似乎永不休止的感冒 爲什麼一直不見好轉大綱

About a Month ago Sharon Gilbert was hit with a runny nose, sore throat and a cough. The whole snotty works.

大約在一個月前，莎倫·吉爾伯特(Sharon Gilbert)出現了流涕、咽喉疼痛、咳嗽等一系列令人煩惱的症狀。

A few weeks later she thought she had recovered. Then her husband Derek got sick, and bam. 'Suddenly I started getting all the symptoms [again] and it was worse,' said Ms. Gilbert, a 61-year-old writer in Charleston, Ill.

幾個星期後，她覺得自己已經康復了。可是，接下來她的丈夫德里克(Derek)又病了，而且猛地一下，“突然間我開始（再次）出現所有的症狀，而且這次更嚴重了，”吉爾伯特說道。今年61歲的她是伊利諾伊州查爾斯頓(Charleston)的一名作家。

In the winter that seems to have no end in many parts of the country, people like Ms. Gilbert have been plagued with the seemingly everlasting cold.

在美國衆多冬季似乎沒有盡頭的地區，像吉爾伯特這樣的人一直受到似乎永不休止的感冒的折磨。

That's partly because the common cold can last longer than many people think -- up to two weeks for the principal symptoms and perhaps weeks more for a cough that lingers even after the virus has been cleared away. There's also the possibility of secondary infections such as bacterial sinusitis.

一部分原因是，普通感冒的持續時間要比許多人所認爲的更長——主要症狀會持續長達兩週時間，至於在感冒病毒已被清除後仍久不見愈的咳嗽，它可能要再持續幾周時間。此外，患上細菌性鼻竇炎之類的繼發性感染的可能性也存在。

And some patients might get back-to-back colds, doctors say. It isn't likely people will be reinfected with the same virus because the body builds some immunity to it. But people can pick up another of the more than 200 known viruses that can cause the common cold, some of which are worse than others.

醫生說，有些患者或許會連續患感冒。人們不大可能會重新感染同一種病毒，因爲人體已對它形成了一定的免疫力。然而，能引發普通感冒的已知病毒有200多種（有些病毒比其他更厲害），人們還是會感染上其中一種。

'When you hear people who have the cold that 'won't go away,' those are typically back-to-back infections of which we see a lot of in the cold weather when people are cohorting together,' said Darilyn Moyer, a physician at Temple University Hospital and chairwoman-elect of the American College of Physicians Board of Governors.

天普大學醫院(Temple University Hospital)醫生、美國醫師協會(American College of Physicians)理事會候任主席達爾琳·莫耶(Darilyn Moyer)說：“如果你聽到別人得了‘永不見好’的感冒，那通常就是連續性感染，這種情況在人們常窩在一起的寒冷季節較多見。”

Influenza may get all the attention, but the common cold is the leading cause of doctor visits, according to the National Institutes of Health. Each year, people in the U.S. get about one billion colds, and 22 million school days are lost to the stubborn viruses.

美國國家衛生研究院(National Institutes of Health，簡稱“NIH”)稱，流感吸引了人們所有的注意力，但普通感冒纔是人們就醫的首要原因。美國每年約有10億人次得感冒，學生們因頑固的感冒病毒共停課2,200萬天。專家們說，成年人每年平均患兩到五次感冒，學齡兒童的感冒次數則多達七到10次。老年人感染病毒的次數往往較少，因爲他們已經形成了對多種病毒的免疫力。與兒童生活在一起或者工作中與兒童接觸的成年人感冒較多。

Experts say adults on average get two to five colds a year; school children can get as many as seven to 10. The elderly tend to get infected less because they've built up immunity to many viruses. And adults who live or work with young children come down with more colds.

對此我是深有體會。最近一個多月來，我們家似乎就在玩討厭的感冒傳遞遊戲。我的丈夫得了感冒，又持續咳嗽了幾周時間，我們懷疑他又傳染給了我們幼小的孩子。最後我也倒下了。

Don't I know it. For more than a month now my family seems to be playing a game of pass-the-nasty-cold. My husband had a cold and lingering cough for weeks, which we suspect he gave to our infant. Finally I succumbed.

我們認爲我們上幼兒園的孩子是各種病菌的傳播者。就在我們大家逐漸康復時，孩子開始上日託了，把某種病毒帶回了家，於是我們全都開始了新一輪明顯與第一次不同的感冒。

We blamed the purveyor of all germs, our kindergartner. Just as we were all recovering, the infant started day care and brought home a virus and we're all on round two of apparently a different cold.

專家指出，病菌攜帶者——在我們家則是我們上幼兒園的孩子——有可能會將病菌傳染給別人，而自己不會出現症狀。

Experts say it's possible that the carrier of germs -- in this case our kindergartner -- can infect others without having symptoms himself.

威斯康星大學麥迪遜分校(University of Wisconsin-Madison)分子病毒學研究所(Institute of Molecular Virology)的研究員安·帕爾門伯格(Ann Palmenberg)說：“在任何時候，要是我們用棉籤擦拭你的鼻子，大概都能發現它裏面存在着五種不同的鼻病毒，但是你也並沒有生病。”鼻病毒是引發普通感冒最常見的病毒，佔成年人感冒誘因的30%至50%，而且它的種類超過了150種。

'At any given moment if we were to swab you. . 'd probably come up with five different rhinoviruses sitting in your nose but you're not sick,' said Ann Palmenberg, a researcher at the Institute of Molecular Virology at the University of Wisconsin-Madison. Rhinovirus is the most common viral cause of the common cold, accounting for 30% to 50% of adult colds, and there are more than 150 strains of it.

