Everyone it seems is coming down with a nasty cold. ‘Whether it’s a bad strain of the common cold or a resurgence of Covid, it’s too soon to say, but I’m already running low on stocks of cold and flu remedies,’ says Sid Dajani, a community pharmacist in Southampton.
‘While colds tend to become more common in the autumn anyway, the surprise is that the numbers of people for help with symptoms including chesty coughs, high temperature and streaming noses is at least double what’s normal at this time of year.’
Official figures bear this out: cases of rhinovirus infections – the main cause of the common cold – jumped by a third in the week to September 22, according to the UK Health Security Agency (UKHSA). And a new strain of Covid-19, XEC, which first appeared in Germany in June, has now spread throughout Europe and the US, with cases increasing to 11.8 per cent of those tested, compared with 9.1 per cent in the previous week.
While flu cases remain low, they are likely to soon rise quickly too as temperatures plummet, nights get longer and people stay indoors.
‘Wearing a mask may help reduce the likelihood of you transmitting your respiratory virus to other people and may offer some protection to you the wearer, too,’ says Professor Oxford
The government’s decision to delay flu jabs this year may fuel the rise. Last year, the vaccination scheme for people aged over 65, those in care homes and with long-term health conditions started on September 11 – this year, it was rolled back to October 3, which could leave some people vulnerable to infection before the jab has a chance to boost their immunity, which can take one or two weeks.
‘It is a balancing act,’ says Ron Eccles, emeritus professor at Cardiff University and former director of the Common Cold Centre. ‘Flu vaccines can wane in strength towards the end of the winter. You don’t want to have them too late, so you aren’t protected as the flu season – which varies every year but typically runs between October and March in the UK – begins, and you don’t want to have them too early so you are vulnerable in the spring.’
The current rise in respiratory infections, he says, is due to a collection of things such as kids going back to school and spreading bugs ‘as well as the very wet weather which has kept everyone indoors in close proximity to one another’. Professor Eccles, a regular babysitter to his five grandchildren ranging in age from 18 months old to ten years old, is currently suffering from the sniffles.
Ron Eccles, emeritus professor at Cardiff University and former director of the Common Cold Centre
Colds and flu are spread by particles of the virus usually in a droplet of mucus from someone who is infected and coughs or sneezes, he explains.
‘But you can also get them from touching surfaces that have been contaminated with these droplets [the viruses can survive for a few hours outside the body] and then touching your mouth, nose or eyes.
‘The viruses can attach to cells at the back of the nose, and that’s where you’ll often get the first signs of infection – a sore or tickly throat, for instance.’
Covid also spreads easily via tiny droplets in coughs and sneezes – and to a lesser extent, touching an infected surface, says Professor Eccles.
Symptoms of XEC appear to be the same as with previous Covid variations, including a high temperature, aches and pains, tiredness and a cough or sore throat.
And then there’s respiratory syncytial virus (RSV), which is transmitted by droplets and coming into contact with secretions such as mucus from with an infected person. The rate of transmission of the RSV virus, which can survive on surfaces or objects for up to seven hours, has risen slightly, according to the latest UKHSA figures.
This causes symptoms such as a runny nose and congestion, reduced appetite, coughing, sneezing and a fever.
‘Don’t underestimate RSV, which is a serious and widespread pathogen every winter which can make babies and older adults seriously ill,’ says John Oxford, emeritus professor of virology at Queen Mary, University of London. He points out that adults aged from 75-79 are now being offered (since 1 September 1 2024) a new RSV vaccine which ‘is excellent news both for them personally and for A&E doctors who would have to treat them in hospital if their symptoms were severe’.
Any respiratory virus has multiple obstacles to overcome in order to enter the body and cause an infection, says Professor Oxford. ‘First it has to run the gauntlet of the cilia, tiny hair-like cells dotted throughout the nasal cavity which move in a rhythm to sweep mucus and viruses away down the throat and swallowed out of harm’s way.’
Even those viruses that do reach the upper respiratory tract – the nose, mouth, throat and voice box – face another obstacle, as the cells lining these airways are so tightly bonded together, they usually provide an impermeable seal.
‘These cells also have sensors on their surface which detect the presence of hostile viruses and rapidly send messages to the cell to produce cytokines, chemical messengers that call in help from white blood cells and can also destroy the viruses themselves,’ says Professor Oxford.
‘However, when we are over-tired, stressed, or our immune systems are weaker than normal, cytokine production reduces, and white blood cells are less effective.’
