Common cold

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Common Cold
Classification and external resources




Signs and symptoms[change | change source]


Progression[change | change source]


Cause[change | change source]

Viruses[change | change source]




Transmission[change | change source]


Weather[change | change source]


Other[change | change source]

Herd immunity, immunity that occurs when an entire group of people become immune to a particular infection, occurs from previous exposure to cold viruses. Thus younger populations have greater rates of respiratory infections and older populations have lower rates of respiratory infections.[23] Poor immune function is also a risk factor for disease.[23][24] Lack of sleep and poor nutrition have also been associated with a greater risk of developing infection following rhinovirus exposure. This is believed to be due to their effects on immune function.[25][26]

Pathophysiology[change | change source]

The common cold is a disease of the upper respiratory tract.

The symptoms of the common cold are believed to be mostly related to the immune response to the virus.[27] The mechanism of this immune response is virus-specific. For example, the rhinovirus is typically acquired by direct contact. It binds to human ICAM-1 receptors through unknown methods to trigger the release of inflammatory mediators.[27] These inflammatory mediators then produce the symptoms.[27] It does not generally cause damage to the nasal epithelium.[3]

In contrast, the respiratory syncytial virus (RSV) is contacted by both direct contact and airborne droplets. It then replicates in the nose and throat before frequently spreading to the lower respiratory tract.[28] RSV does cause epithelium damage.[28]

Human parainfluenza virus typically results in inflammation of the nose, throat, and airways.[29] In young children, when it affects the trachea it may produce croup, a hoarse cough and difficulty breathing. This is due to the small size of the airway in children.[29]

Diagnosis[change | change source]

The distinction between different upper respiratory tract infections (URTIs) is loosely based on the location of the symptoms. The common cold primarily affects the nose, pharyngitis primarily affects the throat, and bronchitis primarily affects the lungs.[2] The common cold is frequently defined as inflammation of the nose and may include varying amounts of throat inflammation.[30] Self-diagnosis is common.[3] Isolation of the actual viral agent involved is rarely performed.[30] It is generally not possible to identify the specific virus through symptoms.[3]

Prevention[change | change source]

The only effective way to prevent the common cold is by physically preventing the spread of the viruses.[31] This primarily includes hand washing and wearing face masks. In the health care environment, gowns and disposable gloves are also worn.[31] Isolating infected individuals is not possible because the disease is so widespread and symptoms are not specific. Vaccination has proved difficult because there are so many viruses involved and the viruses undergo rapid change.[31] Developing a broadly effective vaccine is very unlikely.[32]

Regular hand washing reduces the spread of cold viruses. It is most effective and is especially recommended for use in children, due to a lack of evidence supporting the effectiveness of over-the-counter cold medicines for children, and due to the risk for harm from those medicines.[33][34] In 2009, Canada restricted the use of over-the-counter cough and cold medication in children six years old and younger due to concerns regarding risks and unproven benefits.[33] The misuse of dextromethorphan (an over-the-counter cough medicine) has led to its ban in a number of countries.[35]

In adults, the symptoms of a runny nose can be reduced by first-generation antihistamines. However, first-generation antihistamines are associated with adverse side effects such as drowsiness.[36] Other decongestants such as pseudoephedrine are also effective in adults.[37] Ipratropium nasal spray may reduce the symptoms of a runny nose, but there is little effect on stuffiness.[38] Second-generation antihistamines do not appear to be effective.[39]

Due to the lack of studies, it is not known whether drinking more fluids improves symptoms or shortens respiratory illness.[40] A similar lack of data exists for the use of heated humidified air.[41] One study found chest vapor rub to be effective in providing some symptomatic relief of night-time cough, congestion, and sleep difficulty.[42]

Antibiotics and antivirals[change | change source]

Antibiotics have no effect against viral infections and thus have no effect against the common cold.[43] Antibiotics are often prescribed even though antibiotic side effects cause overall harm.[43][44] Antibiotics are commonly prescribed because people expect doctors to prescribe them, and doctors want to help people. Prescribing antibiotics also happens because it is difficult to exclude causes of infection that may be managed by antibiotics.[45] There are no effective antiviral drugs for the common cold, even though some preliminary research has shown benefit.[36][46]