帕爾門伯格博士指出，鼻病毒附着在細胞間黏附分子(ICAM)受體上以便進入壁細胞，在該受體張開時，人們纔會感染病毒。

To get infected, the so-called ICAM receptors, which the rhinovirus attaches to in order to enter the nasal cells, need to be open, Dr. Palmenberg said.

她說：“鼻病毒一直都存在，問題在於你什麼時候會變得易受感染。”壓力、缺乏睡眠和總體的健康狀況等因素會使人們更容易感染。研究人員已發現了鼻病毒的150多種菌株或基因類型，他們相信可能還存在更多。病毒在上呼吸道區體溫相對較低的環境（如鼻通道、鼻竇和咽喉）中複製最快。

'Rhinos are out there all the time, it's just a question of when you are susceptible,' she said. Factors such as stress, lack of sleep and people's overall health can make them more likely to get infected. More than 150 strains or genotypes of the rhinovirus have been identified and researchers believe there are probably many more.

其他病毒（如較少見的腺病毒）能在上呼吸道與下呼吸道自我複製並附着在受體上，引發更嚴重的疾病。

Rhinovirus replicates best in the relatively lower body temperatures of the upper respiratory area, such as the nasal passages, sinuses and throat.

包括冠狀病毒、呼吸道合胞病毒和腸道病毒在內的其他病毒也被確認會引發感冒症狀。NIH的分支、美國國家過敏症與傳染病研究所(National Institute of Allergy and Infectious Diseases)主任安東尼·福西(Anthony Fauci)說：“最令人困惑的事情是，還有20%至30%成年人普通感冒病症的原因未查明。”

Other viruses, such as the less-common adenovirus, can replicate and attach to receptors in the upper and lower respiratory tracts, causing a more serious illness.

有些情況下，似乎永不休止的感冒可能是更嚴重病症的信號。感冒有可能引發鼻竇感染、支氣管炎或肺炎，而有時候感冒症狀又會被誤認爲是季節性過敏。

Other viruses -- including the coronavirus, respiratory syncytial virus and enterovirus -- have also been identified as causing cold symptoms. 'The most confounding thing of all is that we still haven't identified the cause of 20% to 30% of adult common colds,' said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health.

醫生指出，感冒之後持續的乾咳通常是由支氣管高反應性或氣管感染造成的。天普大學醫院的莫耶醫生說：“你的呼吸系統經歷了感染後，基本上你會出現暫時性的哮喘，你的支氣管反應會非常劇烈，感染和炎症也會很嚴重。”

Sometimes a cold that never seems to end could be a sign of something more serious. A cold may result in a sinus infection, bronchitis or pneumonia. And cold symptoms are at times confused with seasonal allergies.

去年發表於《家庭醫學年鑑》(Annals of Family Medicine)的一篇論文對多項不同研究進行了綜述，它發現咳嗽平均持續18天左右。該研究還指出，針對近500人的調研發現，大多數調研參與者認爲咳嗽症狀應該會在一週左右後消失，並相信醫生開給他們的抗生素對他們有幫助。（實際上是大大的不可能！）

A usually dry cough that lingers after a cold is typically due to bronchial hyperreactivity or tracheal inflammation, doctors say. 'After you go through an infection in your respiratory system, you can almost have a transient form of asthma where your bronchial tubes are very highly reactive and very irritated and inflamed,' said Dr. Moyer, of Temple University Hospital.

有些專家認爲，在感染了一種感冒病毒、免疫系統減弱後，你會更容易感染另一種病毒。這是因爲當你感冒時你鼻內的上皮襯裏會變弱，充當保護屏障的黏膜受損後可能更易於感染另一種病毒。

A review of various studies, published last year in the journal Annals of Family Medicine, found that coughs on average last about 18 days. The report also said a survey of nearly 500 people found that most participants expected a cough should disappear in about a week and believed antibiotics from their doctor would help them. (A big no-no!)

但是，另一些專家則持有不同看法。NIH的福西醫生說，干擾素之類的蛋白質（在感冒期間分泌以幫助抵抗病毒）可能會提高對感染第二種病毒的抵抗力。

Some experts believe having one cold virus and a weakened immune system could make catching another virus easier. Because the epithelial linings in the nose are weakened when you have a cold, the broken down mucus-membrane barrier may be more prone to picking up another virus.

那麼，我們能做些什麼來防止感冒或縮短感冒時間？幾乎每個人都認識一些深信服用紫錐菊、鋅或吞下大量維生素C有效的人。

But others suggest that proteins such as interferons, which are secreted during a cold to help fight the virus, may also boost resistance to getting infected by a second virus, according to Dr. Fauci, of the NIH.

然而，醫生指出，沒有確鑿的證據能證明這些療法有效。有些研究指出，運動和冥想可能有助於防止感冒。

What can a person do to prevent or shorten a cold? Nearly everyone knows someone who swears by taking echinacea or zinc or downing packs of vitamin C.

好消息是，春天來臨了（至少名義上如此），冬季最糟糕的寒冷時節就要結束了。不過，到了夏天，又會有新一批的病毒出現，你也許會發現自己又和討厭的夏季感冒碰面了。