Simple hygiene measures can help as Professor Oxford explains: ‘I advise washing your hands using soap and water at regular intervals such as when you come home from work or before you eat.’
And don’t just shake them dry.
‘Always dry your hands carefully because wet hands are more likely to spread germs such as bacteria and viruses than dry ones,’ he adds.
Towels should also be washed regularly. Studies show that damp towels that are not washed frequently can harbour bacteria and virus infections. According to Professor Oxford towels should be washed after ‘three or four uses’.
And avoid rubbing your eyes. ‘Virus particles can invade the body through the tear ducts and conjunctiva, the thin, clear membrane that protects your eye, so avoid rubbing your eyes with your hands, which can transmit infection,’ says Professor Oxford.
John Oxford, emeritus professor of virology at Queen Mary, University of London
‘Wearing a mask may help reduce the likelihood of you transmitting your respiratory virus to other people and may offer some protection to you the wearer, too,’ says Professor Oxford.
Professor Eccles says he would wear a mask in public to prevent transmitting his bugs to other people if he was coughing and sneezing.
Social distancing can help reduce the likelihood of spreading respiratory infections including Covid, flu and colds but it can be impractical, says Professor Eccles. ‘If you are in a crowded train on your way to work, how are you going to move away from someone who starts coughing and sneezing?’
The ‘safe’ distance you can keep between yourself and someone who is the throes of a respiratory infection is six feet, according to the Centers for Disease Control in the US. However, a 2014 study published in the Journal of Fluid Mechanics suggests this distance may need to be much greater for smaller airborne particles – mimicking sneezes they showed that smaller droplet particles travelled as far as 2.5 meters horizontally through the air. That’s more than eight feet.
How long before you have symptoms?
COLD AND FLU
INCUBATION PERIOD: For colds and flu it’s 12 hours to three days after becoming infected with either type of infection.
HOW LONG ARE YOU INFECTIOUS? From one or two days before symptoms start, up to 14 days after symptoms start.
You are most infectious in the first three days of symptoms starting, then gradually less so as your immune response kicks in.
HOW LONG DOES IT TAKE TO RECOVER? ‘The symptoms of flu usually develop one to three days after becoming infected,’ says Professor Eccles. ‘Flu symptoms can last a week or longer depending on the severity of the symptoms and a cold usually takes one to two weeks to recover from completely.’
Covid-19
INCUBATION PERIOD: Between two and 14 days. The reason Covid spread so effectively was that people were infectious before they developed symptoms – and that’s still the case, says Adam Kucharski, a professor of infectious disease epidemiology at the London School of Hygiene & Tropical Medicine.
‘People might worry when they hear someone with a lingering cough in a public space, but by that stage it might be the tail end of their infection and the amount of virus coming out – if any – is lower.’
HOW LONG ARE YOU INFECTIOUS? This varies depending on the immunity you have (e.g. from vaccination or prior infection) – some people are no longer infectious after five days, but others can be infectious for up to ten days, according to the NHS.
HOW LONG DOES IT TAKE TO RECOVER? Most people feel better within a few days and make a full recovery within three months.
RSV
INCUBATION PERIOD: Around three to five days.
HOW LONG ARE YOU INFECTIOUS? RSV is infectious as long as you have symptoms, which is between three to eight days, but you may be able to spread the illness in a day or two before your develop symptoms.
HOW LONG DOES IT TAKE TO RECOVER? Normally one or two weeks but it can take longer for people with compromised immune systems, including children under the age of five and adults over the age of 65.
How can I tell if it’s flu, a cold, Covid or RSV?
Common cold symptoms tend to come on quickly and may include a streaming nose, sore throat, coughing and sneezing, explains pharmacist Sid Dajani.
‘It lasts less time and is less debilitating than flu. If someone comes into my pharmacy and says they have flu, I suspect they have a common cold because flu really floors you and you struggle to get out of bed for a few days.’
Professor Eccles adds that it can be hard to tell apart the symptoms of the common cold, RSV and Covid as they can all lead to coughing and sneezing, fever and shortness of breath. ‘However,’ he says. ‘Covid can uniquely lead to a loss of taste and smell, although not everyone with Covid is affected. It may also cause problems such as vomiting and diarrhoea.’
RSV in healthy people might look like a cold or a mild case of Covid. But for children and people over 65, a telltale sign of a potential RSV infection is that a patient may develop wheezing or has asthma symptoms which get worse quickly.
