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Common Cold

Common cold refers to any specific viral or group of viral diseases that affect the parts of the upper respiratory tract like the sinuses (sinusitis) and the pharynx (pharyngitis). It sometimes affects the eyes causing conjunctivitis [1].


Presentation

The typical symptoms are cough, which is milder most of the times. They may also have a runny nose, nasal congestion sore throat, and the color of the nasal secretion may vary form clear to green thick secretion. There might also be fatigue, feeling of mild depression, headache, loss of appetite and muscle ache. Fever is a common presenting symptom in infants but not generally present in adults. If fever is seen in an adult, influenza should be considered [7].

Some patients may present with complications like otitis media, chronic bronchitis, otitis media. Aggravation of reactive airways in susceptible patients.

Cervical Lymphadenopathy
  • Infectious mononucleosis (glandular fever) : presents with persistent severe sore throat, fever, cervical lymphadenopathy and malaise; it is particularly common in teenagers and young adults.[patient.info]
  • Anterior cervical lymphadenopathy is common in bacterial pharyngitis and difficulty in swallowing may be present.[ncbi.nlm.nih.gov]
Fever
  • When to see a doctor For adults — seek medical attention if you have: Fever greater than 101.3 F (38.5 C) Fever lasting five days or more or returning after a fever-free period Shortness of breath Wheezing Severe sore throat, headache or sinus pain For[mayoclinic.com]
  • Common cold and flu are the most common human illnesses, and over-the-counter (OTC) analgesics are widely used to treat the pain and fever symptoms.[ncbi.nlm.nih.gov]
Chills
  • Delayed effects of chilling A delayed effect of chilling on the incidence of colds and symptoms was observed in the 4/5 days following the chill procedure.[fampra.oxfordjournals.org]
  • The symptoms of flu can include fever or feeling feverish/chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches and fatigue (tiredness). Cold symptoms are usually milder than the symptoms of flu.[web.archive.org]
  • […] the time of confinement indoors (MD -0.41, 95% CI [-0.62, -0.19], and P 0.0002), and relieve the symptoms associated with it, including chest pain (MD -0.40, 95% CI [-0.77, -0.03], and P 0.03), fever (MD -0.45, 95% CI [-0.78, -0.11], and P 0.009), and chills[ncbi.nlm.nih.gov]
  • It is characterized by chills, headaches, mucopurulent nasal discharge, coughing, and facial pain.[icd9data.com]
Malaise
  • Acetaminophen did not improve sore throat or malaise in two of the four studies. Results were inconsistent for some symptoms.[ncbi.nlm.nih.gov]
  • Influenza : initially presents with systemic symptoms, including fever, rigors, headaches, myalgia, malaise and anorexia.[patient.info]
Fatigue
  • The symptoms of flu can include fever or feeling feverish/chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches and fatigue (tiredness). Cold symptoms are usually milder than the symptoms of flu.[web.archive.org]
  • Scores of symptoms typically responsive to ibuprofen (headache, pharyngeal pain, joint pain and fever), typically responsive to pseudoephedrine (congested nose, congested sinus and runny nose), considered non-specific (sneezing, fatigue, dry cough, cough[ncbi.nlm.nih.gov]
Weakness
  • Some of the many viruses that cause colds may cause mild additional symptoms such as sore throat, weakness, dizziness, and tearing.[ncbi.nlm.nih.gov]
  • People who need this remedy often feel weak, "spaced out," and anxious or fearful when ill.[uofmhealth.org]
  • On the other hand, patients with influenza may first begin to complain about headaches, severe fatigue and weakness and a high temperature (fever). Is the common cold contagious? Yes.[irishhealth.com]
Cough
  • Although urge to cough and inability to control cough were the most bothersome aspects of cough due to cold, few ( CONCLUSION: Symptoms of urge to cough and cough are common and have a significant impact on cold sufferers.[ncbi.nlm.nih.gov]
  • Cough syrups. In winter, nonprescription cough syrups practically fly off the drugstore shelves.[web.archive.org]
Sneezing
  • Move away from people before coughing or sneezing. Cough and sneeze into a tissue then throw it away, or cough and sneeze into your upper shirt sleeve, completely covering your mouth and nose.[cdc.gov]
  • Cough and sneeze into a tissue then throw it away, or cough and sneeze into your upper shirt sleeve, completely covering your mouth and nose Wash your hands after coughing, sneezing, or blowing your nose Disinfect frequently touched surfaces, and objects[web.archive.org]
  • Subjective severity assessment of sneezing ‐ all trials: mean severity assessment of sneezing ‐ first day of treatment ( Analysis 9.1 ), mean severity assessment of sneezing ‐ second day of treatment ( Analysis 9.2 ), mean severity assessment of sneezing[doi.org]
  • […] on a four- or five-point severity scale; sneezing on day three: MD -0.35, 95% CI -0.49 to -0.20 on a four-point severity scale), but this effect is clinically non-significant.[ncbi.nlm.nih.gov]
Sore Throat
  • Bacterial infections in the throat can cause a sore throat or tonsillitis. Infections of the upper airways only very rarely cause serious complications like pneumonia.[ncbi.nlm.nih.gov]
  • Presentation The most frequent symptoms are nasal discharge, nasal obstruction, sneezing, sore throat, general malaise and cough.[patient.info]
Nasal Congestion
  • To determine the effect of IB versus placebo or no treatment on severity of rhinorrhoea and nasal congestion in children and adults with the common cold.[ncbi.nlm.nih.gov]
  • However, no results for subjective nasal congestion were provided on days two and three and it was unclear if subjective nasal congestion in the treatment group was compared to the control group.[doi.org]