Alternative treatments[change | change source]

While there are many alternative treatments used for the common cold, there is not enough scientific evidence to support the use of most treatments.[36] As of 2010, there is not enough evidence to recommend for or against either honey or nasal irrigation.[47][48] Zinc supplements may reduce the severity and duration of symptoms when taken within 24 hours of their onset.[49] The effect of vitamin C on the common cold, while extensively researched, is disappointing.[50][51] Evidence about the usefulness of echinacea is inconsistent.[52][53] Different types of echinacea supplements may vary in their effectiveness.[52]

Outcome[change | change source]

The common cold is generally mild and goes away on its own with most symptoms improving in one week.[2] Severe complications, if they occur, are usually in the very old, the very young, or those who are immunosuppressed (have a weakened immune system).[54] Secondary bacterial infections may occur resulting in sinusitis, pharyngitis, or an ear infection.[55] It is estimated that sinusitis occurs in 8% of cases. Ear infections occur in 30% of cases.[56]

Likelihood[change | change source]

The common cold is the most common human disease[54] and people are affected all around the world.[16] Adults typically have two to five infections per year.[2][3] Children may have six to ten colds per year (and up to twelve colds per year for school children).[36] Rates of symptomatic infections increase in the elderly due to a weakening immune system.[23]

History[change | change source]

While the cause of the common cold has been known since only the 1950s, the disease has been with humanity since ancient times.[57] Its symptoms and treatment are described in the Egyptian Ebers papyrus, the oldest existing medical text, written before the 16th century BC.[58] The name "common cold" came into use in the 16th century, due to the similarity between its symptoms and those of exposure to cold weather.[59]

In the United Kingdom, the Common Cold Unit (CCU) was set up by the Medical Research Council in 1946, and it was here that the rhinovirus was discovered in 1956.[60] In the 1970s, the CCU demonstrated that treatment with interferon during the incubation phase of rhinovirus infection provided some protection against the disease.[61] No practical treatment could be developed. The unit was closed in 1989, two years after it completed research of zinc gluconate lozenges in the prevention and treatment of rhinovirus colds. Zinc was the only successful treatment developed in the history of the CCU.[62]

Economic impact[change | change source]

The economic impact of the common cold is poorly understood in much of the world.[56] In the United States, the common cold leads to 75 million to 100 million physician visits annually, costing at least $7.7 billion per year (by conservative cost estimates). Americans spend $2.9 billion on over-the-counter (OTC) drugs. Americans spend an additional $400 million on prescription medicines for symptomatic relief.[63] More than one-third of people who saw a doctor received an antibiotic prescription. The use of antibiotic prescriptions has implications for antibiotic resistance.[63] An estimated 22 million to 189 million school days are missed each year due to a cold. As a result, parents missed 126 million workdays to stay home to care for their children. When added to the 150 million workdays missed by employees suffering from a cold, the total economic impact of cold-related work loss exceeds $20 billion per year.[12][63] This accounts for 40% of time lost from work in the United States.[64]

Research[change | change source]

A number of antivirals have been tested for effectiveness in the common cold. As of 2009, none have been both found effective and licensed for use.[46] There are ongoing trials of the antiviral drug pleconaril. It shows promise against picornaviruses. There are also ongoing trials of BTA-798.[65] The oral form of pleconaril had safety issues and an aerosol form is being studied.[65]


References[change | change source]

