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Medical Encyclopedia:

Common Cold

Definition

The common cold is a viral infection of the upper respiratory system, including the nose, throat, sinuses, eustachian tubes, trachea, larynx, and bronchial tubes. Although over 200 different viruses can cause a cold, 30–50% are caused by a group known as rhinoviruses. Almost all colds clear up in less than two weeks without complications.

Description

Colds, sometimes called rhinovirus or coronavirus infections, are the most common illness to strike any part of the body. It is estimated that the average person has more than 50 colds during a lifetime. Anyone can get a cold, although pre-school and grade school children catch them more frequently than adolescents and adults. Repeated exposure to viruses causing colds creates partial immunity.

Although most colds resolve on their own without complications, they are a leading cause of visits to the doctor and of time lost from work and school. Treating symptoms of the common cold has given rise to a multi-million dollar industry in over-the-counter medications.

Cold season in the United States begins in early autumn and extends through early spring. Although it is not true that getting wet or being in a draft causes a cold (a person has to come in contact with the virus to catch a cold), certain conditions may lead to increased susceptibility. These include:

Colds make the upper respiratory system less resistant to bacterial infection. Secondary bacterial infection may lead to middle ear infection, bronchitis, pneumonia, sinus infection, or strep throat. People with chronic lung disease, asthma, diabetes, or a weakened immune system are more likely to develop these complications.

— Tish Davidson


 
 
Alternative Medicine Encyclopedia: Common Cold

Definition

The common cold is a viral infection of the upper respiratory system, which includes the nose, throat, sinuses, eustachian tubes, trachea, larynx, and bronchial tubes. Although more than 200 different viruses can cause a cold, 30–50% are caused by a group known as rhinoviruses. Almost all colds clear up in less than two weeks without complications.

Description

Colds, sometimes called rhinovirus or coronavirus infections, are the most common illness to strike any part of the body. It is estimated that the average person has more than 50 colds during a lifetime. Anyone can get a cold, although preschool and grade school children catch them more frequently than adolescents and adults. Repeated exposure to viruses causing colds creates partial immunity.

Although most colds resolve on their own without complications, they are a leading cause of visits to the doctor and of time lost from work and school. Treating symptoms of the common cold has given rise to a multimillion dollar industry in over-the-counter medications, yet none of these medications are actually anti-viral to the rhinovirus.

Cold season in the United States begins in early autumn and extends through early spring. Although it is not true that getting wet or being in a draft causes a cold (a person has to come in contact with the virus to catch a cold), certain conditions may lead to increased susceptibility. These include:

  • fatigue and overwork
  • emotional stress
  • poor nutrition
  • smoking
  • inadequate rest or sleep
  • living or working in crowded conditions

Colds make the upper respiratory system less resistant to secondary bacterial infection. Secondary bacterial infection may lead to a number of other complications, including middle ear infection, bronchitis, pneumonia, sinus infection, or strep throat. People with chronic lung disease, asthma, diabetes, or a weakened immune system are more likely to develop these complications.

Causes & Symptoms

Colds are caused by more than 200 different viruses. The most common groups include rhinoviruses and coronaviruses. Different groups of viruses are more infectious at different seasons of the year, but knowing the exact virus causing the cold is not important in treatment.

People with colds are contagious during the first two to four days of the onset of symptoms. Colds pass from person to person in several ways. When an infected person coughs, sneezes, or speaks, tiny fluid droplets containing the virus are expelled. If these are breathed in by other people, the virus may establish itself in their noses and airways.

Colds may also be passed through direct contact. For example, if a person with a cold touches his runny nose or watery eyes, then shakes hands with another person, some of the virus is transferred to the uninfected person. If that person then touches his mouth, nose, or eyes, the virus is transferred to an environment where it can reproduce and cause a cold.

Finally, cold viruses can be spread through inanimate objects (door knobs, telephones, toys) that become contaminated with the virus. This is a common method of transmission in child care centers. Another vector of transmission is air travel, due to closed air circulation in buildings.

Once acquired, the cold virus attaches itself to the lining of the nasal passages and sinuses. This causes the infected cells to release a chemical called histamine. Histamine increases the blood flow to the infected cells, causing swelling, congestion, and increased mucus production. Within one to three days, the infected person begins to show cold symptoms.

The first cold symptoms are usually a tickle in the throat, runny nose, and sneezing. The initial discharge from the nose is clear and thin. Later, it may change to a thick yellow or greenish discharge. Most adults do not develop a fever when they catch a cold. Young children may develop a low fever of up to 102°F (38.9°C).

Other symptoms of a cold include coughing, sneezing, nasal congestion, headache, muscle ache, chills, sore throat, hoarseness, watery eyes, fatigue, dull hearing and blocked eustachian tube (a danger when flying), and lack of appetite. The cough that accompanies a cold is usually intermittent and dry.

Most people begin to feel better four to five days after their cold symptoms become noticeable. All symptoms are generally gone within 10 days, except for a dry cough that may linger for up to three weeks.

Colds make people more susceptible to secondary bacterial infections such as strep throat, middle ear infections, and sinus infections. A person should seek a doctor's consultation if the cold does not begin to improve within a week. If an individual experiences chest pain, fever for more than a few days, difficulty breathing, bluish lips or fingernails, a cough that brings up greenish-yellow or grayish sputum, skin rash, swollen glands, or whitish spots on the tonsils or throat, then that person should also consult a doctor to see if they have acquired a secondary bacterial infection that needs to be treated with an antibiotic.