  • Repeated dosing may provide some benefit over a three to five day period for the symptom of nasal congestion.[dx.doi.org]
Nasal Discharge
  • Symptoms may include sneezing, headaches, fatigue, chills, sore throat, inflammation of the nose ( rhinitis ), and nasal discharge. There is usually no fever. The nasal discharge is the first warning that one has caught a cold.[britannica.com]
  • Hydrastis canadensis This remedy relieves thick nasal discharge that irritates the throat. Kali bichromicum This helps relieve thick, greenish, irritating nasal discharge.[uofmhealth.org]
  • It is characterized by chills, headaches, mucopurulent nasal discharge, coughing, and facial pain.[icd9data.com]
  • RESULTS: Zinc acetate lozenges shortened the duration of nasal discharge by 34% (95% CI: 17% to 51%), nasal congestion by 37% (15% to 58%), sneezing by 22% (-1% to 45%), scratchy throat by 33% (8% to 59%), sore throat by 18% (-10% to 46%), hoarseness[ncbi.nlm.nih.gov]
  • An exception was Todd 1984, where the children had non‐transparent nasal discharge.[doi.org]
Loss of Appetite
  • Patient may also have headache, weakness, muscle pain, loss of appetite and a general feeling of unwell. Diagnosis: Diagnosis is usually clinical, and made by the doctor.[symptoma.com]
  • […] of appetite Cold: Sometimes Flu: Common Symptom: Sneezing Cold: Common Flu: Sometimes Symptom: Cough Cold: Common Flu: Sometimes Symptom: Sore throat Cold: Common Flu: Sometimes Symptom: Chest congestion, discomfort Cold: Common (mild to moderate) Flu[my.clevelandclinic.org]
  • Antibiotic versus placebo, loss of appetite[doi.org]
  • Symptoms include fever, loss of appetite, feeling unwell, feeling chilled, with headache, muscle aches, and pains. Many signs and symptoms are caused by congestion from swelling of membranes and thickened mucus inside the nose.[cochrane.org]
  • In addition, take your baby or child to the doctor if they have: a bulging fontanelle (the soft spot on top of the baby's head); excessive irritability; high pitched cry; loss of appetite; or earache.[mydr.com.au]
Palpitations
  • […] dry mouth, hallucinations, heart block, paradoxic excitability, respiratory depression, sedation, tachycardia, urinary retention Decongestants Oral: agitation, anorexia, dysrhythmia, dystonic reactions, headache, hypertension, irritability, nausea, palpitations[aafp.org]
Heart Block
  • View/Print Table TABLE 3 Adverse Effects Associated with Cold Therapies Therapy Adverse effects Antihistamines Arrhythmia, blurred vision, dizziness, dry mouth, hallucinations, heart block, paradoxic excitability, respiratory depression, sedation, tachycardia[aafp.org]
  • Table 3 Adverse Effects Associated with Cold Therapies Therapy Adverse effects Antihistamines Arrhythmia, blurred vision, dizziness, dry mouth, hallucinations, heart block, paradoxic excitability, respiratory depression, sedation, tachycardia, urinary[web.archive.org]
Blurred Vision
  • View/Print Table TABLE 3 Adverse Effects Associated with Cold Therapies Therapy Adverse effects Antihistamines Arrhythmia, blurred vision, dizziness, dry mouth, hallucinations, heart block, paradoxic excitability, respiratory depression, sedation, tachycardia[aafp.org]
  • Other adverse effects described included blurred vision, tachycardia, mouth and eye dryness, as well as blood‐tinged mucus.[dx.doi.org]
  • Other reported adverse effects included blurred vision (Analysis 1.1.8), tachycardia (Analysis 1.1.7), mouth and eye dryness (Analysis 1.1.4; Analysis 1.1.3), as well as blood‐tinged mucus.[doi.org]
  • Table 3 Adverse Effects Associated with Cold Therapies Therapy Adverse effects Antihistamines Arrhythmia, blurred vision, dizziness, dry mouth, hallucinations, heart block, paradoxic excitability, respiratory depression, sedation, tachycardia, urinary[web.archive.org]
Increased Sweating
  • Minor side effects (including gastrointestinal adverse events, dizziness, dry mouth, somnolence and increased sweating) in the acetaminophen group were reported in two of the four studies.[ncbi.nlm.nih.gov]
Myalgia
  • We extracted and summarised data on global efficacies of analgesic effects (such as reduction of headache and myalgia), non-analgesic effects (such as reduction of nasal symptoms, cough, sputum and sneezing) and side effects.[ncbi.nlm.nih.gov]
  • Secondly, the trial included participants with myalgia and fever, which did not meet our inclusion criteria.[doi.org]
  • Influenza : initially presents with systemic symptoms, including fever, rigors, headaches, myalgia, malaise and anorexia.[patient.info]
Musculoskeletal Pain
  • Wilson KGWatson STCurrie SR Daily diary and ambulatory activity monitoring of sleep in patients with insomnia associated with chronic musculoskeletal pain. Pain 1998;75 (1) 75- 84 PubMed Google Scholar Crossref 26.[doi.org]
  • Daily diary and ambulatory activity monitoring of sleep in patients with insomnia associated with chronic musculoskeletal pain. Pain. 1998; 75 (1):75–84. [ PubMed ] [ Google Scholar ] 26. Gwaltney JM, Jr, Hendley JO, Patrie JT.[ncbi.nlm.nih.gov]
Arthralgia
  • These medications effectively relieve pain from headache, myalgias, and arthralgias experienced during a cold; however, decreased sneezing is the only effect they have on respiratory symptoms. 34 The ACCP has concluded that naproxen (Naprosyn) is beneficial[aafp.org]
Headache
  • Signs and symptoms, which can vary from person to person, might include: Runny or stuffy nose Sore throat Cough Congestion Slight body aches or a mild headache Sneezing Low-grade fever Generally feeling unwell (malaise) The discharge from your nose may[mayoclinic.com]
  • For outcomes related to the analgesic effects of NSAIDs (headache, ear pain, and muscle and joint pain) the treatment produced significant benefits.[ncbi.nlm.nih.gov]

