- When Should You See a Doctor for a Cold?
- Serious Complications of the Common Cold
- Checklists of Cold Symptoms to Watch For
- Is It “Just a Cold”?
- Common cold
- General advice
- Over-the-counter cold medications
- Other remedies
- Treatments not recommended
- Acute Upper Respiratory Infection (Cold)
- Chronic Cough
- When should you worry about a cough?
- Common causes of acute coughs
- Common causes of subacute coughs
- Common causes of chronic coughs
- Less common causes of chronic coughs
- What to expect from a cough
- Cough treatments
- When to see a doctor
When Should You See a Doctor for a Cold?
If your infant is younger than 3 months old and has a fever of 100 F (37.8 C) or higher, go to the doctor immediately, says pediatrician Carlos Lerner, MD, medical director for children’s health at Mattel Children’s Hospital at University of California, Los Angeles. When in doubt, Dr. Lerner advises parents to give their doctor a call: “It’s worth getting some advice over the phone,” he says.
Serious Complications of the Common Cold
Colds can wear down your body’s natural defenses, leaving you vulnerable to health issues ranging from ear and sinus infections to strep throat, bronchitis, and pneumonia. Headaches, fever, and sinus pain could point to a sinus infection that requires treatment.
“Certainly if you’ve had a cold or sinus infection and now you’ve got a worsening headache and a fever, that needs to be seen,” says David Ross, MD, an emergency medicine physician at Penrose-St. Francis Health Services in Colorado Springs, Colorado.
If you have symptoms such as stabbing pains in the chest, a cough that brings up colored sputum, fever, or shortness of breath you may have pneumonia and should see your doctor. If symptoms came on fast, you should seek immediate medical care, Dr. Ross says.
Respiratory syncytial virus, or RSV, is a common respiratory virus that shares symptoms with the common cold but can cause severe symptoms in infants, young children, and older adults. While most people recover from RSV infection in one to two weeks, the virus is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia in U.S. children under 12 months of age.
Signs of breathing difficulties in infants include flaring nostrils, breathing faster than usual, straining muscles in the neck, or bluish discoloration around the lips and on fingers. “If you see those things, bring them to the emergency room right away,” Ross says.
Checklists of Cold Symptoms to Watch For
Of course, most colds will never require an emergency room visit. But if the signs and symptom are looking questionable, it’s worth a trip.
According to the American Academy of Family Physicians, here are some red flags to look for.
- High fever (above 103 F), or a fever that lasts more than 3 days
- Symptoms that last more than 10 days
- Trouble breathing, fast breathing, or wheezing
- Bluish skin color
- Earache or drainage from the ear
- Changes in mental state (such as not waking up, irritability, or seizures)
- Flu-like symptoms that improve, but return with a fever and a worse cough
- Worsening of chronic medical condition
- A high, prolonged fever (above 102 F)
- Symptoms that last for more than 10 days or get worse instead of better
- Trouble breathing or shortness of breath
- Pain or pressure in the chest
- Fainting or feeling like you are about to faint
- Confusion or disorientation
- Severe or persistent vomiting
- Severe pain in your face or forehead
- Hoarseness, sore throat, or a cough that won’t go away after 10 days
Is It “Just a Cold”?
The common cold is an infection of the respiratory (breathing) tract. This includes your throat, nasal passages, and lungs. More than 200 different viruses can cause a cold. Rhinovirus is the most common cause.
As a family doctor, I see patients every day who have cold symptoms, especially in the fall and winter months. Usually, cold symptoms develop slowly and can include:
- Fever up to 102°F
- Runny or stuffy nose (often with green- or yellow-colored discharge)
- Sore throat
- Muscle aches
- Watery eyes
In most cases, you don’t need to see your doctor when you have a common cold. But you should call your family doctor if your cold symptoms last for more than 10 days or get worse instead of better.
Recently, my patient Rachel (not her real name) came in for an office visit. She’s a 31-year-old woman who is generally healthy. I have been her family doctor for the past five years. She doesn’t usually call or come into the office for ordinary illnesses, like a common cold. But she decided to make an appointment because she had cold symptoms that hadn’t gone away after two weeks of over-the-counter (OTC) treatments.