People who have emphysema, chronic lung disease, diabetes, or a weakened immune system—either from diseases such as AIDS or leukemia, or as the result of medications, (corticosteroids, chemotherapy drugs)—should consult their doctor if they get a cold. People with these health problems are more likely to get a secondary infection.

Diagnosis

Colds are diagnosed by observing a person's symptoms and symptom history. There are no laboratory tests readily available to detect the cold virus. However, a doctor may do a throat or nasal culture, or blood test to rule out a secondary infection.

Influenza is sometimes confused with a cold, but the flu causes much more severe symptoms, and is generally accompanied by a fever. Allergies to molds or pollens also can cause a runny nose and eyes. Allergies are usually more persistent than the common cold. An allergist or a physician can do tests to determine if the cold-like symptoms are being caused by an allergic reaction. Also, some people get a runny nose when they go out-side in winter and breathe cold air. This type of runny nose, however, is not a symptom of a cold.

Treatment

The patient should drink plenty of fluids and eat nutritious foods. In fact, the old adage, "Feed a cold, starve a fever" was scientifically proven true in 2002. Dutch scientists found that cold-fighting immune responses rose after consuming a full meal while fasting increased those that combat most fevers. Chicken soup with ginger, scallions, and rice noodles is nutritious and has properties that help the patient to recover. Rest, to allow the body to fight infection, is very important. Gargling with saltwater (half teaspoon salt in one cup of water) helps to soothe a sore throat. A vaporizer also will make the patient feel more comfortable. Rubbing petroleum jelly or some other lubricant under the nose will prevent irritation from frequent nose blowing. For babies, nasal mucus should be suctioned gently with an infant nasal aspirator. It may be necessary to soften the mucus first with a few drops of salt water.

Herbals

Herbals can be taken to stimulate the immune system, for antiviral activity, and to relieve symptoms. The following herbs are used to treat colds:

  • Ginger (Zingiber officinale) reduces fever and pain, has a sedative effect, settles the stomach, and suppresses cough.
  • Forsythia (Forsythia suspensa) fruit can be taken as a tea for its anti-inflammatory, fever reducing, and antimicrobial properties.
  • Honeysuckle (Lonicera japonica) flower can be taken as a tea for its anti-inflammatory, fever reducing, and antimicrobial properties.
  • Aniseed (Pimpinella anisum) can be added to tea to expel phlegm, induce sweating, ease nausea, and ease stomach gas.
  • Slippery elm powdered bark (Ulmus fulva) can be taken as a tea or slurry or capsules to soothe sore throat, to ease cough, and to thin mucous.
  • Echinacea (Echinacea purpurea or augustifolia) relieved cold symptoms in clinical studies. The usual dosage is 500 mg of crude powdered root or plant thrice on the first day, then 250 mg four times daily thereafter. This may also be taken as a tincture.
  • Goldenseal (Hydrastis canadensis) has fever reducing, antibacterial, anti-inflammatory, and antitussive properties. The usual dose is 125 mg three to four times daily. Goldenseal should not be taken for more than one week. Goldenseal may also be prepared as a tincture.
  • Astragalus (Astragalus membranaceus) boosts the immune system and improves the body's response to stress. The common dose is 250 mg of extract four times daily.
  • Cordyceps (Cordyceps sinensis) modulates and boosts the immune system and improves respiration. The usual dose is 500 mg two to three times daily.
  • Elder (Sambucus) has antiviral activity, increases sweating, decreases inflammation, and decreases nasal discharge. The usual dose is 500 mg of extract thrice daily.
  • Stinging nettle (Urtica dioica) has antihistamine and anti-inflammatory properties. The common dose is 300 mg four times daily.
  • Schisandra (Schisandra chinensis) helps the body fight disease and increases endurance.
  • Grape (Vitis vinifera) seed extract has antihistamine and anti-inflammatory properties. The usual dose is 50 mg three times daily.
  • Eucalyptus (Eucalyptus globulus) or peppermint (Mentha piperita) essential oils added to a steam vaporizer may help clear chest and nasal congestion and disinfect room air.
  • Boneset infusion (Eupatroium perfoliatum) relieves aches and fever.
  • Yarrow (Achillea millefolium) is a diaphoretic.
  • Supplemental larch from the inner bark of the western larch tree has been shown in some clinical trials to fight persistent colds and ear aches.

Chinese Medicines

Chinese herbal treatments are based on the specific symptoms of colds and include a variety of Radix, Rhizoma, Semen, and Herba species. Chinese patent medicines for cold include:

  • Wu Shi Cha (Noon tea): once or twice daily.
  • Yin Qiao Jie Du Pian (Honeysuckle and Forsythia Tablet to Overcome Toxins): four to six, twice daily.
  • Sang Ju Gan Mao (Mulberry Leaf and Chrysanthemum to Treat Common Cold): one packet of infusion or four to eight tablets, twice or thrice daily.
  • Ling Yang Gan Mao Pian (Atelopis Tablet for Common Cold): four to six, twice daily.
  • Ban Lan Gen Chong Ji (Isatidis Infusion): one packet twice or thrice daily.
  • Huo Xiang Zheng Qi (Agastache to Rectify Qi): 6 g or four to six tablets.

Other Remedies

The effectiveness of zinc lozenges for preventing or treating the common cold is controversial. Numerous studies have generated contradicting results. It has been suggested that the citric acid, sorbitol, or mannitol in some lozenges may bind zinc and reduce effectiveness, hence the varying results of these studies. The recommended dosage is to suck on one lozenge every two hours while awake beginning at the first cold symptoms. Side effects are bad taste, nausea, and vomiting.

