common cold

Common Cold How to get through one.

More about Common Cold: Causes and symptoms Diagnosis Treatment Alternative treatment Prognosis Prevention Resources

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:

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

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

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

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]

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.]

Common cold
Classification and external resources
Molecular surface of one variant of human rhinovirus.
ICD-10	J00.0
ICD-9	460
DiseasesDB	31088
MedlinePlus	000678
eMedicine	aaem/118 med/2339
MeSH	D003139

The common cold (acute viral rhinopharyngitis, acute coryza, viral upper respiratory tract infection, or a cold) is a contagious, viral infectious disease of the upper respiratory system, primarily caused by rhinoviruses, (picornaviruses) or coronaviruses. It is the most common infectious disease in humans;^[1] there is no known cure, but it is very rarely fatal.

Collectively, colds, influenza, and other infections with similar symptoms are included in the diagnosis of influenza-like illness. Often, influenza and the common cold are mistaken for each other, even by professional healthcare workers, but most of the recommended home treatments (drinking plenty of warm fluids, keeping warm, etc.) are similar if not the same. The symptoms of influenza often include a fever and are more severe than the cold.

Contents 1 Symptoms 1.1 Complications 2 Cause and susceptibility 2.1 Sleep 2.2 Vitamin D 2.3 Exposure to cold weather 3 Pathophysiology 3.1 Incubation period and progression of disease 4 Prevention 5 Management 5.1 Conservative 5.2 Antibiotics and antivirals 5.3 Alternative treatments 6 Prognosis 7 Epidemiology 8 History 8.1 Common Cold Unit 9 Social and cultural 9.1 Economic cost 9.2 Legal 10 Research 11 See also 12 References 13 External links

Symptoms

Common symptoms are cough, sore throat, runny nose, nasal congestion, and sneezing; sometimes accompanied by 'pink eye', muscle aches, fatigue, malaise, headaches, muscle weakness, uncontrollable shivering, loss of appetite, and rarely extreme exhaustion. Fever is more commonly a symptom of influenza, another viral upper respiratory tract infection (URTI) whose symptoms broadly overlap with the cold^[2] but are more severe.^[3] Symptoms may be more severe in infants and young children (due to their immune system not being fully developed) as well as the elderly (due to their immune system often being weakened).

Those suffering from colds often report a sensation of chilliness even though the cold is not generally accompanied by fever, and although chills are generally associated with fever, the sensation may not always be caused by actual fever.^[2] In one study, 60% of those suffering from a sore throat and upper respiratory tract infection reported headaches^[2], often due to nasal congestion. The symptoms of a cold usually resolve after about one week; however, it is not rare that symptoms last up to three weeks.^[4]

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.^[5]

Cause and susceptibility

The common cold is most often caused by infection with one of the 99 known serotypes of rhinovirus, a type of picornavirus.^[6][7] Around 30-50% of colds are caused by rhinoviruses.^[2] Other viruses causing colds are coronavirus (causing 10-15%^[2]), human parainfluenza viruses, human respiratory syncytial virus, adenoviruses, enteroviruses, or metapneumovirus.^[8] 5-15% are caused by influenza viruses.^[2] In total over 200 serologically different viral types cause colds.^[2] Coronaviruses are particularly implicated in adult colds. Of over 30 coronaviruses, 3 or 4 cause infections in humans, but they are difficult to grow in the laboratory and their significance is thus less well-understood.^[8] Due to the many different types of viruses and their tendency for continuous mutation, it is impossible to gain complete immunity to the common cold.

Sleep

Lack of sleep has been associated with the common cold. Those who sleep fewer than 7 hours per night were three times more likely to develop an infection when exposed to a rhinovirus when compared to those who sleep more than 8 hours per night.^[9]

Vitamin D

A 2009 study found that low blood serum levels of vitamin D were associated with increased rates of the common cold.^[10] A randomized controlled trial found that 104 post-menopausal African American women living in New York given vitamin D were three times less likely to report cold and flu symptoms than 104 placebo controls. A low dose (800 IU/day) not only reduced reported incidence, it abolished the seasonality of reported colds and flu. A higher dose (2000 IU/day), given during the last year of the trial, virtually eradicated all reports of colds or flu.^[11]

