A cold is an infection of the upper respiratory tract. It's common and relatively harmless — but it sure doesn't feel that way when you have one. If it's not a runny nose, sore throat and a cough, it's watery eyes, sneezing and miserable congestion. Or maybe all of the above. In fact, because any one of more than 200 viruses can cause colds, symptoms tend to vary greatly.
Unfortunately, if you're like most adults, you're likely to have two to four colds a year. Children, especially preschoolers, may have between five and nine colds annually. Colds are particularly prevalent among children attending child care.
The good news is that your symptoms should improve within a week, although some colds may last as long as two weeks. If a cold lasts longer than that, see your doctor to make sure you don't have a secondary bacterial infection in your lungs, larynx, trachea, sinuses or ears.
The onset of cold symptoms occurs within one to three days after you're exposed to a cold virus. The first major symptom is usually a watery nose. You may also develop an itchy or sore throat, increased nasal congestion, slight body aches or a mild headache early in the course of the infection.
The discharge from your nose may become thicker and yellowish as your cold runs its course. Other signs and symptoms of a cold include:
- Sneezing
- Watery eyes
- Cough
- Low fever — less than 102 F
- Mild fatigue
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 cold.
Although more than 200 viruses can cause colds, the rhinovirus is the most common, known culprit. The cause of up to 50 percent of colds is unknown.
A cold virus enters your body through your mouth or nose, but it's likely you also had a "hand" in your own illness. Although colds can be spread through sneezing and coughing, they're often spread by hand-to-hand contact with someone who has a cold or by using shared objects such as utensils, towels or telephones. Touch your eyes or nose after such contact or exposure, and you're likely to acquire a cold.
Children are especially susceptible to colds because they haven't yet developed resistance to most of the viruses that cause colds. 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 aren't always careful about washing their hands, which makes it easy for colds to spread.
Both children and adults are most susceptible to colds in fall and winter, when children are in school and most people are spending a lot of time indoors.
As you age, you develop immunity to many of the viruses that cause colds. You'll have colds less frequently than you did as a child, but you're at increased risk when you are:
- Spending most of your time indoors and in close contact with other people during fall and winter
- Experiencing psychological stress
- Having an allergic reaction that affects your nasal passages
Other common beliefs about how you catch cold — going outdoors with wet hair or getting chilled, for example — have never been shown in clinical studies to increase your risk.
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When to seek medical advice
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Colds generally get better after less than a week, although they may not disappear as quickly as you'd like. Seek medical attention if you have a fever greater than 102 F or feel your symptoms are getting worse. A high fever accompanied by achiness and fatigue might be the flu (influenza) rather than just a cold. Prescription antiviral medications for influenza are available and may be somewhat helpful, but you need to start taking them within 48 hours of your first symptoms.
If you have fever, sweating, chills and a cough that produces colored phlegm, you might have pneumonia. It's best to see a doctor right away.
Also see your doctor if your symptoms don't improve after seven to 10 days or if you have a chronic respiratory condition made worse by cold symptoms.
In general, children are sicker with colds than adults are, and often suffer from complications such as ear infections. Call your physician immediately if your child has any of the following signs and symptoms:
- Fever of 103 F or higher, chills or sweating
- Fever that lasts more than 72 hours
- Vomiting or abdominal pain
- Unusual sleepiness
- Severe headache
- Difficulty breathing
- Persistent crying
- Ear pain
An acute ear infection (otitis media), which occurs when bacteria infiltrate the space behind the eardrum, is the most common complication of colds in children.
Typical signs and symptoms include earaches — children who are too young to verbalize their distress may simply cry or pull on the affected ear — and, in some cases, a green or yellow discharge from the nose or the return of a fever following a cold.
Drainage from the ear means your child's eardrum has ruptured. This actually may relieve pressure and pain, but your child still needs to see your physician promptly.
Unlike a cold, ear infections may require treatment with antibiotics. Young children and children with chronic health problems are most likely to need antibiotics to treat an ear infection.
A cold that doesn't resolve may turn into sinusitis. Other secondary infections that may develop following a cold include strep throat (streptococcal pharyngitis), chronic bronchitis and pneumonia. These are serious infections and need to be treated aggressively by your doctor.
Over time, decongestant drops and sprays can actually cause rebound congestion, which means that you may need to use more and more of these products to keep your nasal passages clear. Prolonged use can also cause chronic inflammation of the mucous membranes. If you must use decongestant drops and sprays, don't use them for more than a few days.
Colds account for more visits to the doctor's office than does any other condition in the United States. They also lead to millions of trips to the emergency room each year. But there's no cure for the common cold. Antibiotics are of no use against cold viruses, and although over-the-counter (OTC) cold preparations may make you feel better, they won't cure a cold or make it go away any sooner.
OTC medications that combine antihistamines and decongestants won't relieve cold symptoms in preschool children and may have side effects. For relief of fever or pain, acetaminophen (Tylenol, others) is preferred instead of aspirin. Aspirin might have a role in causing Reye's syndrome, a rare but potentially fatal disease, in children younger than 16.
Because so many different viruses can cause colds, no effective vaccine has been developed. But though it may seem that colds are inevitable, you can take some common-sense precautions to slow the spread of cold viruses:
- Wash your hands frequently and teach your children the importance of hand washing.
- Keep kitchen and bathroom countertops clean, especially when someone in your family has a cold.
- Always sneeze and cough into tissues. Discard used tissues right away.
- Don't share drinking glasses with other family members. Use your own glass or disposable cups
when you or someone else is sick.
- Avoid close, prolonged contact with someone who has a cold.
- Look for a child-care setting with sound hygiene practices and clear policies about keeping sick
children at home.
- If possible, use a child-care center with a 5-to-1 or lower ratio of children to adults.
- Wash your child's toys after play if your child has a cold.
Although many people believe that the herb echinacea and and megadoses of vitamin C can help prevent colds, studies have not found any protective benefit. Echinacea may, however, help shorten the duration of a cold.
You may not be able to cure your cold, but you can make yourself as comfortable as possible. These tips may help:
- Drink lots of fluids. Drink at least eight glasses of fluids and get plenty of rest.
Avoid alcohol, caffeine and cigarette smoke, which can cause dehydration and aggravate your
symptoms.
- Take a break from work. Consider staying home 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, however, 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 nasal drops. To help relieve nasal congestion, try saline nasal drops. You can purchase
these drops over-the-counter, and they're effective, safe and nonirritating, even for children. To
use them instill several drops into one nostril, then immediately bulb suction that nostril. Repeat
the process in the opposite nostril.
Children get frequent colds, and that can take a toll on working parents. The following suggestions may help:
- Before your child gets sick, line up people who may be able to help with child care, including grandparents, friends, neighbors or college students.
- If you have a partner or spouse, decide ahead of time who will stay home with a sick child.
- Consider taking your child to a child-care center for sick children. These centers don't take children who are seriously ill.
- Make your work life flexible. If possible, arrange to telecommute when your child is sick.
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May 14, 2003 —
