It is never fun to have an annoying cough, a stuffy nose, or a sore throat. The common cold often feels uncommon while you are infected. The signs and symptoms of a cold became much more alarming when the coronavirus disease pandemic set upon us last year, but colds continue to cause the same nuisance they have caused for years.
They call it a cold…
A cold, or viral respiratory infection, is normally a mild illness affecting mostly the upper airway. A typical cold will present with gradual worsening of nasal congestion, headache, runny nose, sore throat, sneezing, and/or cough.Those ill with a cold will notice increased mucous in their nose, which may be clear or colored.
Traditionally, diagnosing a cold has never required a test; in fact, no clinical test is approved for diagnosing a cold. The diagnosis of a cold is best made based on signs and symptoms. However, many cold symptoms have received extraordinary attention in the last year due to the emergence of a new, more serious respiratory infection, COVID-19. Because of these overlapping symptoms, your healthcare provider may recommend that you get tested for COVID-19 to rule out this alternative diagnosis. If your cold comes with more serious symptoms like fever or joint/muscle aches, you may also be advised to undergo other tests, such as a flu or strep test, or even a chest x-ray, to determine other causes.
What the common cold lacks in severity, it makes up for in the sheer number of people infected every year. Over twenty million days of missed work and an even greater number of days of missed school are attributed to the common cold every year in the U.S.
When am I most likely to catch a cold?
Incidence of cold increases around September to November, but cases circulate year-round. Peaks of cold cases can also be observed every March and April.
What causes a cold?
Colds can be caused by more than 200 different viruses, but colds are most commonly caused by rhinovirus. During cooler months of the year, rhinoviruses cause about 80% of cases of colds. This is why rhinovirus is often referred to as “the common cold.” This family of viruses was first identified over 60 years ago.
Viruses that cause colds can spread through close contact with someone who has a cold or from their respiratory droplets. If an infected person sneezes or coughs, they can spread their virus through droplets in the air or the droplets can land on surfaces. You can become infected by breathing in these droplets or touching contaminated surfaces and touching your face or rubbing your eyes without washing your hands.
What are the complications of the common cold?
Up to a third of all middle ear infection in children are caused by common colds. Sinusitis frequently occurs alongside cold symptoms, but nearly all cases resolve without antibiotic use. In asthmatic children, the common cold frequently creates exacerbations of coughing and wheezing. In older adults, underlying lung disease, like emphysema or chronic bronchitis, causes more severe cases that might require hospitalization.
A leading theory among experts states that rhinovirus may increase the risk of developing bacterial infections, which can lead to more serious diseases like pneumonia. As with other infections, the risk of complications is highest among the elderly and those with compromised immune systems. A cold can even be fatal for someone with a high-risk condition, like cancer.
Colds can cause other long-lasting effects called post-viral syndrome. Post-viral syndromes are diagnosed when the infected person’s body has cleared the infection, but they continue to experience symptoms of the cold, such as cough, fatigue, headaches, or joint pains for several weeks or months afterward. This complication is more common with influenza or Epstein-Barr virus (the virus that causes mononucleosis), rather than with the common cold.
If I have a cold, how can I feel better?
There are no approved antiviral medications to treat the common cold. Antibiotics do not treat viruses, and taking antibiotics inappropriately can contribute to antimicrobial resistance. Antimicrobial resistance can lead to bacterial infections in the community that cannot be treated with antibiotics.
Most people do not require any medical interventions and recover completely from their cold within one week. Some of the most effective interventions include rest and drinking plenty of fluids. Warm drinks and hot soup can ease congestion.
Taking over-the-counter medications can help you feel better until your symptoms improve. Always check with your healthcare provider or pharmacist if you are taking any prescription medications to make sure there are no interactions with the medications you are taking or if you have health conditions that may limit which medicines are safe for you. Some examples of medicines available without prescription that may help with symptoms of the common cold include:
- Saline nasal spray
When would I need medical care for a cold?
While COVID-19 remains a threat to public health, everyone with cold symptoms should consult with their healthcare provider to limit the spread of COVID-19 infection in the community.
Other symptoms that require an evaluation by your healthcare provider include:
- Fever and symptoms last longer than 10 days
- Fever of over 101.3o F (38.5o C) at any point in the illness
- Upper toothache
- Symptoms initially improve, then worsen
- Facial pain on one side
- Shortness of breath or wheezing
- Severe pain (head, neck, or ears)
How can I prevent the common cold?
Rhinoviruses and coronaviruses are respiratory viruses, meaning that they infect people through their mouth, nose, and airways. The viruses are spread through the air, so beware of those coughing or sneezing around you. Always cover your cough with your elbow when tissues are not available.
You can help reduce your chances of getting the common cold by following these preventative measures:
- Throw away used tissues right away
- Change hand towels regularly
- Do not share eating utensils or drinking glasses
- Wash your hands often or use an appropriate hand sanitizer containing at least 60% alcohol
- Avoid touching your eyes, nose, and mouth with unwashed hands
- Do not smoke and avoid secondhand smoke
- Disinfect frequently touched surfaces
- Avoid close contact with people who have colds or signs of other respiratory infections
If you have children in daycare, try to choose centers that have good hygiene policies and that encourage sick children to stay home.
Alison Gwinn, “Better Ways to Handle the Common Cold,” AARP, October 28, 2019.
Antonio Anzueto, Michael Niederman, “Diagnosis and Treatment of Rhinovirus Respiratory Infections,” Chest Journal 123, no. 5 (2003).
Centers for Disease Control and Prevention, “Antibiotic / Antimicrobial Resistance (AR / AMR): 5 Things to Know,” February 10, 2020.
Daniel J. Sexton, Micah T. McClain, “The common cold in adults: Diagnosis and clinical features,” UpToDate, December 27, 2019.
Jon Johnson, “What to know about post-viral syndrome,” MedicalNewsToday, October 10, 2019.
Liza Torborg, “Mayo Clinic Q and A: Nasal mucus color — what does it mean?,” Mayo Clinic, January 26, 2018.
Masanori Yamato, Yosky Kataoka, “Fatigue sensation following peripheral viral infection is triggered by neuroinflammation: who will answer these questions?,” Neural Regeneration Research 10, no. 2 (2015): 203–204.
Mayo Clinic, “Common Cold,” April 20, 2019.
Richard M. Rosenfeld, “Acute Sinusitis in Adults,” The New England Journal of Medicine, September 8, 2016.
Ronald B. Turner, “Rhinovirus: More than Just a Common Cold Virus,” Journal of Infectious Diseases 195, no. 6 (2007): 765–766.
Ronald B. Turner, Janice L. Fuls, et al., “A Randomized Trial of the Efficacy of Hand Disinfection for Prevention of Rhinovirus Infection,” Clinical Infectious Diseases 54, no. 10 (2012): 1–5.
Stephen B. Greenberg, “Respiratory Consequences of Rhinovirus Infection,” Archives of Internal Medicine 163, no. 3 (2003): 278–284, doi:10.1001/archinte.163.3.278
World Health Organization, “Coronavirus disease (COVID-19),” November 10, 2020.