She’s rarely taken a day off sick, yet two weeks after the Queen had to delay her trip to Sandringham for the Royal Family’s Christmas gathering, Her Majesty was still too unwell to attend church on New Year’s Day.
According to Palace officials, she is ‘recuperating from a heavy cold’.
And she’s hardly alone — for, across the country, people of all ages have succumbed to a particularly nasty cold.
As Dr Claire Gerada, a former head of the Royal College of General Practitioners, explains, doctors are currently seeing ‘a lot of people with a virus more severe than a normal cold, almost a type of bronchitis’.
She’s rarely taken a day off sick, yet the Queen had to delay her trip to Sandringham for the Royal Family’s Christmas gathering
One of the key characteristics of the infection is that it appears to cause a hacking cough.
‘If the Queen has got it, then she is probably exhausted from coughing,’ says Dr Gerada.
A cold and cough normally last from seven to ten days (according to NHS Choices, it is infectious from a few days before symptoms appear until they have all gone).
But Dr Gerada suggests this season’s cold is taking up to three weeks to clear.
Although it is too early to say for sure, experts suspect the bug that’s causing problems is an adenovirus — typically, colds are caused by the more common rhinovirus. (Out of more than 200 strains, rhinovirus accounts for 35 per cent of cases.)
John Oxford, an emeritus professor of virology at Queen Mary University of London, who has just recovered from the infection himself, says it is ‘highly likely’ the adenovirus is to blame for the outbreak.
‘If there was a Richter scale for common cold viruses, adenovirus would be right at the top in terms of its impact,’ he says, pointing out that adenovirus is a complex virus with 30 genes, compared to just nine genes in rhinovirus, that is capable of causing infections from hepatitis to cystitis.
‘Importantly, rhinovirus only thrives in cool temperatures, so stays put in the nose and throat, which are around 33c.
Adenovirus can survive at 37c — internal body temperature — so can push down into the lungs, causing a chesty cough,’ he explains.
This season’s cold is taking up to three weeks to clear. Although it is too early to say for sure, experts suspect the bug that’s causing problems is an adenovirus
Adenovirus is non-discriminate and attacks all age groups. ‘Whether you are nine or 90, you are not safe from this infection,’ says Professor Oxford.
However, older people — including the Queen, at 90 — can struggle more to overcome it, as their immune systems are less effective and they are more easily tired by constant coughing, he adds.
But coughing is no bad thing. The cough reflex is essential to clear lungs of debris and foreign bodies.
The cough happens when tiny nerve cells in the lining of the respiratory tract — known as pulmonary irritant receptors — become sensitised by chemical or mechanical stimulation.
In other words, if you have a cold or swallow something the wrong way.
These receptor cells send messages via the vagus nerve in the chest and up into the brain.
Coughing is not a bad thing. The reflex is essential to clear lungs of debris and foreign bodies
The brain then sends commands to the diaphragm and the muscles between the ribs to contract, causing the explosive cough.
‘Unfortunately, a hacking cough can remain long after other symptoms have eased,’ explains Professor Ron Eccles, director of the Common Cold Centre at Cardiff University.
People with asthma or pre-existing pulmonary disease are even more susceptible.
Cold air can cause a coughing fit if someone has been laid up with adenovirus — the Queen has stayed indoors for around a fortnight, avoiding exposure to the chilly temperatures in Norfolk.
‘Cold air can irritate the lung lining and make coughing worse, which may be her reason for not going outside,’ explains Professor Ian Watson, a GP in Oldham, who has seen a sharp rise in the number of patients with symptoms more severe than a normal cold.
‘If you can give your lungs a rest, you may find the coughing will stop on its own.’
Cold air can irritate the lung lining and make coughing worse, which may be a good reason for not going outside
Other ways to rest the lungs include staying out of areas where there is high air pollution.
Dry air can also be irritating, so bowls of water or damp towels placed on a radiator can be a good alternative to electric humidifiers.
Medicine, however, may not be helpful. A Which? investigation in 2012 found many popular cough medicines do not work as well as they claim to.
‘That said, some over-the-counter medications containing pholcodine can temporarily suppress coughing, which allows the inflammation to calm down,’ says Professor Watson, who advises you consult a pharmacist before buying any remedy.
He is also sceptical about claims on the NHS Direct website that honey and lemon is a cheap and effective way to treat short-term coughing.
‘There is no firm evidence that this has any effect — although it doesn’t do any harm.’
So there isn’t much you can do except nurse a cold and alleviate the symptoms. Some preliminary research has looked into the effectiveness of antivirals, but no drugs have yet been licensed to treat the common cold.
Once a cold virus has established itself in the nose, it may travel to the lungs and damage cells there. This makes it easier for bacteria to follow on
And antibiotics won’t work ‘as it is caused by a virus, not bacteria,’ says Professor Oxford.
A small percentage of people will go on to develop a more serious secondary bacterial infection in the lungs.
That’s because, once a cold virus has established itself in the nose, it may travel to the lungs and damage cells there. This makes it easier for bacteria to follow on.
Doctors will listen to the chest and look for crackling sounds that suggest infection has taken hold.
Professor Watson advises that it is very difficult for a layperson to tell the difference between a bacterial and viral infection.
‘Some people think that greenish sputum is a sign of a bacterial infection, but this can occur in viral colds, too, and is really just a sign the immune system is working.’
He says that length of time symptoms last can signify a bacterial infection, as well as a persistent fever that doesn’t drop below 38c.
Professor Watson advises people to go and see a doctor if their symptoms last longer than ten days, or if they are finding it more difficult to breathe.
Whether or not they should stay indoors — as the Queen has done for the past two weeks — is a moot point.
While rest is essential to help the body recover, people with heavy colds should try to stay mobile as much as possible.
The Queen has stayed indoors for around a fortnight, avoiding exposure to chilly Norfolk, but doctors say it’s important to keep moving in order to avoid an infection
‘Bedbound people are more likely to develop chest infections, and staying active increases airflow in the lungs,’ says Professor Watson.
‘In my opinion, it is always best to get up and about as soon as possible, both for your physical and psychological well-being.
‘People who feel better get better sooner.’
Of course, prevention is better than cure.
The common cold is the most common infectious disease in humans and is spread through droplets in the air, close contact with infected people and even transfer from doorknobs and other household objects.
Symptoms start less than two days after exposure and can include coughing, a sore throat, runny nose, sneezing and a headache.
‘The key is to practise good hygiene — wash your hands before eating or touching your face, get plenty of sleep and eat healthily,’ says Professor Oxford.