Exposure to cold weather

An ancient belief still common today claims that a cold can be "caught" by prolonged exposure to cold weather such as rain or winter conditions, which is where the disease got its name.^[12] Although common colds are seasonal, with more occurring during winter, experiments so far have failed to produce evidence that short-term exposure to cold weather or direct chilling increases susceptibility to infection, implying that the seasonal variation is instead due to a change in behaviors such as increased time spent indoors at close proximity to others.^{[8][13][14][15][16]}

With respect to the causation of cold-like symptoms, researchers at the Common Cold Centre at Cardiff University^[17] conducted a study to "test the hypothesis that acute cooling of the feet causes the onset of common cold symptoms."^[18][19][20] The study measured the subjects' self-reported cold symptoms, and belief they had a cold, but not whether an actual respiratory infection developed. It found that a significantly greater number of those subjects chilled developed cold symptoms 4 or 5 days after the chilling. It concludes that the onset of common cold symptoms can be caused by acute chilling of the feet. Some possible explanations were suggested for the symptoms, such as placebo, or constriction of blood vessels of the nasal passages which might lead to reduced immunity, however "further studies are needed to determine the relationship of symptom generation to any respiratory infection."

Another possibility which remains to be explored involves the role that proteins of the complement system play in the prevention of a sustained infection. Decreased temperature may result in a drop in tissue permeability and, as a result, may lead to reduced plasma leakage. Among the many proteins suspended in plasma are complement proteins (e.g. C3) which serve to disable, destroy, or tag for destruction foreign particulate (in this case viral capsids). Thus, sustained exposure to cold may inhibit the effectiveness of the complement system and allow the virus a better chance of establishing a state of infection.^{[citation needed]}

ICAM-1, the receptor that Rhinovirus binds to in order to infect cells, is known to increase in number and receptiveness in response to many irritants, including dust and pollen. That a cold climate in combination with varying degrees of humidity can act as a similar "irritant" needs to be investigated.^{[citation needed]}

Pathophysiology

The common cold is a disease of the upper respiratory tract

The common cold virus is transmitted mainly from contact with the saliva or nasal secretions of an infected person, either directly, in aerosol form generated by coughing and sneezing, or from contaminated surfaces.^[21]

Symptoms are not necessary for viral shedding or transmission, as a percentage of asymptomatic subjects exhibit viruses in nasal swabs.^[22] It is generally not possible to identify the virus type through symptoms, although influenza can be distinguished by its sudden onset, fever, and cough.^[2]

The major entry point for the virus is normally the nose, but can also be the eyes (in this case drainage into the nasopharynx would occur through the nasolacrimal duct). From there, it is transported to the back of the nose and the adenoid area. The virus then attaches to a receptor, ICAM-1, which is located on the surface of cells of the lining of the nasopharynx. The receptor fits into a docking port on the surface of the virus. Large amounts of virus receptor are present on cells of the adenoid. After attachment to the receptor, virus is taken into the cell, where it starts an infection.^[5] Rhinovirus colds do not generally cause damage to the nasal epithelium. Macrophages trigger the production of cytokines, which in combination with mediators cause the symptoms. Cytokines cause the systemic effects. The mediator bradykinin plays a major role in causing the local symptoms such as sore throat and nasal irritation.^[2]

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.^[5]

Incubation period and progression of disease

The upper respiratory viral replication cycle begins 8 to 12 hours after initial infection.^[5] Symptoms usually begin 2 to 5 days after initial infection but occasionally occur in as little as 10 hours after.^[23] Symptoms peak 2–3 days after symptom onset, whereas influenza symptom onset is constant and immediate.^[2] The symptoms usually resolve spontaneously in 7 to 10 days but some can last for up to three weeks.^[4]

The first indication of an upper respiratory virus is often a sore or scratchy throat. Other common symptoms are runny nose, congestion, and sneezing.^[8] These are sometimes accompanied by muscle aches, fatigue, malaise, headache, weakness, or loss of appetite.^[17] Cough and fever generally indicate influenza rather than an upper respiratory virus with a positive predictive value of around 80%.^[2] Symptoms may be more severe in infants and young children, and in these cases it may include fever and hives.^[24] Upper respiratory viruses may also be more severe in smokers.^[25]

