DOCSLIB.ORG

Common Cold BRUCE ARROLL, Department of General Practice and Primary Health Care, Auckland, New Zealand

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Common Cold BRUCE ARROLL, Department of General Practice and Primary Health Care, Auckland, New Zealand Clinical Evidence Handbook A Publication of BMJ Publishing Group Common Cold BRUCE ARROLL, Department of General Practice and Primary Health Care, Auckland, New Zealand This is one in a series of Transmission of common cold infections is can affect any part of the mucosa, it is often chapters excerpted from mostly through hand-to-hand contact rather arbitrary whether an upper respiratory tract the Clinical Evidence than droplet spread. Several types of viruses infection is called a cold or sore throat Handbook, published by the BMJ Publishing Group, can cause cold symptoms. (pharyngitis or tonsillitis), sinusitis, acute London, U.K. The medical • Each year, children have up to five colds otitis media, or bronchitis. Sometimes all information contained and adults have two to three colds, leading areas of the mucosa, simultaneously or at herein is the most accurate available at the date of to time off from school or work and consid- different times, are affected during one ill- publication. More updated erable discomfort. Most symptoms resolve ness. Symptoms include sneezing, rhinorrhea and comprehensive infor- within one week, but cough often persists. (runny nose), headache, and general malaise. mation on this topic may Nasal and oral decongestants reduce nasal In addition to nasal symptoms, one-half of be available in future print editions of the Clinical congestion over three to 10 hours, but we do patients experience sore throat, and 40 per- Evidence Handbook, as not know how effective they are for longer- cent experience cough. This review does not well as online at http:// term relief (more than 10 hours). include treatments for persons with acute www.clinicalevidence. Antibiotics do not reduce symptoms over- sinusitis, acute bronchitis, or sore throat. One bmj.com (subscription required). Those who all and can cause adverse effects and increase prospective study in the United States (1,246 receive a complimentary antibiotic resistance. children enrolled at birth) found that chil- print copy of the Clinical • Antibiotics may improve symptoms dren who had frequent colds at two or three Evidence Handbook from after five days compared with placebo years of age were twice as likely to experience United Health Foundation can gain complimentary in persons with nasopharyngeal culture- frequent colds at six years of age, compared online access by register- positive Haemophilus influenzae, Moraxella with children who had infrequent colds at ing on the Web site using catarrhalis, or Streptococcus pneumoniae, but two or three years of age (relative risk = 2.8; the ISBN number of their book. it is difficult to identify which persons may 95% confidence interval, 2.1 to 3.9). have these infections. Vitamin C seems unlikely to reduce the Incidence and Prevalence This clinical content con- duration or severity of cold symptoms com- Upper respiratory tract infections, nasal con- forms to AAFP criteria for pared with placebo. gestion, throat problems, and cough are evidence-based continu- • We do not know whether zinc gel or responsible for 11 percent of general prac- ing medical education lozenges, echinacea, steam inhalation, anal- tice consultations in Australia. Each year, (EB CME). See CME Quiz on page 1343. gesics, or anti-inflammatory drugs reduce children have about five such infections and the duration of symptoms of colds. adults have two or three infections. One A collection of Clinical Evidence Handbook pub- Antihistamines may slightly reduce runny cross-sectional study of Norwegian children lished in AFP is available nose and sneezing, but their overall effect four to five years of age found that 48 percent at http://www.aafp.org/ seems small. Some antihistamines may experienced more than two common colds afp/bmj. cause sedation or arrhythmias. annually. We found insufficient evidence to assess whether decongestants plus antihistamines Etiology and Risk Factors are effective in reducing cold symptoms. Transmission of common cold infections is mostly through hand-to-hand contact, with Definition subsequent passage to the nostrils or eyes— Common colds are defined as upper respira- rather than, as commonly perceived, through tory tract infections that affect the predomi- droplets in the air. Common cold infections nantly nasal part of the respiratory mucosa. are mainly caused by viruses (typically rhi- Because upper respiratory tract infections novirus, but also coronavirus, respiratory Downloaded from the American Family Physician Web site at www.aafp.org/afp. Copyright © 2011 American Academy of Family Physicians. For the private, noncommercial use 1390 Americanof one individualFamily Physicianuser of the Web site. All other rights reserved.www.aafp.org/afp