Saline nasal drops can reduce the duration of the common cold

Using hypertonic saline nasal drops can reduce the length of the common cold in children by two days, according to a study presented last month at the European Respiratory Society (ERS) Congress in Vienna. The nasal drops can also reduce the onward transmission of colds to family members.

The results of the ELVIS-Kids randomised controlled trial were presented by Professor Steve Cunningham from Child Life and Health, The University of Edinburgh. He noted that children have up to 10–12 upper respiratory tract infections per year, and while there are medicines to improve symptoms, there were until now no known treatments that can make a cold get better quicker.

ELVIS-Kids Chief Investigator Dr Sandeep Ramalingam, consultant virologist at NHS Lothian, had meanwhile observed that saltwater solutions are often used by people in South Asia to treat a cold through nasal irrigation and gargling. He wanted to explore if this clinical benefit could be replicated in a large study.

The research team recruited 407 children aged up to six years to a study where they were given either hypertonic saline ~2.6% (salt water) nasal drops or usual care when they developed a cold. Overall, 301 children developed a cold; for 150 of these, their parents were given sea salt and taught to make and apply saltwater nose drops to the children’s noses (three drops per nostril, a minimum of four times per day, until well) and 151 children had usual cold care.

“We found that children using saltwater nose drops had cold symptoms for an average of six days where those with usual care had symptoms for eight days,” Cunningham said. “The children receiving saltwater nose drops also needed fewer medicines during their illness.

“Salt is made up of sodium and chloride. Chloride is used by the cells lining the nose and windpipes to produce hypochlorous acid within cells, which they use to defend against virus infection. By giving extra chloride to the lining cells this helps the cells produce more hypochlorous acid, which helps suppress viral replication, reducing the length of the virus infection and therefore the duration of symptoms.”

When children got saltwater nose drops, fewer households reported family members catching a cold (46% vs 61% for usual care). 82% of parents said the nose drops helped the child get better quickly and 81% said they would use nose drops in the future.

“Reducing the duration of colds in children means that fewer people in their house also get a cold, with clear implications for how quickly a household feels better and can return to their usual activities like school and work,” Cunningham said.

“Our study also showed that parents can safely make and administer nose drops to their children and therefore have some control over the common cold affecting their children.”

The team hope to further investigate the effect of saltwater nose drops on wheeze during colds, after initial results from this study showed that children who received the drops had significantly fewer episodes of wheeze (5% vs 19%).

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