Prevention

The best way to avoid a cold is thorough and regular washing of the hands. Anti-bacterial and non anti-bacterial soaps are equally effective.^[26] Alcohol-based hand sanitizer well not completely eliminating the cold virus are also effective^[27] and are recommended as a method for reducing viruses on the hands of health care workers.^[28]

Probiotics in children 3 – 5 years old were found effective in decreases cold symptoms when taken over 6 months.^[29]

Developing a vaccine for the common cold as of 2009 has been unsuccessful. This is due to a number of reason including: a large variety of viruses and the fact that they mutate rapidly. Many thus believe that successful immunization is highly improbable.^[30]

Management

Poster encouraging citizens to "Consult your Physician" for treatment of the common cold

The common cold usually resolves spontaneously in 7 to 10 days, but some symptoms can last for up to three weeks.^[4] There are no medications or herbal remedies proven to shorten the duration of illness. Treatment is symptomatic support usually via analgesics for fever, headache and myalgia, nasal decongestants, and lozenges for sore throat.

Conservative

Treatments that help alleviate symptoms include simple analgesics such as ibuprofen,^[31] and acetaminophen.

Evidence does not show that cold medicines are any more effective than simple analgesics.^[32] They are not recommended for use in children due to no evidence supporting their effectiveness and the potential of harm.^[33][34]

Getting plenty of rest, drinking fluids to maintain hydration, gargling with warm salt water, or use of over-the-counter pain medicines are reasonable conservative measures.^[8] Saline nasal drops may help alleviate nasal congestion.^[35]

Evidence for encouraging the active intake of fluids in acute respiratory infections is lacking^[36] as is the use of heated humidified air.^[37]

Antibiotics and antivirals

Antibiotics only target bacteria and thus do not have any beneficial effect in the common cold.^[38] There are no approved antiviral drugs for the common cold.

Alternative treatments

Main article: Alternative treatments used for the common cold

Many alternative treatments are used to treat the common cold. None however are recommended due to insufficient scientific evidence.^[25][39] Some alternative treatments, like echinacea, have not been shown to have any effects on the frequency of infection, the duration of infection, or the severity of symptoms of the common cold.^[40][41] Other alternative treatments which similarly lack solid scientific evidence include calendula^[42], ginger^[43], garlic^[44] and vitamin C supplements.^[45]

While vitamin C in normal or increased doses has not been shown to be beneficial in a normal population for the prevention or treatment of the common cold, it might be beneficial in people exposed to periods of severe physical exercise or cold environments.^[46]

Prognosis

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 annual cumulative societal cost of the common cold in developed countries is considerable in terms of money spent on remedies, and hours of lost productivity.

There are no antiviral drugs approved to treat or cure the infection; all medications used are palliative and treat symptoms only. Alternative treatments such as vitamin C, echinacea, and zinc have been proposed but none of them has been shown to decrease the duration of the illness,^[25] and thus none of them is approved by the Food and Drug Administration or European Medicines Agency. To prevent infection, washing or disinfecting^[47] hands has been found effective, as this minimizes person-to-person transmission of the virus.

Epidemiology

Upper respiratory tract infections are the most common infectious diseases among adults, who have two to four respiratory infections annually.^[48] Children may have six to ten colds a year (and up to 12 colds a year for school children).^[8][49] In the United States, the incidence of colds is higher in the fall (autumn) and winter, with most infections occurring between September and 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.^[8]

History

"Definition of a Cold." Benjamin Franklin's notes for a paper he intended to write on the common cold.

The name "common cold" came into use in the 16th century, due to the similarity between its symptoms and those of exposure to cold weather.^[50] Norman Moore relates in his history of the Study of Medicine that James I continually suffered from nasal colds, which were then thought to be caused by polypi, sinus trouble, or autotoxaemia.^[51]

In the 18th century, Benjamin Franklin considered the causes and prevention of the common cold. After several years of research he concluded: "People often catch cold from one another when shut up together in small close rooms, coaches, etc. and when sitting near and conversing so as to breathe in each other's transpiration." Although viruses had not yet been discovered, Franklin hypothesized that the common cold was passed between people through the air. He recommended exercise, bathing, and moderation in food and drink consumption to avoid the common cold.^[52] Franklin's theory on the transmission of the cold was confirmed some 150 years later.^[53]

