Common cold

Definition

The common cold is a viral infection of your upper respiratory tract — your nose and throat. A common cold is usually harmless, although it may not feel that way. If it's not a runny nose, sore throat and cough, it's the watery eyes, sneezing and congestion — or maybe all of the above. In fact, because any one of more than 200 viruses can cause a common cold, symptoms tend to vary greatly.

Most adults are likely to have a common cold two to four times a year. Children, especially preschoolers, may have a common cold as many as six to 10 times annually.

Most people recover from a common cold in about a week or two. If symptoms don't improve, see your doctor.

Symptoms

Symptoms of a common cold usually appear about one to three days after exposure to a cold virus. Signs and symptoms of a common cold may include:

• Runny or stuffy nose
• Itchy or sore throat
• Cough
• Congestion
• Slight body aches or a mild headache
• Sneezing
• Watery eyes
• Low-grade fever (up to 102 F, or 39 C)
• Mild fatigue

The discharge from your nose may become thicker and yellow or green in color as a common cold runs its course. What makes a cold different from other viral infections is that you generally won't have a high fever. You're also unlikely to experience significant fatigue from a common cold.

When to see a doctor
For adults — Seek medical attention if you have:

• Fever of 102 F (39 C) or higher
• High fever accompanied by achiness and fatigue
• Fever accompanied by sweating, chills and a cough with colored phlegm
• Significantly swollen glands
• Severe sinus pain

For children — In general, children are sicker with a common cold than adults are and often develop complications, such as ear infections. Your child doesn't need to see the doctor for a routine common cold. But seek medical attention right away if your child has any of the following signs or symptoms:

• Fever of 103 F (39.5 C) or higher, chills or sweating
• Fever that lasts more than three days
• Vomiting or abdominal pain
• Unusual sleepiness
• Severe headache
• Difficulty breathing
• Persistent crying
• Ear pain
• Persistent cough

Causes

Although more than 200 viruses can cause a common cold, the rhinovirus is the most common culprit, and it's highly contagious.

A cold virus enters your body through your mouth or nose. The virus can spread through droplets in the air when someone who is sick coughs, sneezes or talks. But it also spreads by hand-to-hand contact with someone who has a cold or by using shared objects, such as utensils, towels, toys or telephones. Touch your eyes, nose or mouth after such contact or exposure, and you're likely to "catch" a cold.

Risk factors

Cold viruses are almost always present in the environment. But the following factors can increase your chances of getting a cold:

Age. Infants and preschool children are especially susceptible to common colds because they haven't yet developed resistance to most of the viruses that cause them. But an immature immune system isn't the only thing that makes kids vulnerable. They also tend to spend lots of time with other children and frequently aren't careful about washing their hands and covering their coughs and sneezes. Colds in newborns can be problematic if they interfere with nursing or breathing through the nose.

Immunity. As you age, you develop immunity to many of the viruses that cause common colds. You'll have colds less frequently than you did as a child. However, you can still come down with a cold when you are exposed to cold viruses, have an allergic reaction that affects your nasal passages or have a weakened immune system. All of these factors increase your risk of a cold.

Time of year. Both children and adults are more susceptible to colds in fall and winter. That's because children are in school, and most people are spending a lot of time indoors. In places where there is no winter season, colds are more frequent in the rainy season.

Complications

• Acute ear infection (otitis media). Ear infection occurs when bacteria or viruses infiltrate the space behind the eardrum. It's a frequent complication of common colds in children. Typical signs and symptoms include earaches and, in some cases, a green or yellow discharge from the nose or the return of a fever following a common cold. Children who are too young to verbalize their distress may simply cry or sleep restlessly. Ear pulling is not a reliable sign.
• Wheezing. A cold can trigger wheezing in children with asthma.
• Sinusitis. In adults or children, a common cold that doesn't resolve may lead to sinusitis — inflammation and infection of the sinuses.
• Other secondary infections. These include strep throat (streptococcal pharyngitis), pneumonia, bronchitis in adults and croup in children. These infections need to be treated by a doctor.

Preparing for your appointment

If you have a cold, you're likely to start by first seeing your family doctor, a general practitioner or your child's pediatrician.

Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor.

What you can do

• Write down the symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
• Write down key personal information, including any major stresses or recent life changes.
• Make a list of all medications, as well as any vitamins or supplements and over-the-counter (OTC) cold remedies that you're taking.
• Write down questions to ask your doctor.

Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For common cold, some basic questions to ask your doctor include:

• What is likely causing my symptoms or condition?
• Other than the most likely cause, what are other possible causes for my symptoms or condition?
• What kinds of tests do I need?
• Is my condition likely temporary or chronic?
• What is the best course of action?
• What are the alternatives to the primary approach that you're suggesting?
• I have these other health conditions. How can I best manage them together?
• Are there any restrictions that I need to follow?
• Should I see a specialist? What will that cost, and will my insurance cover seeing a specialist?
• Is there a generic alternative to the medicine you're prescribing me?
• Are there any brochures or other printed material that I can take home with me? What Web sites do you recommend?
• What will determine whether I should plan for a follow-up visit?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.

What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may allow more time later to cover other points you want to address. Your doctor may ask:

• When did you first begin experiencing symptoms?
• Have your symptoms been continuous, or occasional?
• How severe are your symptoms?
• What, if anything, seems to improve your symptoms?
• What, if anything, appears to worsen your symptoms?

What you can do in the meantime
While you're waiting for your appointment, you may consider taking OTC pain medications and decongestants to ease symptoms. Get plenty of rest and drink lots of fluids.