Contact [email protected] for copyrightVolume questions 84, and/or Number permission 12 ◆ requests. December 15, 2011 Clinical Evidence Handbook Research Clinical Questions What are the effects of treatments for common cold? essential to Likely to be Antihistamines (may improve runny nose beneficial and sneezing, no significant difference in overall symptoms) Decongestants (norephedrine, family medicine oxymetazoline, or pseudoephedrine provides short-term [three to 10 hours] relief of congestive symptoms) The Annals of Family Medicine, a peer-reviewed Unknown Analgesics or anti-inflammatory drugs clinical research journal, is dedicated to advancing effectiveness Decongestants (insufficient evidence to knowledge essential to understanding and improving assess longer-term [more than 10 hours] health and primary care. View the full content online at effects on congestive symptoms) www.AnnFamMed.org, or order your print subscription Decongestants plus antihistamines online or by calling 1-800-274-2237, Ext. 5165. Echinacea Steam inhalation Zinc (intranasal gel or lozenges) Unlikely to be Vitamin C beneficial Likely to be Antibiotics ineffective www.AnnFamMed.org or harmful syncytial virus, metapneumovirus, and others). Often, no infecting organism can be identified. Prognosis Common colds are usually short-lived, lasting a few days, with a few lingering symptoms lasting longer. Symptoms peak within one to three days and generally clear by one week, although cough often persists. Although they cause no mortality or serious morbidity, common colds are responsible for considerable discomfort, lost work, and medical costs. EDITOR’S NOTE: Norephedrine is called phenylpropanolamine in the United States, where it is no longer available. SEARCH DATE: January 2010. Author disclosure: Dr. Arroll is on the advisory board for the Pharmac educational seminars, a government-funded pharmaceutical purchasing agency in New Zealand, and is on the primary care committee of the Future Forum, an educational foundation funded by AstraZeneca (United Kingdom). He is the lead author of two studies included in this review. Free online Adapted with permission from Arroll B. Common cold. Clin Evid Hand- access! book. June 2011:521-522. Please visit http://www.clinicalevidence.bmj. com for full text and references. ■ Sponsors: American Academy of Family Physicians, American Board of Family Medicine, Society of Teachers of Family Medicine, Association of Departments of Family Medicine, Association of Family Medicine Residency Directors, North American Primary Care Research Group, College of Family Physicians of Canada The Annals of Family Medicine is indexed in MEDLINE, MEDLARS, Science Citation Index Expanded, Current Contents/Clinical Medicine, PsycINFO, EMBASE, and CINAHL. Complete text of the journal is available online at http://www.annfammed.org and through various aggregators, including PubMed Central, EBSCO, and MDConsult. hlf_vert_An_12.10.indd 1 1/4/11 11:16 AM.
Load more

Recommended publications
  • Respiratory Syncytial Virus Bronchiolitis in Children DUSTIN K
    Respiratory Syncytial Virus Bronchiolitis in Children DUSTIN K. SMITH, DO; SAJEEWANE SEALES, MD, MPH; and CAROL BUDZIK, MD Naval Hospital Jacksonville, Jacksonville, Florida Bronchiolitis is a common lower respiratory tract infection in infants and young children, and respiratory syncytial virus (RSV) is the most common cause of this infection. RSV is transmitted through contact with respiratory droplets either directly from an infected person or self-inoculation by contaminated secretions on surfaces. Patients with RSV bronchiolitis usually present with two to four days of upper respiratory tract symptoms such as fever, rhinorrhea, and congestion, followed by lower respiratory tract symptoms such as increasing cough, wheezing, and increased respira- tory effort. In 2014, the American Academy of Pediatrics updated its clinical practice guideline for diagnosis and man- agement of RSV bronchiolitis to minimize unnecessary diagnostic testing and interventions. Bronchiolitis remains a clinical diagnosis, and diagnostic testing is not routinely recommended. Treatment of RSV infection is mainly sup- portive, and modalities such as bronchodilators, epinephrine, corticosteroids, hypertonic saline, and antibiotics are generally not useful. Evidence supports using supplemental oxygen to maintain adequate oxygen saturation; however, continuous pulse oximetry is no longer required. The other mainstay of therapy is intravenous or nasogastric admin- istration of fluids for infants who cannot maintain their hydration status with oral fluid intake. Educating parents on reducing the risk of infection is one of the most important things a physician can do to help prevent RSV infection, especially early in life. Children at risk of severe lower respiratory tract infection should receive immunoprophy- laxis with palivizumab, a humanized monoclonal antibody, in up to five monthly doses.
