COLD

•What is Cold?
 THE COMMON COLD
A common cold, also known as an Upper Respiratory Infection
(URI), may occur at any time of year with seasonal peaks
occurring in fall and spring and is characterized by irritation and
drainage in any of the airways. Any one or more of over 300
viruses are known to cause a common cold.

Symptoms of a common cold may include: scratchy, sore throat,

stuffy or runny nose, sneezing, decreased energy, muscle aches,
watery eyes or cough (dry or with phlegm).
 Colds are primarily spread through contact with an
infected individual. It is more likely that the virus will
be transmitted if you touch your eyes or nose shortly
after hand to hand contact with an infected person.
Good hand washing is one of the best protective
measures.

A cold is also caused by a virus and is probably one of the

most common illnesses known. The common cold is usually
mild and will only last a week or less. Colds are far more
common amongst children and they can get up to 10 colds in
1 year.
Common Cold
an acute, highly contagious virus infection of the upper
respiratory tract. There are different types of colds, because of
different causative agents and individual reactions. Usually the
common cold starts with a runny nose, sneezing, a stuffy feeling in
the head, slight headache, watering of the eyes, general aching
and listlessness, inability to concentrate, and perhaps a slight
fever. The affected membranes swell until the nasal passages are
blocked. Often the inflammation spreads to the throat, causing
sore throat and cough.

Complications that sometimes occur with a cold include sinusitis,

laryngitis, bronchitis, and pneumonia. Called also acute rhinitis.
 General Common Cold Information

Common cold is the most common disease

Common cold infections are so widespread that there can be very
few humans who escape infection each year and most will suffer
multiple infections. It has been estimated that adults suffer 2 to 5
colds per year, and school children may suffer 7 to 10 colds per
year1.

As we get older we get fewer colds

As we get older our immune system learns how to deal with more
and more viruses as we generate antibodies each time we get a
cold.
Symptoms of the common cold

usually begin 2-3 days after inoculation. Viral URIs typically last
6.6 days in children aged 1-2 years in home care and 8.9 days for
children older than 1 year in daycare. Cold symptoms in adults can
last from 3-14 days, yet most people recover or have symptomatic
improvement within a week. If symptoms last longer than 2 weeks,
consider alternative diagnoses, such as allergy, sinusitis, or
pneumonia.
Can a cold kill you?
Yes! Babies and the very elderly can develop chest infections such
as bronchiolitis caused by the RSV virus that can be fatal. You are
also at risk take any medication that depresses your immune
system.

Infection usually occurs at home

Young children represent the main reservoir of common cold
viruses and infection usually occurs at home or in the nursery or
school. Adults with regular contact with children are most exposed
to infection.
Common cold viruses are not very contagious
Despite the fact that very few of us escape from at least a couple
of common cold infections each year, common cold viruses are
not very contagious. Under laboratory conditions when healthy
volunteers are kept with others who are suffering from common
cold infections it has proven remarkably difficult to spread
infection from one person to another.
Kissing is OK

Close personal contact is necessary for the virus to spread and the
home and school are the places where spread most often occurs.
The common cold viruses are not spread by contact such as
kissing but appear to be spread by large particles expelled at close
range by coughs and sneezes, and by contaminated fingers that
pass the virus to the nose and eye
How to avoid catching a cold
Become a hermit. If you are in contact with other people you are
likely to get a cold as the viruses are so common.