Workup

Diagnosis of common cold can generally made on the basis of a thorough history and the typical physical findings. If the history and physical examination point to a viral cause, a serious work up is unnecessary.

The white blood cell count might be elevated within the first 3 days although this has little clinical relevance or diagnostic value. Complete blood count and Erythrocyte sedimentation rate also have no benefit. Viral cultures have little or no significant clinical value because of the prolonged time it takes to obtain the result.

Isolation of the particular strain of virus is difficult and even if it is possible, has no bearing on the clinical course or outcome.

If the specific viral diagnosis is however required, culture can be obtained from nasal secretions. Real-time microarray and Polymerase chain reaction could also be used.

If there is suspicion of a secondary infection, then a bacteria culture should be done. A chest x-ray should also be done if involvement of the lower respiratory tract is suspected.

Positive Throat Culture
  • There is also the issue of contaminants, which may be as high as 57% in children under 15 years with pharyngitis ( Kaplan 1971 ), hence our desire to remove studies with high proportions of participants with positive throat cultures.[doi.org]

Treatment

There is no known cure for common cold, as such, treatment centers on providing symptomatic relief and supportive care [8].

Supportive care include; nursing at a 45 degree angle, plenty of rest, proper hydration, disinfecting the environment, use of decongestants, cessation of smoking and alcohol, eating hot soups, and use of nasal saline drops.

Medication that may be used include analgesics for pain, decongestants to relieve the airways and antihistamines to mediate the inflammatory reaction [9].

Antibiotics may be used if a bacterial superinfection is suspected.

Prognosis

The common cold is a self-limiting disease and the attacks are generally mild. The patients begin to show signs of improvement within a week. Half of infected individuals attain full recovery within 10 days while by day 15, over 90% of cases would have been resolved. Complications, though rare, may occur in young children, the elderly, the malnourished and the immunosuppressed. Secondary bacterial infection may complicate up to 30% of cases [6].