    [Show full text]
  • The Common Cold.Pdf
    PATIENT TEACHING AID The Common Cold PERFORATION ALONG TEAR Everyone has experienced the misery of the common Rhinovirus Infection cold. A cold causes familiar symptoms such as a runny nose, sore throat, congestion, postnasal drip, and cough. For most sufferers, these symptoms are annoying, but not serious. Cold symptoms gradually improve and disappear over 7 to 10 days without complications. Colds are viral infections, so treatment with an antibiotic is not helpful. The best treatment for a cold is rest, fluids, and nonprescription medicines to help relieve symptoms. Although there is no vaccine to prevent colds, the spread of cold viruses can be slowed by frequent hand washing and avoiding close contact with those suffering from a cold. ILLUSTRATION: KRISTEN WIENANDT MARZEJON 2016 MARZEJON WIENANDT KRISTEN ILLUSTRATION: Copyright Jobson Medical Information LLC, 2016 continued MEDICAL PATIENT TEACHING AID Antibiotics Should Not Be Used to Treat a Cold Colds are caused by a variety of viruses, most commonly rhinoviruses. These viruses are highly contagious, and they are spread through the air or when someone is in contact with an infected person or contaminated object. There is no good evidence that exposure to cold or being overheated © Jobson Medical Information LLC, 2016 LLC, Information Medical Jobson © increases the risk of contracting a cold. Although most Wash your hands thoroughly and frequently colds occur in the winter months, some viruses that cause to prevent the spread of cold viruses. colds are more common in the fall or spring. Infants and young children are more prone to colds, as are people with weakened immunity.
    [Show full text]
  • Intranasal Ipratropium Bromide Reduced Rhinorrhea and Improved Cold Symptoms
    /:*-..= S Evid Based Med: first published as 10.1136/ebm.1996.1.205 on 1 December 1996. Downloaded from Intranasal ipratropium bromide reduced rhinorrhea and improved cold symptoms Hayden FG, Diamond L, Wood PB, 0.06% in a buffered salt solution (P = 0.003). {This 17% absolute dif- KortsDC, Wecker MT. Effectiveness (2 sprays/nostril [84 u,g] 3 times/d ference in improvement between the and safety of intranasal ipratropium for 4 d) (n = 137), the same nasal ipratropium and placebo groups bromide in common colds. A ran- spray without ipratropium in = 137), means that 6 patients (95% CI, 4 to domized, double-blind, placebo- or no medication (n = 137). No cold 16) would need to be treated with controlled trial. Ann Intern Med. medications other than analgesics ipratropium (rather than placebo) for 1996JullS;12S:89-91. and antitussives were allowed. 4 days to result in improvement for 1 additional patient; the relative risk Main outcome measures improvement was 26%, CI 9% to Objective 47%* }. Rates of nasal dryness (12% To determine whether intxanasal ipra- The main outcome measure was a vs 4%), blood-tinged mucus (17% vs tropium bromide is effective and safe global assessment of overall improve- 4%), and headache (9% vs 2%) were for reducing common cold symptoms. ment (report by patients of being better or much better). Rhinorrhea greater in the ipratropium group than Design was monitored in the clinic hourly in the placebo group. 6-day, randomized, double-blind, for the first 6 hours on day 1 and Conclusion placebo-controlled trial. hourly for 3 hours on day 2.
