Everyone gets a cold or upper respiratory infection at some time. On average, most adults develop two to three colds a year, while young children may have five to seven. A cold nearly always starts with throat irritation and stuffiness in the nose. Within hours, full blown cold symptoms usually develop, which can include sneezing, mild sore throat, low grade fever, minor headaches, muscle aches and coughing. In children, fever could be higher for one or two days; it should go down after that and be normal by day 5. Nasal discharge is usually clear and runny the first one to three days; it then thickens and becomes yellow to greenish. A runny nose usually lasts two to seven days; coughing and nasal discharge can persist for more than two weeks.
More than 200 viruses can cause colds, the most common being the RhinoVirus- this means that each one is new to your immune system and developing a cold just after having gotten over one, or even right on top of one, is not uncommon. Colds are transmitted by personal contact, and by droplets of virus-infected fluid passing from one person to another during coughing or sneezing. Virus particles can also live for several hours on doorknobs and other surfaces and then be passed on to someone else.
Covering mouth and nose while coughing and or sneezing and washing hands frequently reduces risk of spread.
The risk of respiratory infections is increased by exposure to cigarette smoke, which can injure airways and damage the cilia (tiny hair-like structures that help keep the airways clear), and other air pollutants. Seasonal changes in relative humidity also may affect the prevalence of colds. The most common cold causing viruses survive better when humidity is low and during the colder months of the year. Cold weather also may make the nasal passages` lining drier and more vulnerable to viral infection.
TreatmentPlenty of fluids and rest are still the best bits of advice. In general, home remedies and medications may relieve some of the symptoms of the cold but will not affect the duration of the illness. Antibiotics are not appropriate treatment for uncomplicated colds. Chicken soup does indeed help colds, but it appears to be the hot steam that offers the benefit; tea or any hot beverage may have the same effects. Gargling warm salt water, cough drops, or throat sprays may help relieve a sore throat and reduce coughing. Petroleum jelly helps a raw nose. Acetaminophen / paracetamol help to relieve headache or fever. Several studies have linked the use of aspirin to the development of Reye`s syndrome in children with viral illnesses therefore, aspirin should be avoided but acetaminophen / paracetamol or ibuprofen (not in children below 6 months of age) would be fine for fever control.
Non- prescription cold remedies, including decongestants and cough suppressants, may relieve some cold symptoms but not prevent, cure, or even shorten the duration of illness. For thick phlegm, patients may try cough medications that contain guaifensin, which loosens mucus. For patients with a dry cough, a suppressant may be useful, such as one that contains dextromethorphan. Decongestants can help dry a runny nose. Nasal sprays work well, but are generally recommended for not more than two to three days because of the risk of nasal irritation and, with more prolonged use, they become ineffective. Decongestants can raise blood pressure, cause anxiety and a fast heart rate and can cause difficulty in men with enlarged prostate. Pseudoephedrine and phenylephrine are popular decongestants; they work rapidly and rarely stimulate the nervous system. Older generation sedating antihistamines may have some effect in relieving symptoms such as runny nose and watery eyes that are commonly associated with colds, but probably are mostly effective for the sedation they cause. They should not be used if you need to drive. Similar to decongestants, they can raise blood pressure, cause a fast heart rate and problems in men with enlarged prostate. Infants and small children should not be given antihistamines or decongestants at all. Saline nose drops or spray to unblock the nose, hydration and humidifying the air may be all that is needed in children with colds.
What about Zinc, Echinacea and Vitamin C? All of these have not been found to be of any proven benefit in the treatment or prevention of common cold.
When to call the Doctor?Cold symptoms go away in 5-7 days, with the cough perhaps lingering a little longer. Treatment by a health care provider is necessary only if symptoms continue, the coughing is bad despite using over the-counter medications, existing respiratory conditions such as asthma are worsened, you have a high fever or shortness of breath, you suspect an ear infection or if symptoms suddenly worsen. In these situations, it may no longer be an uncomplicated cold and other treatments may be indicated.
For some persons with a cold, and particularly for ones who are susceptible to asthma, inhaled medications called bronchodilators may be effective. These drugs relax and open the airways and may relieve symptoms and reduce the duration of coughing. The most common bronchodilator used is albuterol or salbutamol. It can cause a jittery feeling and a fast heart rate. Antibiotics may be prescribed if the doctor suspects a secondary bacterial infection such as sinusitis, an ear infection or coughing due to pneumonia or bacterial bronchitis (most bronchitis is viral). Antibiotics do not kill viruses and using them "just in case" will not prevent secondary bacterial infections and are therefore, not recommended.
In summary, use home care measures first. Call for an appointment if symptoms worsen or do not begin to improve after 7 days, if breathing difficulty develops, or if you suspect other complications.
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(Revised: April 2010)