She described the following symptoms:
- Low-grade fever (under 102°F)
- Stuffy nose
- Headache across her forehead that felt worse when she was lying down
- Blocked sinuses
She said she had no body aches and only had a mild cough.
Rachel told me that she felt better a few days after she first got sick. Then, on day 10 of her illness, her symptoms got worse again. I realized that she was describing something called “double sickening.” This just means that she felt better at first, but then she felt sicker after a short break from her symptoms. Double sickening is a very common sign of sinusitis.
Sinusitis is a condition in which the lining of your sinuses becomes inflamed (red and swollen). Adults have eight sinuses in the face and forehead, with four on each side. When sinusitis is caused by bacteria or a virus, it’s called a sinus infection. Sinus infections are less common than colds. They usually last longer. They’re also more likely to cause nasal congestion and headaches that don’t go away.
There are several treatment options for sinusitis. I often recommend a saline nasal spray to clean out my patient’s nasal passages. I also recommend an OTC or prescription decongestant to treat swelling. These medicines usually work well for sinusitis. However, some people don’t feel better after using them. For these patients, an antibiotic may be necessary to kill bacteria that have grown in their infected sinuses.
I told Rachel that she had a sinus infection, so it was a good thing she had called my office. Because she had already tried OTC medicines for two weeks, I decided it was time for an antibiotic. Infection takes longer to clear from your sinuses than from many other parts of the body, so I prescribed a 14-day course of antibiotics. I also prescribed a decongestant. I suggested that Rachel try deep breathing of warm steam to help clear her nasal passages.
Rachel felt much better after three days of taking the medicines I prescribed, breathing warm steam, and getting plenty of rest. If she had not improved, I would have ordered a computed tomography (CT) scan of her nasal passages and throat. Fortunately, this wasn’t necessary. By the time Rachel finished her full course of antibiotics, all of her symptoms were gone.
Easy ways to prevent the common cold virus from spreading include the following:
- Wash your hands frequently with soap and warm water for 20-30 seconds to remove germs from your palms and fingers.
- If soap and water aren’t available, use hand sanitizer gel, especially in public places like gas stations, supermarkets, and shopping malls.
- Sneeze and cough into your elbow if you don’t have a tissue handy.
- Colds and the Flu
- Protecting Your Family During Cold and Flu Season
You can manage cold symptoms yourself by following some simple advice. You’ll normally start to feel better within 7 to 10 days.
Until you’re feeling better, it may help to:
- drink plenty of fluids to replace those lost from sweating and having a runny nose
- eat healthily – a low-fat, high-fibre diet is recommended, including plenty of fresh fruit and vegetables
You may lose your appetite when you have a cold. This is perfectly normal and should only last a few days. Don’t force yourself to eat if you’re not feeling hungry.
You may also wish to try some of the medications and remedies described below to help relieve your symptoms.
Over-the-counter cold medications
The main medications used to treat cold symptoms are:
- painkillers – such as paracetamol and ibuprofen, which can help relieve aches and a high temperature (fever)
- decongestants – which may help relieve a blocked nose
- cold medicines – containing a combination of painkillers and decongestants
These medications are available from pharmacies without a prescription. They’re generally safe for older children and adults to take, but might not be suitable for babies, young children, pregnant women, people with certain underlying health conditions, and people taking certain other medications.
Always read the patient information leaflet that comes with your medicine before taking it, and follow the recommended dosage instructions. If you’re not sure which treatments are suitable for you or your child, speak to a pharmacist for advice.
More information about over-the-counter cold medicines is provided below.
Paracetamol and ibuprofen can help reduce a fever and also act as painkillers. Aspirin may also help, but it isn’t normally recommended for a cold and should never be given to children under the age of 16.
If your child has a cold, look for age-appropriate versions of paracetamol and ibuprofen (usually in liquid form). Always follow the manufacturer’s instructions to ensure the correct dose is given.
Taking both ibuprofen and paracetamol at the same time is not usually necessary for a cold and should be avoided in children as using both together may be unsafe.
Paracetamol and ibuprofen are also included in some cold medicines. If you’re taking painkillers and want to also take a cold medicine, check the patient information leaflet first or ask your pharmacist or GP for advice to avoid exceeding the recommended dose.
If you’re pregnant, paracetamol is the preferred choice to treat mild to moderate pain and fever.