    [Show full text]
  • Influenza Planning Guide for Alberta's Vulnerable Populations And
    Pandemic (H1N1) 2009 10.29.2009 Influenza Planning Guide For Alberta’s Vulnerable Populations and Shelter Serving Agencies Pandemic Influenza Guide for Vulnerable Populations Page 1 Issued by: Pandemic Influenza Planning Liaison Committee - Vulnerable Populations Version 7, Approved by: Alberta Health Services Emergency Coordination Centre October 28, 2009 Table of Contents Introduction: Purpose of This Guide............................................................................................1 Responsibilities of Shelter Serving Agencies .............................................................................2 Pandemic Influenza Information ...................................................................................................2 What is influenza? ........................................................................................................................2 How is influenza spread? .............................................................................................................2 When is a person with influenza infectious? ................................................................................3 How long does influenza remain on surfaces? ............................................................................3 How can we distinguish influenza from the common cold? .........................................................3 How to deal with Influenza ...........................................................................................................4 Prevention, Control and
    [Show full text]
  • Common Human Coronaviruses
    Common Human Coronaviruses Common human coronaviruses, including types 229E, NL63, OC43, and HKU1, usually cause mild to moderate upper-respiratory tract illnesses, like the common cold. Most people get infected with one or more of these viruses at some point in their lives. This information applies to common human coronaviruses and should not be confused with Coronavirus Disease-2019 (formerly referred to as 2019 Novel Coronavirus). Symptoms of common human coronaviruses Treatment for common human coronaviruses • runny nose • sore throat There is no vaccine to protect you against human • headache • fever coronaviruses and there are no specific treatments for illnesses caused by human coronaviruses. Most people with • cough • general feeling of being unwell common human coronavirus illness will recover on their Human coronaviruses can sometimes cause lower- own. However, to relieve your symptoms you can: respiratory tract illnesses, such as pneumonia or bronchitis. • take pain and fever medications (Caution: do not give This is more common in people with cardiopulmonary aspirin to children) disease, people with weakened immune systems, infants, and older adults. • use a room humidifier or take a hot shower to help ease a sore throat and cough Transmission of common human coronaviruses • drink plenty of liquids Common human coronaviruses usually spread from an • stay home and rest infected person to others through If you are concerned about your symptoms, contact your • the air by coughing and sneezing healthcare provider. • close personal contact, like touching or shaking hands Testing for common human coronaviruses • touching an object or surface with the virus on it, then touching your mouth, nose, or eyes before washing Sometimes, respiratory secretions are tested to figure out your hands which specific germ is causing your symptoms.
    [Show full text]
  • Allergic Fungal Airway Disease Rick EM, Woolnough K, Pashley CH, Wardlaw AJ
    REVIEWS Allergic Fungal Airway Disease Rick EM, Woolnough K, Pashley CH, Wardlaw AJ Institute for Lung Health, Department of Infection, Immunity & Inflammation, University of Leicester and Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK J Investig Allergol Clin Immunol 2016; Vol. 26(6): 344-354 doi: 10.18176/jiaci.0122 Abstract Fungi are ubiquitous and form their own kingdom. Up to 80 genera of fungi have been linked to type I allergic disease, and yet, commercial reagents to test for sensitization are available for relatively few species. In terms of asthma, it is important to distinguish between species unable to grow at body temperature and those that can (thermotolerant) and thereby have the potential to colonize the respiratory tract. The former, which include the commonly studied Alternaria and Cladosporium genera, can act as aeroallergens whose clinical effects are predictably related to exposure levels. In contrast, thermotolerant species, which include fungi from the Candida, Aspergillus, and Penicillium genera, can cause a persistent allergenic stimulus independent of their airborne concentrations. Moreover, their ability to germinate in the airways provides a more diverse allergenic stimulus, and may result in noninvasive infection, which enhances inflammation. The close association between IgE sensitization to thermotolerant filamentous fungi and fixed airflow obstruction, bronchiectasis, and lung fibrosis suggests a much more tissue-damaging process than that seen with aeroallergens. This review provides an overview of fungal allergens and the patterns of clinical disease associated with exposure. It clarifies the various terminologies associated with fungal allergy in asthma and makes the case for a new term (allergic fungal airway disease) to include all people with asthma at risk of developing lung damage as a result of their fungal allergy.