Pills and sprays to stop yourself getting ill (and what to take if you do…)
By CAROLINE JONES
UK adults succumb to an average of two to three cold viruses each year – and there’s still no cure.
‘A cure is elusive because colds are caused by over 200 different viruses, so it’s complex to eliminate,’ says Professor Ron Eccles, a virus expert and founder of the Common Cold Research Centre.
However, there are some simple home remedies that research has found can help.
SEAWEED NASAL SPRAY
Carrageenan – a seaweed extract used in some nasal sprays – has been shown to reduce the symptoms and duration of the common cold and may even prevent catching one.
Professor Eccles has conducted clinical trials on Boots Dual Defence Nasal Spray (which contains carrageenan) and found using it can shorten the duration of the cold by two days.
‘Carrageenan works by trapping cold viruses and reducing their spread, but to be effective you need to use it at least three times a day and within 48 hours of the first symptoms,’ he explains.
This was confirmed by a review of existing studies, which concluded nasal carrageenan sprays may increase the rate of recovery by 54 per cent, reported the journal Pharmacology Research & Perspectives in 2021.
Professor Eccles adds: ‘It could also be useful in preventing colds because of these antiviral effects.’
Try: Boots Dual Defence Nasal Spray, £6.25 for 20ml
ZINC AND VITAMIN C
It’s not yet clear how zinc targets the cold virus, but it is often taken in combination with vitamin C
A review of research on supplementing zinc by the respected Cochrane group earlier this year concluded that if zinc was taken within 24 hours of the onset of cold symptoms, it reduced the duration by an average of two days.
It’s not yet clear how zinc targets the cold virus, but it is often taken in combination with vitamin C as some studies suggest the ascorbic acid in the latter can help boost zinc absorption.
Separately, a review of ten studies on the impact of vitamin C on colds, by the University of Helsinki in Finland, found that when compared with a placebo, vitamin C supplements decreased the severity by 15 per cent.
‘Research shows that vitamin C supports our cells’ barrier function, which is important for keeping out bacteria and viruses,’ says Aidan Goggins, a pharmacist and independent advisor to the supplements industry.
You can get vitamin C from eating fruit and veg, including citrus fruits, berries and peppers, or take a supplement. Aidan Goggins recommends doses of 500-1000mg vitamin C and zinc 10mg to 40mg.
Try: Holland & Barrett High Strength Effervescent Vitamin C & Zinc, £3.49 for 20.
ELDERBERRY
The purple berries of the elder tree contain anthocyanins [the pigment that give the berries their purple colour] and polysaccharides [a kind of starch], that research has shown can help fight respiratory infections, says Aidan Goggins.
‘They bind to the proteins on the surface of cold and flu viruses, which inhibits their ability to flourish within the body.’
Meanwhile, a 2019 review of research into elderberry, by the US Franklin Institute, found the extract was effective in reducing the duration and severity of flu symptoms.
Try: Sambucol Immuno Forte Black Elderberry, £11.50 for 120ml, hollandandbarrett.com
VITAMIN D
Sambucol could help with flu symptoms
Figures show 40 per cent of Britons are deficient in vitamin D, which has been linked to a weakened immune system.
And taking a supplement could help ward off cold and flu – a 2017 review by Queen Mary University of London, found that taking extra vitamin D protected against respiratory tract infections, with the strongest impact in those who had a serious deficiency.
Meanwhile, a 2020 study led by Dr Eamon Laird, a vitamin D researcher at Trinity College in Dublin, found that vitamin D could help people fight off respiratory infections including Covid, colds and flu. ‘There’s good evidence that supplementing vitamin D can as much as halve the risk of chest infections, particularly in older adults who typically have low levels.’
Try: Healthspan Vitamin D3 10ug, £9.99 for 240 tablets, healthspan.co.uk
PELARGONIUM
Dubbed as a natural antiviral, pelargonium – the root of a South African species of geranium – is thought to prevent the viruses responsible for respiratory infections from attaching to the cells inside our nose, according to a 2007 lab study by Berlin University in Germany.
There are now almost 30 published clinical trials which suggest this herbal plant extract can reduce the severity and duration of colds.
‘My family and I are fans of pelargonium – I suggest patients try this herbal remedy at the first sign of a cold,’ says Dr Simon Chapple, a GP based in Shropshire.
