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Coughs and Colds

COMMON COLD CAUSES — The common cold is a group of symptoms typically caused by one of greater that a 100 different varieties of Rhino or Adenoviruses. The average adult experiences two to three colds per year, more in crowded class and living conditions…sound familiar to college life?

Direct contactwith hands: The virus may remain alive on the skin and capable of infecting another person for at least two hours. Thus, if a sick person shakes someone's hand and that individual then touches his eye, nose, or mouth, the virus can be transmitted and later infect that person.

Infection from particles on surfaces: Some cold viruses can live on surfaces (such as a counter top, door handle, cell phone or tablet) for several hours and be spread to others in contact w/such devices.

Inhaling viral particles: Droplets containing viral particles can be breathed, coughed, or sneezed into the air by a person with a cold. Colds are not caused by cold climates or being exposed to cold air. However, some specific types of virus are more seasonal in occurrence. 

COMMON COLD SIGNS AND SYMPTOMS — The common cold usually causes nasal congestion, runny nose, and sneezing. A sore throat may be present on the first day but usually resolves quickly. If a cough occurs, it generally develops on about the fourth or fifth day of symptoms, typically when congestion and runny nose are usually resolving.

COLD PREVENTION & SPREAD OF COLDS TO OTHERS:

  • Avoid close contact w/others known to have cold symptoms
  • Don’t share drinks, foods, etc.
  • Wash your hands frequently (15-30 second washing w/soap/H2O), or use hand sanitizer (spread over the entire surface of hands, fingers, and wrists until dry) before touching area of mouth, nose or eyes, or personal items of others.
  • If you need to sneeze or cough in class, tuck your face into the bend of your elbow to keep germs from spreading
  • Carry tissue for wiping a runny nose
  • Stay well rested & eat a healthy diet to give your immune system every opportunity to fight a cold
  • Stay home and rest if you can once cold symptoms develop
  • Consider an annual flu vaccination; available at the IU Health Center each fall (will not prevent common cold, but effective for the more dreaded annual influenza virus).

COMMON COLD COMPLICATIONS - In most cases, colds do not cause serious illness. Most colds last for three to seven days, although symptoms of coughing, sneezing, congestion often last for up to two weeks. The following commonly accompany lingering colds.

  • Mild fever and/or body aches, especially at onset of cold
  • Mild to moderate sore throat
  • Mild to moderate fatigue
  • Sinus pressure/fullness (only about 2 percent of the timeactually caused by bacteria). Having thick or yellow to green-colored nasal discharge does not mean that bacterial sinusitis has developed; discolored nasal discharge can be a normal phase of the common cold.
  • Lower respiratory infections with frequent cough, such as bronchitis (90% of time viral in normally healthy college students), may develop following a cold.
  • Non-infectious ear discomfort or fullness or popping, can accompany or follow a cold.

SERIOUS COLD COMPLICATIONS: these require evaluation per healthcare provider

  • Fever of 100° or higher lasting over 24 hours despite use of antipyretics such as Tylenol (Acetaminophen) or Advil/Motrin (Ibuprofen)
  • Sore throat lasting longer than three days or inability to swallow
  • White spots on or near tonsils
  • Swollen glands
  • Significant pain in ears or sinuses
  • Shortness of breath
  • Relentless cough despite use of self-care measures or OTC meds

COMMON COLD and COUGH TREATMENT — Goal is reduction of patient specific symptoms, but not necessarily duration.  Antibiotics are not useful for treating the common cold; antibiotics are only used to treat illnesses caused by bacteria, not viruses.

The symptoms of a cold typically resolve over time, with use of self-care measures only. The following are treatments that may reduce the symptoms caused by the common cold. People with underlying medical conditions and those who use other over-the-counter or prescription medications should speak with their healthcare provider or pharmacist to ensure that it is safe to use these treatments.

SELF CARE TREATMENT OF COLD AND COUGH SYMPTOMS

  • Rest
  • Hydration with water, decaffeinated teas, soups, etc.
  • Neti pot sinus rinse for nasal/sinus congestion (recommend use of sterile water to mix w/product).
  • Warm salt water gargle (1/2 teaspoon in 8 ounces water) for sore throat and to clear post nasal drainage.
  • For nasal / sinus congestion or sore throat: hot chicken soups and hot decaf teas
  • Teaspoons of honey or honey in tea for cough due to post nasal congestion.
  • Head of bed at approximately 30 degrees for better breathing and control of post nasal drainage.
  • Room humidifier, steam inhalation, or hot showers for cough and nasal/sinus congestion. 

