The Common Cold
Sneezing, scratchy throat, runny nose-everyone knows the first signs of a cold, probably the most common illness known. Although the common cold is usually mild, with symptoms lasting 1 to 2 weeks, it is a leading cause of doctor visits and missed days from school and work. According to the Centers for Disease Control and Prevention, 22 million school days are lost annually in the United States due to the common cold.
In the course of a year, people in the United States suffer 1 billion colds, according to some estimates.
Children have about 6 to 10 colds a year. One important reason why colds are so common in children is because they are often in close contact with each other in daycare centers and schools. In families with children in school, the number of colds per child can be as high as 12 a year. Adults average about 2 to 4 colds a year, although the range varies widely. Women, especially those aged 20 to 30 years, have more colds than men, possibly because of their closer contact with children. On average, people older than 60 have fewer than one cold a year.
More than 200 different viruses are known to cause the symptoms of the common cold. Some, such as the rhinoviruses, seldom produce serious illnesses. Others, such as parainfluenza and respiratory syncytial virus, produce mild infections in adults but can precipitate severe lower respiratory infections in young children.
Rhinoviruses (from the Greek rhin, meaning “nose”) cause an estimated 30 to 35 percent of all adult colds, and are most active in early fall, spring, and summer. More than 110 distinct rhinovirus types have been identified. These agents grow best at temperatures of about 91 degrees Fahrenheit, the temperature inside the human nose.
Scientists think coronaviruses cause a large percentage of all adult colds. They bring on colds primarily in the winter and early spring. Of the more than 30 kinds, three or four infect humans. The importance of coronaviruses as a cause of colds is hard to assess because, unlike rhinoviruses, they are difficult to grow in the laboratory.
Approximately 10 to 15 percent of adult colds are caused by viruses also responsible for other, more severe illnesses: adenoviruses, coxsackieviruses, echoviruses, orthomyxoviruses (including influenza A and B viruses, which cause flu), paramyxoviruses (including several parainfluenza viruses), respiratory syncytial virus, and enteroviruses.
The causes of 30 to 50 percent of adult colds, presumed to be viral, remain unidentified. The same viruses that produce colds in adults appear to cause colds in children. The relative importance of various viruses in pediatric colds, however, is unclear because it’s difficult to isolate the precise cause of symptoms in studies of children with colds.
There is no evidence that you can get a cold from exposure to cold weather or from getting chilled or overheated.
There is also no evidence that your chances of getting a cold are related to factors such as exercise, diet, or enlarged tonsils or adenoids. On the other hand, research suggests that psychological stress and allergic diseases affecting your nose or throat may have an impact on your chances of getting infected by cold viruses.
THE COLD SEASON
In the United States, most colds occur during the fall and winter. Beginning in late August or early September, the rate of colds increases slowly for a few weeks and remains high until March or April, when it declines. The seasonal variation may relate to the opening of schools and to cold weather, which prompt people to spend more time indoors and increase the chances that viruses will spread to you from someone else.
Seasonal changes in relative humidity also may affect the prevalence of colds. The most common cold-causing viruses survive better when humidity is low-the colder months of the year. Cold weather also may make the inside lining of your nose drier and more vulnerable to viral infection.
Symptoms of the common cold usually begin 2 to 3 days after infection and often include
- Mucus buildup in your nose
- Difficulty breathing through your nose
- Swelling of your sinuses
- Sore throat
Fever is usually slight but can climb to 102 degrees Fahrenheit in infants and young children. Cold symptoms can last from 2 to 14 days, but like most people, you’ll probably recover in a week. If symptoms occur often or last much longer than 2 weeks, you might have an allergy rather than a cold.
Colds occasionally can lead to bacterial infections of your middle ear or sinuses, requiring treatment with antibiotics. High fever, significantly swollen glands, severe sinus pain, and a cough that produces mucus, may indicate a complication or more serious illness requiring a visit to your healthcare provider.
You can get infected by cold viruses by either of these methods.
- Touching your skin or environmental surfaces, such as telephones and stair rails, that have cold germs on them and then touching your eyes or nose
- Inhaling drops of mucus full of cold germs from the air
There is no cure for the common cold, but you can get relief from your cold symptoms by
- Resting in bed
- Drinking plenty of fluids
- Gargling with warm salt water or using throat sprays or lozenges for a scratchy or sore throat
- Using petroleum jelly for a raw nose
- Taking aspirin or acetaminophen, Tylenol, for example, for headache or fever
A word of caution: Several studies have linked aspirin use to the development of Reye’s syndrome in children recovering from flu or chickenpox. Reye’s syndrome is a rare but serious illness that usually occurs in children between the ages of 3 and 12 years. It can affect all organs of the body but most often the brain and liver. While most children who survive an episode of Reye’s syndrome do not suffer any lasting consequences, the illness can lead to permanent brain damage or death. The American Academy of Pediatrics recommends children and teenagers not be given aspirin or medicine containing aspirin when they have any viral illness such as the common cold.
Over-the-counter cold medicines
Nonprescription cold remedies, including decongestants and cough suppressants, may relieve some of your cold symptoms but will not prevent or even shorten the length of your cold. Moreover, because most of these medicines have some side effects, such as drowsiness, dizziness, insomnia, or upset stomach, you should take them with care.
Nonprescription antihistamines may give you some relief from symptoms such as runny nose and watery eyes which are commonly associated with colds.
Never take antibiotics to treat a cold because antibiotics do not kill viruses. You should use these prescription medicines only if you have a rare bacterial complication, such as sinusitis or ear infections. In addition, you should not use antibiotics “just in case” because they will not prevent bacterial infections.
Although inhaling steam may temporarily relieve symptoms of congestion, health experts have found that this approach is not an effective treatment.