Common Cold Unit

Main article: Common Cold Unit

In the United Kingdom, the Common Cold Unit was set up by the Medical Research Council in 1946. The unit worked with volunteers who were infected with various viruses.^[54] The rhinovirus was discovered there.^[55] In the late 1950s, researchers were able to grow one of these cold viruses in a tissue culture, as it would not grow in fertilized chicken eggs, the method used for many other viruses. In the 1970s, the CCU demonstrated that treatment with interferon during the incubation phase of rhinovirus infection protects somewhat against the disease^[56], but no practical treatment could be developed. The unit was closed in 1989, two years after it completed research of zinc gluconate lozenges in the prophylaxis and treatment of rhinovirus colds, the only successful treatment in the history of the unit.^[57]

Social and cultural

Economic cost

A British poster from World War II describing the cost of the common cold^[58]

The examples and perspective in this article deal primarily with the United States and do not represent a worldwide view of the subject. Please improve this article and discuss the issue on the talk page.

In the United States, 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.^[48][59]

More than one-third of patients who saw a doctor received an antibiotic prescription, which has implications for antibiotic resistance from overuse of such drugs.^[59]

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 per year.^[8][48][59]

Legal

Canada in 2009 restricted the use of over-the-counter cough and cold medication in children 6 years and under due to concerns regarding risks and unproven benefits.^[34]

Research

Biota Holdings are developing a drug, currently know as BTA798, which targets rhinovirus. The drug has recently successfully completed Phase IIa clinical trials.^[60][61]

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.^[62][63] Schering-Plough is developing an intra-nasal formulation that may have fewer adverse effects.^[64]

Researchers from University of Maryland, College Park and University of Wisconsin–Madison have mapped the genome for all known virus strains that cause the common cold.^[64]

See also

• Influenza
• Rhinitis
• Acute pharyngitis
• Severe acute respiratory syndrome

References

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v • d • e Infectious diseases · Viral diseases (A80–B34, 042–079) Oncovirus DNA virus: HBV (Hepatocellular carcinoma) · HPV (Cervical cancer) · Kaposi's sarcoma-associated herpesvirus (Kaposi's sarcoma) · Epstein-Barr virus (Nasopharyngeal carcinoma, Burkitt's lymphoma, Primary central nervous system lymphoma) · MCPyV (Merkel cell cancer) · SV40 RNA virus: HCV (Hepatocellular carcinoma) · HTLV-I (Adult T-cell leukemia/lymphoma) Immune disorders HIV (AIDS) Central nervous system Encephalitis/ meningitis DNA virus: JCV (Progressive multifocal leukoencephalopathy) RNA virus: MeV (Subacute sclerosing panencephalitis) · LCV (Lymphocytic choriomeningitis) · Arbovirus encephalitis · Orthomyxoviridae (probable) (Encephalitis lethargica) · RV (Rabies) Myelitis Poliovirus (Poliomyelitis, Post-polio syndrome) · HTLV-I (Tropical spastic paraparesis) Eye Cytomegalovirus (Cytomegalovirus retinitis) · HSV (Herpetic keratitis) Cardiovascular CBV (Pericarditis, Myocarditis) Respiratory system/ acute viral nasopharyngitis/ viral pneumonia DNA virus Epstein-Barr virus (EBV infection/Infectious mononucleosis) · Cytomegalovirus RNA virus IV: SARS coronavirus (Severe acute respiratory syndrome) V, Orthomyxoviridae: Influenzavirus A/B/C (Influenza/Avian influenza) V, Paramyxovirus: Human parainfluenza viruses (Parainfluenza) · RSV · hMPV Digestive system Oropharynx/Esophagus MuV (Mumps) · Cytomegalovirus (Cytomegalovirus esophagitis) Gastroenteritis/ diarrhea DNA virus: Adenovirus (Adenovirus infection) RNA virus: Rotavirus · Norovirus · Astrovirus · Coronavirus Hepatitis DNA virus: HBV (B) RNA virus: CBV · HAV (A) · HCV (C) · HDV (D) · HEV (E) · HGV (G) Pancreatitis CBV Skin and mucous membrane lesions, including exanthem DNA virus Herpesviridae HSV (Herpes simplex, Herpetic whitlow) · VZV (Chickenpox, Herpes zoster) · Human herpesvirus 6/Roseolovirus (Exanthema subitum) · KSHV (Kaposi's sarcoma) · Herpes B Virus Poxviridae Variola (Smallpox) · MoxV (Monkeypox) · CV (Cowpox) · VV (Vaccinia) · MCV (Molluscum contagiosum) Other HPV (Wart/Plantar wart) · Parvovirus B19 (Erythema infectiosum, Reticulocytopenia) RNA virus MeV (Measles) · Rubella virus (Rubella, Congenital rubella syndrome) picornavirus: CAV (Hand, foot and mouth disease, Herpangina) · FMDV (Foot-and-mouth disease) Urogenital BK virus · MuV (Mumps) see also DNA antivirals, RNA antivirals, Antiretroviral drug

