Main Article Content
The aim of the present article is to describe bi-directional interactions between fatigue and infection with common cold producing viruses. Over one hundred years ago, researchers started to investigate the association between been fatigue and infection. Studies of psychological risk factors for upper respiratory tract illnesses (URTIs) have been carried out for over fifty years. Early research did not control for exposure and also often relied on self-report rather than clinical and virological assessment. Research on experimentally-induced URTIs has demonstrated that susceptibility to infection is increased by stress. Other research has shown that job insecurity, few social contacts, emotional disposition, early childhood experiences, sleep problems and self-rated health are key risk factors for infection. This article provides an interpretation of these results in terms of chronic fatigue increasing susceptibility to infection. Infection and illness also lead to changes in behaviour. These effects include greater fatigue, impaired attention and slower motor speed. Such effects occur not only when the person has symptoms but in the incubation period, with sub-clinical infections, and after the symptoms have gone. Those with URTIs are also more sensitive to other negative factors such as prolonged work, and this has implications for safety-critical jobs. Ingestion of caffeine, which is an established countermeasure for fatigue, can reduce the behavioural malaise induced by URTIs. Further support for the use of a fatigue framework comes from a secondary analysis of data on real-life colds. Previous research has demonstrated that chronic fatigue leads to greater effects of acute fatigue. The new analysis showed that those with high levels of fatigue prior to developing a cold had larger behavioural impairments when they became ill.
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
2. Charrin Le G, Roger, CW (1890) Contribution à l'étude expérimentale du surmenage. Son influence, surl'infection. Arch. de Physol. 1890. (cited in Editorial JAMA. Fatigue and susceptibility to infection, 1911).
3. De Sandro D Riforma Med. 1910. 841-871. (cited in Editorial JAMA. Fatigue and susceptibility to infection, 1911).
4. Cohen S, Williamson, GM. Stress and infectious disease in humans. Psychological Bulletin.1991; 109(1): 5–24.
6. Cohen S, Tyrrell DA.J, Smith AP. Psychological stress in humans and susceptibility to the common cold. New England Journal of Medicine. 1991; 325: 606 - 612. www.nejm.org/doi/full/10.1056/NEJM199108293250903
7. Cohen S,Tyrrell DAJ, Russell M, Jarvis MJ, Smith AP. Smoking, alcohol consumption and susceptibility to the common cold. American Journal of Public Health, 1993; 83: 1277-1283. https://dx.doi.org/10.2105%2Fajph.83.9.1277
8. Cohen S. Tyrrell DAJ, Smith AP. Negative Life Events, Perceived Stress, Negative Affect and Susceptibility to the Common Cold. Journal of Personality and Social Psychology. 1993; 64: 131 -140. doi: 10.1037//0022-3518.104.22.168
9. Smith AP, Nicholson KG. Psychosocial factors, respiratory viruses and exacerbation of 2020, asthma. Psychoneuroendocrinology. 2001; 26: 411-420. https://doi.org/10.1016/S0306-4530(00)00063-9
10. Song H, Fall K, Fang F, et al. Stress related disorders and subsequent risk of life threatening infections: population based sibling controlled cohort study. British Medical Journal. 2019; 367: 15784. doi:10.1136/bmj.l5784
11. Cohen S. The Pittsburgh Common Cold Studies: Psychosocial predictors of susceptibility to respiratory infectious illness. International Journal of Behavioral Medicine. 2005; 12: 123-154. doi: 10.1207/s15327558ijbm1203_1
12. Cohen S, Frank E, Doyle WJ, Skoner DP, Rabin BS, Gwaltney JM, Jr. Types of stressors that increase susceptibility to the common cold in healthy adults. Health Psychology. 1998; 17: 214-223.
13. Cohen S, Doyle WJ, Skoner DP, Rabin BS, Gwaltney J.M,Jr. Social ties and susceptibility to the common cold. Journal of the American Medical Association. 1997; 277: 1940-1944.
14. Cohen S, Alper CM, Doyle WJ, Treanor JJ, Turner RB. Positive emotional style predicts resistance to illness after experimental exposure to rhinovirus or influenza A virus. Psychosomatic Medicine. 2006; 68: 809-815.
