Common cold
Common cold: Excerpt from Handbook of Diseases
The common cold — an acute, usually afebrile viral infection — causes inflammation of the upper respiratory tract. It accounts for more time lost from school or work than any other cause and is the most common infectious disease. Although it’s benign and self-limiting, it can lead to secondary bacterial infections.
Causes
The common cold is more prevalent in children than in adults, in adolescent boys than in girls, and in women than in men. In temperate zones, it occurs more commonly during the colder months; in the tropics, during the rainy season.
About 90% of colds stem from a viral infection of the upper respiratory passages and consequent mucous membrane inflammation; occasionally, colds result from Mycoplasma.
More than a hundred viruses can cause the common cold. Major offenders include rhinoviruses, coronaviruses, myxoviruses, adenoviruses, coxsackieviruses, and echoviruses.
Transmission occurs through airborne respiratory droplets, contact with contaminated objects, and hand-to-hand transmission. Children acquire new strains from their schoolmates and pass them on to family members. Fatigue or drafts don’t increase susceptibility.
Signs and symptoms
After a 1- to 4-day incubation period, the common cold produces pharyngitis, nasal congestion, rhinitis, headache, and burning, watery eyes; the patient may experience fever (in children), chills, myalgia, arthralgia, malaise, lethargy, and a hacking, nonproductive, or nocturnal cough.
As the cold progresses, signs and symptoms develop more fully. After a day, signs and symptoms include a feeling of fullness with a copious nasal discharge that usually irritates the nose, adding to discomfort. About 3 days after onset, major signs diminish, but the “stuffed-up” feeling may persist for a week.
Reinfection (with productive cough) is common, but complications (sinusitis, otitis media, pharyngitis, lower respiratory tract infection) are rare. A cold is communicable for 2 to 3 days after the onset of symptoms.
Diagnosis
No explicit diagnostic test exists to isolate the specific organisms responsible for the common cold. Consequently, the diagnosis rests on a cold’s typically mild, localized, and afebrile upper respiratory tract symptoms. Despite infection, white blood cell count and differential are within normal limits.
A diagnosis must rule out allergic rhinitis, measles, rubella, and other disorders that produce similar early symptoms. A temperature higher than 100° F (37.8° C), severe malaise, anorexia, tachycardia, exudate on the tonsils or throat, petechiae, and tender lymph glands may point to more serious disorders and require additional diagnostic tests.
Treatment
The primary treatment — aspirin or acetaminophen, fluids, and rest — is purely symptomatic because the common cold has no cure. Aspirin eases myalgia and headache; fluids help loosen accumulated respiratory secretions and maintain hydration; and rest combats fatigue and weakness. For a child with a fever, acetaminophen is the drug of choice.
Decongestants can relieve congestion. Throat lozenges relieve soreness. Steam encourages expectoration. In infants, saline nose drops and mucus aspiration with a bulb syringe may be beneficial.
Nasal douching, sinus drainage, and antibiotics aren’t necessary except if there are complications or if the patient has a chronic illness. Pure antitussives relieve severe coughs but are contraindicated with productive coughs, when cough suppression is harmful. The role of vitamin C and zinc remain controversial.
Although no known measure can prevent the common cold, vitamin therapy, interferon administration, and ultraviolet irradiation are under investigation.
Special considerations
❑ Emphasize to the patient that antibiotics don’t cure the common cold.
❑ Tell the patient to maintain bed rest during the first few days, use a lubricant on his nostrils to decrease irritation, relieve throat irritation with hard candy or cough drops, increase his fluid intake, and eat light meals.
❑ Inform the patient that warm baths or heating pads can reduce aches and pains, but they don’t hasten a cure. Suggest hot or cold steam vaporizers. Commercial expectorants are available, but their effectiveness is questionable.
Clinical tip Advise the patient against overuse of nose drops or sprays; they may cause rebound congestion.
❑ To help prevent colds, warn the patient to minimize contact with people who have colds.
❑ To avoid spreading colds, teach the patient to wash his hands often, to cover his mouth when he coughs or sneezes, and to avoid sharing towels and drinking glasses.
Book Source Details
- Book Title: Handbook of Diseases
- Author(s): Springhouse
- Year of Publication: 2003
- Copyright Details: Handbook of Diseases, Copyright © 2003 Lippincott Williams & Wilkins.
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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
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More About This Book:
Title: Handbook of Diseases
Authors: Springhouse
Publisher: Lippincott Williams & Wilkins
Copyright: 2003
ISBN: 1-58255-266-5
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