Decongestants can be taken by mouth (oral decongestants), or as drops or a spray into your nose (nasal decongestants). They can help make breathing easier by reducing the swelling inside your nose.
However, they’re generally only effective for a short period and they can make your blocked nose worse if they’re used for more than a week.
Decongestants are not recommended for children under six years old and children under 12 years old shouldn’t take them unless advised by a pharmacist or GP. They’re also not suitable for people with certain underlying conditions and those taking certain medications.
Read more about who can use decongestant medication
The remedies outlined below may also help relieve your symptoms.
Gargling and menthol sweets
Some people find gargling with salt water and sucking on menthol sweets can help relieve a sore throat and blocked nose.
Vapour rubs can help babies and young children breathe more easily when they have a cold. Apply the rub to your child’s chest and back. Don’t apply it to their nostrils because this could cause irritation and breathing difficulties.
Nasal saline drops
Nasal saline (salt water) drops can help relieve a blocked nose in babies and young children.
Vitamin and mineral supplements
There is some evidence to suggest that taking zinc supplements within a day of the symptoms starting will speed up recovery from a cold and reduce the severity of symptoms.
However, there is currently little evidence to suggest that taking vitamin C supplements is beneficial when a cold starts.
Treatments not recommended
The following treatments aren’t usually recommended to treat colds because there isn’t strong evidence to suggest they’re effective, and they may cause unpleasant side effects:
- cough treatments or syrups
- antibiotics – these are only effective against bacteria (colds are caused by viruses)
- complementary and alternative medicine (CAM) treatments such as echinacea and Chinese herbal medicines
Acute Upper Respiratory Infection (Cold)
- Acute Upper Respiratory Infection (Cold) Symptoms
Symptoms in otherwise healthy individuals include:
• Sore throat and sneezing occur early in the course of the infection and usually resolve in 3 – 6 days.
• Low grade fever (less than 100 degrees Fahrenheit) and muscle aches commonly accompany these initial symptoms and usually resolve within a week.
• Nasal congestion, sinus pressure, ear pressure are common symptoms and usually persist through the first week of illness. About 30% of patients still have these symptoms at 2 weeks, although they should be improving after 7 – 10 days.
• Nasal or post-nasal drainage is usually clear and watery the first few days, but often becomes thick and discolored (green to yellow) after several days. Discolored secretions do not automatically imply that a bacterial infection is present; most improve after 5-7 days.
• Cough occurs in the majority of colds and is usually more productive than seen with the flu. Sputum varies from clear to yellow-green and usually resolves within 2-3 weeks, although a lingering dry cough can persist 4 weeks in up to 25% of infections.
Treatment of Acute Upper Respiratory Infections
Avoid the ‘everything but the kitchen sink’ multi-drug cold formulas since many contain unnecessary medications that cause unwanted side-effects. It is best to take only the medication(s) that will alleviate your predominant respiratory symptoms. Antibiotics will not hasten the resolution of acute cold symptoms.
Before taking any medication, it is important to read the package label for active ingredients. Certain medications should be avoided by persons with certain medical conditions, drug allergies, or who are taking medicines that could cause unwanted drug interactions. Consult with your pharmacist or healthcare provider if you are not certain about the appropriateness of a particular medication.
1. Monitor your temperature: Fever greater than 100 degrees Fahrenheit can be a distinguishing feature of influenza, as well as an indicator for determining when to seek medical attention for complications of a respiratory infection. If you do not own a thermometer, it is recommended that you obtain one to monitor your illness.
2. Analgesics may be used to control fever, muscle aches, headache, and sore throat. These include: Acetaminophen (Tylenol), Ibuprofen (Advil), Naproxen (Naprosyn), and Aspirin. Aspirin use should be avoided in children and teenagers if influenza is suspected.
3. Decongestants* help alleviate nasal congestion, sinus pressure and ear pressure from inflamed/swollen sinus passages caused by most acute respiratory infections. Decongestants are chemically related to adrenalin and can cause side-effects that include increased pulse, jitteriness, insomnia, and loss of appetite.
• Pseudoephedrine (PSE) is the most effective oral decongestant for adults. While it is a non-prescription item, illegal use to produce methamphetamine has required it to be moved behind the counter at pharmacies. Sudaphed is a brand pseudoephedrine.