Hand washing may help

Since cold viruses can be passed from person to person by hand
contact or by touching contaminated surfaces such as door
handles you can help prevent infection by washing your hands.
Home studies have shown that hand washing can reduce the
spread of common colds within the family4
The colds season
Colds occur all year round but there is an increased incidence
during autumn and winter months.
Can a chill cause a cold?
Folklore indicates that chilling such as getting your feet wet in
winter and going out with wet hair may cause a common cold but
until recently there has been no scientific research to support this
idea. Recent research has demonstrated that chilling may cause
the onset of common cold symptoms5. A study at the Common
Cold Centre in Cardiff UK in 2005 took 90 students and chilled
their feet in cold water for 20 minutes and showed that the chilled
group had twice as many colds over the next 5 days as a control
group of 90 students whose feet were not chilled. The authors
propose that when colds are circulating in the community some
persons carry the virus without symptoms and that chilling the
feet causes a constriction of blood vessels in the nose and this
inhibits the immune response and defences in the nose and
allows the virus to replicate and cause cold symptoms. The chilled
person believes they have caught a cold but in fact the virus was
already present in the nose but not causing symptoms.
Why more colds when its cold?
Colds and flu are definitely seasonal, with more colds in the colder
weather but there is no real agreement as to why colds are
seasonal. Most textbooks state that there are more colds in cold
weather because we tend to crowd indoors in poorly ventilated
rooms. This crowding theory has been around for over a hundred
years but it does not really make sense, as our cities are just as
crowded in summer as winter. A new theory that has been put
forward to explain the seasonality of colds and flu, and this theory
puts forward the idea that our noses are colder in winter than
summer and that cooling of the nose lowers resistance to
infection. If the weather is freezing outside we wrap up in winter
clothes but we still leave our nose exposed to the freezing air.
Every time we breathe in we cool the nasal lining and weaken our
local defences against infection. If this theory is correct then
covering our nose with a scarf in cold weather could help prevent
colds6.
 Common Cold Viruses
Which viruses cause colds?
The symptoms of the common cold syndrome are caused by over
two hundred different viruses. Rhinoviruses (nose viruses)
account for approximately 30-50% of adult colds. Other viruses,
such as coronavirus, respiratory syncytial virus (RSV), adenovirus,
parainfluenza virus and influenza virus also cause the common
cold syndrome. There is no way of identifying the nature of the
virus infection from the symptoms as these are very similar across
the whole range of viruses.
Incidence of colds according to virus
Rhinovirus 30-50% Parainfluenza 5%
Coronavirus 10-15% Influenza 5-15%
Respiratory Syncytial Virus 10% Enteroviruses <5%
Adenovirus <5% Metapneumovirus unknown
Unknown 20-30%
 What are the symptoms?
Symptoms are mostly caused by the body's reaction to the cold
virus, which triggers the release of chemicals that make the blood
vessels leaky and send the mucous glands into overtime.
As a result, the nasal passages become swollen and choked with
secretions.

Cold symptoms reach their peak after 36 to 72 hours and include:

Dry, scratchy sore throat (usually the first sign of a cold)
Runny nose and sneezing
Hoarse voice
Blocked, snuffly nose
Cough
Mild headache
Mild fever
Generally feeling unwell or muzzy headed
 Treatment of the common cold.

The common cold is a viral illness that affects persons of all ages,
prompting frequent use of over-the-counter and prescription
medications and alternative remedies. Treatment focuses on
relieving symptoms (e.g., cough, nasal congestion, rhinorrhea).
Dextromethorphan may be beneficial in adults with cough, but its
effectiveness has not been demonstrated in children and
adolescents. Codeine has not been shown to effectively treat
cough caused by the common cold. Although hydrocodone is
widely used and has been shown to effectively treat cough caused
by other conditions, the drug has not been studied in patients
with colds. Topical (intranasal) and oral nasal decongestants have
been shown to relieve nasal symptoms and can be used in
adolescents and adults for up to three days.
Antihistamines and combination antihistamine/decongestant
therapies can modestly improve symptoms in adults; however, the
benefits must be weighed against potential side effects. Newer
nonsedating antihistamines are ineffective against cough. Topical
ipratropium, a prescription anticholinergic, relieves nasal
symptoms in older children and adults. Antibiotics have not been
shown to improve symptoms or shorten illness duration.
Complementary and alternative therapies (i.e., Echinacea, vitamin
C, and zinc) are not recommended for treating common cold
symptoms; however, humidified air and fluid intake may be useful
without adverse side effects. Vitamin C prophylaxis may modestly
reduce the duration and severity of the common cold in the
general population and may reduce the incidence of the illness in
persons exposed to physical and environmental stresses.
Keeping your cold to yourself
You're most contagious during the first three days of a cold, when
you shed huge amounts of the virus from your nose.

