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Colds

Alternate Names

  • upper respiratory infection
  • URI
  • common cold
  • viral pharyngitis
  • viral URI

Definition

A cold is a viral infection that affects the upper airway including the nose, pharynx, throat, airways, and lungs.

What is going on in the body?

The common cold is the most common reason that people miss work or school. There are at least 200 different viruses that cause colds. These include rhinoviruses and coronaviruses, and they are different from the viruses that cause the flu. Cold viruses are very contagious. They are airborne and are transmitted when one breathes, coughs, or sneezes. Cold viruses can be spread when a person with a cold sneezes into his or her hand or blows his or her nose and then touches an object. Cold viruses can live for up to 3 hours on a surface such as a doorknob or toy.

Risks

What are the causes and risks of the infection?

Colds are caused by rhinoviruses and coronaviruses. Children generally have 6 to 8 colds a year, but they may get as many as 12 if they live in a family with school-age children. Adults usually have 2 to 4 colds a year, and individuals over 60 years of age have about 1 cold a year. Adults have fewer colds than children because they have developed immunity to the particular viruses that cause colds.
Under the following conditions, people are more susceptible to getting a cold:
  • during the winter months, when people are indoors with others and the humidity is lower. The cold season begins slowly in late August and goes until March or April.
  • during periods of stress
  • in women, during certain points in the menstrual cycle
  • if they have allergies affecting the nose or throat

Prevention

What can be done to prevent the infection?

Good hand washing is the best way to avoid spreading colds from person to person. There are many measures that can help you avoid catching a cold.
To reduce the spread of colds, a person with a cold should:
  • cover his or her mouth with a disposable tissue when sneezing or coughing, and then discard the tissue
  • avoid touching his or her eyes, nose, or mouth
  • wash his or her hands frequently, and especially after coughing or sneezing
Healthy individuals should:
  • avoid close contact with a person who has a cold
  • try not to handle objects touched by a person with a cold
  • wash their hands frequently
The Natural Medicines Comprehensive Database has concluded that there is no or insufficient evidence that any of the following prevent colds:
  • andrographis
  • astragalus
  • echinacea
  • garlic
  • ginseng, panax
  • great plantain
  • propolis
  • vitamin C
  • zinc

Diagnosed

How is the infection diagnosed?

Often an individual will diagnose a cold without seeing a healthcare professional. If a professional is seen, he or she will examine the person's head, neck, and lungs. The professional will also look for signs and symptoms of more serious respiratory illnesses, such as pneumonia or bronchitis.

Long Term Effects

What are the long-term effects of the infection?

Most colds resolve within 7 to 10 days. Some people will develop complications, such as a sinus infection, ear infection, or long-term cough. People who have breathing difficulties or lung conditions, such as asthma, are more likely to develop complications.

Other Risks

What are the risks to others?

Most colds are highly contagious. They are transmitted through respiratory secretions. Sneezing and coughing can spread these droplets. The germ can also be passed on when an individual touches his or her nose and then handles an object that another person later touches. The second person can then pick up the germ from the object and transfer it into his or her own respiratory tract by bringing the hand to the face.

Treatments

What are the treatments for the infection?

Colds are generally treated by addressing the person's symptoms. Bed rest and drinking plenty of fluids can help prevent some complications.
Antibiotics do not work against the viruses and can reduce the body's ability to fight viruses.
Medications such as acetaminophen (i.e., Tylenol), ibuprofen (i.e., Advil, Motrin), naproxen (i.e., Aleve, Anaprox, Naprosyn) or aspirin can help reduce fever and muscle aches. Because of the risk of a serious condition called Reye's syndrome, those under 18 years old should never be given aspirin.
Medications that the Food and Drug Administration (FDA) considers safe and effective for treatment of cold symptoms include:
  • nasal decongestants in the form of sprays, drops, or oral medications. These medications open up the nasal passageways and make breathing easier.
  • cough suppressants in the form of oral medications, throat lozenges, ointments to be rubbed on the chest, and ointments used in humidifiers and vaporizers. These medications can relieve coughs caused by an irritated throat.
  • expectorants, which are taken by mouth to loosen mucus and make it easier to cough up phlegm
  • clemastine fumarate (i.e., Tavist), which is currently the only antihistamine approved for cold symptoms. Antihistamines generally dry up nasal secretions.
The Natural Medicines Comprehensive Database has concluded that the following are "Possibly Effective" in reducing the symptoms of the common cold:
  • andrographis (with or without Siberian ginseng)
  • echinacea (may reduce symptom severity and duration by 10% to 30%)
  • vitamin C (may reduce duration of cold symptoms by 1-1.5 days)
  • zinc
The Natural Medicines Comprehensive Database has also concluded that the following have "Insufficient Evidence" to recommend in reducing the symptoms of the common cold:
  • great plantain
A decongestant called phenylpropanolamine, or PPA, which is found in many over-the-counter cold remedies, has recently been linked to strokes in young women. The FDA has requested that manufacturers stop producing medications containing PPA. In view of the FDA's public health advisory, anyone who has products at home containing phenylpropanolamine should discard them.

Side Effects

What are the side effects of the treatments?

Side effects of fever-fighting medications such as ibuprofen, aspirin, and acetaminophen include stomach upset and allergic reactions. Other medications used to treat a cold may cause drowsiness, insomnia, dry mouth, or allergic reactions.

After Treatment

What happens after treatment for the infection?

Cold symptoms usually go away completely in 7 to 10 days. Some adults and children may have secondary ear infections or sinus infections.

Monitor

How is the infection monitored?

Cold symptoms usually clear up within 7 to 10 days. Any new or worsening symptoms should be reported to the healthcare professional.

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