Colds in Adults and Older Children

What is a cold and what causes it?

A cold is an infection of the nose and upper airways caused by a virus. Many different viruses can cause a cold. This is why colds recur, and immunisation against colds is not possible. Children tend to have more colds than adults as adults have built up immunity to many viruses. Adults and older children have an average of 2-4 colds a year.

(Young children of primary school age or below have an average of 3-8 colds a year. See separate leaflet called 'Coughs and Colds in Young Children'.)

What are the symptoms of a cold?

• The common symptoms are a blocked (congested) nose, a runny nose, and sneezing. At first there is a clear discharge (mucus) from the nose. This often becomes thick and yellow/green after 2-3 days. It may be difficult to sleep due to a blocked nose.
• You may feel generally unwell and tired, and you may develop a high temperature (fever).
• Sometimes there is a mild sore throat, hoarseness and a cough.
• A build up of mucus behind the eardrums may cause dulled hearing or mild earache.

Symptoms typically peak after 2-3 days and then gradually ease off. Symptoms have usually gone within a week, but in some cases they can take three weeks to clear completely. In particular, a cough may linger for up to three weeks, often when other symptoms have gone. The symptoms, particularly cough, tend to be worse and last longer in smokers.

What are the treatments for a cold?

There is no magic cure for the common cold! There is no treatment that will shorten the length of the infection. Treatment aims to ease symptoms whilst your immune system clears the virus. Note: antibiotics do not kill viruses, so are of no use for colds. The most useful teatments are:

• Paracetamol or ibuprofen which will ease fever, sore throats, aches and pains.
  
• Make sure you drink enough. A fever may cause you to lose extra body fluid by sweating. This may lead to mild dehydration which can make you feel more tired, and may cause a headache. Let your thirst be your guide. Hot drinks are often soothing too.
• A steam inhalation may help to 'clear the nose'. It has a temporary effect, but may be useful before bedtime to help you get off to sleep. However, beware of scalding yourself if you use hot water. A hot steamy shower is perhaps the safest option.
• A menthol sweet may also clear a bunged up nose for a while.

You can buy many other 'cold remedies' at pharmacies. There is little evidence that they do much good, but some people find them useful. For example, decongestant nose sprays, etc.

But remember, cold remedies often contain several ingredients. Some may make you drowsy. This may be welcome at bedtime if you have difficulty sleeping with a cold. However, do not drive if you are drowsy. Some contain paracetamol, so be careful not to take more than the maximum safe dose of paracetamol if you are already taking paracetamol tablets.

A note of caution

If you do use a decongestant nasal spray, do not use it for more than a few days. It can have an immediate effect to clear a blocked nose. However, the effect does not last very long. But note: if you use one for more than 5-7 days, a 'rebound' severe congestion of the nose may develop.

Are there any possible complications from a cold?

Most colds do not cause complications. A cold may trigger coughing, wheezing and shortness of breath in people with asthma or other lung diseases. Sometimes the infection travels to the chest, sinuses, or ears. Bacteria may thrive in the mucus so some people develop a 'secondary' bacterial infection of the chest, ears or sinuses. Therfore, consult a doctor if symptoms do not start to ease within a few days, or if you suspect that a complication is developing. In particular, symptoms to look out for that may mean more than just a cold include:

• fever, wheezing or headaches that become worse or severe.
• fast breathing, shortness of breath, chest pains, or if you cough up blood.
• drowsiness or confusion.
• a cough that persists longer than 3-4 weeks.
• any symptom that you cannot explain and you are concerned about.

References

1. Common Cold Clinical Knowledge Summary SCHIN 2007
2. Nilangi Virgincar and Robert Spencer. Management of upper respiratory tract infection Prescriber 19 October 2003

© EMIS and PIP 2007   Updated: February 2007   PRODIGY Validated