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 June 14, 2003
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Common Cold
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The common cold (also called viral rhinitis) is a viral infection, characterized by nasal congestion, a clear, runny nose, sneezing, scratchy throat and general malaise.


For all its achievements, medical science does not have a cure for the common cold. The common cold is a minor illness caused by one of as many as 200 different kinds of viruses, including rhinovirus and adenovirus. These viruses can also cause laryngitis or bronchitis by infecting either the larynx (the "voice box") or the bronchial tubes in the lungs. Infections are spread from one person to another, by hand-to-hand contact, or by a cough or sneeze that sprays many virus particles into the air. A person in good health who becomes the victim of a cold may not need to see a doctor. These viruses do not respond to antibiotics. Severe infections, however, may require medical care and prescription medication. If you develop a fever higher than 102 degrees Fahrenheit, have a history of asthma, an ear infection, laryngitis or bronchitis, you should see you doctor as soon as possible. If your symptoms last longer than five days, you should also see you doctor. If you have a very high temperature and pains all over your body, you may have an influenza virus.


The set of symptoms we call a cold, may be caused by one of more than 100 different types of rhinovirus. The large number of different strains makes the chances of an effective vaccine slight. Rhinovirus grows well at relatively low temperatures, such as those found in the nose. This is why it's rarely found in the trachea or lungs. There are many misconceptions about how people get a cold. A handshake is an effective way to give someone your cold. It's easy for a child with a cold to pick the virus up on his hands. All he has to do is touch his nose or eyes, and he has the virus on his hands, and anyone who touches his hands, can pick up the virus. If the recipient touches his eyes or nose, the virus can set up shop and cause a cold. Rhinovirus can survive for about three hours on a doorknob or Formica surface.


Headache, nasal congestion, a clear runny nose, sneezing, scratchy throat, and general malaise may all be symptoms of the common cold. A typical common cold will last three to four days; a mild secondary bacterial infection often prolongs this to a week or longer.


Diagnosis of the common cold is based on a medical history, symptoms and a physical exam.


There is no proven specific treatment for a cold, but supportive measures may be helpful. Home Care: Infants and Preschool-aged Children There are several steps that can be taken to make an infant or a small child with a cold more comfortable:

  • The nose can be cleared with a bulb syringe (ask your pediatrician).
  • Saltwater nose drops (made from a teaspoon of salt and eight ounces of warm water) may be soothing every few hours.
  • Warm humidified air can alleviate congestion.
  • Increase fluid intake.
Home Care: Adolescents and Adults
  • Drink about eight glasses of fluid daily.
  • Get plenty of bedrest.
Medications: (check with your physician first) Most cold sufferers experience nasal congestion, caused by swelling of the mucous membranes in the nose. Decongestants can ease that problem. They constrict dilated blood vessels, shrinking the swollen tissue and opening nasal passages. The result is freer breathing, better drainage and a reduced feeling of stuffiness. There are two kinds of decongestants: topical (sprays and drops) and oral (tablets and caplets). Each has advantages and drawbacks. Topical decongestants may be more effective than oral decongestants. One study showed that the topical ingredient, oxymetazoline, produced four times the decongestion as the oral use of pseudoephedrine (the ingredient in Sudafed and several other oral products). The topical remedy also worked faster, producing improvement within five minutes versus 30 to 60 minutes for the oral decongestant. Most standard topical decongestants, such as Dristan and Neo-Synephrine, use phenylephrine hydrochloride as their active ingredient. Other, longer-acting products (such as Afrin) contain oxymetazoline. The drawback of topical decongestants is that overuse can lead to "rebound congestion" - stuffiness worse than the original problem. Each application produces an initial decongestant effect and some irritation and inflammation, which tends to go unnoticed, but if the drug is used frequently, the delayed effects begin to predominate. The more you use the product, the more irritated, inflamed and blocked up your nasal passages become. Eventually, treatment may require the use of oral or topical steroid drugs to break the cycle. Accordingly, topical decongestants should be used sparingly and only for a few days. Probably the best time to use a topical decongestant is before bed, to help ensure a good night's sleep. Another good time is the first thing in the morning, when nasal passages tend to be the stuffiest. In contrast to topical decongestants, oral decongestants can be taken daily, for up to a week. They can be used alone or along with a topical product, serving as maintenance therapy to reduce the need for the topical decongestant. Oral decongestants do not generally produce rebound congestion, but they can cause other side effects, such as mouth dryness or interference with sleep (if taken shortly before bedtime). Potentially more serious are blood-pressure elevations that can occur with their use. The oral decongestant that may raise blood pressure is phenylpropanolamine (PPA), which is widely used in cold remedies. About 25 percent of all people with colds get headaches; 10 percent have muscle pain; and 1 percent run mild fevers. All these symptoms respond well to the three standard nonprescription pain relievers: aspirin, acetaminophen or ibuprofen. Aspirin and acetaminophen can be found in many cold remedies, however, it is cheaper to buy the straight pain reliever. Children must not be given aspirin because of association with Reye’s syndrome. A sore throat is often the first symptom of a cold. It affects about half of all cold sufferers. You can choose from a legion of lozenges, sprays and mouthwashes to soothe the pain. The FDA considers at least seven ingredients effective in relieving or dulling sore-throat irritation. These sore-throat medications include: benzocaine, benzyl alcohol, dyclonine hydrochloride, hexylresorcinol, menthol, phenol compounds and salicyl alcohol. Brands with these ingredients include Chloraseptic Sore Throat Lozenges and Spray, Oracin, Spec-T Sore Throat Anesthetic Lozenges and Sucrets. When You Have More Than A Cold Seek medical help when any of the following occur: 1. A fever greater than 101 degrees F (38.3 degrees C), accompanied by shaking, chills and coughing up thick phlegm (especially if greenish or foul-smelling) 2. Sharp chest pain when you take a deep breath 3. Cold-like symptoms that do not improve after five days 4. Coughing up blood 5. Any significant throat pain in a child 6. A painful throat, in addition to any of the following:
  • pus (yellowish-white spots) on the tonsils or the throat
  • fever greater than 101 degrees F or 38.3 degrees C
  • swollen or tender glands or bumps in the front of the neck
  • exposure to someone who has a documented case of "strep" throat
  • a rash during or after a sore throat
  • a history of rheumatic fever, rheumatic heart disease, kidney disease or chronic lung disease, such as emphysema or chronic bronchitis


Avoidance: Keep your distance from people who have colds, especially when they cough or sneeze. Additionally, avoid touching your nose or eyes. Viruses usually invade through the nasal mucous membranes, but if deposited in the eyes, they can also travel down through the tear ducts. Diet: A U.S. Department of Agriculture study revealed that Americans are deficient in many of the nutrients necessary for optimal functioning of the immune system - the same system that helps ward off colds and flus! At least 33 percent of all Americans consume less than 70 percent of the government's Recommend Dietary Allowances for vitamins A, C, B1, B2, B3, B12 and pantothenic acid, as well as the minerals calcium, iron, magnesium and zinc. Stay well hydrated. Drink lots of non-alcoholic fluids to help keep the mucous membranes moist. Rest: Try not to get overly stressed or overly tired. Good Hygiene: Wash your hands often, especially before eating and after going to the bathroom or being in contact with individuals with colds.


What over-the-counter medications/decongestants are most effective? Would you recommend topical or oral decongestants? Which pain medications should I use? How long will it take for me to feel better? Are there any home treatments you might recommend to help relieve the symptoms?

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