15. Janicki-Deverts D, Cohen S, Doyle WJ. Dispositional affect moderates the stress-buffering effect of social support on risk for developing the common cold. Journal of Personality. 2017; 85: 675-686.
16. Cohen S, Doyle WJ, Turner RB, Alper CM, Skoner DP. Childhood socioeconomic status and host resistance to infectious illness in adulthood. Psychosomatic Medicine. 2004; 66: 553-558.
17. Murphy MLM, Cohen S, Janicki-Deverts D, Doyle WJ. Offspring of parents who were separated and not speaking to one another have reduced resistance to the common cold as adults. Proceedings of the National Academy of Sciences. 2017; 114: 6515-6520.
18. Prather AA, Janicki-Deverts D, Adler NE, Hall M, Cohen S. Sleep habits and susceptibility to upper respiratory illness: the moderating role of subjective socioeconomic status. Annals of Behavioral Medicine. 2017; 51: 137-146.
19. Prather AA, Janicki-Deverts D, Hall MH, Cohen S. Behaviorally assessed sleep and susceptibility to the common cold. Sleep. 2015; 38(9):1353-1359. PMCID: PMC4531403
20. Cohen S, Janicki-Deverts D, Doyle WJ. Self-rated health in healthy adults and susceptibility to the common cold. Psychosomatic Medicine. 2015; 77 (9): 959-968.
21. Cohen S, Janicki-Deverts D, Turner RB, Casselbrant ML, Li-Korotky H, Epel E S, Doyle W J. Association between telomere length and experimentally induced upper respiratory viral infection in healthy adults. Journal of the American Medical Association. 2013; 309: 699-705. doi: 10.1001/jama.2013.613
22. Doyle WJ, Gentile DA, Cohen S. Emotional style, nasal cytokines, and illness expression after experimental rhinovirus exposure. Brain, Behavior, and Immunity. 2007; 20:175-181.
23. Doyle WJ, Casselbrant ML, Li-Korotky H, Cullen Doyle AP, Lo C, Turner R, Cohen S. The interleukin 6 -174 C/C genotype predicts greater rhinovirus illness. The Journal of Infectious Diseases. 2010; 201: 199-206.
24. Janicki-Deverts D, Cohen S, Turner RB, Doyle WJ. Basal salivary cortisol secretion and susceptibility to upper respiratory infection. Brain, Behavior, & Immunity. 2016; 53: 255-261.
25. Cohen S, Janicki-Deverts D, Doyle WJ, Miller GE, Frank E, Rabin BS, Turner RB. Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk. Proceedings of the National Academy of Sciences. 2012; 109: 5995-5999.
26. Smith AP. Effects of upper respiratory tract illness and stress on alertness and reaction time. Psychoneuroendocrinology. 2013; 38: 2003-2009. http://dx.doi.org/10.1016/j.psyneuen.2013.03.012
27. Ray C, Weir WRC, Phillips S, Cullen S. Development of a measure of symptoms in Chronic Fatigue Syndrome: The Profile of Fatigue-Related Symptoms (PFRS). Psychology and Health. 1992; 7(1): 27-43. doi: 10.1080/08870449208404293
28. Borsini A, Hepgul N, Mondelli V, Chalder T, Pariante C. Childhood stressors in the development of fatigue syndromes: a review of the past 20 years of research. Psychological Medicine. 2014; 44 (9): 1809-1823.
29. Fujimaru C, Okamura H, Kawasaki M, Tatsuyuki Y, Matsuishi T. Self-perceived work-related stress and its relation to salivary IgA, cortisol and 3-methoxy-5-hydroxyphenyl glycol levels among neonatal care nurses. Stress and Health. 2012; 28: 171-174.
30. Rohleder N, Aringer M, Boentert M. Role of interleukin-6 in stress, sleep and fatigue. Annals of the New York Academy of Sciences. 2012; 1261: 88-96.
