NPR News

Excerpt: 'Ah-Choo'

NPR | By Jennifer Ackerman

Published September 13, 2010 at 10:56 AM EDT

Chapter 1

IN COLD PURSUIT

One Monday in October, against the counsel of friends, I applied to catch a cold. Five weeks later, on Friday, the 13th of November, tucked away on the seventh floor of a three-star hotel, I open up my nose to assault by a virus and wait.

It’s the peak of the swine flu epidemic. Colleagues, friends, and family are succumbing one after another to the feverish misery of H1N1. After weeks of scrupulously avoiding the sniffling masses, I actually invite infection, opting to join a select group of subjects taking part in a cold study at the University of Virginia. The plan is to check in to a local hotel on a Friday afternoon, have a common strain of cold virus injected into the nose, and then hunker down for the weekend, waiting for cold symptoms to develop.

My family thinks I’ve gone off the deep end. My plan elicits this merry note from my dour sister: “You know our family. It’ll go straight to your chest.” One friend dubs it my weekend “frolic at the rhinovirus festival.” “Chin up!” he says. “That way your nose won’t drip.” Another friend takes a darker view. “I’ll keep you in my prayers: Death by cold is one of my greatest anxieties.”

Death by cold?

It’s a strange thing to anticipate even mild illness, to know that in a few days viral lightning will strike. It’s like awaiting the arrival of a massive snowstorm or a hurricane. There’s that sense of urgency, of the need to get things done before you’re under the weather and not feeling like doing much more than hanging around in your bathrobe, nursing a cup of hot tea. What kind of people normally go in for this form of weekend entertainment? As far as I can tell, mostly young male students.

The researchers have set up shop in Room 726. Oddly enough, there are no signs in the lobby, “welcome virus study subjects!” But when I reach the seventh floor, the hall is lined with boys and their backpacks in cold pursuit of three free meals a day, a clean bed, and a $600 fee. I look around for one young man I met earlier at the screening for this study, a big guy with tattoos and what sounded like serious congestion. The screening took place at around 9 a.m. on a Monday morning. When the nurse asked this fellow if he had a cold, he said no, he wasn’t sick; he had just been “playing outside in the cold all morning, since 3:30 a.m.”

Oh, and what was the game?

“Setting traps for animals.”

There are a few outliers. As we’re checking in with the study nurse, I ask the middle-aged woman in line ahead of me whether her family thinks she’s crazy to be participating in this study. “Oh no,” she says cheerily. “In fact, I’ve brought my 18-year-old daughter” -- the dark-haired beauty sitting with the nurse to the right of us, awaiting the results of the routine pregnancy test. “This will take care of Christmas. My husband would have come, too, but he works for Student Health, and that created some kind of conflict of interest.” A couple of years ago, she joined another such study in order to give her daughter a bang-up sweet sixteen party.

With the help of willing subjects such as these, researchers can probe the basics of a disease and also try out remedies. At a hotel up the road from ours, similar studies produced the flu drugs Relenza and Tamiflu. The flu studies are the really lucrative gigs. Nine days of isolation in a hotel room with a nasty case of flu will net you $1,750. One such opportunity recently drew a married couple who participated sequentially. First the wife got the flu (while the husband cared for their three boys) and then her spouse did. This -- 18 days of combined illness -- so the whole family could take a $3,500 vacation.

It’s money hard earned. There’s the sledgehammer of the flu itself. Then there’s the isolation in a hotel room. Nine days is a long time in one room, even under perfect conditions. And conditions are not always perfect. Once, lightning struck the hotel, and the electricity went out for three days. No lights, no television, no coffee pot. The hotel staff had to carry food for 80 subjects up five flights of stairs from the kitchen in the basement; meals were a little less than punctual and a lot less than hot. For entertainment, younger subjects resorted to saving up their fruit from dinner and bowling with it in the halls.

Another time, a fire in the elevator shaft prompted a hotel-wide evacuation. The study participants stood around in the icy parking lot in their slippers and pajamas, wearing masks, while the rest of the hotel guests gawked.

Our three-day stay is easy by comparison. Still, it feels strangely surreal, like a hybrid of holiday, hospital, and prison. During these three days, we can’t leave the hotel for any reason (unless we drop out of the study and forsake our fee), which prompts young Tom Jackson in the room next door to mutter from his doorway, “I feel like I’m in The Shining.” We’re not even supposed to wander down to the end of the floor, where regular guests are lodged (one would hope at a deep discount). And, of course, we have to submit to a litany of nasal exams, nasal washes, and nasal sprays at all hours of the day and night.

This study is testing the effects of a new nasal spray, one of the latest shining hopes of cold treatment. The spray contains a synthetic version of a compound the body’s own immune system uses to kill microbes. In this nasal form, it’s designed to murder a virus before it can do its dirty work in the nose. But it’s also effective against bacteria and fungi and has been used effectively as a treatment for conjunctivitis and impetigo. The study is carefully designed as a so-called randomized, placebo-controlled, double-blind experiment. Half of us picked at random will get spritzed with the real McCoy, the active -- ingredient spray; half with a placebo saline spray. No one knows which group they’re in; not even the scientists conducting the study -- hence the expression “double blind.” I’m secretly hoping the roll of the dice put me in the placebo group; I’m not sure I want up my nose what may turn out to double as a cure for toe fungus.