Treatments and drugs

There's no cure for the common cold. Antibiotics are of no use against cold viruses. Over-the-counter cold preparations won't cure a common cold or make it go away any sooner, and most have side effects. Here's a look at the pros and cons of some common cold remedies.

• Pain relievers. For fever, sore throat and headache, many people turn to acetaminophen (Tylenol, others) or other mild pain relievers. Keep in mind that acetaminophen can cause liver damage, especially if taken frequently or in larger than recommended doses. Be especially careful when giving acetaminophen to children because the dosing guidelines can be confusing. For instance, the infant-drop formulation is much more concentrated than the syrup commonly used in older children. Never give aspirin to children. It has been associated with Reye's syndrome — a rare but potentially fatal illness.
• Decongestant nasal sprays. Adults shouldn't use decongestant drops or sprays for more than a few days because prolonged use can cause chronic inflammation of mucous membranes. And children shouldn't use decongestant drops or sprays at all. There's little evidence that they work in young children, and they may cause side effects.
• Cough syrups. In winter, nonprescription cough syrups practically fly off the drugstore shelves. But the American College of Chest Physicians strongly discourages the use of these medications because they're not effective at treating the underlying cause of cough due to colds. Some contain ingredients that may alleviate coughing, but the amounts are too small to do much good and may actually be harmful for children. In fact, the college recommends against using OTC cough syrups or cold medicines for anyone younger than age 14. The Food and Drug Administration (FDA) strongly recommends against giving OTC cough and cold medicines to children younger than age 2. Meantime, under an agreement announced by manufacturers in late 2008, several brands of OTC cold and cough medications began carrying a warning that these products should not be used in children under 4. For young children, an accidental overdose could be fatal. Coughs associated with a cold usually last less than two to three weeks. If a cough lingers longer than that, see your doctor.

Lifestyle and home remedies

You may not be able to cure your common cold, but you can make yourself as comfortable as possible. These tips may help:

• Drink lots of fluids. Water, juice, tea and warm soup are all good choices. They help replace fluids lost during mucus production or fever. Avoid alcohol and caffeine, which can cause dehydration, and cigarette smoke, which can aggravate your symptoms.
• Try chicken soup. Generations of parents have spooned chicken soup into their sick children. Now scientists have put chicken soup to the test, discovering that it does seem to help relieve cold and flu symptoms in two ways. First, it acts as an anti-inflammatory by inhibiting the movement of neutrophils — immune system cells that help the body's response to inflammation. Second, it temporarily speeds up the movement of mucus through the nose, helping relieve congestion and limiting the time viruses are in contact with the nasal lining.
• Get some rest. If possible, stay home from work if you have a fever or a bad cough, or are drowsy from medications. This will give you a chance to rest as well as reduce the chances that you'll infect others. Wear a mask when you have a cold if you live or work with someone with a chronic disease or compromised immune system.
• Adjust your room's temperature and humidity. Keep your room warm, but not overheated. If the air is dry, a cool-mist humidifier or vaporizer can moisten the air and help ease congestion and coughing. Be sure to keep the humidifier clean to prevent the growth of bacteria and molds.
• Soothe your throat. Gargling with warm salt water several times a day or drinking warm lemon water with honey may help soothe a sore throat and relieve a cough.
• Use saline nasal drops. To help relieve nasal congestion, try saline nasal drops. You can buy these drops over-the-counter, and they're effective, safe and nonirritating, even for children. To use in babies, put several drops into one nostril, then immediately bulb suction that nostril. Repeat the process in the opposite nostril. Doing this before feeding your baby can improve your child's ability to nurse or take a bottle, and before bedtime it may improve sleep.

Alternative medicine

Alternative therapies probably won't cure your cold, but they may help make you more comfortable by easing your symptoms.

Echinacea. Whether taking preparations of the herb echinacea protects you from getting a cold or relieves cold symptoms continues to be debated. While no studies have shown that taking echinacea can prevent you from getting a cold, there is some evidence that it can modestly relieve cold symptoms or shorten the duration of a cold. Echinacea seems most effective when taken soon after cold symptoms are first experienced.

Vitamin C. There's no evidence that taking large doses of vitamin C reduces your risk of catching cold. However, there is some evidence that high doses of vitamin C — up to 6 grams a day — may have a small effect in reducing the duration of cold symptoms.

Zinc. There's evidence that zinc nasal sprays or lozenges taken at the beginning of a cold may help reduce symptoms. While some studies also suggest zinc nasal sprays can be helpful, many users experienced permanent loss of smell and therefore the use of these sprays is discouraged.

Prevention

No vaccine has been developed for the common cold, which can be caused by many different viruses. But you can take some common-sense precautions to slow the spread of cold viruses:

• Wash your hands. Clean your hands thoroughly and often, and teach your children the importance of hand washing. Carry a bottle of alcohol-based hand rub containing at least 60 percent alcohol for times when soap and water aren't available. These gels kill most germs, and are safe for older children to use themselves.
• Scrub your stuff. Keep kitchen and bathroom countertops clean, especially when someone in your family has a common cold. Wash children's toys after play.
• Use tissues. Always sneeze and cough into tissues. Discard used tissues right away, and then wash your hands carefully. Teach children to sneeze or cough into the bend of their elbow when they don't have a tissue. That way they cover their mouth without using their hands.
• Don't share. Don't share drinking glasses or utensils with other family members. Use your own glass or disposable cups when you or someone else is sick. Label the cup or glass with the name of the person with the cold.
• Steer clear of colds. Avoid close, prolonged contact with anyone who has a cold.
• Choose your child care center wisely. Look for a child care setting with good hygiene practices and clear policies about keeping sick children at home. The number of children in the center directly relates to the number of colds to which your child will be exposed.