  1. 1.0 1.1 Eccles Pg. 24
  2. 2.0 2.1 2.2 2.3 2.4 Arroll, B (2011-03-16). "Common cold". Clinical evidence 2011 (03). PMID 21406124. 
  4. Eccles Pg.26
  5. Eccles Pg. 129
  6. Eccles Pg.50
  7. Eccles Pg.30
  11. Eccles Pg.77
  12. 12.0 12.1 "Common Cold". National Institute of Allergy and Infectious Diseases. 27 November 2006. Retrieved 11 June 2007.
  13. Eccles Pg.107
  14. 14.0 14.1 14.2 Pappas DE, Hendley JO (2009). "Transmission of colds". In Ronald Eccles; Olaf Weber (eds.). Common cold (Online-Ausg. ed.). Basel: Birkhäuser. p. 197. ISBN 9783764398941.
  15. 15.0 15.1 Eccles Pg.211
  18. Zuger, Abigail (4 March 2003). "'You'll catch your death!' An old wives' tale? Well..." The New York Times.
  20. Eccles Pg.79
  21. 21.0 21.1 Eccles Pg.80
  22. Eccles Pg. 157
  23. 23.0 23.1 23.2 Eccles. pg. 78
  24. Eccles Pg.166
  26. Eccles Pg.160–165
  27. 27.0 27.1 27.2 Eccles Pg. 112
  28. 28.0 28.1 Eccles Pg.116
  29. 29.0 29.1 Eccles Pg.122
  30. 30.0 30.1 Eccles Pg. 51–52
  31. 31.0 31.1 31.2 Eccles Pg.209
  34. Vassilev, ZP; Kabadi, S and Villa, R (2010 Mar). "Safety and efficacy of over-the-counter cough and cold medicines for use in children.". Expert opinion on drug safety 9 (2): 233–42. doi:10.1517/14740330903496410. PMID 20001764. 
  35. Eccles Pg. 246
  36. 36.0 36.1 36.2 36.3 Simasek M, Blandino DA (2007). "Treatment of the common cold". American Family Physician 75 (4): 515–20. PMID 17323712. 
  38. Albalawi, ZH; Othman, SS and Alfaleh, K (July 6, 2011). "Intranasal ipratropium bromide for the common cold". Cochrane database of systematic reviews (Online) (7). doi:10.1002/14651858.CD008231.pub2. PMID 21735425. 
  40. Guppy, MP; Mickan, SM, Del Mar, CB, Thorning, S, Rack, A (2011-02-16). "Advising patients to increase fluid intake for treating acute respiratory infections". Cochrane database of systematic reviews (Online) (2): CD004419. doi:10.1002/14651858.CD004419.pub3. PMID 21328268. 
  41. Singh, M; Singh, M (2011-05-11). "Heated, humidified air for the common cold". Cochrane database of systematic reviews (Online) (5): CD001728. doi:10.1002/14651858.CD001728.pub4. PMID 21563130. 
  42. Paul IM, Beiler JS, King TS, Clapp ER, Vallati J, Berlin CM (Dec 2010). "Vapor rub, petrolatum, and no treatment for children with nocturnal cough and cold symptoms". Pediatrics 126 (6): 1092–9. doi:10.1542/peds.2010-1601. PMID 21059712. 
  44. Eccles Pg.238
  45. Eccles Pg.234
  46. 46.0 46.1 Eccles Pg.218
  47. Oduwole, O (2010-01-20). Meremikwu, MM; Oyo-Ita, A; Udoh, EE. "Honey for acute cough in children". Cochrane database of systematic reviews (Online) (1): CD007094. doi:10.1002/14651858.CD007094.pub2. PMID 20091616. 
  48. Kassel, JC; King, D and Spurling, GK (2010-03-17). "Saline nasal irrigation for acute upper respiratory tract infections". Cochrane database of systematic reviews (Online) (3): CD006821. doi:10.1002/14651858.CD006821.pub2. PMID 20238351. 
  49. Singh, M; Das, RR (2011-02-16). "Zinc for the common cold". Cochrane database of systematic reviews (Online) (2): CD001364. doi:10.1002/14651858.CD001364.pub3. PMID 21328251. 
  54. 54.0 54.1 Eccles Pg. 1
  55. Eccles. pg.76
  56. 56.0 56.1 Eccles. pg.90
  57. Eccles. pg. 3
  58. Eccles. pg.6
  59. "Cold". Online Etymology Dictionary. Retrieved 12 January 2008.
  60. Eccles. pg.20
  62. Al-Nakib, W; Higgins, PG; Barrow, I; Batstone, G; Tyrrell, DA (Dec 1987). "Prophylaxis and treatment of rhinovirus colds with zinc gluconate lozenges". J Antimicrob Chemother. 20 (6): 893–901. doi:10.1093/jac/20.6.893. PMID 3440773. 
  65. 65.0 65.1 Eccles Pg.226
  66. "Genetic map of cold virus a step toward cure, scientists say". Val Willingham. CNN. March 2009. Retrieved 28 April 2009.

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