Using hypertonic saline nasal drops can reduce the duration of the common cold in children by two days, according to a study to be presented at the European Respiratory Society (ERS) Congress in Vienna, Austria. [1]They can also reduce the transmission of colds to other family members.
The results of the ELVIS-Kids randomised controlled trial were presented by Professor Steve Cunningham, from Child Life and Health at the University of Edinburgh (UK).
“Children suffer up to 10 or 12 upper respiratory infections, what we call colds, a year, which has a huge impact on them and their families. There are medications to improve symptoms, such as paracetamol and ibuprofen, but there are no treatments that can make a cold get better faster,” she said.
ELVIS-Kids lead investigator Dr Sandeep Ramalingam, consultant virologist at NHS Lothian, Edinburgh, UK, had observed that people in South Asia commonly use saltwater solutions as nasal irrigation and gargling to treat a cold and wanted to explore whether this clinical benefit could be replicated in a large-scale study.
The research team recruited 407 children up to the age of six for a study in which they were given either 2.6% hypertonic saline (salt water) nasal drops or usual care when they came down with a cold. In total, 301 children came down with a cold; for 150 of them, their parents were given sea salt and taught how to prepare and apply salt water nasal drops to the children’s nose (three drops per nostril, a minimum of four times a day, until they recovered); and 151 children received usual cold care.
Professor Cunningham said: “We found that children using saltwater nose drops had cold symptoms for an average of six days, while those receiving usual care had symptoms for eight days. Children receiving saltwater nose drops also needed less medication during their illness.
“Salt is made up of sodium and chloride. The cells lining the nose and tracheas use chloride to produce hypochlorous acid within the cells, which then use it to defend against viral infection. By providing extra chloride to the cells lining the nose, the cells are helped to produce more hypochlorous acid, which helps suppress viral replication, reducing the duration of the viral infection and therefore the duration of symptoms.”
When children received saltwater nose drops, fewer families reported that their family members had caught a cold (46% vs. 61% of those receiving usual care). 82% of parents said the nose drops helped their child get better quickly, and 81% said they would use them again in the future.
Professor Cunningham added: “Reducing the duration of colds in children means that fewer people in their household also catch a cold, with clear implications for how quickly a household feels better and can return to their usual activities, such as school and work etc.
“Our study also showed that parents can safely prepare and administer nasal drops to their children and thus have some control over the common cold affecting their children.”
Professor Alexander Möeller, director of the ERS Paediatric Assembly and the Department of Respiratory Medicine at the University Children’s Hospital in Zurich, Switzerland, was not involved in the research. “This is an important study, the first of its kind to investigate the impact of salty nasal drops on children with colds. Although most colds do not usually develop into anything serious, we all know how terrible they can be, especially for young children and their families,” he says.
“This extremely cheap and simple intervention has the potential to be applied globally; offering parents a safe and effective way to limit the impact of colds on their children and their family would represent a significant reduction in the health and economic burden of this very common disease.”
The team hopes to further investigate the effect of saltwater nasal drops on wheezing during colds, after initial results from this study showed that children who received the drops had significantly fewer wheezing episodes (5% vs. 19%).