MEDICATIONS FOR COLD SYMPTOMSall Over The Counter (OTC) or non-prescription meds should be taken w/consideration to personal health history which may contraindicate use of a given med. Precautions and dosing instructions should be read by consumer or reviewed w/healthcare professional prior to use.

Pseudoephedrine is a decongestant that can improve nasal congestion and help w/cough due to post nasal drainage. Drugstores carry it behind the counter, so it must be requested, and unless accompanied w/a prescription, requires government photo ID (license, visa, etc.).  It is available in 6, 12, and 24 hour dosing. Side effects and medication precautions should be reviewed before consideration for its use.

First generation antihistaminesdiphenhydramine (Benadryl®), chlorpheniramine, brompheniramine, etc. may also help runny nose, nasal congestion and a cough due to post nasal drainage, but can cause side effects such as drowsiness and drying of the eyes, nose, and mouth, as well as delayed drainage when sinus fullness, pressure or pain is present. The combination of first generation antihistamines and pseudoephedrine may be particularly helpful in controlling a cough due to post nasal drainage.

Cromolyn sodium (NasalCrom®) - may relieve runny nose, cough due to post nasal drainage, and sneezing.

Other nasal sprays such an oxymetazoline (Afrin®) or phenylephrine (Neo-Synephrine) can also give temporary relief of nasal congestion. However, these sprays should not be used for more than three days; use for more than three days use can worsen congestion.

Sore throat and headache - Sore throat and headache are best treated with a mild pain reliever such as acetaminophen (Tylenol®) or a non-steroidal anti-inflammatory (NSAID) such as ibuprofen or naproxen (Motrin® or Aleve®). NSAIDs should be taken after a meal and w/full glass H2O.

CoughSuppressants – The use teaspoons of honey or honey in tea have been found to be more effective for cough due to upper respiratory congestion and post nasal drainage than most OTC cough suppressants. Additionally, Ibuprofen (Advil, Motrin, etc.) can reduce inflammation associated with the cause of a cough due to common cold. Common OTC cough suppressants

often include guaifenesin (found in Mucinex and many Robitussin brand products) and dextromethorphan (found in Delsym and others with DM added to the end of product name). Their benefit, however, in instances of an upper respiratory viral cough due to post nasal drainage is likely to be small to non-existent. They can be helpful when lower respiratory cough (bronchitis, pneumonia or flu like respiratory illness exists.

Lozenges – Those containing benzocaine provide temporary relief from sore throat. Menthol lozenges temporarily help w/nasal and sinus stuffiness. Zinc lozenges (such as Ziacam) will shorten duration of sore throat and runny nose by ~ 30% if taken in first 24 hours of onset, and if directions for use closely followed…otherwise of limited value and not proven effective for control of cough.

Alternative treatments - A number of alternative products, including vitamin C and herbal products such as Echinacea, are advertised to treat or prevent the common cold. While none of these treatments is likely to cause harm, none has been proven to be effective in clinical trials; their use is not recommended. Certain products, such as nasal gels that contain zinc (Zicam®) have been associated with a permanent loss of smell.

Antibiotics -  Antibiotics should not be used to treat an uncomplicated common cold or cough due to cold. As noted above, colds are caused by viruses. Antibiotics treat bacterial, not viral infections.

 

SUMMARY

  • The average adult experiences two to three colds per year, while children average 8 to 12 colds per year.
  • Symptoms of the common cold usually include nasal congestion, runny nose, and sneezing. They typically last for three to seven days, although many people have symptoms (coughing, sneezing, and congestion) for up to two weeks.
  • People with colds typically carry the cold virus on their hands, where it can infect another person for at least two hours. Some cold viruses can live on surfaces (such as a counter top, door handle, or phone) for several hours. Droplets containing viral particles can be breathed, coughed, or sneezed into the air.
  • There is no specific treatment for colds. Treatment may reduce some of the symptoms of the cold, but most do not shorten or cure the cold. Antibiotics are not useful for treating the common cold.
  • Hand washing can prevent the spread of infection. Hands should be wet with water and plain soap, and rubbed together for 15 to 30 seconds. Alcohol-based hand rubs are a good alternative for disinfecting hands if a sink is not available.
Contact your IUHC healthcare provider if you have further questions or concerns that your symptoms may represent an illness more serious than a common cold.