll. Even research looking at kids with attention deficit hyperactivity disorder (ADHD) or those who were considered sensitive to sugar found no evidence of behavioral change.

Interestingly, in one study when parents thought their children had been given a sugary drink (it was actually sugar free), they perceived their behavior as more hyperactive.

We do get energy from sugar, says Dr. Carroll, so it doesn’t take a huge leap to believe that too much sugar would create too much energy. While sugar does seem to be associated with events that may trigger misbehavior, science shows that sugar is not the real culprit. “A lot of occasions when kids are exposed to sugar are when they are most likely to be super excited, running around, and acting out,” he explains. “They get more ice cream and candy often at times when they are at parties, getting presents, and seeing friends, and these factors all contribute.”

Other research has hinted that artificial dyes and preservatives may be a problem, not sugar.

Myth: Suicides increase during the holidaysWhile the holiday season is a joyful time for many, it can also be stressful or depressing for those with family tensions or no family at all. However, a 35-year study on Minnesota residents found that suicides did not increase on or around Christmas or any other major holidays, including birthdays, Thanksgiving, or the Fourth of July. Research from all over the world, in fact, shows that suicides are actually more prevalent in warm, summer months—a pattern that scientists can’t quite explain. While suicidal thoughts should be taken seriously at any time of year, there’s no reason to think that this month is especially dangerous.

Myth: Poinsettias are toxicEven though public health officials have reported that poinsettias are safe, many people believe they are toxic plants. However, in a 1996 analysis of 22,793 poinsettia cases (reported to the American Association of Poison Control Centers), none revealed significant poisoning.

Edward Krenzelok, PharmD, director of the Pittsburgh Poison Control Center and Drug Information Center at the University of Pittsburgh (and lead author of the 1996 study), says that it is possible to become ill by consuming a large amount of the plant—but it’s also rare, even in small children and pets. “A new Christmas puppy or a playful black Lab may decide to make the plant the focus of play and ingest a large quantity,” he adds. “However, I would expect nothing more than vomiting or diarrhea.”

Some studies suggest that poinsettia sap can be irritating to the skin, and, of course, any adverse reactions to plant ingestion should be reported to poison control centers.

Myth: You lose most of your body heat through your headThis oft-repeated factoid probably originated with an old military study in which scientists put subjects in Arctic survival suits (but no hats) in extremely cold temperatures, and found that they did indeed lose a great deal of heat through their heads.

However, experts say that had this experiment been performed with subjects wearing swimsuits, they would have lost heat evenly across all exposed body surfaces—and no more than 10% from the head specifically.

“We often hear parents say that as long as their kids are wearing a hat, they feel that they’re sufficiently dressed,” says Dr. Vreeman. “Of course they should bundle up for protection from the cold, but they should be equally concerned about gloves and boots as well.”

Myth: Eating at night makes you fatHoliday festivities provide people with many opportunities to indulge in large meals and lots of desserts at all times of the day. But the commonly held belief that eating before bed causes more weight gain than eating at other times of the day isn’t supported by research. Several studies promote the weight-control benefits of eating breakfast and eating meals at consistent times, but that’s only because they help people limit their overall intake of daily calories, the study authors report.

“The time of day a person eats is not as important for overall weight gain as the amount of calories eaten during the day,” agrees Jeannie Gazzaniga-Moloo PhD, RD, a spokesperson for the American Dietetic Association. “However, the danger in eating late at night is that it tends to be mindless eating, of calorie-laden foods.” Avoid your favorite go-to comfort foods before bed, she suggests, but don’t fret if your regular dinner gets pushed back several hours.

Myth: You can cure a hangoverSorry, but there’s no magic bullet for this one. Internet searches reveal seemingly endless options for hangover cures, the authors report, from aspirin and bananas to prickly pear and Vegemite. But no large, well-designed studies have found that anything but time—and drinking water to treat dehydration—can ease the aftermath of too much alcohol consumption.

The authors’ analysis—which was not a systematic review—was performed mainly for entertainment reasons, although the authors stress that there is a larger lesson to be learned.

“With the Internet today, it’s easier to find good information but it’s also just as easy to find bad [information],” says Dr. Carroll, and advice is often passed by word of mouth, even by medical professionals. “Doctors spend a lot of time simply doing things they’ve been told to do or things they’ve learned in the past.”

