Common Cold*The information on this website is not intended to diagnose, treat, cure or prevent any disease.
What is the Common Cold?
The Common Cold is a viral upper respiratory infection, usually affecting the throat and nasal passages. It is easily transmitted from person to person, and is the most common viral illnesses in the world. After exposure, there is typically an incubation period of about 48 hours. The typical duration of illness lasts from 7 to 10 days in most people. The name “Cold” is due to its link with tending to emerge more frequently in colder months, however it can cause infection at any time of the year. The majority of adults will catch the Common Cold about three times a year. Children are at higher risk due to exposure in schools (and probably due to poorer hand washing habits), and then tend to catch about six Colds per year.
For most people, the Common Cold is a mild illness, but sometime secondary infections (opportunistic bacteria) if the sinuses or ears can occur. For immunosuppressed people, the Common Cold can bring more complicated problems like secondary pneumonias, which can become life-threatening. Additionally, although the Common Cold is generally a mild disease, it has a huge economic impact due to lost productivity at work and causing visits to the doctor.
The most common symptoms of the Common Cold are:
- Sore throat
- Runny nose
- Nasal congestion
- Loss of appetite
- Muscle aches
The diagnosis of the Common Cold is generally based on the presenting symptoms of nasal congestion/inflammation and some degree of sore throat. Most people do not go to the doctor when these symptoms arise and correctly diagnose themselves based on past experiences. There are over 200 viruses which are associated with the Common Cold, but virus isolation is rarely performed. In situations where the disease becomes more severe than expected, certain diagnostics may be performed to rule out other opportunistic infections or ensure that you don’t have a problem which can present with similar signs, such as strep throat.
The main diagnostic which be performed is x-rays of the chest to screen for evidence of pneumonia in very ill people. Throat swabs with bacterial culture may be performed if strep throat is suspected. If hospitalization is required in order to manage fever or other issues, expect routine blood work which includes a complete blood count (CBC) and serum chemistry (to evaluate kidney, liver function, and electrolytes).
In general, if your signs fit with usual presentation of the Common Cold and your illness is mild, you are unlikely to undergo any additional tests beyond a physical examination.
The Common Cold usually requires only supportive treatment with over-the-counter products. Mild cases may not require any treatment at all.
Pharmaceuticals and Medical Procedures:
- Non-Steroid Anti-Inflammatories and Fever Reducers: Drugs like ibuprofen, aspirin, naproxen, and acetaminophen can be extremely helpful in reducing the discomfort associated with sore throats and headaches. These medications are available over-the-counter.
- Decongestant Medications: Decongestants like phenylephrine and pseudoephedrine can help reduce the severity of nasal congestion and alleviate runny noses. These medications are usually stimulatory in nature and may increased blood pressure. There are also decongestant nasal sprays which may have fewer systemic side effects.
- Cough Suppressants and Expectorants: For people who have a cough from their cold, cough syrups and expectorants can decrease the severity and frequency of coughs, while at the same time making the coughs more productive.
- Antibiotics: These are not typically needed for the cold itself, however secondary bacterial infections may affect the ears, sinuses, and lungs. In these scenarios, antibiotics may be required. Antibiotics should not be prescribed for the common cold unless infections of these other areas occur. As the common cold is a viral infection, antibiotics have no effect on them.
- Mentholated Vapor Rubs: These products do not actually relieve congestion; however, they do provide the sensation of relief and they may facilitate sleep.
- Menthol Throat Lozenges: Throat lozenges can help provide temporary topical relief by temporarily numbing the back of the throat with menthol.
There are many non-pharmaceutical options which may provide a great deal of relief to cold suffers, or even shorten the duration of illness.
- Zinc: Zinc is the only product to have been shown to shorten the duration and severity of a cold in normal, otherwise healthy people. It should be taken at the first sign of a cold and continued until symptoms begin to resolve. Zinc nasal sprays should be used with caution, as they have resulted in the loss of sense of smell in some people.
- Vitamin C: Although vitamin C is considered an essential therapy for treating the common cold, a study found only elite-level athletes experienced shorter durations of illness. It may be helpful in prevention, especially for those who exercise in cold weather. Given that vitamin C is safe and easily supplemented however, it may make sense to ensure you are getting adequate intake during a cold.
- Tea with Honey: Warm beverages sooth the throat and the addition of honey may provide a coating texture. Honey also has antibacterial properties itself, which may be beneficial in preventing secondary infections.
- Humidifiers: Keeping the air human can help avoid further irritation to the throat and may reduce the urge to cough.
- Net Pot: Using sterile/distilled water and salt, rinsing the nasal passages can help provide relief from congestion.
- Gargles: Salt water, tea, or apple cider vinegar-based gargles may help provide relief to a sore throat.
- Hot and Cold Packs: Applying these to the sinuses and around the nasal passages may help decrease inflammation and relief congestion.
- Elevate your head when sleeping: This will help encourage drainage of the nasal passages while sleeping and make it easier to breath. It can also help reduce the need to cough.
- Probiotics: Although probiotics are generally thought of as being for maintaining GI health, gut health is important for supporting the entire body’s immune system. Consider eating foods rich in probiotics like yogurt, kombucha, or kefir to help maintain your intestinal flora.
- Constitutional Hydrotherapy: Water of varying temperatures is applied to the body to encourage improved circulation of blood and lymphatics. The water may alternate between cold and hot to encourage relaxation and constriction of blood vessels, facilitating fluid movement.
- Acupuncture: Acupuncture may help relieve many of the symptoms of the common cold including headache, fatigue, and muscle pain. There appears to be a generally positive benefit.
