Medicine: The Uncommon Cold

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The U.S. Public Health Service announced last week an all-out effort to conquer some of the assorted sniffles, coughs and other discomforts generally but misleadingly known as the "common cold." The core of the program, said Surgeon General Luther L. Terry, will be to develop and test vaccines against viruses already known to cause many of the infections that afflict the average American three or more times a year, keep an estimated 125,000 workers (and probably even more schoolchildren) at home every day, cost industry about $3 billion a year, and spur the sale of at least $100 million worth of tablets, drops, sprays, gargles and unguents.

It was not the first time that PHS had launched such a "fight to the finish'' against these ailments. But when it did so in 1946, many doctors expected to find a single "common cold virus," or only a few of them. With $50,000 a year for research, PHS hoped to solve the problem in five years. But the problem has proved to be nowhere as simple. Now millions have been spent, and of 100 to 120 different viruses under suspicion, about half have been convicted. Most importantly, it has become clear that one virus can cause what looks like many different diseases, and what looks like one disease can be caused by many different viruses.

Runny Nose or Flu? "We've got to stop talking about the common cold as a specific disease, peculiar to man, and caused by a single virus which does not engender lasting immunity," said Dr. George Gee Jackson. He bases his conclusion on the more than 2,500 volunteer cold-catchers that he has studied at the University of Illinois, and is now working on the PHS vaccine project. "What we have is a whole gamut of respiratory infections. A single virus, even the Asian flu virus, may give one person only a runny-nose sort of 'cold,' and give somebody else a severe case of influenza. It depends on the individual's previous history, present health, age, and the size of the virus dose he is exposed to."

Dr. Robert J. Huebner, head of PHS's laboratory for infectious diseases, said: "We have to define the problem as 'acute respiratory disease, upper and lower.' The 'upper' refers to disease at the level of the larynx or above, such as laryngitis, nasal pharyngitis and simple rhinitis. 'Lower' covers tracheitis, bronchitis and pneumonitis. Then we have to identify them further as mild, moderate or severe, and as with fever or without."

Children have five times as many acute respiratory diseases as adults, said Dr. Huebner. This is presumably because young children have no defenses against the viruses. Healthy adults, it is now believed, can usually stage an antibody counterattack to keep the virus from running wild.

Ten Viruses & a Microbe. Since the commonest victims of acute respiratory disease-ARD in medical jargon-are children, the PHS's vaccine program will be tailored for them. The first vaccines will be made from ten viruses-respiratory syncytial virus (the most important), three types of parainfluenza virus, six of adenovirus-and one non-viral microbe, the "Eaton agent" (TIME, Nov. 10). Together, these microbes are estimated to cause 60% of ARD cases judged to be severe enough to send most children into hospitals.