Ayurvedic medicine practitioners recommend gargling with a mixture of water, salt, and turmeric powder or astringents such as alum, sumac, sage, and bayberry to ease a sore throat.

Homeopaths recommend microdoses of Viscue album,Natrum muriaticum, Allium cepa, or Nux vomica.

Allopathic Treatment

There are no known medicines proven to shorten or cure the common cold. Antibiotics are useless against a cold, and can enhance bacterial resistance, if used carelessly. Nonprescription products to relieve cold symptoms usually contain antihistamines, decongestants, and/or pain relievers. Over-the-counter cold remedies should not be given to infants without consulting a doctor first. Care should be taken not to exceed the recommended dosages, especially when combination medications or nasal sprays are taken. Aspirin should not be given to children with a cold because of its association with a risk of Reye's syndrome, a serious disease.

Antihistamines are taken to relieve the symptoms of sneezing, runny nose, itchy eyes, and congestion. Side effects are dry mouth and drowsiness, especially with the first few doses. Some people have allergic reactions to antihistamines. Common over-the-counter antihistamines include Chlor-Trimeton, Dimetapp, Tavist, and Actifed. The generic name for two common antihistamines are chlorpheniramine and diphenhydramine.

Decongestants reduce congestion and open inflamed nasal passages, making breathing easier. Decongestants can make people feel jittery or keep them from sleeping. They should not be used by people with heart disease, high blood pressure, or glaucoma. Some common decongestants are Neo-Synepherine, Novafed, and Sudafed. The generic names of common decongestants include phenylephrine, phenylpropanolamine, pseudoephedrine, and in nasal sprays naphazoline, oxymetazoline, and xylometazoline. Nasal sprays and nose drop decongestants can act more quickly and strongly than ones found in pills or liquids because they are applied directly in the nose. Congestion returns after a few hours. Persons can become dependent on nasal sprays and nose drops, so they should not be used for more than a few days.

Many over-the-counter medications are combinations of both antihistamines and decongestants; an ache and pain reliever, such as acetaminophen (Datril, Tylenol, Panadol) or ibuprofen (Advil, Nuprin, Motrin, Medipren); and a cough suppressant (dextromethorphan). Common combination medications include Tylenol Cold and Flu, Triaminic, Sudafed Plus, and Tavist D.

Expected Results

Given time, the body will make antibodies to cure itself of a cold. Most colds last seven to 10 days. Most people start feeling better within four or five days. Occasionally, a cold will lead to a secondary bacterial infection that causes strep throat, bronchitis, pneumonia, sinus infection, or a middle ear infection.

Prevention

Prevention focuses on strengthening the immune system by eating a healthy diet low in sugars and high in fresh fruits and vegetables, practicing meditation to reduce stress, getting adequate sleep, and getting regular moderate exercise. Some steps persons can take to prevent catching a cold and to reduce their spread include:

  • washing hands well and frequently
  • covering the mouth and nose when sneezing
  • avoiding close contact with someone who has a cold during the first two to four days of their infection
  • not sharing food, eating utensils, or cups
  • avoiding crowded places where cold viruses can spread
  • keeping hands away from the face
  • avoiding cigarette smoke
  • taking Echinacea; 250 mg up to four times daily for three weeks on, one week off
  • taking astragalus; 250 mg to 500 mg daily.
  • taking a multivitamin with zinc
  • taking vitamin C ; 500 mg
  • taking Anas barbariae hepatis; one dose weekly

In 2002, researchers discovered that transmission of the rhinovirus may be prevented through the use of anti-septic skin cleansers containing salicylic acid or pyroglutamic acid. The cleansers have properties that can kill the viruses and help prevent hand-to-hand transmission, but further research on their effectiveness remains to be done.

Resources

Books

Castleman, Michael. "Cold and Flu Therapy." In Nature's Cures. Emmaus, PA: Rodale Press, 1996.

Silverstein Alvin, et al. Common Cold and Flu (Diseases and People). Springfield, MA: Enslow Publishers, 1996.

Ying, Zhou Zhong, and Jin Hui De. "Exterior Invasion." In Clinical Manual of Chinese Herbal Medicine and Acupuncture. New York: Churchill Livingston, 1997.

Periodicals

"Antispetic Skin Cleansers May Prevent Rhinovirus Transmission."Clinical Infectious Diseases (February 1, 2002): ii.

Bourassa, Nicole. "Larch: This Immune Booster Fights Tenacious Colds and Ear Infections."Natural Health (March 2002): 35.

Elkins, Rita. "Combat Colds and Flu."Let's Live 68 (January 2000): 81+.

Jackson, Jeffrey L., Cecily Peterson, and Emil Lesho. "A Meta-Analysis of Zinc Salts Lozenges and the Common Cold." Archives of Internal Medicine 157 (1997): 2373–2376.

Le Page, Michael. "Eat to Treat: The Maxim "Feed a Cold, Starve a Fever" May be Right After All."New Scientist (January 19, 2002): 15.

Marshall, Shaun. "Zinc Gluconate and the Common Cold: Review of Randomized Controlled Trials."Canadian Family Physician 44 (1998): 1037–1042.

Mayo Health Clinic. "Zinc: A Weapon Against the Common Cold?"Mayo Health Oasishttp://www.mayohealth.org/mayo/9709/htm/zinc.htm. (9 September 1997).

