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Encyclopaedia


Cold, common

Introduction

Cold, common

A cold is a mild viral infection of the nose, throat, sinuses and upper airways. It can cause a blocked mose followed by a runny nose, sneezing, a sore throat and a cough.

More than 200 types of virus can cause the common cold, which is why people will become infected again at a later stage. Read more about the causes of cold.

Adults have about two to four colds a year, and children have three to eight. A child’s immune system is less well developed compared to an adult’s, so they're more vulnerable to infection.

Women get more colds than men, possibly because they're more likely to come into close contact with children.

Colds are also more frequent during the winter months. This may be because people are more likely to stay indoors and be in close contact with each other.

 

How a cold spreads 

A cold can be spread through:

  • direct contact – if you sneeze or cough, tiny droplets of fluid containing the cold virus are launched into the air and can be breathed in by others
  • indirect contact – if you sneeze onto a door handle and someone else touches the handle a few minutes later, they may catch the cold virus if they then touch their mouth or nose

In general, a person first becomes contagious two to three days before their symptoms begin, and they remain contagious until all their symptoms have gone. So most people will be contagious for around two weeks.

Why colds occur in the winter

Colds are more frequent during the winter months. This may be because people are more likely to stay indoors and be in close contact with each other.

Outlook

In adults and older children, the cold will usually last for about a week as the body fights off the infection. Colds in younger children can last up to two weeks.

There is no cure for a cold, although you can usually relieve the symptoms of a cold at home by taking over-the-counter medication, such as paracetamol, and drinking plenty of fluids.

Read the treating colds section for more information.

You can use our Cold and Flu symptom checker to check your symptoms and find out what to do.

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Symptoms

The first symptom of a cold is usually a sore or irritated throat. This is then followed by other symptoms, including:

  • a blocked nose (nasal congestion) - caused by a build up of phlegm or mucus (catarrh)
  • nasal pain and irritation 
  • sneezing 
  • a runny nose (nasal discharge) – the discharge is usually clear and runny at first before becoming thicker and darker over the course of the infection 
  • coughing – this symptom occurs in one out of every three cases 
  • a hoarse voice 
  • a general sense of feeling unwell

Less common symptoms of a cold include:

  • a usually mild temperature (fever) of around 38–39°C (100.4–102.2°F) 
  • headache 
  • earache - severe earache may be a sign of a middle ear infection (otitis media)
  • muscle pain 
  • loss of taste and smell 
  • mild irritation of your eyes 
  • a feeling of pressure in your ears and face  

The symptoms of a cold are usually at their worst during the first two to three days of the infection before they gradually start to improve. In adults and older children, the cold usually lasts for about a week. However, if you or your child has a cough, it may last for up to three weeks.

Colds tend to last longer in younger children who are under five. Their symptoms typically last between 10–14 days.

Read more about the common cold in children

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Causes

Colds are caused by viruses which attack the lining of the nose and throat, inflaming these areas. As they become inflamed, they begin to produce more mucus, resulting in a runny nose and sneezing

There are more than 200 types of virus can cause a cold. Those most responsible for colds belong to one of two groups:

  • rhinoviruses
  • coronaviruses

Because a number of viruses can cause a cold, it's possible to have several colds, one after the other, as each one is caused by a different virus.

How is a cold spread?

Colds can be spread in several ways:

Direct contact -  If you have a cold and you sneeze, cough or speak, tiny droplets of fluid containing the cold virus are launched into the air.

Indirect contact -  If you sneeze onto a door handle and someone else touches the handle a few minutes later, they may catch the cold virus if they then touch their mouth or nose.

In general, a person first becomes contagious two to three days before their symptoms begin, and they remain contagious until all their symptoms have gone. So most people will be contagious for around two weeks.

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Diagnosis

In most cases, you will know when you have a cold from the symptoms.

When to seek medical advice

You only really need to see your GP if:

If you're concerned about your baby or an elderly person, or you have a long-term illness, such as a chest condition, arrange to see your GP. Alternatively, you can phone NHS Direct Wales on 0845 4647, for an assessment.