    [Show full text]
  • Influenza (PDF)
    INFLUENZA Outbreaks of influenza, or “flu”, typically occur every winter. Colds may occur at any time of year with seasonal peaks occurring in fall and spring. Influenza is a respiratory illness usually caused by infection with one of two influenza viruses – influenza A or influenza B. Outbreaks of influenza (flu) typically occur every winter. Influenza is characterized by an abrupt onset of fever, chills, headache, body aches, and lack of energy accompanied by respiratory symptoms, most frequently cough and sore throat. Most people are largely recovered in one week, although many feel fatigued for several weeks. Serious complications of flu, such as pneumonia, however, can occur, especially if the body’s defenses are weakened by age or disease. Influenza is spread by inhaling the influenza virus which is usually carried on tiny, invisible water droplets in the air generated by coughs and sneezes. Hand-to-hand contact as well as contact with infected secretions on a hard surface may also cause transmission of the virus. Each year influenza viruses change and new vaccines are made to combat the particular strains that are expected to cause illness that year. The flu vaccine may reduce the chance of getting the flu by 60-80%, and lessen the severity of illness in the person who does get the flu. According to the Centers for Disease Control (CDC), everyone 6 months or order should get a yearly flu vaccine. The following people are at high risk for complications of flu and are especially urged to get vaccinated: Individuals with chronic heart or lung problems that have required regular medical follow-up or hospitalization during the last year.
    [Show full text]
  • Cold and Flu Fact Sheet
    Cold and Flu Fact Sheet The common cold, including chest colds, head colds, and the seasonal flu are caused by viruses that can put a damper on your holiday spirit. While Cold and Flu season can start as early as October and can last as late as May, activity peaks during Christmas time and will want to make you say Bah-Humbug! General Information Virology Clinical manifestations Cold - The common cold is a viral infection of the upper Cold - Symptoms of a common cold usually appear about respiratory tract. The most commonly implicated virus is a one to three days after exposure to a cold-causing virus. rhinovirus. Other commonly implicated viruses include Signs and symptoms typically include a runny/stuffy nose, human coronavirus, influenza viruses, and adenovirus. itchy/sore throat, cough, congestion, slight body aches and Frequently, more than one virus is present. The difficultly mild headache, sneezing, water eyes, and mild fatigue. with pathogens associated with the common cold is that some viruses are enveloped, meaning they are easy to kill Flu - Symptoms of seasonal influenza are very similar to (such as influenza) while others are non-enveloped, those of the common cold, except the flu can be meaning they are harder to kill (such as rhinovirus). This distinguished by a high fever and more severe symptoms emphasizes the importance of choosing disinfectant of the common cold. products with the ability to kill both enveloped and non- enveloped viruses. Pandemics and Outbreaks A pandemic is a global disease outbreak. It is determined Flu - Influenza (commonly known as the flu) are influenza by how the disease spreads, not by how many deaths it viruses which are enveloped, RNA viruses that make up causes.
    [Show full text]
  • The Common Cold
    THE COMMON COLD From infancy to adulthood, all children suffer from occasional colds. Preschool age children commonly experience 6-10 colds a year, with each illness lasting 10 to 14 days. Over time, children gain some immunity to cold viruses, resulting in fewer and less severe episodes. CAUSES There are thousands of different virus types that cause colds. Colds are more common in the winter. They are transferred from person to person by coughing, sneezing and direct hand to hand contact. People are most contagious during the first 2-3 days of their illness, especially if there is fever. EXPECTED COURSE A cold usually begins with nasal stuffiness and a watery runny nose. It may be accompanied by sneezing and watering eyes. Some coughing, especially at night, is common. It helps clear the throat and bronchial tubes of secretions. Fever is common, especially in the first few days of the illness. Some children will have no fever at all, others can have fevers of 102 – 104 F. Fever is often higher at night than during the daytime. Fevers can be brief, but often last from 3 to 5 days. Colds are often accompanied by sore throat, headache, tiredness, and muscle aches. By the third or fourth day of the cold, the nasal discharge usually becomes thicker and it may develop a yellow or green discoloration. Most symptoms are gone in 7 to 10 days, but some may last 2 to 3 weeks. TREATMENT 1. Make sure your child gets plenty of rest. 2. Encourage extra fluids. Don't worry about poor appetite.
    [Show full text]
  • COMMON COLD & INFLUENZA (Cont.)