[Article by: Belinda Rowland; Teresa G. Odle]

 
Children's Health Encyclopedia: Common Cold

Definition

The common cold, also called a rhinovirus or coronavirus infection, is a viral infection of the upper respiratory system, including the nose, throat, sinuses, eustachian tubes, trachea, larynx, and bronchial tubes. Over 200 different viruses can cause a cold. Almost all colds clear up in less than two weeks without complications.

Description

Cold season in the United States begins in early autumn and extends through early spring. Although it is not true that getting wet or being in a draft causes a cold (a person has to come in contact with the virus to catch a cold), certain conditions may lead to increased susceptibility. These include:

  • fatigue and overwork
  • emotional stress
  • poor nutrition
  • smoking
  • living or working in crowded conditions

Although most colds resolve on their own without complications, they are a leading cause of visits to the doctor and of time lost from work and school. Treating symptoms of the common cold has given rise in the United States to a multi-million dollar industry in over-the-counter medications.

Colds make the upper respiratory system less resistant to bacterial infection. Secondary bacterial infection may lead to middle ear infection (otitis media), bronchitis, pneumonia, sinus infection, or strep throat. People with chronic lung disease, asthma, diabetes, or a weakened immune system are more likely to develop these complications.

Transmission

People with colds are contagious during the first two to four days of the infection. Colds pass from person to person in several ways. When an infected person coughs, sneezes, or speaks, tiny fluid droplets containing the virus are expelled. If these are breathed in by other people, the virus may establish itself in their noses and airways.

Colds may also be passed through direct contact. If a person with a cold touches his runny nose or watery eyes, then shakes hands with another person, some of the virus is transferred to the uninfected person. If that person then touches his mouth, nose, or eyes, the virus is transferred to an environment where it can reproduce and cause a cold.

In addition, cold viruses can be spread through inanimate objects (door knobs, telephones, toys) that become contaminated with the virus. This is a common method of transmission in childcare centers. If a child with a cold touches his runny nose, then plays with a toy, some of the virus may be transferred to the toy. When another child plays with the toy a short time later, he may pick up some of the virus on his hands. The second child then touches his contaminated hands to his eyes, nose, or mouth and transfers some of the cold virus to himself.

Demographics

Colds are the most common illness to strike any part of the body, with over one billion colds in the United States each year. Anyone can get a cold, although pre-school and grade school children catch them more frequently than adolescents and adults. Children average six to ten colds a year. In families with children in school, the number can be as high as 12 per year. Women, especially those aged 20 to 30 years old, have more colds than men, possibly because of their closer contact with children. Individuals older than 60 usually have fewer than one cold per year. Repeated exposure to viruses causing colds creates partial immunity.

Causes and Symptoms

Colds are caused by more than 200 different viruses. The most common groups are rhinoviruses and coronaviruses. Different groups of viruses are more infectious at different seasons of the year, but knowing the exact virus causing the cold is not important in treatment.

Once acquired, the cold virus attaches itself to the lining of the nasal passages and sinuses. This condition causes the infected cells to release a chemical called histamine. Histamine increases the blood flow to the infected cells, causing swelling, congestion, and increased mucus production. Within one to three days the infected person begins to show cold symptoms.

The first cold symptoms are a tickle in the throat, runny nose, and sneezing. The initial discharge from the nose is clear and thin. Later it changes to a thick yellow or greenish discharge. Most adults do not develop a fever when they catch a cold. Young children may develop a low fever of up to 102°F (38.9°C).

In addition to a runny nose and fever, signs of a cold include coughing, sneezing, nasal congestion, headache, muscle ache, chills, sore throat, hoarseness, watery eyes, tiredness, and lack of appetite. The cough that accompanies a cold is usually intermittent and dry.

Most people begin to feel better four to five days after their cold symptoms become noticeable. All symptoms are generally gone within ten days, except for a dry cough that may linger for up to three weeks.

When to Call the Doctor

Colds make people more susceptible to bacterial infections such as strep throat, middle ear infections, and sinus infections. People who have colds that do not begin to improve within a week or who experience chest pain, fever for more than a few days, difficulty breathing, bluish lips or fingernails, a cough that brings up greenish-yellow or grayish sputum, skin rash, swollen glands, or whitish spots on the tonsils or throat should consult a doctor to see to determine if they have acquired a secondary bacterial infection that needs to be treated with an antibiotic.

Children who have chronic lung disease, diabetes, or a weakened immune system—either from diseases such as AIDS or leukemia or as the result of medications, (corticosteroids, chemotherapy drugs)—should consult their doctor if they get a cold. Children with these health problems are more likely to get a secondary infection. For children with asthma, colds are a common trigger of asthma symptoms.

Diagnosis

Colds are diagnosed by observing a child's symptoms. There are no laboratory tests as of 2004 for detecting the cold virus. However, a doctor may do a throat culture or blood test to rule out a secondary infection.

Influenza is sometimes confused with a cold, but flu causes much more severe symptoms, as well as a fever. Allergies to molds or pollens also can make the nose run. Allergies are usually more persistent than the common cold. An allergist can do tests to determine if the cold-like symptoms are being caused by an allergic reaction. Also, some people get a runny nose when they go outside in winter and breathe cold air. This type of runny nose is not a symptom of a cold.

Treatment

There are no medicines that will cure the common cold. Given time, the body's immune system makes antibodies to fight the infection, and the cold is resolved without any intervention. Antibiotics are useless against a cold. However, there are many products that have been developed by pharmaceutical companies in the United States designed to relieve cold symptoms. These products usually contain antihistamines, decongestants, and/or pain relievers.