31. Bendix L, Thingaard M, Kimura M, Aviv A, Christensen K, Osler M, Avlund K. Association of leukocyte telomere length with fatigue in nondisabled older adults. Journal of Aging Research. 2014; Article ID: 403253, 8 pages.
32. Smith AP, Thomas M, Borysiewicz L, Llewelyn,M. Chronic fatigue syndrome and susceptibility to upper respiratory tract illnesses. British Journal of Health Psychology. 1999; 4: 327-335.
33. Smith AP, Thomas MA. Chronic fatigue syndrome and increased susceptibility to upper respiratory tract infections and illnesses. Fatigue: Biomedicine, Health & Behavior. 2015; 3(3): 156-163. http://dx.doi.org/10.1080/21641846.2015.1033271
34. Smith AP. Twenty-five years of research on the behavioural malaise associated with influenza and the common cold. Psychoneuroendocrinology. 2013; 38: 744-751. https://doi.org/10.1016/j.psyneuen.2012.09.002
35. Smith AP, Tyrrell DAJ, Coyle K, Willman JS. Selective effects of minor illnesses on human performance. Brit J Psychol. 1987; 78: 183 - 188. doi:10.1111/j.2044-8295.1987.tb02238.x
36. Smith AP, Tyrrell DAJ, Al-Nakib W, Coyle KB, Donovan CB, Higgins PG, Willman JS. Effects of experimentally-induced virus infections and illnesses on psychomotor performance. Neuropsychobiology. 1987; 18: 144 - 148. doi: 10.1159/000118408
37. Smith AP, Tyrrell DAJ, Al-Nakib W, Coyle KB, Donovan CB, Higgins PG, Willman J S. The effects of experimentally-induced respiratory virus infections on performance. Psychol Med. 1988; 18: 65 - 71. doi: 10.1017/s0033291700001896
38. Smith AP, Tyrrell DAJ, Al-Nakib W, Barrow GI, Higgins PG, Leekam S, Trickett S. Effects and after-effects of the common cold and influenza on human performance. Neuropsychobiology. 1989; 21: 90 - 93. doi: 10.1159/000118558
39. Smith AP, Tyrrell DAJ, Barrow GI, Coyle KB, Higgins PG, Trickett S, Willman JS. The effects of experimentally induced colds on aspects of memory. Percept Mot Skills. 1990; 71: 1207 - 1215. doi: 10.2466/pms.1990.71.3f.1207
40. Smith AP, Tyrrell DAJ, Barrow GI, Higgins PG, Willman JS, Bull S, Coyle KB, Trickett S. Mood and experimentally-induced respiratory virus infections and illnesses. Psychol Health. 1992; 6: 205-212. doi: 10.1080/08870449208403184
41. Smith AP, Tyrrell DAJ, Barrow GI, Higgins PG, Bull S, Trickett S, Wilkins AJ. The Common Cold, pattern sensitivity and contrast sensitivity. Psychol Med. 1992; 22: 487-494 doi: 10.1017/S0033291700030427
42. Smith AP. Minor illnesses and performance. In: Different Aspects of Performance. (eds) W Rohmert & H G Wenzel Frankfurt: Peter Lang. 2009; 300 – 306.
43. Smith AP. A review of the effects of colds and influenza on human performance. Journal of the Society of Occupational Medicine. 1989; 39: 65-68. https://doi-org.abc.cardiff.ac.uk/10.1093/occmed/39.2.65
44. Smith AP. Respiratory virus infections and performance. In: Human Factors in Hazardous Situations, (eds) D Broadbent, A D Baddeley and J Reason. Oxford Science Publications. 1990.
45. Smith AP. Respiratory illnesses and performance. In: Contemporary Ergonomics. 1991; (ed) E J Lovesey. London: Taylor & Francis, 203 – 207.
46. Smith AP. Colds, influenza and performance. In: Handbook of Human Performance, Vol2: Health and Performance. (eds) A P Smith & D M Jones London: Academic Press. 1992; pp 197-218.