Avoid contact with other people

Wash your hands frequently
Avoid touching your nose and eyes
Use disposable tissues and bin used ones promptly
 How To Care For Yourself
Medications used to treat the flu or a cold control symptoms.
Antibiotics won’t work – they combat bacterial, not viral,
infections. Viruses actually hide inside your own cells where
antibiotics cannot affect them. Flu and cold care is aimed at
symptom relief and immune system support. These include the
following:
Get plenty of rest

Do not smoke

Drink plenty of fluids—up to 3-4

liters per day (to prevent
dehydration from fever and to help
loosen mucous or phlegm)
For fever, headache, body aches, or sore throat pain, take Tylenol
(acetaminophen) Advil (ibuprofen), or Aleve (naproxen) every 4-6
hours

For sore throat, gargle every 4 hours with warm, salty water (mix
1/2 teaspoon salt or baking soda in 8 oz. of warm water). Also, try
using throat lozenges containing a numbing medication.

For hoarseness or laryngitis, talk as little as possible. Straining

the voice can prolong or worsen
laryngitis.

For heavy amounts of nasal discharge or a large amount of

phlegm associated with cough, consider using a mucolytic, such as
Mucinex (available over-the-counter).
For persistent runny nose or nasal congestion, antihistamines
and decongestants may be used. Mild antihistamines such as
Chlor-Trimeton are useful for runny nose, sneezing and watery
eyes. Use a decongestant such as Sudafed PE (phenylephrine) for
nasal/sinus congestion or ear fullness. A combination
antihistamine/decongestant such as Actifed or Dimetapp may be
taken for multiple symptoms. But remember, antihistamines may
make you drowsy (decongestants usually will not)!
 When To Seek Medical Care
Flu and colds may lead to secondary bacterial infections or
worsening of chronic conditionssuch as asthma for which
prescription medication would be necessary. You should seek
medical attention if you are not improving after 7-10 days or for
any of the following
symptoms:
Very sore throat that shows no signs of improving after 3 days,
or that is accompanied by
fever and without any other usual cold symptoms
Painful swelling of the lymph nodes or glands in the neck
Discolored mucus from nasal passages
Pain or tenderness around the eyes
Ear pain (as opposed to a “full” feeling)
Cough with production of a large amount of discolored mucus
Painful breathing, wheezing or shortness of breath
Cough that persists more than 2-3 weeks
Severe headaches
Fever higher than 100.4 degrees for more than 3-4 days
 Colds in Children

Why children get so many colds

The ‘common cold’ is caused by viruses that infect the nose,
throat and sinuses. A virus is a germ that makes people sick.
Young children get lots of colds, some as many as 8 to 10
each year before they turn 2 years old. Colds tend to be
more common in fall and winter when children are indoors
and in closer contact with each other, so it may seem like
your child has one cold after another all winter long. Young
children have more colds than older children and adults
because they haven’t built up immunity (defences) to the
more than 100 different cold viruses that are around.
Children can catch colds from siblings, parents, other family
members, playmates or caregivers. Children with older siblings and
those who attend daycare have more colds. Once you’ve had a
cold virus, you become immune to that virus, so children get fewer
colds as they get older. By the time they start school, children who
attended daycare will have fewer colds than other children.  

If a child gets many colds, it’s not a sign of a weak immune
system. It just means he’s exposed to many viruses. The only
reason to have a child’s immune system tested is if the colds often
lead to more serious problems.  
Is it just a cold or something more serious?

Typical cold symptoms are a runny nose, nasal congestion,

sneezing, coughing and a mild sore throat.
Some children may not want to eat, have a headache or be more
tired than usual.  
Colds can sometimes cause fever, but the fever usually isn’t very
high.
Colds usually last about a week but can last for as long as 2
weeks.  
Some respiratory viruses that cause colds in older children and
adults may cause more serious illness when they infect infants and
toddlers. These illnesses include croup (hoarseness, noisy
breathing, barking cough), bronchiolitis (wheezing, difficulty
breathing), or sore eyes, sore throat and neck gland swelling.
 How colds are spread
Cold viruses are found in the nose and throat. Because
children touch their noses, eyes and mouths often, put things in
their mouths, and touch each other often during play, cold germs
spread easily. There is also a lot of contact between parents or
caregivers and children: holding hands, picking up, feeding,
changing diapers and so on.