Antihistamines block the action of the chemical histamine that is produced when the cold virus invades the cells lining the nasal passages. Histamine increases blood flow and causes the cells to swell. Antihistamines are taken to relieve the symptoms of sneezing, runny nose, itchy eyes, and congestion. Side effects are dry mouth and drowsiness, especially with the first few doses. Antihistamines should not be taken by people who are driving or operating dangerous equipment. Some people have allergic reactions to antihistamines. Common over-the-counter antihistamines are Chlor-Trimeton, Dimetapp, Tavist, and Actifed. The generic name for two common antihistamines are chlorpheniramine and diphenhydramine.

Decongestants work to constrict the blood flow to the vessels in the nose. They can shrink the tissue, reduce congestion, and open inflamed nasal passages, making breathing easier. Decongestants can make people feel jittery or keep them from sleeping. They should not be used by people with heart disease, high blood pressure, or glaucoma. Some common decongestants are Neo-Synepherine, Novafed, and Sudafed. The generic names of common decongestants include phenylephrine, phenylpropanolamine, pseudoephedrine, and in nasal sprays naphazoline, oxymetazoline, and xylometazoline.

Many over-the-counter medications are combinations of both antihistamines and decongestants; an ache and pain reliever, such as acetaminophen (Datril, Tylenol, Panadol) or ibuprofen (Advil, Nuprin, Motrin, Medipren); and a cough suppressant (dextromethorphan). Common combination medications include Tylenol Cold and Flu, Triaminic, Sudafed Plus, and Tavist D. Aspirin should not be given to children with a cold because of its association with a risk of Reye's syndrome.

Nasal sprays and nose drops are other products promoted for reducing nasal congestion. These usually contain a decongestant, but the decongestant in the nasal preparations can act more quickly and strongly than ones found in pills or liquids because it is applied directly in the nose. Congestion returns after a few hours. People can become dependent on nasal sprays and nose drops. If used for a long time, users may suffer withdrawal symptoms when these products are discontinued. The label on the preparation should be checked for recommendations on length and frequency of use, since nasal sprays and nose drops should not be used for more than a few days.

People react differently to different cold medications and may find some more helpful than others. A medication may be effective initially then lose some of its effectiveness. Children sometimes react differently than adults. Over-the-counter cold remedies should not be given to infants without consulting a doctor first.

Care should be taken not to exceed the recommended dosages, especially when combination medications or nasal sprays are taken. These medicines do not shorten or cure a cold; at best they can only help a person feel more comfortable.

In addition to the optional use of over-the-counter cold remedies, there are some self-care steps that can be taken to ease discomfort. These include:

  • drinking plenty of fluids, but avoiding acidic juices, which may irritate the throat
  • gargling with warm salt water—made by adding one teaspoon of salt to 8 oz of water—for a sore throat
  • avoiding second-hand smoke
  • getting plenty of rest
  • using a cool-mist room humidifier to ease congestion and sore throat
  • rubbing Vaseline or other lubricant under the nose to prevent irritation from frequent nose blowing
  • for babies too young to blow their noses, the mucus should be suctioned gently with an infant nasal aspirator (It may be necessary to soften the mucus first with a few drops of salt water.)

Alternative Treatment

Alternative practitioners emphasize that people get colds because their immune systems are weak. They point out that everyone is exposed to cold viruses, but not everyone gets every cold. The difference seems to be in the ability of the immune system to fight infection. Prevention focuses on strengthening the immune system by eating a healthy diet low in sugars and high in fresh fruits and vegetables, practicing meditation or using other means to reduce stress, and getting regular moderate exercise.

Once cold symptoms appear, some naturopathic practitioners believe the symptoms should be allowed to run their course without interference. Others suggest the following:

  • Aromatherapy remedy: Inhaling a steaming mixture of lemon oil, thyme oil, eucalyptus, and tea tree oil (Melaleuca spp.).
  • Ayurvedic medicinal remedy: Gargling with a mixture of water, salt, and turmeric powder or astringents, such as alum, sumac, sage, and bayberry to ease a sore throat.
  • Herbal remedies: Taking coneflower (Echinacea spp.) or goldenseal (Hydrastis canadensis). Other useful herbs to reduce symptoms are yarrow (Achillea millefolium), eyebright (Euphrasia officinalis), garlic (Allium sativum), and onions (Allium cepa).
  • Homeopathic remedies: Microdoses of Viscue album, Natrum muriaticum, Allium cepa, or Nux vomica.
  • Chinese traditional medicinal remedies: Taking yin chiao (sometimes transliterated as yinquiao) tablets that contain honeysuckle and forsythia when symptoms appear as well as using natural herb loquat syrup for cough and sinus congestion.
  • Nutritional therapy: The use of zinc lozenges every two hours along with high doses of vitamin C as well as eliminating dairy products for the duration of the cold.

Prognosis

Given time, the body produces antibodies to cure itself of a cold. Most colds last a week to ten days. Most people start feeling better within four or five days. Occasionally a cold will lead to a secondary bacterial infection that causes strep throat, bronchitis, pneumonia, sinus infection, or a middle ear infection. These conditions usually clear up rapidly when treated with an antibiotic.