    COMMON COLD & INFLUENZA (cont.) COMMON COLD & INFLUENZA Common colds are mild infections of the nose and What is the treatment? throat, which are very common in young children While there is medication available, most health (and in adults who are around them), and are caused care providers suggest rest and plenty of fluids. To by many different viruses. Usually the viral illness see if there is bacterial infection in addition to the causes some combination of stuffy nose, runny viral infection, a healthcare provider should nose, sore throat, cough, runny eyes, ear fluid and evaluate a child who has a high fever, persistent fever. cough, or earache. Because of a possible association with Reye’s Syndrome (i.e., vomiting, Influenza (the flu) is also caused by a virus (e.g., liver problems and coma), salicylate-containing influenza-A, influenza-B) and causes symptoms of products (i.e., aspirin) are not recommended for fever, headache, sore throat, cough, muscle ache control of fever. and fatigue. Most people with influenza feel too ill to attend childcare. How can the spread of these diseases be prevented? Occasionally, the common cold or influenza can be Influenza vaccine is the primary method of complicated by a bacterial infection such as an ear preventing influenza and its severe complications. infection, sinus infections, or pneumonia. These The vaccine should be given annually beginning at complications can be treated with appropriate 6 months of age. Two doses should be given the antibiotics after evaluation by their health care first year the child receives the influenza vaccine. provider. Annual influenza vaccination is recommended for Who gets these diseases? all children aged 6 months through age 18 with Anyone can.
    [Show full text]
  • The Common Cold
    THE COMMON COLD Colds are caused by viruses. Children often come down with an average of 8-10 colds per year. If you watch children, you will notice how often they put their hands or other objects in their mouths. We all know that we should wash our hands as much as possible, avoid sharing utensils and cups. But, despite all that washing, kids will find some way to get those pesky viruses into their bodies and disrupt your life for the next week or two. Colds usually last between 4-14 days, but can drag on longer at times. Children can also get a second virus during the first virus which can make them seem to last for months. If you pay close attention to the symptoms you may notice when one cold begins, when it fades, and when the next one starts. Colds are difficult for everyone. Nasal mucus is often what causes the most distress for parents and children. It makes it harder to breathe and eat, increases the cough, and complicates sleeping. Your child is cranky. Then on top of that you or your spouse, or both usually come down with the virus soon thereafter and everyone is feeling horrible. Unfortunately there are no medications that cure the common cold. Antibiotics do not work against a virus. Over the counter cold medicines are not very helpful in relieving symptoms and will certainly not cure a cold. The American Academy of Pediatrics recommends against the use of over the counter cough and cold medications in children younger than the age of 6 years.
    [Show full text]
  • Ah-Choo! Is It a Cold, Hay Fever, Sinusitis Or the Flu?
    Upper Respiratory Tract Infection Comparison Chart Ah-choo! Is it a Cold, Hay Fever, Sinusitis or the Flu? Name Symptoms Causes Onset & duration of Prevention Treatment symptoms Common Cold • No fever More than 200 different viruses, • Usually comes on gradually Frequent hand washing • Bed rest & plenty of fluids (“Head Cold”) • No aches and pains including: • Most common Sept-April • Acetaminophen or aspirin for • Still have an appetite • Rhinovirus (nose virus) • Adults will get 2-4 colds/year headache/ fever • Sore throat • RSV (respiratory syncytial • Children will get up to 12 • See a physician if cold lasts • Runny, stuffy nose virus) colds/year more than 10 days • Sneezing • Corona viruses • Colds are a powerful asthma • Most prominent symptoms trigger are in the nose • Lasts about one week Flu • Sudden fever, chills Viruses, spread by: • Usually comes on suddenly • Highly recommended to get Most people recover without (Influenza) • Aching muscles and joints • Sneezed or coughed droplets • Lasts about a week a flu shot to prevent the flu, treatment • Headache into the air from an infected especially if history of • Severe malaise person asthma, recurrent ear • Dry cough & lack of appetite • Cold & dry weather, as people infections, and sinusitis. • Blocked and/or runny nose spend more time close together • Best time for flu shot is Oct - • Your ” whole body” feels sick indoors. Nov Allergic Rhinitis • No fever Exposure to irritants/triggers: • Weeks, months or all year. Avoid triggers; for example: • Antihistamines (“Hay Fever”) • Congestion • Dust mites • Symptoms last as long as • Remove carpeting to reduce • Intranasal steroids • Runny or stuffy nose (clear, • Animal dander you are exposed to the dust mites and mould • Immunotherapy may help white thin mucus) • Pollen allergen.
    [Show full text]