• Phenylephrine (PE) is a weaker, less effective decongestant available over the counter.
• Oxymetazoline is a potent topical nasal decongestant that does not cause the systemic side effects seen with oral agents. Because rebound nasal congestion can occur with this agent, multi-daily use should be limited to less than or equal to 3 days, 6 if only used at night.
*Persons with certain medical illness (including cardiovascular disease) or who are on certain medications (including MAO inhibitors) should consult with their healthcare provider before using decongestants or dextromethorphan.
4. Nasal Drainage: To properly clear nasal secretions, one should blow gently, one nostril at a Time. For tenacious secretions one can use nasal decongestants to decrease the blockage, and instill saline into the nasal passages to thin the mucus, making them easier to clear with gentle blowing. Blowing your nose forcefully transports air, mucus, and bacteria into the sinuses; this can worsen sinus pressure and potentially increase the risk of a secondary bacterial infection.
5. Expectorants help loosen thick secretions and facilitate drainage from the sinuses and chest. These include:
• Water is an effective expectorant. Drink approximately 8 glasses a day.
• Steam, Humidified Air, Hot Shower can help loosen secretions.
• Guaifenesin: Available as a liquid or pill to help loosen nasal secretions to facilitate drainage.
• Saline nasal irrigation of the nasal passages can loosen nasal secretions to facilitate drainage and relieve obstruction.
6. Cough Suppressants* have demonstrated modest success in alleviating the cough which commonly accompanies acute respiratory infections. These include:
• Dextromethorphan: Over-the-counter
• Opiod Cough Suppressants (Codeine/Hydrocodone): Rx required.
• Benzonatate perles (non-narcotic peripherally acting agent): Rx required.
• First Generation Antihistamines (Diphenhydramine, Chlorpheniramine, Bropheniramine) help thicken respiratory secretions when cough is due to post-nasal drainage.
*Some cough suppressants cause sedation or should not be used in patients with certain medical conditions. It is important to consult with your healthcare provider and pharmacist on the advisability of taking certain agents.
7. Antihistamines are commonly found in over-the-counter cough/flu formulas and in allergy medications. The elevated histamine levels seen in allergic conditions are not present in most viral respiratory infections, so the benefits of 1st generation antihistamines are in large part due to their anti-cholinergic properties (increasing the viscosity of nasal secretions).
• 1st Generation Antihistamines include Carbinoxamine, Diphenhydramine, Tripelennamine, Chlorpheniramine, Brompheniramine, and Clemastine.
Benefits include: decreasing the cough when due to post-nasal drainage, decreasing sneezing, decreased runny nose in cold sufferers. They are not effective in treating nasal congestion, sinus pressure, sore throat, headache, or malaise from infections. Sedation is a common side-effect and should be used at bed time and avoided when engaged in activities that require mental alertness.
• 2nd Generation Antihistamines (Loratidine, Fexofenadine, Cetirizine) lack anti-cholinergic properties and have no proven benefit in relieving cold and flu symptoms.
A cough that lasts for 3-8 weeks is often caused by a cold or other lung infection that lasts longer than normal. A cough that lasts 3-8 weeks may go away by itself but it may also need treatment. If you have a three-week cough and you are not sure if you should see your doctor, read the following questions:
- Are you coughing up blood?
- Are you short of breath?
- Has your cough has changed over time?
- Are you losing weight without trying?
- Are you coughing up phlegm?
- Do you have a fever?
- Do you currently smoke?
- Did you smoke in the past?
- Are you living with asthma or COPD or other respiratory conditions?
If you answered yes, to any of these questions, you should talk to your doctor about your cough.
To diagnose your cough your doctor may ask you questions about your family history, things you may have been exposed to at home or work, and if you smoked. Your doctor may want to examine you. Your doctor may also give you a few tests including:
- A chest X-ray to take a picture of your lungs. This can tell your doctor if you have something like pneumonia or lung cancer.
- Spirometry – This test measures how much air you can breathe out and in. Your doctor will use spirometry to diagnose conditions such as asthma or COPD.
