The viral upper respiratory infection (URI)

shutterstock_118647259The common cold is a group of symptoms that are caused by one of a large number of viruses.  Most viruses only cause the patient to be sick once, but because of the large number of viruses, a person can have a cold multiple times throughout a lifetime.  The average adult experiences 3-4 upper respiratory infections per year, while children experience 8-12 colds/year.

Transmission:  Spread of the infection is from person-to-person, but can also be transmitted by an infected person touching a surface and leaving some virus particles and then an un-infected person touching the contaminated surface.

Direct contact is the most frequent way the virus is spread.  Most commonly the virus is on the infected persons hands.  If a sick person shakes another persons hand and that un-infected person touches their eye, nose or mouth, they can get infected.

Inhaling viral particles is another way cold viruses are spread.  They can be breathed, coughed or sneezed into the air by a sick person and the virus can be transmitted to another person if they are standing nearby (within a few feet) and the droplets touch the unsick persons eye, nose or mouth.  Covering the mouth while coughing reduces the risk of transmission.

Symptoms:  Possible symptoms include nasal congestion, runny nose, sneezing, sore throat, low grade fever and cough.  Usually symptoms last from 3-10 days, but sometimes last longer.

Most of the time a cold does not cause a serious illness, however if the virus depress the immune system enough, a secondary bacterial infection such as a sinus infection, ear infection, or pneumonia can result.  We usually don’t treat for these kind of infections until the patient has not had resolution for 10-14 days because the infection is likely viral.

Influenza virus:  Symptoms can be similar to a common cold, but are usually more severe and can include high fever (above 102 degrees), body aches, headaches, etc.  The influenza virus is more serious and has even caused death in elderly and young people.

Treatment:  Most treatments are aimed at relieving the symptoms, but they do not shorten the course of the illness.  The body has a series of defenses and fights off the virus over the course of a few days to two weeks.

Runny nose/congestion:

1)   Benadryl or other antihistamines can be helpful for the nasal drainage

2)   Nasal sprays may also be helpful for the nasal congestion

3)   Afrin is often helpful but can cause rebound congestion if used more than 3 days in a row.

Sore throat:

1)   Tylenol, ibuprofen or aleve may be helpful for sore throat pain

2)   One dose of oral Dexamethasone has been shown to reduce throat swelling and pain.

3)   Tessalon is a medicine that numbs the back of the throat and can reduce the pain

Cough:   This is controversial because cough is the body’s natural mechanism for ridding the airways in the lungs of mucus.  It can be miserable however, so we do treat it in some people.  (be aware that cough is very difficult to treat)

1)  Humidifying the air is helpful to increase the bodies ability to express the mucus from the airways.  Therefore I recommend a steamer in the sick person’s house/room.

2)  Robitussin(guaifenesin) or dextromethorphan may be helpful

3)  Some people find that codeine cough syrup helps suppress cough

Using antibiotics to treat a cold:  Antibiotics should NOT be used to treat a common cold because they do not work for viruses.  The possible consequences of using antibiotics for a virus include:

1)   Allergic reaction to the antibiotic

2)   Side effect of the antibiotic such as nausea, heartburn, headache, or diarrhea

3)   Allergic reaction to antibiotic such as hives, swelling of the lips or rash

4)   Antibiotic resistance – the bacteria that are present within the patients body may become resistant to the antibiotics that are being used and thereby increase the chances in the future a bacterial infection caused by these bacteria might not be susceptible to antibiotics.  In fact, there are bacteria in our community now that we have no way to treat.  They are resistant to every antibiotic that we have.  The “super” bacteria are created by overuse of antibiotics or stopping an antibiotic too early in a person who does have a bacterial infection.

This document is for informational purposes only, and should not be considered medical advice for any individual patient.  If you have questions please contact your medical provider.


I hope that you have found this information useful.  Wishing you the best of health,

Scott Rennie, DO



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