47. Hall SR, Smith AP. An investigation of the effects and after-effects of naturally occurring upper respiratory tract illnesses on mood and performance. Physiology and Behavior. 1996; 59: 569-577. https://doi.org/10.1016/0031-9384(95)02112-4
48. Smith AP. Psychological studies of the common cold. In: The Common Cold - The condition and its treatment. 1996; pp 89-111. Ed DAJ Tyrrell. Stuttgart: Gustav Fischer (In German).
49. Smith AP, Thomas M, Brockman P, Kent J, Nicholson KG. Effect of influenza B virus infection on human performance. British Medical Journal. 1993; 306: 760 – 761. doi: 10.1136/bmj.306.6880.760
50. Smith A, Thomas M, Kent J, Nicholson K. Effects of the common cold on mood and performance. Psychoneuroendocrinology. 1998; 23: 733-739. http://dx.doi.org/10.1016/S0306-4530(98)00042-0
51. Smith A, Rich N, Sturgess W, Brice C, Collison C, Bailey J, Wilson S, Nutt D. Effects of the common cold on subjective alertness, simple and choice reaction time and eye movements. Journal of Psychophysiology. 1999; 13: 145-151. doi: 10.1027//0269-8803.13.3.145
52. Smith AP, Thomas M, Whitney H. After-effects of the common cold on mood and performance. Ergonomics. 2000; 43: 1342-1349. http://dx.doi.org/10.1080/001401300421789
53. Matthews G, Warm JS, Dember WN, Mizoguchi H, Smith AP. The common cold impairs visual attention, psychomotor performance and task engagement. Proceedings of the Human Factors and Ergonomics Society 45th Annual Meeting. Santa Monica, CA : Human Factors and Ergonomics Society. 2001; pp 1377-1381.
54. Smith AP. From the brain to the workplace: research on cognitive fatigue in the laboratory and on board ship In: Cognitive Fatigue: Multidisciplinary perspectives on current research and future applications. Ed P Ackerman. American Psychological Association. 2011; Chapter 14: pp 291-305. ISBN: 978-1-4338-0839-5
55. Smith AP. Behavioral effects of upper respiratory illnesses: A consideration of possible underlying cognitive mechanisms. Behavioral Sciences. 2012; 2: 38-49. doi:103390/b2010038
56. Smith AP. Effects of the common cold on mood, psychomotor performance, the encoding of new information, speed of working memory and semantic processing. Brain, Behavior & Immunity. 2012; 26:1072-1076. http://dxdoiorg/101016/jbbi201206012
57. Smith AP. Upper respiratory tract illnesses and fatigue. In: Matthews, G, Desmond, PA, Neubauer, C, & Hancock, PA (Eds), The Handbook of Operator Fatigue. Farnham, Surrey, UK: Ashgate Publishing. ISBN: 978-0-7546-7537-2. 2012; Chapter 20: Pg 321-332.
58. Smith AP. Effects of upper respiratory tract illness and stress on alertness and reaction time. Psychoneuroendocrinology.2013;38:2003-2009. http://dxdoiorg/101016/jpsyneuen201303012
59. Matthews G, Warm JS, Smith AP. Task engagement and attentional resources: Multivariate models for individual differences and stress factors in vigilance. Human Factors. 2017; 59: (1), 44-61. doi: 101177/0018720816673782
60. Smith AP. Effects of the Common Cold on simulated driving. In Contemporary Ergonomics 2006. Editor: PD Bust. pp621-624. ISBN10 0415398185
61. Smith AP, Jamson SL. An investigation of the effects of the common cold on simulated driving performance and detection of collisions: a laboratory study. BMJ Open. 2012; 2:e001047. doi:101136/bmjopen-2012-001047
62. Smith AP, Thomas M, Brockman P. Noise, respiratory virus infections and performance. Proceedings of 6th International Congress on Noise as a Public Health Problem. Actes Inrets. 1993; 34: Vol 2, 311-31
63. Smith AP, Whitney H, Thomas M, Brockman P, Perry K. A comparison of the acute effects of a low dose of alcohol on mood and performance of healthy volunteers and subjects with upper respiratory tract illnesses. Journal of Psychopharmacology. 1995; 9: 225-230. https://doi.org/10.1177/026988119500900310
64. Smith AP, Thomas M, Whitney H. Effects of upper respiratory tract illnesses on mood and performance over the working day. Ergonomics. 2000; 43: 752-763. http://dx.doi.org/10.1080/001401300404724
65. Smith AP, Brice C, Leach A, Tiley M, Williamson S. Effects of upper respiratory tract illnesses in a working population. Ergonomics. 2004; 47: 363-369.