After three years of suffering a stuffed-up nose, postnasal drip and cough, Tracey Haddleton, a 31-year-old Toronto chartered accountant, finally learned she had chronic sinus infection–not allergies. Like Haddleton, many people attribute nasal congestion, head pain, postnasal drip, throat irritation, fever and cough to allergies or a cold that “just won’t go away.”
Rather than going to the doctor, many of us head to the nearest drugstore and treat our symptoms with over-the-counter cold and allergy remedies. But what we may really need is an antibiotic. “Anyone who develops pain and tenderness over a short period of time definitely needs medical help,” says Dr. Holly Stevens, past president of the British Columbia Society of Otolaryngology, Head and Neck Surgery.
Many sinus infections start with a cold or allergies, which can make the tissues in the lining of the nose swell, preventing oxygen flow from the nose to the sinuses’ tiny openings. A closed, warm moist environment provides an ideal breeding ground for bacteria, which, in turn, can lead to infection. Congested sinuses, whether caused by a cold, allergy or infection, can also result in fever, painful swelling in the face, and toothache.
Even doctors can mistake sinusitis for perennial allergy (the kind that lasts year-round). The tip-off that it’s sinusitis and not a cold or allergy? Deeply colored mucus. “We all get some discharge when we have a cold or allergy, but dark green mucus–not just yellow–indicates sinus infection,” says Dr. Stevens. And unlike colds or seasonal allergies, which eventually go away, sinus infections can last for weeks or months, even longer.
Although physician-prescribed antibiotics will get rid of sinus infection, you can help yourself by taking hot showers and inhaling steam, which will open sinuses and get them draining. Saline nasal solutions which help flush out the nose can be purchased at the drugstore or made at home with a half teaspoon of salt and a cup of water. Irrigating the nasal passages three or four times daily washes out excess mucus and bacteria, reduces swelling and eases breathing (use a rubber ear syringe to squeeze the solution up the nostrils, then let the liquid drain out into the sink).
Over-the-counter nasal decongestants are also useful during the first five to seven days of the infection, when sinus clogging peaks. But Dr. Stevens warns that prolonged use of such sprays can cause a “rebound” effect in which the nose becomes less responsive to the spray and ends up just as clogged as it was in the first place. After the first week, an oral decongestant can be substituted for the nose spray. Be aware that while an antihistamine will dry up the nose, it won’t decrease the swelling of tissues which closes the sinuses off; for this you need a decongestant.
If you have a sinus infection, your doctor will probably prescribe a two- to three-week course of antibiotics. Sinus infections often require longer treatment than other types of infection simply because the sinus openings are small and tend to swell. Explains Dr. Stevens: “Although the infections may be sterilized after the first few days of antibiotics, if the swelling hasn’t gone down sufficiently to let the sinuses reopen and drain, you risk another infection.”
This article is from the archive of our partner .
That notorious cold that “won’t go away” probably doesn’t exist. Doctors say that those bugs (that seem to have haunted everyone this winter) are actually just you getting sick over and over agains with new infections, probably given to you by someone you share your home with, according to a new look at the science of colds in The Wall Street Journal.
“When you hear people who have the cold that ‘won’t go away,’ those are typically back-to-back infections of which we see a lot of in the cold weather when people are cohorting together,” Darilyn Moyer, a physician at Temple University Hospital, told The Wall Street Journal. “Cohorting” is a weird word there, but what they mean here is someone or some people you share your home with and come in contact with— like a husband/wife, child, or an inappropriate roommate.
There are times that a persistent cold can be a symptom of something more serious like bronchitis, pneumonia, or bronchial hyperreactivity, which experts say can almost feel like asthma. If that’s the case, a doctor should be consulted.
But let’s get back to these back-to-back infections. One of the biggest reasons they occur is because we don’t realize that the common cold can last up to two weeks, and coughs can linger up to six weeks. “Experts say it’s possible that the carrier of germs—in this case our kindergartner—can infect others without having symptoms himself,” The WSJ’s Sumathi Reddy explains.
This is disconcerting, but necessary information. Clearly, the solution is to just be forever alone or check yourself into a hotel when the first of your loved ones succumbs to disease. It’s every man and woman for themselves.
This article is from the archive of our partner The Wire.
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Alexander Abad-Santos is a former writer for The Wire. Connect Twitter
When should you worry about a cough?