Prevention

It is not possible to prevent colds because the viruses that cause colds are common and highly infectious. However, there are some steps individuals can take to reduce their spread. These include:

  • washing hands well and frequently, especially after touching the nose or before handling food
  • using instant hand sanitizers, which are antiseptics and not antibiotics
  • covering the mouth and nose when sneezing
  • disposing of used tissues properly
  • avoiding close contact with someone who has a cold during the first two to four days of their infection
  • not sharing food, eating utensils, or cups
  • using paper towels rather than shared cloth towels
  • avoiding crowded places where cold germs can spread
  • eating a healthy diet and getting adequate sleep
  • using a daycare facility with six or fewer children, to dramatically reduce germ contact

Parental Concerns

The over-use of antibiotics has led to the development of antibiotic-resistant stains of bacteria. For these bacteria, antibiotics may be ineffective. Therefore, parents should not press the doctor to prescribe antibiotics when their children only have a cold.

Also, a parent should not give a child aspirin during a cold, because aspirin has been linked to the development of Reye's syndrome in children recovering from viral illnesses, especially influenza (flu) or chickenpox. Reye's syndrome can lead to permanent brain damage or death.

Resources

Books

Royston, Angela. Colds (It's Catching) Oxford, UK: Heinemann Library, 2001.

Silverstein, Alvin. Common Colds. Minneapolis, MN: Sagebrush Corp., 2001.

[Article by: Judith Sims Tish Davidson, A.M.]


 
Britannica Concise Encyclopedia: common cold

Viral infection of the upper and sometimes the lower respiratory tract. Symptoms, which are relatively mild, include sneezing, fatigue, sore throat, and stuffy or runny nose (but not fever); they usually last only a few days. About 200 different strains of virus can produce colds; they are spread by direct or indirect contact. The cold is the most common of all illnesses; the average person gets several every year. Incidence peaks in the fall. Treatment involves rest, adequate fluid intake, and over-the-counter remedies for the symptoms. Antibiotics do not combat the virus but may be given if secondary infections develop.

For more information on common cold, visit Britannica.com.

 
Columbia Encyclopedia: common cold,
acute viral infection of the mucous membranes of the nose and throat, often involving the sinuses. The typical sore throat, sneezing, and fatigue may be accompanied by body aches, headache, low fever, and chills. The congested and discharging mucous membrane may become a fertile ground for a secondary bacterial invasion that can spread to the larynx, bronchi, lungs, or ears. Uncomplicated infections usually last from three to ten days.

The cold is the most common human ailment. Most adult Americans suffer from one to four colds per year, but children ages one to five—who are the most susceptible—typically may contract as many as eight. Colds are spread by respiratory droplets or by contaminated hands or objects. Although the incidence of colds is higher in winter, exposure to chilling or dampness is considered to be of little significance.

Any one of up to 200 viruses (such as the rhinoviruses, coronaviruses, or respiratory syncytial virus [RSV]) can cause colds, to which it seems almost no one is immune. Infection with a viral strain confers only temporary immunity to that strain. Colds in infants and young children caused by RSV can progress to pneumonia and other complications, especially in those under a year old who were born prematurely or have chronic lung disease; RSV causes an estimated 4,500 deaths yearly in these groups in the United States.

There is no treatment for the common cold other than that aimed at relieving symptoms and keeping the body well-rested, -fed, and -hydrated. Because of the growing problem of drug resistance, doctors are being discouraged from prescribing antibiotics (which do not affect viruses) for colds unless secondary bacterial infection makes them necessary. There is no convincing evidence that vitamin C megadoses can prevent the common cold.

Researchers have reported reduction or prevention of cold symptoms in human tests of an experimental drug against rhinoviruses, which cause nearly half of all colds. The drug acts by imitating a molecule in the body called ICAM-1, to which the rhinovirus attaches to produce colds. As rhinoviruses attach to the decoy molecules instead, the likelihood or severity of infection is decreased.

 
Wikipedia: common cold
Acute nasopharyngitis
Classification & external resources
ICD-10 J00.0
ICD-9 460
DiseasesDB 31088
MedlinePlus 000678
eMedicine med/2339 
MeSH D003139

Acute viral nasopharyngitis, or acute coryza, usually known as the common cold, is a highly contagious, viral infectious disease of the upper respiratory system, primarily caused by picornaviruses or coronaviruses.

Common symptoms are sore throat, runny nose, nasal congestion, sneezing and cough; sometimes accompanied by muscle aches, fatigue, malaise, headache, muscle weakness, or loss of appetite. Fever and extreme exhaustion are more usual in influenza. The symptoms of a cold usually resolve after about one week, but can last up to 14 days. Symptoms may be more severe in infants and young children. Although the disease is generally mild and self-limiting, patients with common colds often seek professional medical help, use over-the-counter drugs, and may miss school or work days. The cumulative societal cost of the common cold in the United States is billions of dollars.

No vaccines are available: the primary method to prevent infection is hand-washing to minimize person-to-person transmission of the virus. There are no antiviral drugs approved to treat or cure the infection. Most available medications are palliative and treat symptoms only. Megadoses of vitamin C, preparations from echinacea, and zinc gluconate have been studied as treatments for the common cold although none have been approved by the Food and Drug Administration or European Medicines Agency.

Pathology

Epidemiology

Upper respiratory tract infections are the most common infectious diseases among adults who have two to four respiratory infections annually.[1] Children may have six to ten colds a year (and up to 12 colds a year for school children).[2][3] In the United States, the incidence of colds is higher in the fall and winter, with most infections occurring between September to April. The seasonality may be due to the start of the school year, or due to people spending more time indoors (thus in closer proximity with each other) increasing the chance of transmission of the virus.[2]

Virus

Rhinoviruses cause most common colds
Enlarge
Rhinoviruses cause most common colds

Most common colds are caused by infection by rhinoviruses. Other viruses causing colds are coronavirus, human parainfluenza viruses, human respiratory syncytial virus, adenoviruses, enteroviruses, or metapneumovirus.[4][5]

Transmission

The common cold virus is transmitted between people by one of two ways:

  • through the air from aerosols containing the virus created by coughs or sneezes, or
  • from contact with the saliva or nasal secretions of an infected person, either directly or from contaminated surfaces.