v • d • e Pathology of respiratory system (J, 460-519), respiratory diseases Upper RT (including URTIs, Common cold) Head sinuses: Sinusitis nose: Rhinitis (Vasomotor rhinitis, Atrophic rhinitis, Hay fever) · Nasal polyp · Rhinorrhea · nasal septum (Nasal septum deviation, Nasal septum perforation, Nasal septal hematoma) tonsil: Tonsillitis · Adenoid hypertrophy · Peritonsillar abscess Neck pharynx: Pharyngitis (Strep throat) larynx: Laryngitis · Croup · Laryngospasm · vocal folds: Vocal fold nodule · epiglottis: Epiglottitis trachea: Tracheitis · Tracheal stenosis Retropharyngeal abscess Lower RT/lung disease (including LRTIs) Bronchial/ obstructive acute: Acute bronchitis chronic: COPD (Chronic bronchitis, Emphysema, Diffuse panbronchiolitis) · Asthma (Status asthmaticus) · Bronchiectasis unspecified: Bronchitis · Bronchiolitis (Bronchiolitis obliterans) Interstitial/ restrictive External agents/ occupational lung disease Pneumoconiosis (Asbestosis, Baritosis, Bauxite fibrosis, Berylliosis, Caplan's syndrome, Chalicosis, Coalworker's pneumoconiosis, Siderosis, Silicosis, Byssinosis) Hypersensitivity pneumonitis (Bagassosis, Bird fancier's lung, Farmer's lung) Other ARDS · Pulmonary edema · Löffler's syndrome/Eosinophilic pneumonia · Respiratory hypersensitivity (Allergic bronchopulmonary aspergillosis) Hamman-Rich syndrome · Idiopathic pulmonary fibrosis · Sarcoidosis Obstructive or restrictive Pneumonia/ pneumonitis By pathogen Viral · Bacterial (Pneumococcal, Klebsiella) / Atypical bacterial (Mycoplasma, Legionnaires' disease, Chlamydiae) · Fungal (Pneumocystis) · Parasitic · noninfectious (Chemical/Mendelson's syndrome, Aspiration/Lipid) By vector/route Community-acquired · Healthcare-associated · Hospital-acquired By distribution Broncho- · Lobar IIP UIP · DIP · BOOP-COP · NSIP · RB Other Atelectasis · circulatory (Pulmonary hypertension, Pulmonary embolism) · Lung abscess Pleural cavity/ mediastinum Pleural disease Pleuritis/pleurisy Pneumothorax/Hemopneumothorax (Tension pneumothorax) Pleural effusion: Hemothorax · Hydrothorax · Chylothorax · Empyema/pyothorax · Malignant Fibrothorax Mediastinal disease Mediastinitis · Mediastinal emphysema Other/general Respiratory failure · Influenza · SARS · Idiopathic pulmonary haemosiderosis · Pulmonary alveolar proteinosis respiratory system navs: anat nose,larynx/lower+thoracic cavity/physio/dev, noncongen/congen/tumors, symptoms+signs/eponymous, proc

v • d • e Common cold Viruses Rhinovirus - Coronavirus - Human parainfluenza viruses - Human respiratory syncytial virus - Adenovirus - Enterovirus - Metapneumovirus Symptoms Pharyngitis - Rhinorrhea - Nasal congestion - Sneezing - Cough - Muscle aches - Fatigue - Malaise - Headache - Weakness - Loss of appetite Complications Acute bronchitis - Bronchiolitis - Croup - Pneumonia - Sinusitis - Otitis media - Strep throat Antiviral drugs Pleconaril (experimental)

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