Children with colds get viruses on their hands when they touch
their runny noses or mouths or when they cough or sneeze. When
they touch other children, they pass on the viruses.
Children with colds get viruses on their hands and then touch an
object, such as a toy or furniture. Cold viruses can live on objects
for several hours and can be picked up on the hands of other
children who touch the same object. These children then get
infected when they touch their eyes, nose or mouth.  
Caregivers can get viruses on their hands and spread them
between children by touch.

Some cold viruses may be spread through the air when a child
with a cold coughs or sneezes. Droplets from the cough or sneeze
may reach another child’s nose or mouth.
When to call a doctor
Babies under 3 months of age have difficulty breathing through a
blocked nose. Feeding becomes difficult. Call your doctor or take
your baby to an emergency department if your baby:
has trouble breathing;
is not eating or is vomiting; or
has a fever (rectal temperature of 38.5°C or higher).  
Babies and children of all ages should see a doctor if the cold
seems to be causing more serious problems. Call your doctor or
take your child to an emergency department if you notice any of
the following signs:
your child is breathing rapidly or seems to be working hard to
breathe;
your child’s lips look blue; or  
coughing is so bad that the child is choking or vomiting.  
Call your doctor if your child shows any sign of a middle
ear infection, which can result from a cold. These signs include:

high fever (especially fever that begins several days after the start
of a cold);
earache;  
crankiness;  
vomiting; or  
pus draining from the ear.  
 Other reasons to contact your doctor:

If your child wakes in the morning with one or both eyes stuck
shut with dried yellow pus. Although red eyes and watery
discharge are common with a cold, pus is a sign of an eye
infection and should be treated.
If your child is much more sleepy than usual, doesn’t want to
feed or play, or is very cranky or fussy and cannot be comforted.  
It’s common to have thick or discoloured (yellow, green)
discharge from the nose with a cold. This doesn’t need an
antibiotic. However, if it lasts for more than 10 to 14 days, contact
your doctor.  
Treating colds: What parents can do

There is no cure for the common cold. Colds usually go away on

their own.

Keep your child as comfortable as possible. If she doesn’t want

to eat, offer plenty of fluids and small, nutritious meals.  

‘Over-the-counter’ cough and cold medicines (which don’t need

a doctor’s prescription) should not be given to children younger
than 6 years old unless prescribed by your doctor. Talk to your
doctor or pharmacist before giving over-the-counter drugs to
children under 12 years of age, or to anyone taking other
medicines or with a chronic illness. Read label instructions
carefully and do not give more than is recommended.
Coughing helps clear mucus from the chest. If coughing is
frequent, dry and is preventing an older child from sleeping, a
product with dextromethorphan may help ease it, although
studies have shown limited benefit.  
Decongestants and antihistamines have no effect on coughing.
Decongestants taken by mouth are not very effective and can
cause rapid heartbeat or insomnia (inability to sleep) in children.
Antihistamines are not effective for colds.  
If an infant is having trouble feeding because of a stuffed nose,
use a rubber suction bulb to clear mucus from the nose. Use
saline nose drops or saline nose spray if the mucus is very thick.
The spray goes well into the nasal passages and may be more
effective than the drops.  
Cool mist humidifiers are not recommended because of the risk
of contamination from bacteria and mould. If used, they must be
disinfected daily. Hot water vaporizers are not recommended
because of the risk of burns.  
Medicated nose drops or sprays provide only brief relief and
shouldn’t be used for more than 2 to 3 days because the
congestion can actually get worse. Don’t use these products in
children under 6 years old.  
Monitor your child’s temperature. To ease pain, aches or a fever
with a temperature greater than 38.5°C, use acetaminophen (eg,
Tylenol, Tempra and Panadol). Ibuprofen (eg, Advil and Motrin)
may be used for children over 6 months old. Use the dose and
schedule recommended on the package or by your doctor or
pharmacist. Acetylsalicylic acid (ASA [eg, Aspirin]), or any cold
medicine containing it, should be avoided in children and
teenagers with colds because it can lead to brain and liver damage
(Reye syndrome).
Colds cannot be treated with antibiotics. Antibiotics should be
used only when children develop complications from bacteria,
such as an ear infection or pneumonia.