If these holiday myths can be dispelled, he says, then more serious health advice might be disproved as well.

“Plus,” adds Dr. Vreeman, “we don’t want people going outside with just hats and no other clothing.”

Related Links:Slideshow: Survive the Holidays Without Gaining Weight11 Holiday Health Hazards to AvoidHoliday Sleep Saboteurs That May Disrupt Your Schedule

Study: Can More Sleep Help Fight Off Colds?


By Theresa TamkinsMONDAY, Jan. 12, 2009 (Health.com) — Are you getting enough sleep? If not, it could be hurting your health. A new study suggests that people who lose just a bit of sleep, or those who have poor quality sleep, are more likely to get sick after being exposed to a cold virus than those who get more shut-eye.

“People who slept less than seven hours were about three times more likely to get a cold than people who slept eight hours or more a night,” Sheldon Cohen, PhD, of Carnegie Mellon University, in Pittsburgh, said in a podcast. The study was published Monday in Archives of Internal Medicine.

Cohen and his colleagues interviewed 153 men and women ages 21 to 55 every day for two weeks; they asked how long they slept, how much they tossed and turned before dropping off, and whether they felt rested in the morning, in addition to other factors.

After that, the study subjects were quarantined for six days and given cold-virus-containing nose drops at a dose about 125 times the amount that it takes to infect cells in a laboratory.

The researchers measured everything from symptoms to the weight of nasal secretions (discarded tissues were weighed in a plastic bag, and the weight of the tissue and bag subtracted) to determine who became infected.

They found that 88% of people became infected with the virus (as measured by cold virus in their nose or antibodies in their blood), but not all of those people actually got sick. About 43% of the volunteers had signs of infection plus cold symptoms, such as a stuffy nose, cough, and sore throat.

“People whose sleep was disturbed were much more likely to develop colds than people who went to sleep, slept all night, and got up in the mornings,” said Cohen.

Study subjects who had less than seven hours of sleep were at greater risk than those who got eight hours of sleep a night. And those with lower sleep efficiency—the amount of time they spent in bed asleep—were at higher risk too. People with a sleep efficiency of less than 92% had a 5.5-times greater risk of developing a cold than those with a 98% or more sleep efficiency.

“If an eight-hour sleeper lost as little as 10 minutes of sleep a night, they could be three and a half times more likely to get colds; if they lost as much as 40 minutes of sleep on an average night, they were over five times as likely to get a cold,” said Cohen.

Next: Why insomniacs shouldn’t worry

The researchers don’t know why less sleep is associated with a greater susceptibility to colds. They believe that sleep deprivation or sleep disturbances may affect the immune system’s ability to function at an optimal level.

David Rapoport, MD, the director of the sleep medicine program at New York University School of Medicine, says the study is interesting and adds to a large body of research on the interaction between sleep and the immune system.

“Many of the molecules and substances that circulate in body and also within cells overlap between immune function and sleep,” he says. “There are parallel paths here, so it’s not at all surprising that they affect each other.”

He notes that it’s a two-way street: When you’re sick, you often feel a greater need to sleep.

“Everybody knows that when you’re sick, you sleep. Likewise, when you don’t sleep, that seems to—according to grandma—make you more susceptible, and this study is along those lines. So it’s not totally out of left field to find these relationships,” he explains.

However, relying on the volunteers to recall how much they slept tends to be a relatively inaccurate way to measure sleep time, so it’s hard to say if 10 minutes of lost sleep would really make a difference, he says.

And insomniacs shouldn’t add “catching a cold” to their list of things to worry about when they’re tossing and turning.

“Insomniacs worry a lot and the last thing you want to do is add to their worries,” Dr. Rapoport says. “You can’t quite jump from the conclusion that people who get less sleep who were selected from a relatively healthy population will have exactly the same effects as people who have a chronic condition that limits the amount of sleep they get.”

Related Links:How Not to Get Sick at Any Age6 Feel-Better Products for Cold and Flu SeasonHow to Use Steam to Fight a ColdEchinacea: Effective Cold Remedy or Just a Waste of Money?