66. Smith AP, Thomas M, Perry K, Whitney H. Caffeine and the common cold. Journal of Psychopharmacology. 1997; 11 (4): 319-324. https://doi.org/10.1177/026988119701100406
67. Smith AP, Nutt DJ. Effects of upper respiratory tract illnesses, ibuprofen and caffeine on reaction time and alertness Psychopharmacology. 2014; 231: 1963-1974. doi: 101007/s00213-013-3339-7
68. Smith AP, Sturgess W, Rich N, Brice C, Collison C, Bailey J, Wilson S, Nutt DJ. Effects of idazoxan on reaction times, eye movements and mood of healthy volunteers and subjects with upper respiratory tract illnesses. Journal of Psychopharmacology. 1999; 13: 148-151. doi: 10.1007/s00213-013-3339-7
69. Drake CL, Roehrs TA, Royer H, Koshorek G, Turner RB, Roth T. 2000. Effects of an experimentally induced rhinovirus cold on sleep, performance and daytime alertness. Physiol Behav. 2000; 71: 75-81. doi: 101016/S0031-9384(00)0322-x
70. Smith AP. Sleep, colds and performance. In: Sleep, Arousal and Performance: A tribute to Bob Wilkinson. Eds: R Broughton & R Ogilvie. Boston: Birkhauser. 1991; 233-242.
71. Smith AP. Sleep and the common cold. Journal of Behavioral Health. 2012; 1: 114-117. ISSN 2146-8346. doi:105455/jbh20120322073850
72. Smith AP, Tyrrell DAJ, Coyle KB, Higgins PG. Effects of interferon alpha on performance in man: A preliminary report. Psychopharmacology. 1988; 96: 414 – 416. https://doi.org/10.1007/BF00216072
73. Smith AP, Tyrrell DAJ, Coyle KB, Higgins PG. Effects and after-effects of interferon alpha on human performance, mood and physiological function. Journal of Psychopharmacology. 1991; 5: 243 - 250.
74. Janicki-Deverts D, Cohen S, Doyle WJ, Turner RB, Treanor JJ. Infection-induced pro-inflammatory cytokines are associated with decreases in positive affect, but not increases in negative affect. Brain, Behavior, and Immunity. 2007; 21: 301-307.
75. Balter L, Higgs S, Aldred S, Bosch J, Raymond J. Inflammation Mediates Body Weight and Ageing Effects on Psychomotor Slowing. Scientific Reports. 2019; 9(1): 15727, pp. 1-13. https://doi.org/10.1038/s41598-019-52062-3
76. Smith AP, Borysiewicz L, Pollock J, Thomas M, Perry K, Llewelyn M. Acute fatigue in chronic fatigue syndrome. Psychological Medicine. 1999; 29: 283-290.
77. Bramley TJ, Lerner D, Sarnes M. Productivity losses related to the common cold. J. Occup. Environ. Med. 2002; 44: 822-829.
78. Nichol KL, D’Heilly S, Ehlinger E. Colds and influenza-like illnesses in university students: impact on health, academic and work performance, and health care use. Clin. Infect. Dis. 2005; 40:1263-1270.
79. Nichol KL, D’Heilly S, Ehlinger E. Burden of upper respiratory illnesses among college and university students: 2002-2003 and 2003-2004 cohorts. Vaccine. 2006; 24, 6724-6725.
80. Palmer LA, Rousculp MD, Johnston SS, Mahadevia PJ, Nichol KL. Effect of influenza-like illness and other wintertime respiratory illnesses on worker productivity: the child and house- hold influenza-illness and employee function (CHIEF) study. Vaccine. 2010; 28: 5049-5056.