The infectious period (time during which an infected person can infect others) begins about one day before symptoms begin, and continues for the first five days of the illness. Symptoms, however, are not necessary for viral shedding or transmission, as a percentage of asymptomatic subjects exhibit viruses in nasal swabs.[6]

The virus enters the cells of the lining of the nasopharynx (the area between the nose and throat), and rapidly multiplies. The major entry point is normally the nose, but can also be the eyes (in this case drainage into the nasopharynx would occur through the Nasolacrimal duct).

Symptoms

After initial infection, the viral replication cycle begins within 8 to 12 hours. Symptoms can occur shortly thereafter, and usually peak within 2 to 3 days after infection.[7] The first indication of a cold is often a sore or scratchy throat. Other common symptoms are runny nose, congestion, sneezing and cough. These are sometimes accompanied by muscle aches, fatigue, malaise, headache, weakness, or loss of appetite[8]. Colds occasionally cause fever and can sometimes lead to extreme exhaustion. (However, these symptoms are more usual in influenza, and can differentiate the two infections.) The symptoms of a cold usually resolve after about one week, but can last up to 14 days, with a cough lasting longer than other symptoms. Symptoms may be more severe in infants and young children, and may include fever.[9][2][10]

Complications

The common cold can lead to opportunistic coinfections or superinfections such as acute bronchitis, bronchiolitis, croup, pneumonia, sinusitis, otitis media, or strep throat. People with chronic lung diseases such as asthma and COPD are especially vulnerable. Colds may cause acute exacerbations of asthma, emphysema or chronic bronchitis.[7][4][5]

The economic cost of the common cold

The common cold leads to 75 to 100 million physician visits annually at a conservative cost estimate of $7.7 billion per year. Americans spend $2.9 billion on over-the-counter drugs and another $400 million on prescription medicines for symptomatic relief.[1][11]

More than one-third of patients who saw a doctor received an antibiotic prescription, which not only contributes to unnecessary costs ($1.1 billion annually on an estimated 41 million antibiotic prescriptions in the United States), but also has implications for antibiotic resistance from overuse of such drugs.[11]

An estimated 22 to 189 million school days are missed annually due to a cold. As a result, parents missed 126 million workdays to stay home to care for their children. When added to the 150 million workdays missed by employees suffering from a cold, the total economic impact of cold-related work loss exceeds $20 billion.[2][1][11]

Prevention

The best way to avoid a cold is to avoid close contact with existing sufferers; to wash hands thoroughly and regularly; and to avoid touching the mouth and face. Anti-bacterial soaps have no effect on the cold virus; it is the mechanical action of hand washing that removes the virus particles.[12]

In 2002, the Centers for Disease Control and Prevention recommended alcohol-based hand gels as an effective method for reducing infectious viruses on the hands of health care workers.[13] As with hand washing with soap and water, alcohol gels provide no residual protection from re-infection.

The common cold is caused by a large variety of viruses, which mutate quite frequently during reproduction, resulting in constantly changing virus strains. Thus, successful immunization is highly improbable.

Treatment

As there is no medically proven and accepted medication directly targeting the causative agent, there is no cure for the common cold. Treatment is limited to symptomatic supportive options, maximizing the comfort of the patient, and limiting complications and harmful sequelae. The most reliable treatment is a combination of fluids and plenty of rest.

The common cold is self-limiting, and the host's immune system effectively deals with the infection. Within a few days, the body's humoral immune response begins producing specific antibodies that can prevent the virus from infecting cells. Additionally, as part of the cell-mediated immune response, leukocytes destroy the virus through phagocytosis and destroy infected cells to prevent further viral replication. In healthy, immunocompetent individuals, the common cold resolves in seven days on average.[7]

Palliative care

The National Institute of Allergy and Infectious Diseases suggests getting plenty of rest, drinking fluids to maintain hydration, gargling with warm salt water, using cough drops, throat sprays, or over-the-counter pain or cold medicines.[2] Saline nasal drops may help alleviate congestion.[14]

The American Lung Association recommends avoiding coffee, tea or cola drinks that contain caffeine and avoiding alcoholic beverages. Both caffeine and alcohol cause dehydration.[10]

Antibiotics

Antibiotics do not have any beneficial effect against the common cold. Their use in cases of common cold infection is ineffective and may contribute to antibiotic resistance of bacteria present in the patient's body.

Antivirals

There are no approved antiviral drugs for the common cold.

ViroPharma and Schering-Plough are developing an antiviral drug, pleconaril, that targets picornaviruses, the viruses that cause the majority of common colds. Pleconaril has been shown to be effective in an oral form.[15][16] Schering-Plough is developing an intra-nasal formulation that may have fewer adverse effects.[17]

Over-the-counter symptom medicines

There are a number of effective treatments which, rather than treat the viral infection, focus on relieving the symptoms. For some people, colds are relatively minor inconveniences and they can go on with their daily activities with tolerable discomfort. This discomfort has to be weighed against the price and possible side effects of the remedies.

