Overview
The common cold is a viral infection of the upper respiratory tract. Although >200 viruses cause colds, the majority of colds in children and adults are caused by rhinoviruses. Colds usually are self-limiting. There is no known cure or proven prophylactic treatment; the goal of self-treatment is to reduce bothersome symptoms.
Epidemiology
- Children usually have 6–10 colds per year but may have as many as 12 colds annually. Adults (<60 years of age) typically have 2–4 colds per year.
- Colds may occur at any time, but in the United States cold season is from late August through early April.
Etiology
- The most efficient mode of transmission of cold viruses is self-inoculation of the nasal mucosa or conjunctiva following contact with viral-laden secretions on animate (hands) or inanimate (doorknobs and telephones) objects.
- Aerosol transmission is also important.
- There is conflicting information about whether cold environments, sudden chilling, or exposure to central heating increases susceptibility to viral upper respiratory infections. Walking outside barefoot, teething, or enlarged tonsils or adenoids have not been shown to increase susceptibility to viral upper respiratory infections.
Signs and Symptoms
- Common cold symptoms appear, peak, and resolve at different times in a predictable sequence that begins 1–3 days after infection (see Table 1 for clinical presentation of respiratory disorders).
- Sore throat is the initial symptom.
- Nasal symptoms dominate by day 2 or 3. Nasal secretions are clear and thin at first. The secretions become thicker as the cold progresses, and the color may change to yellow or green. When the cold begins to resolve, the secretions become clear and watery.
- Cough appears by day 4 or 5 in <20% of patients. When present, cough usually is nonproductive.
- Sore throat is the initial symptom.
- Patients may have low-grade fever, but colds rarely are associated with fever > 100°F (37.8°C).
- Rhinovirus cold symptoms persist for about 7–14 days.
TABLE 1. Differentiation of Colds and Other Respiratory Disorders
Disorder | Signs and Symptoms |
Allergic rhinitis | Watery eyes; itchy nose, eyes, or throat; repetitive sneezing; nasal congestion; watery rhinorrhea; red, irritated eyes with conjunctival injection |
Asthma | Cough, dyspnea, wheezing |
Bacterial throat infection | Sore throat (moderate-to-severe pain), fever, exudate, tender anterior cervical adenopathy |
Colds | Sore throat (mild-to-moderate pain), nasal congestion, rhinorrhea, and sneezing common; low-grade fever, chills, headache, malaise, myalgia, and cough possible |
Croup | Fever, rhinitis, and pharyngitis initially, progressing to cough (may be “barking” cough), stridor, and dyspnea |
Influenza | Myalgia, arthralgia, fever (≥100°F), sore throat, nonproductive cough, moderate-to-severe fatigue |
Otitis media | Ear popping, ear fullness, otalgia, otorrhea, hearing loss, dizziness |
Pneumonia or bronchitis | Chest tightness, wheezing, dyspnea, productive cough, changes in sputum color, persistent fever |
Sinusitis | Tenderness over the sinuses, facial pain aggravated by Valsalva’s maneuver or postural changes, fever >101.5°F, tooth pain, halitosis, upper respiratory tract symptoms for >7 days with poor response to decongestants |
West Nile virus infection | Fever, headache, fatigue, rash, swollen lymph glands, and eye pain initially; possibly progressing to GI distress, CNS changes, seizures, or paralysis |
Whooping cough | Initial catarrhal phase (rhinorrhea, sneezing, mild cough, sneezing) of 1–2 weeks, followed by 1–6 weeks of paroxysmal coughing |
CNS = central nervous system; GI = gastrointestinal.
Complications
- Most people do not have complications from colds.
- Possible complications include sinusitis, middle ear infections, bronchitis, pneumonia, and exacerbations of asthma or chronic obstructive pulmonary disease.
Preventing Transmission
- Measures that may help to prevent transmission of cold viruses include:
- Washing hands frequently with (1) soap for at least 15 seconds or (2) hand sanitizers containing ethyl alcohol 62%–95%, benzalkonium chloride, salicylic acid, pyroglutamic acid, or triclosan.
- Cleaning surfaces with antiviral disinfectants such as Lysol.
- Using treated tissues such as Kleenex Anti-Viral.
- Washing hands frequently with (1) soap for at least 15 seconds or (2) hand sanitizers containing ethyl alcohol 62%–95%, benzalkonium chloride, salicylic acid, pyroglutamic acid, or triclosan.
- Prophylaxis with oral zinc (lozenges or syrup) for at least 5 months may reduce the incidence of colds in healthy individuals.
- The safety and efficacy of Airborne effervescent tablets have not been proven.
Treatment
General/Nonpharmacologic Treatment Measures
- Adequate rest and maintenance of fluid intake are the mainstays of therapy.
- Other general treatment measures include:
- Increased humidification with cool mist vaporizers, humidifiers, or steamy showers.
- Saline gargles for sore throat.
- Saline nasal sprays or drops to moisten irritated mucosal membranes and loosen encrusted mucus. (See Appendix 1, Table A1-1 for administration guidelines.)
- Medical devices such as Vicks Breathe Right nasal strips. These devices lift the nares open, thereby enlarging the anterior nasal passages.
Stay updated, free articles. Join our Telegram channel
- Increased humidification with cool mist vaporizers, humidifiers, or steamy showers.
Full access? Get Clinical Tree