There are several ways you can keep yourself from getting a cold or passing one on to others
Influenza, or flu, is a respiratory infection caused by a variety of flu viruses. The most familiar aspect of the flu is the way it can “knock you off your feet” as it sweeps through entire communities.
The flu differs in several ways from the common cold, a respiratory infection also caused by viruses. For example, people with colds rarely get fevers or headaches or suffer from the extreme exhaustion that flu viruses cause.
The Centers for Disease Control and Prevention (CDC) estimates that 10 to 20 percent of Americans come down with the flu during each flu season, which typically lasts from November to March. Children are two to three times more likely than adults to get sick with the flu, and children frequently spread the virus to others. Although most people recover from the illness, CDC estimates that in the United States more than 100,000 people are hospitalized and about 36,000 people die from the flu and its complications every year.
Flu outbreaks usually begin suddenly and occur mainly in the late fall and winter. The disease spreads through communities creating an epidemic. During the epidemic, the number of cases peaks in about 3 weeks and subsides after another 3 or 4 weeks. Half of the population of a community may be affected. Because schools are an excellent place for flu viruses to attack and spread, families with school-age children have more infections than other families, with an average of one-third of the family members infected each year.
IMPORTANCE OF FLU
Besides the rapid start of the outbreaks and the large numbers of people affected, the flu is an important disease because it can cause serious complications. Most people who get the flu get better within a week (although they may have a lingering cough and tire easily for a while longer). For elderly people, newborn babies, and people with certain chronic illnesses, however, the flu and its complications can be life-threatening.
You can get the flu if someone around you who has the flu coughs or sneezes. You can get the flu simply by touching a surface like a telephone or door knob that has been contaminated by a touch from someone who has the flu. The viruses can pass through the air and enter your body through your nose or mouth. If you’ve touched a contaminated surface, they can pass from your hand to your nose or mouth.
You are at greatest risk of getting infected in highly populated areas, such as in crowded living conditions and in schools.
If you get infected by the flu virus, you will usually feel symptoms 1 to 4 days later. You can spread the flu to others before your symptoms start and for another 3 to 4 days after your symptoms appear. The symptoms start very quickly and may include
- Body aches
- Dry cough
- Sore throat
- Stuffy nose
Typically, the fever begins to decline on the second or third day of the illness. The flu almost never causes symptoms in the stomach and intestines. The illness that some call “stomach flu” is not influenza.
Usually, health care providers diagnose the flu on the basis of whether it is epidemic in the community and whether the person’s complaints fit the current pattern of symptoms. Health care providers rarely use laboratory tests to identify the virus during an epidemic. Health officials, however, monitor certain U.S. health clinics and do laboratory tests to determine which type of flu virus is responsible for the epidemic.
The main way to keep from getting flu is to get a yearly flu vaccine. You can get the vaccine at your doctor’s office or a local clinic, and in many communities at workplaces, supermarkets, and drugstores. You must get the vaccine every year because it changes.
Scientists make a different vaccine every year because the strains of flu viruses change from year to year. Nine to 10 months before the flu season begins, they prepare a new vaccine made from inactivated (killed) flu viruses. Because the viruses are killed, they cannot cause infection. The vaccine preparation is based on the strains of the flu viruses that are in circulation at the time. It includes those A and B viruses (see section below on types of flu viruses) expected to circulate the following winter.
Sometimes, an unpredicted new strain may appear after the vaccine has been made and distributed to doctor’s offices and clinics. Because of this, even if you do get the flu vaccine, you still may get infected. If you do get infected, however, the disease usually is milder because the vaccine still will give you some protection.
Until recently, you could get the flu vaccine only as an injection (shot). In 2003, however, the Food and Drug Administration (FDA) approved a nasal spray flu vaccine called FluMist, which you can get from your health care provider. FDA approved it for use in healthy people aged 5 to 49 years.
You should not use FluMist if
- You have certain lung conditions, including asthma, or heart conditions
- You have metabolic disorders such as diabetes or kidney dysfunction
- You have an immunodeficiency disease or are on immunosuppressive treatment
- You have had Guillain-Barré syndrome
- You are pregnant
- You have a history of allergy or hypersensitivity, including anaphylaxis, to any of the parts of FluMist or to eggs
Children or teenagers who regularly take aspirin or products containing aspirin also should not take FluMist.
Your immune system takes time to respond to the flu vaccine. Therefore, you should get vaccinated 6 to 8 weeks before flu season begins in November to prevent getting infected or reduce the severity of flu if you do get it. Because the flu season usually lasts until March, however, it’s not too late to get it after the season has begun. The vaccine itself cannot cause the flu, but you could become exposed to the virus by someone else and get infected soon after you are vaccinated.
Possible side effects
You should be aware that the flu vaccine can cause side effects. The most common side effect in children and adults is soreness at the site of the vaccination. Other side effects, especially in children who previously have not been exposed to the flu virus, include fever, tiredness, and sore muscles. These side effects may begin 6 to 12 hours after vaccination and may last for up to 2 days.
Viruses for producing the vaccine are grown in chicken eggs and then killed with a chemical so that they can no longer cause an infection. The flu vaccine may contain some egg protein, which can cause an allergic reaction. Therefore, if you are allergic to eggs or have ever had a serious allergic reaction to the flu vaccine, CDC recommends that you consult with your health care provider before getting vaccinated.
If you are in any of the following groups or live in a household with someone who is, CDC recommends that you get the flu vaccine.
- You are 50 years of age or older
- You have chronic diseases of your heart, lungs, or kidneys
- You have diabetes
- Your immune system does not function properly
- You have a severe form of anemia
- You will be more than 3 months pregnant during the flu season
- You live in a nursing home or other chronic-care housing facility
- You are in close contact with children 0 to 23 months of