Common Cold

Often referred to as Upper Respiratory Infection (URI), this is the most frequent disease in the world.  A variety of viruses can cause it (see Differences Among Germs).  All cause basically the same symptoms — maybe sore throat for 1-2 days, then lots of runny nose, maybe a cough.  Coughing occurs because mucus from the nose slides down the throat to the trachea (“post-nasal drip”) (see Diagram —  Upper Respiratory Tract). 

Everything goes away on its own in 1-2 weeks.  The average child may get 6 colds a year, the average adult 2-3.  There’s no treatment to cure a Cold.

The cold virus gets spread when a sick person sneezes or coughs, and you breathe it in.  It’s also spread if they wipe their nose and touch something, then you touch the same thing, and happen to touch your own nose.  Virus can live 2 hours on hands, which is why hand-washing helps prevent spread.  Colds are not caused by getting cold (like being out in the cold, etc.); they’ve done studies on workers in Antarctica who don’t get sick any more than others.

We make the diagnosis by typical symptoms, and not finding anything else on exam.  If there’s a fever, it only lasts 1-2 days.  The throat looks pretty normal, the lungs sound normal by stethoscope.  If the person suddenly gets a lot sicker after 5-10 days, they may have developed a bacterial complication like ear infection, strep throat, sinusitis, or pneumonia, but this is rare.

If symptoms go on 3-4 weeks, it’s probably Allergies instead of a cold.  This is especially so if there’s lots of sneezing.  Allergy Medications work a lot better for Allergies than anything does for the Common Cold.

Even though this website is about diagnosis, let me offer a few cynical comments regarding medicines for the Common Cold.  There are all sorts of products being sold, the majority with multiple ingredients.  As per a review of medical studies:

  • Pain medicines like acetaminophen (Tylenolยฎ), aspirin, and NSAIDs effectively relieve fever and pain (sore throat, aches, headache, etc.).
  • Antihistamines hardly do anything except make you sleepy
  • Decongestants aren’t proved to help
  • Many nasal sprays and nose drops can make your nose addicted after 3 days (see Rhinitis Medicamentosa)
  • Dextromethorphan can calm a cough (but is sometimes abused)
  • Zinc can permanently ruin your sense of smell
  • Vitamin C accomplishes little to nothing
  • Herbal medicines are hard to study because versions of the same product can have very different strengths, but there’s no evidence they’re better than placebo
  • Also remember that a cough is part of our body’s defenses, to prevent gunk & germs in the nose from getting into the lungs.  So it may be better to not suppress a cough.

Since placebo certainly works to some extent, anything you try might seem to help.  My advice: just don’t spend much money.

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