Coughing is your body’s way of clearing your airways of mucus and irritants. Most coughs will resolve without treatment in two to three weeks.
But if your cough lasts longer than three weeks, or you have other worrying symptoms, you should see a doctor.
Coughs can either be dry or productive. A dry cough is often described as a ‘tickly cough’, where no mucus is produced. A productive cough is a cough which produces mucus (phlegm).
A cough that lasts less than three weeks is usually the result of a common virus, like the cold or flu, and is rarely a cause for concern.
Keep reading to find out more about the different causes of coughs, how to treat them, and when to see a doctor.
Common causes of acute coughs
An acute cough is a cough that lasts for less than three weeks but tends to improve after one week.
This type of cough is often the result of a viral infection such as the cold or flu. Anyone can be infected by a viral infection, but they are most common in young children between the ages of 5-6.
Other causes of an acute cough include:
- Upper respiratory tract infections – these are the most common cause. They usually get better within a week without treatment, and symptoms can last up to three weeks
- Lower respiratory tract infection – these are less common and can be more serious. They can lead to conditions such as bronchitis or pneumonia
- Irritants – if you breathe in something like chemical fumes or smoke it can irritate your airways and cause a cough
Common causes of subacute coughs
A subacute cough is a cough that lasts for more than three weeks (acute cough) but less than eight weeks (chronic cough).
There are different causes of a subacute cough, such as:
- When your airways are still swollen and irritated following an infection. Even though the germs are gone, your cough remains. This is known as airway hyperresponsiveness
- Whooping cough, which causes a persistent dry cough
- Other infections like tuberculosis
Common causes of chronic coughs
A chronic cough is a cough that lasts for more than eight weeks. This type of cough can result from a number of different conditions, such as:
- Postnasal drip – when your nose produces too much mucus, which drips down the back of your throat. This can be caused by allergies, hay fever, nasal polyps, and infections
- Acid reflux – this is when acid from the stomach flows up into the airways
- Asthma – undiagnosed or poorly controlled asthma
- Medication – certain medications such as angiotensin-converting enzyme (ACE) inhibitor medicines
- Chronic obstructive pulmonary disease (COPD), a lung disease that primarily affects smokers, and can also cause breathlessness
- Irritants, such as smoke
Less common causes of chronic coughs
- Foreign bodies – food or other objects that have gone down your windpipe instead of your food pipe can cause you to cough
- Lung cancer – in some cases lung cancer can cause a cough. This is more likely if you are a smoker
- Cystic fibrosis – this is a genetic condition that affects the lungs and causes a chronic cough
- Pneumothorax – this is when air gets trapped in the chest, outside of the lungs
- Bronchiectasis – this condition causes your airways to widen and produce excess mucus
- Pulmonary embolism – this is a blood clot in your lungs
What to expect from a cough
There are two types of cough, a dry cough, which is a tickly cough in the back of your throat that doesn’t produce any mucus, and a productive cough, which is a chesty cough that does produce mucus.
A dry cough will usually last around 2-3 weeks, and is likely caused by an upper respiratory tract infection.
Most adults will experience an acute cough two to five times a year. It is rarely a cause for concern, and should get better without specific treatment.
However, a chronic cough might suggest an underlying lung condition. You should see a doctor if your cough lasts for longer than three weeks.
Mild, acute coughs don’t always require treatment, and most will resolve on their own. You should try to rest and drink plenty of fluids, including warm water with lemon and honey.
If your cough is caused by a specific illness, then you will need to treat the condition to resolve the cough.
When to see a doctor
Most coughs only last a few days to a few weeks and they are usually caused by a common virus. However, you should see a doctor about your cough if:
- You have had it for more than three weeks
- Your cough is very bad or is getting worse
- You have chest pain
- You’re also experiencing unexpected weight loss
- You have swollen glands
- You are struggling to breathe
- You have a weakened immune system
If you are coughing up blood you should see a doctor immediately.
Coughs can linger, but usually there’s nothing to worry about.
Remember, if your cough is caused by a virus, then antibiotics won’t help. Instead, stay hydrated, and get plenty of rest and relaxation.
If your cough lasts longer than three weeks you should see a doctor. You should also see a doctor if you experience any other worrying symptoms.
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