By Josiah Child MD
Over the last two months, we have seen a virtual tsunami of upper respiratory illness, including influenza A, influenza B, metapneumoviruses, COVID19, non-COVID coronavirus, rhinovirus, and Respiratory Syncytial Virus or RSV. How do we keep this onslaught of viruses – and their accompanying annoying symptoms – from ruining our winter? Here are some answers to the questions we get every day from our patients at Cloudberry.
Why does my nose get runny and stuffed up when I’m sick?
In an attempt to protect from infection, the body produces its own personal protective gear: snot. Made up of defensive enzymes, peroxidases, lysozyme and lactoferrin white blood cells, and immunoglobulin A (IgA) antibodies, our snot is our first line of defense against infection of the posterior nasal pharynx. In addition, white blood cells in the back of the nose secrete neutrophil extracellular traps (or NETS), which makes mucous secretions thick, creating a biomechanical barrier against further infections. Snot also helps the body secrete white blood cells that have died in their fight against invading organisms.
What does the color of snot indicate?
To some extent, the snot color indicates the nature of the infection. In general, a bit of a runny nose is a sign of a healthy immune system, while a good green river is an indication of a pitched battle. Children produce more snot than adults not only because they have more infections but also because they have a healthier immune system.
Can I regulate my nasal immune system?
Surprisingly, your taste receptors are extraordinary regulators of your upper airway immune response. Honey stimulates the sweet receptors resulting in temporary relief of sore throat pain, while bitter receptors in the mucous escalator provide greater protection. You can try increasing nasal secretions by gargling with coffee, chocolate or other bitter tasting substances. This stimulates the bitter taste receptors in the back of the nose, providing increased nasal secretion, innate immunity response, and secretory IgA.
Do antiseptic mouthwashes fight infection?
In general, yes. However, timing is critical. A number of papers were released during the COVID pandemic showing the efficacy of infection prevention with antiseptic mouthwashes, everything from chlorhexidine to povidone/iodine to alcohol. Two caveats however: 1) Alcohol has been shown to be carcinogenic to the back of the mouth and, 2) To be effective, your antiseptic gargle must happen at or very near the time of exposure. So perhaps there is a reason to bring a flask to your winter party!
When should I consider antibiotics?
Bacterial infections usually only happen after prolonged blockage and discomfort. So, if after aggressive use of nasal decongestants, washings and possibly steroids the blockage and pain aren’t going away, we would consider taking a culture and prescribing antibiotics.
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