Etiology

It is caused by a number of viruses. The most implicated virus is a type of picovirus called rhinovirus. Others viruses are influenza virus, human coronavirus, adenovirus, human respiratory syncytial virus, enterovirus, parainfluenza virus and a host of many other viruses. Usually, one or more virus may be responsible for a particular attack.

It is a communicable disease and is transmitted via aerosols, direct contact with secretions from sick people and from contaminated object [2].

Aggravating factor for this condition includes cold weather. Most of the viruses causing common cold thrive during the cold seasons for yet undetermined reasons. This has led to a belief that it can be caught from prolonged exposure to cold weather. There are number of hypothesis to explain increased susceptibility to cold viruses during the cold seasons. Other risk factors are poor immunity, malnutrition and sleep deprivation.

Epidemiology

The common cold is the most common disease affecting the human race. It affects people of all ages, all races and both sexes. It affects children more than adults, affecting children as many as 12 times a year compared to 5 times in adults. Low income earners and the underdeveloped population are at increased risk of developing complications from common cold [3].

Sex distribution
Age distribution

Pathophysiology

The mechanism of the response of the immune system is specific for the causative virus. Rhinoviruses which are characteristically acquired by direct contact, bind to some receptors in humans via unknown mechanisms and trigger the release of inflammatory mediators. These inflammatory mediators are responsible for the symptoms seen in common cold. Rhinoviruses typically do not damage the nasal epithelium [4].

Respiratory syncytial virus is acquired through droplet infection and direct contact. It first replicates in the nose and then the throat, as it continues its spread to the lower respiratory tract. This virus will damage the epithelium [5]. The symptoms seen in common cold are primarily due to the immune response to the viral invasion.

Prevention

Due to the mode of spread, preventive measures include regular handwashing, avoiding putting the finger in the nose and eye, use of hand-sanitizers and the use of facemasks when the person is around infected people [10].

Summary

Common cold is caused by virus and it is infectious and communicable. It is also a fairly common disease and can affect a person more than once a year. Like most viral disease, it has no cure and is self-limiting, running its course within a week.

Patient Information

Definition: Common cold is a disease of the upper respiratory tract like nose and throat. It is a very common disease and it affects people of all ages. It is self-limiting.

Cause: It is caused by one of several viruses including rhinovirus and parainfluenza virus. Some of these viruses thrive in the colder seasons. It can be spread by inhaling aerosols from infected persons, touching infected secretion or contaminated surfaces and then touching the eye or nose.

Symptoms: These include, cough, runny nose, congested nostrils, and sore throat. Patient may also have headache, weakness, muscle pain, loss of appetite and a general feeling of unwell.

Diagnosis: Diagnosis is usually clinical, and made by the doctor. Laboratory tests offer no significant clinical value and are only ordered on very rare occasions.

Treatment: This is usually supportive and it is aimed at relieving the nasal congestions, reducing the pain and managing the inflammation. This can be done by a number of drug and non-drug regimen.

References

Article

  1. Puhakka T, Mäkelä MJ, Alanen A, et al. Sinusitis in the common cold. J Allergy Clin Immunol 1998; 102:403.
  2. Gwaltney JM Jr, Moskalski PB, Hendley JO. Hand-to-hand transmission of rhinovirus colds. Ann Intern Med 1978; 88:463.
  3. Heikkinen T, Järvinen A. The common cold. Lancet 2003; 361:51.
  4. Turner RB. Epidemiology, pathogenesis, and treatment of the common cold. Ann Allergy Asthma Immunol 1997; 78:531.
  5. Hall CB, Douglas RG Jr. Modes of transmission of respiratory syncytial virus. J Pediatr. Jul 1981;99(1):100-3.
  6. Thompson M, Vodicka TA, Blair PS, et al. Duration of symptoms of respiratory tract infections in children: systematic review. BMJ 2013; 347:f7027.
  7. Tyrrell DA, Cohen S, Schlarb JE. Signs and symptoms in common colds. Epidemiol Infect 1993; 111:143.
  8. Simasek M, Blandino DA. Treatment of the common cold. Am Fam Physician 2007; 75:515.
  9. Luks D, Anderson MR. Antihistamines and the common cold. A review and critique of the literature. J Gen Intern Med 1996; 11:240.
  10. Jefferson T, Del Mar C, Dooley L, et al. Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database Syst Rev 2010; :CD006207.

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Last updated: 2019-07-11 22:27