In these circumstances your GP may carry out tests to make sure that your symptoms aren't being caused by another type of infection that may be more serious, such as pneumonia (a bacterial infection of the lungs) or glandular fever (a viral infection caused by the Epstein-Barr virus).

These tests may include:

  • blood tests
  • chest X-rays
  • taking a sample of tissue from your throat using a swab (a small cotton bud with a plastic loop at the end), which is then checked for the presence of bacteria
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Treatment

Self care

In most cases, you will be able to treat the symptoms of cold yourself at home by using a number of self-care techniques. These are listed below:

  • Drink plenty of fluids to replace any fluids you may have lost due to sweating and having a runny nose. 
  • Get plenty of rest: there's no official guidance as to how long a person should stay off work or out of school. Most people usually know when they're fit enough to return to normal activities. 
  • Eat healthily: a low-fat, high-fibre diet is recommended, including plenty of fresh fruit and vegetables (five portions a day).

Many children will lose their appetite when they have a cold. However, this is perfectly normal and it should only last for a few days. It's recommended that children with a cold only eat when they're hungry.

The remedies outlined below may also help to relieve your symptoms.

Steam inhalation

Steam inhalation involves sitting with your head over a bowl of hot water. Place a towel over your head, close your eyes and breathe deeply. Avoid getting the hot steam in your eyes.

The steam may help to ease your congestion by loosening mucus and making it easier to clear by blowing your nose. Adding menthol, eucalyptus, camphor, thymol or pine oil to the water may help to clear the passageways in your nose. 

Steam inhalation is not advised for children due to the risk of scalding. Instead, a child may benefit from sitting in a hot, steamy bathroom.

Gargling

Gargling with salt water can sometimes help to relieve the symptoms of a sore throat and nasal congestion.

Vapour rubs

Vapour rubs can help to soothe the symptoms of a cold in babies and young children. Apply the rub to your child’s chest and back. Don't apply it to their nostrils because this could cause pain and breathing difficulties.

Menthol sweets

Some people find that sucking a menthol sweet can help to relieve the symptom of a sore throat.

Nasal saline drops

Nasal saline drops or sprays can help relieve the symptoms of nasal congestion in babies and young children. Nasal saline drops contain salt water so they're thought to work in the same way as gargling salt, but they're often better tolerated in babies and young children.

Nasal saline drops or sprays are available from most pharmacists.

Over-the-counter cold medications

In England and Wales over-the-counter (OTC) cold medicines are probably the most widely used type of medication. However, there isn’t much evidence that certain OTC medications are effective.

Painkillers such as ibuprofen, paracetamol and aspirin are the only type of medication known to be effective in treating colds.

Children who are under 16 years old or women who are breastfeeding should not take aspirin.

Most over-the-counter cold medications aren't suitable for children under six years old. If your child is unwell, talk to your pharmacist about the best option.

Decongestants (medications designed to reduce nasal congestion) may have some limited effectiveness against colds. However, don't use them for more than seven days because overuse can make the symptoms of congestion worse. Children under 6 years old should not use decongestants.

The use of antibiotics to treat a cold is not recommended. As almost all cases of cold are caused by a viral infection, antibiotics won't have any benefit, and may cause unpleasant side effects, such as nausea and diarrhoea.

Many OTC medications contain a combination of different medicines; typically a painkiller, such as paracetamol, and a decongestant, such as pseudoephedrine.

If you have recently taken an OTC cold medication, it may not be safe for you to take an additional painkiller. Read the manufacturer’s patient information leaflet carefully before taking the medication, and follow the recommended dosage instructions. 

More information about specific OTC medication is provided below.

Decongestants

Decongestants can be taken by mouth (oral decongestants) or taken as a spray in your nose (nasal decongestants). They work by reducing the swelling in the passageways of your nose and they may also help to ease breathing.