Not only has it been shown in research to alleviate symptoms including coughs and a blocked or runny nose, but it is mentioned in NICE guidelines for self-care that pelargonium has ‘evidence of some benefit for the relief of cough symptoms’.
Try: Centoreze, £10.95 for 21 tablets, centoreze.co.uk
GARLIC
Research suggests the clinically effective dose is around 600-900mg, which is equal to just under one clove of garlic per day. But if you can’t stand the taste, you could try a supplement.
‘These should be taken with a meal, as eating lowers the over-all acidity level of the stomach and means more of the active ingredient survives,’ says Aidan Goggins.
Try: Vitabiotics Ultra Garlic, £6 for 60 tablets, hollandandbarrett.com
What to eat to beat winter bugs
By Dr EMILY LEEMING, microbiome scientist and dietitian
Your diet can make a significant difference to your chances of getting a cold or the flu. That’s because good nutrition helps strengthen the immune system, making it more effective at fighting off infections.
So what should you be eating and drinking now to stay healthy? These are the foods that science shows can really make a difference.
Black beans: Your gut microbiome, the community of over 100 trillion tiny organisms that live in your digestive system, is constantly interacting with your immune system, with 70 per cent of your immune cells found in your gut.
A healthy microbiome is essential for defending against infections – and one of the best ways to support it is through your diet, particularly by eating fibre from plant foods and the polyphenols – or antioxidants – that give many fruits and vegetables their colour and that feed your ‘good’ gut bacteria. Black beans are packed with both. Blend beans into a dip, add to stews, pastas and soups.
Mushrooms: During the colder months, it’s hard to get enough immune-supporting vitamin D. Around 20 per cent of Brits are low in this key nutrient in winter and spring (our bodies manufacture vitamin D via exposure to UV light). It’s difficult to get enough vitamin D from food alone, which is why the advice is to take a supplement from October to March. You can further boost your vitamin D levels with mushrooms (though you’ll still need a supplement). And when mushrooms are exposed to UV light, they naturally produce more vitamin D, regardless of the season. In winter, even though the sunlight is weaker, leaving mushrooms by a sunny window gill-side up for 1-2 hours can still significantly boost their vitamin D content, according to a review published in the journal Nutrients in 2018.
Fermented foods: Regularly eating these could help protect against colds and flu, according to a 2021 study published in the journal Cell. This found that six servings of fermented foods a day boosted the diversity of the participants’ gut microbiome (a sign of a healthy gut community) and lowered markers of inflammation (which should help your body fend off colds or flu). If six servings seems overwhelming – and it does seem like a lot – having one or two fermented foods a day is likely to help over the longer-term. Try yoghurt, kefir, kombucha, beet kvass (a sparkling fermented traditional Ukrainian drink) sauerkraut and cottage cheese.
Covid spreads easily via tiny droplets in coughs and sneezes – and to a lesser extent, touching an infected surface, says Professor Eccles
Garlic: One study, published in the journal Advances in Therapy in 2001, found that garlic could help ward off colds. Participants who took a daily supplement of allicin – the active ingredient in garlic – for three months over winter had fewer colds and recovered faster than those who didn’t. As raw garlic contains more allicin than cooked, try blending garlic into pesto or adding it raw to dressings for maximum benefits.
Blueberries: A review of studies published in 2016 in the journal Advances in Nutrition found that eating plenty of flavonoids, a group of plant compounds with antioxidant properties found in blueberries, dark chocolate and parsley, is linked to a 33 per cent lower likelihood of catching upper respiratory tract infections such as the flu and the common cold. Flavonoids work with your immune system in many ways, for example protecting immune cells from damage and helping them communicate with each other.
Green tea: This is rich in catechins, powerful antioxidants which may explain why drinking tea (either green or black tea) regularly is linked to a 30 per cent lower risk of catching a cold or flu, according to a 2021 review of studies published in the European Journal of Nutrition. Black tea is also high in catechins, though not as much as green tea.
If you’ve already been struck down with a cold or flu, then drinking warm fluids such as tea not only soothes a sore throat, but also makes swallowing easier by relaxing the muscles.
Oranges: Last but not least, don’t forget oranges with their high vitamin C content. Vitamin C is a powerful antioxidant that supports the immune system. One orange provides most of your daily vitamin C needs, but they aren’t the only vitamin-C rich food – you’ll get the same amount as in orange from ½ cup of orange juice, one kiwi or ¾ cup of broccoli.