- Diet: Drink plenty of fluids. Eating soups with clear broth help maintain hydration and can help relieve the discomfort of congestion and sore throats. Eat plenty of food rich in vitamin C and polyphenols (mostly fruits and vegetables).
- Other Supplements:
- Echinacea: This is an herb that has a long history of use in Colds and other respiratory infections.
- Elderberries: Products containing elderberry extracts have been shown to be useful in a variety of upper respiratory and sinus infections. They appear to have anti-viral, anti-bacterial, and immune-boosting properties.
- Buckwheat Honey: Honey made from buckwheat pollen appears to be effective at reducing the severity and frequency of coughs. Take honey mixed in tea or eaten as a food
- Geranium extract: This may be helpful in relieving many symptoms of the Common Cold.
- Astralagus: An herb with antiviral and antibacterial properties.
- Hyssop: An antiviral and expectorant natural remedy.
- Ginseng: Ginseng has been used for centuries for a variety of illnesses and may be helpful in the Common Cold as well. It is believed to help the body deal with physical stress and improve immune function.
- Garlic: Garlic is known for its immune-boosting properties. It can be taken as a supplement or added to food for its benefits.
- Licorice Root: Licorice root is very anti-inflammatory and can be boiled into a tea to help recover from the Common Cold.
- Chamomile Tea: Chamomile is well-known to have anti-inflammatory properties and can help relieve throat pain.
- Peppermint: Peppermint oils and peppermint tea contain natural menthols which may provide relief from a sore throat.
- Lomatium: This is another herb with antiviral properties and has a long history of use in upper respiratory infections.
- Oregon Grape: This is an immune-supportive supplement which antiviral and antibacterial properties.
- Capsaicin: Capsaicin is the hot compound found in many peppers such as cayenne. This is a natural pain reliever which induces the body to release its own opioids and blocking the pain response. A little goes a long way, but it can be added to teas or gargles to help relieve throat pain.
- Marshmallow Root: Marshmallow root contains a thick substance which helps coat the throat and protect the inflamed membranes.
- Slippery Elm: This is another plant with thick, mucus-like compounds in it which coat the throat. Slippery elm has a long history of use for sore throats.
- Vitamin A: This vitamin is important for maintaining immune health and the health of mucous membranes.
- Vitamin D: Vitamin D is important for overall immune function health.
Preventing the common cold starts with good hygiene and living a healthy lifestyle and supporting your immune system by getting enough rest, a varied diet rich in anti-oxidants and vitamins, and getting enough exercise. People who are stressed, have weakened immune systems, or live unhealthy lifestyles are generally at high risk of getting infected. Unfortunately, there is no vaccine for the Common Cold.
The common cold is generally transmitted from person to person via direct or indirect contact. A person may blow or wipe their nose, and then shake hands, touch a door handle, hand rail, or other object which is then touched by someone else. The infection usually enters the body when someone with contaminated hands then touches their eyes or mouth. Regularly washing hands is the best way to prevent infection, particularly after handling common objects or shaking hands with people who are sick. Carrying hand sanitizer is a great way to help protect yourself when sinks are not nearby.
When going out into the cold, dress warmly and consider wearing a mask or a scarf. There is some evidence to suggest that part of the increased incidence of colds during the winter months is because we become more susceptible when our mucous membranes lining our nasal passages get cold. Covering up your mouth and nose may help reduce the chance of catching the illness.
If you do become sick, it is important to try and minimize spreading the illness to others. Wash or sanitize your hands after blowing your nose and before shaking hands or touching common objects. People are usually most contagious during the first three days of cold symptoms, and become markedly less contagious after that. Consider taking time off of work to help yourself rest and recover and avoid transmitting it to your co-workers.
The Common Cold is considered a viral disease, although there are a huge number of viruses which are capable of causing it. The most common family of viruses which cause the Common Cold are the rhinoviruses. This virus replicates extremely well at temperatures slightly below core body temperatures, which is why it lives so well in the nose. They are transmitted either through direct and indirect contact or by aerosols from sneezing or coughing. When they find a host, they rapidly infect within 15 minutes and have a short incubation time before symptoms begin (usually about 48 hours).
Although rhinoviruses are the most common, a variety of other viruses are also capable of causing the Common Cold. The next most common type of viruses after rhinoviruses are the coronaviruses. Other viruses include influenza virus, parainfluenza virus, respiratory syncytial virus, adenovirus, and enterovirus. Sometimes, there is a concurrent bacterial infection as well, but these usually take advantage of the disruption of the natural host defenses or grow in mucous which is unable to be cleared from the sinuses, nasal passages, lungs, or middle ear.
When secondary bacterial infections occur, they may require antibiotics, or even hospitalization in some cases of pneumonia. Bacteria which may be associated with the Common Cold include Chlamydia pneumoniae, Haemophilus influenzae, Streptococcus pneumoniae, and Mycoplasma pneumoniae.
Different health issues may lead to a generally weakened immune system, making you more susceptible to infections. A poor lifestyle, chronic illnesses like cancer, HIV infection, exposure to mold, or medications intended to suppress your immune system can all make infections or secondary bacterial infections more likely. If you have any of these co-existing conditions, it is important to take any respiratory infection seriously.
Clinics for Management of the Common Cold
Most primary care facilities will be able to diagnose and manage the Common Cold. If your symptoms are mild and manageable with over the counter medications or supplements, it is generally recommended to avoid going to the doctor and exposing potentially sicker people to the virus. In more serious cases, however, do not hesitate to go to a medical facility for further evaluation.
Massachusetts General Hospital
Links to Articles, Research, and Other Information to Help You Heal from the Common Cold