There's limited evidence to show how effective decongestants are. They may only help some people and often only ease symptoms for a short period of time. 

Decongestants are a safe and rarely cause serious side effects. If you use nasal decongestants frequently or for a long time, your congestion may end up getting worse.

Decongestants are not recommended for children under 6 years old and children under 12 years old shouldn't take them unless advised by a GP.

Oral decongestants can cause a rise in blood pressure and heart rate, leading to a feeling of being more alert. Therefore, if you take OTC decongestants at bedtime, you may have problems sleeping at night. Oral decongestants, such as pseudoephedrine, phenylpropanolamine and phenylephrine are used in many OTC cold remedies.

Oral decongestants may interact with some antidepressants and beta-blockers, so if you're taking either of these medicines, check with your GP or pharmacist before taking oral decongestants. If you have high blood pressure (hypertension), heart problems or glaucoma (a group of eye conditions that affect vision), check with your GP before using an oral decongestant.

Nasal decongestants work specifically on the nose. They're usually safe for adults and older children to use. They are available as nose drops or sprays.

Nasal decongestants shouldn't be used for more than seven days because using them for longer can actually make your congestion worse. If you're taking a type of antidepressant called a monoamine oxidase inhibitor (MAOI), you shouldn't use nasal decongestants.

Read more about Decongestant medication.

Painkillers

Paracetamol, ibuprofen or aspirin can help to reduce a fever. They also act as painkillers. Aspirin should not be given to children under the age of 16 and look for age-appropriate versions of paracetamol and ibruprofen (usually in liquid form). Always follow manufacturer's instructions to ensure  the correct dose is given.

Children must not be given both ibuprofen and paracetamol. You must either use one or the other. Using both could cause adverse side effects. Always follow the manufacturer’s instructions carefully.

Paracetamol, ibuprofen and aspirin are also included in some OTC cold medicines with other ingredients. Check with your pharmacist or GP before taking a cold remedy if you're taking any other painkillers.

Don't take ibuprofen if you have a history of stomach ulcer, indigestion, asthma or kidney disease. Aspirin should also not be taken by children who are under 16 years old or by women who are breastfeeding.

If you're pregnant, paracetamol – not ibuprofen – should be used for the short-term relief of mild to moderate pain and fever.

Read more information about:

Zinc supplements

Taking zinc syrup, tablets or lozenges may be an effective treatment for the common cold.

2011 Cochrane review suggests that taking zinc supplements within a day of the symptoms starting will speed up recovery and lessen the severity of symptoms.

However, long-term use of zinc isn't recommended as it could cause side effects such as vomiting and diarrhoea.

More research is required to determine the recommended dose.

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Complications

Colds don't usually cause complications. However,  the infection can sometimes move to your chest, ears or sinuses.

Sinusitis

Sinusitis is an infection of the small, air-filled cavities inside the cheekbones and forehead. It develops in up to 2% of adults and older children with colds.

Symptoms of sinusitis include:

  • pain and tenderness around your nose, eyes and forehead 
  • a blocked and runny nose

In most cases, the symptoms of sinusitis will resolve without the need for treatment.

Otitis media

Otitis media is a middle ear infection and a common complication of colds in children who are under five years old. It occurs in an estimated 20% of cases.

Symptoms of otitis media include:

  • severe earache
  • a high temperature (fever) of or above 38°C (100°F) 
  • flu-like symptoms, such as vomiting and lethargy (a lack of energy)
  • some loss of hearing

Approximately 80% of cases of otitis media will resolve themselves without treatment, usually within three days.

Additional treatment is usually only required if your child has repeated episodes of otitis media.

Chest infection

chest infection can occur after a cold, as your immune system is lowered. There are two main types of chest infection:

  • bronchitis - which usually resolves itself without treatment after a few weeks
  • pneumonia - which is rarer, but causes more serious symptoms

Symptoms of a chest infection include a persistent cough, bringing up phlegm (mucus) and breathlessness.

