Cut your risk of colds.

In the June issue of InsideMS we celebrated the research achievements of DI: William A. Sibley, who conducted an 8-year study showing that up to one-third of MS attacks follow a viral upper respiratory tract infection--such as a common cold. These results provide some certainty about one of the ways in which MS does its dirty work Dr. Sibley was given the John Dystel Prize for MS Research last May.

The catch for people living with MS is that no one knows which of the 200-odd cold viruses provoke an MS attach. Is there anything people can do to avoid catching a cold? Dr. Julie Mangino, an infectious diseases physician at the Ohio State University Medical Center, offers a professional perspective.

Hand hygiene is number one

The most important prevention for a common cold is hand hygiene. Viruses go from person to person on the hands. This means using soap and water or one of the excellent alcohol-based hand sanitizers now on the market. There are three or four of them and they are extremely useful for decreasing the spread of viruses.

Hand washing sounds simple, but many people don't do it very well. Soap and water kill most microbes in about 15 seconds, but that's longer than we think. Turn on the water and soap your hands for two choruses of "Row, row, row your boat." Then, avoid touching the faucet, because you'll immediately recontaminate your clean wet hands. Use your elbow, forearm, or a paper towel to turn the water off. By the way, there is no evidence that those orange "anti-bacterial" soaps are more effective than ordinary soap.

It is important to match method to the situation. You need hand-washing with soap and water when your hands are visibly dirty, after you've been to the bathroom or changed a diaper, and before you eat or prepare food. You can use an alcohol-based hand sanitizer for all those other occasions when you've handled something suspect. Keep a little bottle on your desk, in your bag or briefcase, and in your car. No water or rinsing are required. They used to be rather drying because of the alcohol, but manufacturers have since added an emollient to reduce that effect, leading to improved skin integrity for those who wash often.

Cough etiquette breaks the cycle Good cough etiquette will help stop a cold virus from circling around the office, school, or family. Break the cycle. Never cover a cough with your hands! You'll touch things and spread these germs to others. Use a tissue, just as you would for a sneeze, and toss it out right away. If you don't have a tissue, cough into your elbow. You aren't going to pick up any object with the inside of your elbow and it's unlikely that anyone will touch you there.

Get a flu shot every fall

The flu is not an ordinary viral cold. Flu can cause very high fevers, which can provoke a spike in MS symptoms, as well as muscle aches and a general "knockdown" for a few days. Talk to your doctor because protection from flu may spare you other infections, too. Germs tend to travel together. Flu vaccine is considered safe for people with MS; however, FluMist nasal spray is not recommended for people with MS.

Keep your bugs to yourself

If you or someone in your family does get a cold, stay home while the cold is active. Even if you feel energetic, take a sick day. Discourage visitors. And ask anyone who has a cold to postpone planned get-togethers with you. My hospital asks visitors who have colds to wear masks and wash their hands to prevent them from giving their virus to others.

Clean your telephone

Your telephone receiver may be a vector for transmitting viruses to anyone who uses it. Clean it with a household spray cleaner at least once a week.

Healthy living helps too

Finally, avoid colds with general good health habits. Don't smoke. Get adequate rest. Drink plenty of water. Eat fruits and vegetables every day. And learn some relaxation techniques to keep stress in check. See www.niaid.nih.gov/factsheets/cold.htm for more details on the common, but not very simple, cold.

Julie E. Mangino, MD, is an associate professor of Internal Medicine and the medical director, Department of Clinical Epidemiology, at Ohio State University Medical Center.