Children can continue their normal activities if they feel well

enough to do so. If they have fever or complications, they may
need a few days of rest at home. Your child can keep going to
school if he feels well enough to take part in the activities.  

In winter, children with colds can still play outside.

 Preventing colds: What parents can do
Keep babies under 3 months old away from people with colds, if
possible.
Make sure your child has received all of the recommended
immunizations. While they won’t prevent colds, they will help
prevent some of the complications, such as bacterial infections of
the ears or lungs. Influenza vaccine protects against influenza but
not against other respiratory viruses.  
Handwashing is the most important way to reduce the spread of
colds:
Wash your hands after coughing, sneezing or wiping your nose.  
Wash your hands after being in direct contact with someone who has a
respiratory infection.  
Wash your own hands and your child’s hands after wiping your child’s nose.  
When water and soap are not available, use premoistened hand wipes or alcohol-
based hand rinses. Keep hand rinses out of the reach of children because they may
be harmful if swallowed.  
Teach children to prevent spreading colds by covering the nose
and mouth with tissues when they sneeze or cough, by disposing
of tissues immediately in a wastebasket, and by washing their
hands after wiping the nose or handling tissues.  

Avoid sharing toys that young children place in their mouths until
the toys have been cleaned.  

If your child attends daycare, tell the caregiver about any
symptoms and ask if your child should stay away from daycare that
day. When both parents work outside the home, plan ahead by
making arrangements for when your child becomes ill.  
 Common Cold Symptoms

Symptoms flare out from a pinpoint of infection

Common cold infections do not cause any visible damage to the

lining of the nose. Sites of infection may occur as tiny pin points
scattered over the lining of the nose and throat. The pinpoint of
infection is represented as the tip of the flare and this triggers a
cascade of events in the lining of the nose starting with the
immune response and sometimes expanding to generate chemical
mediators and symptoms.
Symptoms may last two weeks
Symptoms in patients presenting with common cold usually last
for around seven days although some cold symptoms may persist
for up to 14 days in one quarter of patients.

The first signs of a cold

A dry scratchy sore throat is often the first sign of a common cold
and this may be due to the virus first infecting the back of the
nose

Sneezing and a clear watery nasal fluid are also early signs of
infection.
Is it a cold or flu?
Headache, fever and muscle aches and pains are commonly
associated with influenza and bacterial infections but they are also
associated with common cold viruses.

You cannot distinguish between a cold and flu!

You cannot separate a cold and flu just from the symptoms.

In general influenza has a sudden onset and is associated with

fever and muscle aches and pains but a severe common cold can
also cause these symptoms.
Fever is common in children
Fever associated with common cold is uncommon in the adult but
quite common in infants and children.
 Top recommendations for feeding a cold.
Colds and Foods High in Antioxidants
Eating foods high in antioxidants -- beta-carotene and vitamins C
and E -- may be a helpful cold remedy. Antioxidants are essential
nutrients. They help protect your body against life's stressors, and
are thought to play a role in the body's cell protection system.
They interfere with the disease process by neutralizing free
radicals. Free radicals are special molecules that can disrupt and
tear apart vital cell structures such as cell membranes.
Antioxidants may take away the destructive power of free
radicals, thus helping to reduce your chance of illness. They may
also help you recover from an illness more quickly.

Including more raw fruits and vegetables in your diet is the best
way to ensure a high intake of antioxidants. And when you cook
these super-nutrients, be sure you cook them using as little liquid
as possible to prevent nutrient loss.
Foods rich in beta-carotene and other carotenoids include:
Apricots cantaloupe squash (yellow and winter)
asparagus carrots sweet potato
beef liver corn tangerines
beets guava tomatoes
broccoli pumpkin watermelon

Foods rich in vitamin C include:

broccoli red, green or yellow pepper
cantaloupe sweet potato
cauliflower strawberries
kiwi tomatoes
orange juice
papaya
Foods rich in vitamin E include:
almonds lobster sunflower seeds
corn oil peanut butter
cod-liver oil safflower oil
hazelnuts salmon steak