Herbal remedies

Herbal teas, such as chamomile tea, or lemon or ginger root tisanes may soothe some symptoms and comfort the patient.

Liquorice and garlic preparations have been suggested as treatments for the common cold, although efficacy is unproven.

Echinacea

Echinacea, commonly called coneflowers, are plants with large showy heads of composite flowers. They are herbaceous, drought-tolerant perennial plants, native to North America, growing to 1 or 2 m in height. Echinacea is used in herbal preparations used to treat the common cold.

Although there have been scientific studies evaluating echinacea, its effectiveness has not been convincingly demonstrated. For example, a peer-reviewed clinical study published in the New England Journal of Medicine concluded that "…extracts of E. angustifolia root, either alone or in combination, do not have clinically significant effects on rhinovirus infection or on the clinical illness that results from it."[18][19] Recent randomized, double-blind, placebo-controlled studies in adults have not shown a beneficial effect of echinacea on symptom severity or duration of the cold.[20][21] A structured review of 9 placebo controlled studies suggested that the effectiveness of echinacea in the treatment of colds has not been established.[22] Conversely, two recent meta-analyses of published medical articles concluded that there is some evidence that echinacea may reduce either the duration or severity of the common cold, but results are not fully consistent. However, there have been no large, randomized placebo-controlled clinical studies that definitively demonstrate either prophylaxis or therapeutic effects in adults.[23][24] A randomized, double-blind, placebo-controlled study in 407 children of ages ranging from 2 to 11 years showed that echinacea did not reduce the duration of the cold, or reduce the severity of the symptoms.[25] Most authoritative sources consider the effect of echinacea on the cold unproven.[4][2][10][3]

Reported adverse effects of echinacea include nausea, dizziness, dyspnea, rash, dermatitis, pruritis, and hepatotoxicity. These tend to be infrequent, mild and transient. Echinacea should not be taken with hepatotoxic drugs or immunosuppressants.[26] Forty-five percent of retail echinacea products failed quality testing by an independent consumer testing laboratory, due to either high lead levels, or low plant chemicals.[27]

Other

Vitamin C

A well known supporter of the theory that Vitamin C megadosage prevented infection was Nobel Prize winner Linus Pauling,[28] who wrote the bestseller Vitamin C and the Common Cold.[29] A meta-analysis published in 2005 found that "the lack of effect of prophylactic vitamin C supplementation on the incidence of common cold in normal populations throws doubt on the utility of this wide practice".[30]

A follow-up meta-analysis supported these conclusions:

Prophylactic use "...of vitamin C has no effect on common cold incidence ... [but] reduces the duration and severity of common cold symptoms slightly, although the magnitude of the effect was so small its clinical usefulness is doubtful. Therapeutic trials of high doses of vitamin C ... starting after the onset of symptoms, showed no consistent effect on either duration or severity of symptoms. ... More therapeutic trials are necessary to settle the question, especially in children who have not entered these trials."[31][32]

Most of the studies showing little or no effect employ doses of ascorbate such as 100 mg to 500 mg per day, considered "small" by vitamin C advocates. Equally important, the plasma half life of high dose ascorbate above the baseline, controlled by renal resorption, is approximately 30 minutes,[33][34] which implies that most high dose studies have been methodologically defective and would be expected to show a minimum benefit. Clinical studies of divided dose supplementation, predicted on pharmacological grounds to be effective, have only rarely been reported in the literature.

Because vitamin C is metabolized to oxalic acid in the body, some scientists have long speculated that high doses may contribute to the development of kidney stones.[35]

The U.S. Institute of Medicine recommends a daily requirement of 45mg to 90mg of vitamin C for adults, up to 85mg for pregnant women and up to 120mg for nursing mothers,[36] while the European Commission Health and Consumer Protection DG recommends 40mg/d for adults (50mg/d and 60mg/d for pregnant women and nursing mothers, respectively).[37]

Zinc preparations

Zinc is an essential element, necessary for sustaining life. Recommended daily intake has been established and results of zinc deficiency and toxicity have been well characterized.

Zinc acetate and zinc gluconate have been tested as potential treatments for the common cold, in various dosage form including nasal sprays, nasal gels, and lozenges.[38][39] Some studies have shown some effect of zinc preparations on the duration of the common cold, but conclusions are diverse.[40][41][42] Approximately half of studies demonstrate efficacy. Even studies that show clinical effect have not demonstrated the mechanism of action.[43] The studies differ in the salt used, concentration of the salt, dosage form, and formulation, and some suffer from defects in design or methods. For example, there is evidence that the potential efficacy of zinc gluconate lozenges may be affected by other food acids (citric acid, ascorbic acid and glycine) present in the lozenge.[44] Furthermore, interpretation of the results depends on whether concentration of total zinc or ionic zinc is considered.[45][46]

There are concerns regarding the safety of long-term use of cold preparations in an estimated 25 million persons who are haemochromatosis heterozygotes.[47] Use of high doses of zinc for more than two weeks may cause copper depletion, which leads to anemia.[48] Other adverse events of high doses of zinc include nausea, vomiting gastrointestinal discomfort, headache, drowsiness, unpleasant taste, taste distortion, abdominal cramping, and diarrhea.[43][48] Some users of nasal spray applicators containing zinc have reported temporary or permanent loss of sense of smell.[49]

Although widely available and advertised in the United States as dietary supplements or homeopathic treatments, the safety and efficacy of zinc preparations have not been evaluated or approved by the Food and Drug Administration. Authoritative sources consider the effect of zinc preparations on the cold