You should see your GP if you experience any of the following symptoms:

  • a high temperature (this is usually a sign of a more serious type of infection)
  • confusion or disorientation
  • a sharp pain in your chest
  • coughing up blood-stained phlegm (thick mucus)
  • your symptoms last longer than three weeks
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Prevention

If you have a cold, there are things you can do to help prevent it from spreading.

You should:

  • wash your hands regularly and properly, particularly after touching your nose or mouth and before handling food 
  • always sneeze and cough into tissues as this will help to prevent the virus-containing droplets from your nose and mouth entering the air where they can infect others; throw away used tissues immediately and wash your hands 
  • clean surfaces regularly to keep them free of germs 
  • use your own cup, plates, cutlery and kitchen utensils  
  • use disposable paper towels to dry your hands and face, rather than shared towels. As with tissues, always dispose of the paper towels after you have finished using them
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Children

A cold is a viral infection that affects the nose, throat and sinuses. There are more than 200 different cold viruses. While adults usually have two to four colds a year, children can catch as many as seven to 10.

Dr Rob Hicks, a GP in London, offers his advice.

Is my child’s cold serious?

Colds aren't usually serious. However, babies, the elderly and anyone whose immune system is compromised can be at risk of developing more serious complications, such as a bacterial chest infection.

What are the differences between adult and child colds?

Children contract colds far more often than adults. Cold symptoms in a child may include a raised temperature (fever).

When should I take my child to the doctor?

Most colds get better on their own without treatment. Seek medical advice if:

  • a baby aged less than three months develops a fever higher than 38°C
  • cold symptoms last for more than 10 days, particularly if your child is coughing up green, yellow or brown sputum or has a fever – this could be a sign of a bacterial infection that needs treatment with antibiotics
  • your child is finding it difficult to breathe. Seek medical help immediately from your surgery or local hospital
  • your child complains of pain in the nasal passages after two to four days of home treatment
  • your baby or child has, or seems to have, severe earache (babies with earache often rub their ears and seem irritable) as they could have an ear infection that may need antibiotic treatment
  • your child complains of throat pain for longer than three or four days, or their throat pain seems unusually severe, as they may have bacterial tonsillitis that needs antibiotic treatment
  • your child develops other symptoms such as pain or swelling in the face or in the chest, a headache or a very bad sore throat
  • your child seems to be getting worse rather than better

Why won’t my doctor prescribe antibiotics for my child’s cold?

Antibiotics are used to treat infections caused by bacteria. Colds, however, are caused by viruses, which don’t respond to antibiotics. The overuse of antibiotics can lead to antibiotic resistance where symptoms don’t respond to treatment with antibiotics. The doctor is likely to prescribe antibiotics only if your child has developed a bacterial infection secondary to (on top of) a cold.

Top tips for parents

The following tips may help your child cope with the symptoms of a cold.

  • encourage your child to rest and make sure they drink plenty of fluids. Water is fine but warm drinks can be soothing
  • if they have a blocked nose you can make their breathing easier by raising the pillow end of your child’s bed or cot by putting books or bricks under the legs or placing a pillow under the mattress (although you should not put anything under the mattress of a baby younger than one year old)
  • paracetamol liquid or ibuprofen liquid can help ease a fever and pain. Check the dosage instructions on the packaging. Never give aspirin to children under 16 years old
  • a warm, moist atmosphere can ease breathing if your child has a blocked nose – take your child into the bathroom and run a hot bath or shower or use a vaporiser to humidify the air
  • keep the room aired and at a comfortable temperature, and don't let your child get too hot. If a small child or baby has a temperature let them wear just a nappy or underwear

Advice and information

Birth to five and Bump Baby and Beyond provide NHS-accredited information, including videos and interactive tools to help you through the parenting process. Whether your child is a newborn, a toddler or a pre-schooler, this guide is for you.

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The information on this page has been adapted by NHS Wales from original content supplied by NHS Choices.
Last Updated: 03/03/2015 11:19:52

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